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Systems Phys 2022 > Cardiac Cycle > Flashcards

Cardiac Cycle Flashcards

1
Q

What is the cardiac cycle?

A

phases of cardiac function between each heart beat

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2
Q

What are the 7 steps of the cardiac cycle?

A

atrial systole

isovolumic contraction

rapid ejection

reduced ejection

isovolumic relaxation

rapid filling

reduced filling

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3
Q

Which side of the cardiac cycle generates more pressure?

A

the left

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4
Q

Define: atrial systole

A

contraction of atria

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5
Q

Define: Isovolumic Contraction

A

Contraction of ventricles but no change in volume

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6
Q

Define: Isovolumic Contraction

A

Contraction of ventricles but no change in volume

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7
Q

Define: rapid ejection

A

Ejecting blood

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8
Q

What occurs first, Electrical or Mechanical Events? Example?

A

Electrical events occur before mechanical events

(membrane depolarizes before muscle shortens)

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9
Q

What is pressure in the aorta dependent on?

A

How constricted the arterioles are

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10
Q

what is afterload somewhat equal to?

A

aortic pressure

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11
Q

If you have a patient with hypertension and BP of 150/110, how would that effect the pressures in the diagram?

A

Aortic Valve would open at 110 mmHG

for every heart beat, heart would have to generate 30 mmHG more of pressure before aortic valve would open

increases work of heart

can cause heart failure if untreated

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12
Q

What is the fundamental thing that causes pressure to change in the aorta?

A

the transfer of volume from one chamber to another (LV to aorta)

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13
Q

What would happen to the pressure change if you increases the SV?

A

it would increase

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14
Q

What is aortic pressure loosely dependent on?

A

SV

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15
Q

Why does left atrial pressure increase while the ventricle is contracting and relaxing?

A

while the ventricle is contracting, atria are accumulating volume, which increases pressure

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16
Q

Explain this Diagram

A
  1. Mitral Valve Closes → to stop blood from flowing back into atria
  2. LV pressure increases b/c muscle contracts
  3. atria contracts
  4. aortic valve open s→ blood flows from LV to aorta
  5. Aortic valve closes → pressure in aorta is higher then in LV
  6. LV pressure decreases → Ca flows back into SR and EC
  7. Mitral Valve opens (pressure is lower in LV)
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17
Q

What happens during atrial systole?

A

atria contracts

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18
Q

What happens during isovolumic contraction?

A

valves all closed

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19
Q

What happens during rapid ejection?

A

blood flows from LV to aorta

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20
Q

What happens during reduced ejection?

A

aortic valve closes at end

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21
Q

What happens during isovolumic relaxation?

A

pressure in LV drops

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22
Q

When is aortic pressure highest?

A

during rapid and reduced ejection

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23
Q

Preload is the same as…

A

EDV

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24
Q

Equation: SV

A

SV = EDV - ESV

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25
Q

What happens when atria contracts?

A

blood is forced into ventricle

volume increases slightly

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26
Q

Where is the LVEDV and the LVESV located on this diagram?

A

LVEDV → Top plateau

LVESV → bottom plateau

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27
Q

What are the normal heart sounds?

A

1&2

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28
Q

What are the abnormal (pathological) heart sounds?

A

they don’t always occur

3&4

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29
Q

When does the 1st heart sound occur?

A

at the beginning of isovolumic contraction and mitral valve closing

30
Q

When does the 2nd heart sound occur?

A

when the aortic valve closes

31
Q

When does the 3rd heart sound occur?

A

During rapid filling phase

often heard in patients with congestive heart failure

compliance of ventricle is reduced

32
Q

When does the 4th heart sound occur?

A

During atrial systole

typically heard in patients that have long standing hypertension and hyperphery (thicker) ventricle

33
Q

What is venous pressure pulse?

A

central venous pulse

follows atrial pressure low pressure

>5 mmHg

34
Q

When does the P wave start?

A

before atria contracts

35
Q

When does the QRS complex occur?

A

just before isovolumic contraction → ventricular depolarization/contraction

36
Q

When does the T wave occur?

A

during reduced ejection

37
Q

How would you use the Wiggers Diagram to calculate cardiac output?

A

CO = HR x SV

HR = 60/.8 (time from P wave to T wave) = 75 beats/min

SV = 40 (EDV) - 20 (ESV) = 20 (ventricular volume)

CO = 75 x 20 = 1,500 mL/min

38
Q

Calculate the EF from the Wiggers Diagram.

A

EF = SV/EDV = 20/40 = 50%

39
Q

Are the mitral and tricuspid valve opened or closed during diastole?

A

open

40
Q

Are the mitral and tricuspid valve opened or closed during systole?

A

closed

41
Q

What is the normal % oxygen saturation in the different chambers of the heart?

A

Aorta → 95%

Pulmonary Artery → 75%

L Atrium → 95%

LV → 95%

RV → 75%

R atrium → 75%

42
Q

What is the average pressure of the right atrium?

A

3 mmHg

43
Q

What is the average pressure of the right ventricle?

A

25 mmHg (peak systolic)

44
Q

What is the average pressure of the pulmonary capillary wedge?

A

9 mm Hg

45
Q

What is the average pressure of the left atrium?

A

8 mm Hg

46
Q

What is the average pressure of the left ventricle?

A

130 mm Hg (peak systolic)

47
Q

What is pulmonary capillary wedge?

A

an index of left arterial pressure

48
Q

How is a pulmonary capillary wedge done?

A

through the right atrium → into the right ventricle through tricuspid valve → through pulmonic valve → into pulmonary artery → wedge position → inflate balloon

49
Q

When is a pulmonary capillary wedge used? why?

A

used in patients with heart failure to see if left atrial pressure is increasing

50
Q

When does the “a” wave occur?

A

during atrial systole when the atrium contracts during atrial systole → increasing atrial pressure

51
Q

Atrial Systole: When does atrial pressure drop?

A

when the atria stops contracting

52
Q

When does the P wave occur? What makes it occur?

A

It occurs during atrial systole due to atrial depolarization

53
Q

Atrial Systole: When does the fourth heart sound occur

A

it is associated with the end of atrial emptying after atrial contraction

54
Q

When does the AV valve close?

A

at the beginning of isovolumic contraction

when the pressure in the ventricles exceeds the pressure in the atria

55
Q

Isovolumic contraction: What happens to ventricular volume as the ventricles contract isovolumetrically?

A

their volume does not change

56
Q

When does the QRS complex of the ECG occur? Why?

A

during isovolumic contraction due to ventricular depolarization

57
Q

When does the first heart sound occur?

A

during isovolumic contraction due to AV valves closing

58
Q

When do the aortic and pulmonary valves open?

A

at the beginning of rapid ejection

59
Q

Rapid Ejection: What happens when the aortic and pulmonary valves open?

A

blood exits the ventricles and the volume in the ventricles decreases rapidly

blood enters the arteries until it reaches a peak

atrial pressure increases due to RV contraction opening the tricuspid valve

60
Q

When do the aortic and pulmonary valves close?

A

at the end of reduced ejection

61
Q

Reduced Ejection: What happens after ventricular and arterial pressures peak?

A

blood flow out of the ventricles decreases and ventricular volume decreases more slowly

62
Q

Reduced Ejection: What happens when the pressure in the ventricles falls below the pressure in the arteries?

A

blood in the arteries begins to flow back toward the ventricles and causes the aortic and pulmonary valves to close

marks the end of ventricular systole

63
Q

When does the T wave occur?

A

during reduced ejection due to ventricular repolarization

64
Q

In what phase does diastole begin?

A

isovolumic relaxation

65
Q

What is causing the atrial pressure to rise during isovolumic relaxation?

A

atrium in diastole is filling with blood

66
Q

Isovolumic Relaxation: What causes the “v” wave?

A

back flow of blood after it hits the closed AV valve

67
Q

When is ventricular volume at its lowest?

A

during isovolumic relaxation

68
Q

When does the second heart sound occur?

A

during isovolumic relaxation when the aortic and pulmonary valves are closed

69
Q

Rapid Ventricular Filling: What occurs when the AV valves open?

A

blood accumulated in the atria flows rapidly into ventricles → ventricular volume increases rapidly

70
Q

When does the third heart sound occur?

A

during rapid ventricular filling

Systems Phys 2022 (25 decks)

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