C2- Cardiac Hemodynamics Flashcards

1
Q

How is Potential energy created?

Another word for PE?

A

By contracting of ventricles and vascular resistance from arteries
Static pressure

Has the ability to do work

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2
Q

what is gravitational energy?

A

effect of gravity on static pressure

Think of LE venous return

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3
Q

whats normal BP?

whats a high BP?

A

Norm: 120/80 (systolic/diastolic)
High: >140/90

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4
Q

What is mean arterial pressure?

A

avg. pressure over the cardiac cycle

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5
Q

How much of the cardiac cycle does Systole occupy?

Diastole?

A

Systole: 1/3 of the cycle (at resting HR)
Diastole: 2/3 of the cycle (at resting HR)

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6
Q

What happens to the sys/dias ratios if HR increases?

A

Systole Increases

Diastole Decreases

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7
Q

How do you calculate mean arterial pressure?

A

MAP= Diastolic pressure + 1/3 (Systolic blood press - diastolic blood press)

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8
Q

whats a press gradient?

A

difference of press between to locations within the heart

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9
Q

whats the natural direction of flow if theres a press gradient present?

A

flow from high to low press

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10
Q

whats the relationship between press and velocity?

A

directly proportional

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11
Q

whats Bernoulli’s equation?

A

Change in P = 4(velocity)2

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12
Q

what are the 4 phases of the cardiac cycle?

A
  1. IVCT - isovolumic contraction time
  2. systole
  3. IVRT - isovolumic relaxation time
  4. diastole
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13
Q

when does IVCT occur and whats happened in this phase?

how long does it last?

A

IVCT is the period of time between MV closure and AV valve opening

  • press in LV is rising fron 5-80 mmHg
  • just before ventricles contract

lasts 30-50 ms

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14
Q

what press must the LV reach for the AO valve to open?

A

80 mmHg

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15
Q

are the valves open or closed during IVCT?

A

ALL are closed

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16
Q

what is ventricular systole?

what initiates and stops?

A

the period of time it takes for the ventricles to eject their contents

initiate: when the ventricular pressure exceeds that of the AO and the SL valves open
stops: when the ventricular pressure is lower than that of the AO and the SL valves open

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17
Q

are valves active of passive structures?

A

passive

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18
Q

where does muscles contraction begin?

A

apex

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19
Q

how long does ventricular systole last?

A

200-300ms

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20
Q

when does IVRT occur and what happens in this phase?

how long does it last?

A

period of time after the AOV/PV have closed but before the MV/TV open

  • press falls in the ventircles (below 80mmHg)
  • press increasing in atria
  • occurs just before the heart relaxes

50-100ms

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21
Q

are the valves open or closed during IVRT?

A

ALL closed

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22
Q

when does diastole occur and what happens in this phase?

how long does it last?

A

period of time when the MV/TV are open and blood moves from atria to ventircles

  • starts when ventricular press falls below that of the atria
  • ends when LV press rises above LA and MV closes
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23
Q

3 phases of diastole

A
  1. early filling (suction)
  2. diastasis
  3. late filling
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24
Q

describe the early filling phase.
how long does it last?
which ‘bump’ is this?

A

LV press drops below LA and MV opens, LV chamber fills by sucking blood from the LA

lasts 150-220ms

first bump

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25
Q

describe diastasis.

what is the press difference between LA and LV at this time? how does it appear on US

A

period of time after early filling

press between LV/LA is almost equal so MV hangs in a semi open position

26
Q

what do the atria depolarize during diastasis?

A

end of the phase

27
Q

describe the late filling phase.
how long does it last?
which ‘bump’ is this?

A

press is atria rises above the ventricles which opens the MV again…. atrial contraction pushes remainder of blood into LV

28
Q

how much filling of the LV is done during early filling?

late phase?

A

70-75%

25-30%

29
Q

two other terms for Late filling phase?

A

slow filling

atrial kick

30
Q

how much does the diastolic and systolic press change in the RV?

A

Systolic. 15-30 mmHG

Diastolic: 2-8 mmHg

31
Q

how much does the diastolic and systolic press change in the LV?

A

Systolic. 100-140 mmHG

Diastolic: 3-12 mmHg

32
Q

What’s the mean press in the RA and the LA?

A

RA: 2-8 mmHg
LA: 2-12 mmHg

33
Q

when do the atria increase in volume?

A

during ventricular systole and diastole from the Pulmonary veins

34
Q

when is the LV at its largest, and smallest?

A

large: end diastole
small: end systole

35
Q

whats a normal stroke volume?

A

50-100 ml/beat at rest

36
Q

stoke volume equation?

A

SV= EDV-ESV

37
Q

cardiac output equation?

A

CO= SV x HR

38
Q

cardiac index equation?

A

CI: CO/BSA

39
Q

what is VTI?

A

velocity time intergral which equals the stroke distance (in cm)

40
Q

stoke volume doppler equation?

A

SV= (pie x r2) x (VTI)

41
Q

what % of O2 does deoxygenated blood have?

A

~75%

42
Q

whats the O2 saturation in the R heart and L heart?

A

R: 75%
L: 98%

43
Q

whats angina pectoris and what causes it?

A

chest pain

caused by lack of O2 and nutrients to the heart, muscle of the heart is too thick or high afterload

44
Q

what factors effect stoke volume and cardiac output?

A

preload
afterload
inotropic force
chronotropic force

45
Q

whats preload?

A

amount of blood volume in the ventricles at end diastole

volume of blood delivered to the ventricles

46
Q

whats the frank starling law?

another word for it?

A

the degree of stretch of the ventricles is proportional to the volume of blood in the chamber

more volume = more stretch = harder contraction

length tension relationship

47
Q

how does the frank starling law effect SV?

A

it increases it

48
Q

whats the relationship pf preload to HR?

A

slow HR: more time for ventricular filling = more ventricular stretch

higher HR: less time for filling = less stretch

49
Q

define inotropic force?

another name for it

A

contractility of the heart muscle

force velocity relationship

50
Q

whats the relationship between preload and inotropic force?

A

direct

51
Q

whats afterload and what effects it?

A

resistance to ventricular emptying

effected by:
viscosity
arterial resistance
vascular geometry
valvular stenosis
52
Q

how does disease effect inotropic force?

What relationship represents inotropic force?

A

diease: negative inotropic response, LV cant contract enough

Force velocity

53
Q

what is chronotropic force?

another term for it?

A

rate of contraction.. how fast and how much that walls move inwards

interval strength relationship

54
Q

how does increased afterload effect the velocity of fiber shortening, stroke volume and CO?

A

decreases ALL

55
Q

What is pulse presssure formula?

A

SBP-DBP

56
Q

What’s border line blood pressure?

A

130/85

57
Q

How blocked does a coronary artery have to be to create angina pectoris?

A

75%

58
Q

How does medication effect inotropic force?

A

Produces a + inotropic response and makes it easier for the heart to contract by altering the sympathetic NS

59
Q

What’s happening to the volume in the LV during IVRT?

A

It remains constant

60
Q

When MPAP is elevated, does the PAT get longer or shorter?

A

Shorter…. velocity and pressure and directly related

61
Q

Which vessels of the heart have the lowest O2 content and what is it?

A

Coronary sinuses

50%

62
Q

The LV uses approximately how much of the Ow supplied by the coronary arteries at rest

A

50%