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FM1020 Physiology > Cardiac Cycle > Flashcards

Cardiac Cycle Flashcards

1
Q

What is the Leyman’s term for the cardiac cycle?

A

Heartbeat

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2
Q

When do the atrioventricular valves open?

A

Atrial contraction

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3
Q

What generates the first heart sound?

A

Closure of atrioventricular valves

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4
Q

When do the semilunar valves open?

A

Ventricular contraction

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5
Q

What generates the second heart sound?

A

Closure of semilunar valves

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6
Q

What is a systole?

A

Phase of contraction in the heart

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7
Q

What is diastole?

A

Phase of relaxation in the heart

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8
Q

Before atrial systole, what chambers have a higher pressure?

A

Atria

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9
Q

During atrial contraction, how much of the ventricles become filled?

A

~80%

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10
Q

When is the remaining blood pushed into the ventricles?

A

At atrial systole

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11
Q

What is the end diastolic volume at rest?

A

120-135 ml

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12
Q

After how many milliseconds does ventricular systole/isovolumetric contraction begin?

A

100msec

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13
Q

What pressure does the left ventricle require to open the semilunar valves into the aorta?

A

80 mmHg

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14
Q

What pressure does the right ventricle require to open semilunar valves into the pulmonary artery?

A

8 mmHg

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15
Q

How long does ventricular systole last?

A

30 msec

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16
Q

What stays constant during isovolumetric contraction?

A

Ventricular volume

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17
Q

What name is given to the total volume of blood ejected?

A

Stroke volume

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18
Q

What are the two forms of ejection that happen in the ejection phase?

A

Rapid ejection and reduced ejection

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19
Q

What name is given to the residual blood remaining in the ventricles following systole?

A

End systolic volume

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20
Q

What is the end systolic volume at rest?

A

50-65 ml

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21
Q

During isovolumetric contraction, what does the ventricular and aortic pressure increase to?

A

120 mmHg

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22
Q

What name is given to the abrupt drop in ventricular volume?

A

Rapid ejection

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23
Q

What is reduced ejection?

A

Blood leaving the ventricle as pressure is beginning to fall

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24
Q

What does the pressure in the atria fall to during isovolumetric contraction and why?

A

0 mmHg as the atria are stretched

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25
Q

When does pressure in the atria begin to rise again?

A

Atrial filling

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26
Q

After how many milliseconds does ventricular diastole/isovolumetric relaxation occur?

A

300 msec

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27
Q

What closes the semilunar valves?

A

Backflow of blood

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28
Q

After how many milliseconds do the semilunar valves close?

A

350msec

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29
Q

After how many milliseconds do the atrioventricular valves open again?

A

T = 450 msec

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30
Q

What is the rapid filling phase?

A

Blood flowing abruptly into ventricles

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31
Q

What name is given to blood entering atria from veins continuing into ventricles?

A

Diastasis

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32
Q

How long does diastasis last until (milliseconds)?

A

800 msec

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33
Q

How long does isovolumetric contraction take?

A

0.05 sec rapid phase
0.3 sec longer phase

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34
Q

How long does isovolumetric relaxation take?

A

0.5 sec

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35
Q

When is there a rise in the atrial pressure curve on an ECG?

A

Immediately after P wave

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36
Q

When is there a rise in ventricular pressure on an ECG?

A

After the QRS complex

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37
Q

during what phase of the cardiac cycle does the T wave occur on an ECG?

A

Slightly before the end of ventricular contraction

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38
Q

Why does pressure fall during the T wave?

A

Due to ejection of blood

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39
Q

What is the name of the diagram which displays the cardiac cycle?

A

Wiggers Diagram

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40
Q

How much EDV is delivered by atrial contraction?

A

Up to an additional 20%

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41
Q

Does a slow or fast heart rate aid in completion of diastasis and why?

A

Fast as ventricular contraction can begin during rapid filling

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42
Q

What is shortened during tachycardia?

A

Diastasis

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43
Q

What can happen if inadequate ventricular filling occurs?

A

Syncope/fainting

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44
Q

What is an A wave?

A

Rise in pressure caused by atrial contraction

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45
Q

What is the pressure increase during the A wave for both the right and left atrium?

A

Pressure increases by 4 to 6 mm Hg in right atrium
Pressure increases and by 7 to 8 mm Hg in left atrium

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46
Q

What is the C wave?

A

Increasing ventricular pressure causes bulging of the AV valves into atria

47
Q

What is the V wave?

A

Rise in pressure associated with atrial filling

48
Q

Where are pressure changes in atria transmitted to?

A

Back into large veins e.g., jugular vein

49
Q

What name is given to the irregular fluctuations in atrial fibrillation?

A

f waves

50
Q

Which contractions are irregular during a fib and why?

A

Ventricular due to AV node activation being irregular

51
Q

What is not occurring in individuals with atrial fibrillation?

A

No atrial contraction: therefore, no blood is pumped into ventricles

52
Q

What is the major danger involving atrial fibrillation?

A

Clots can form in atria

53
Q

What does ejection of blood from the left ventricle do to the walls of the arteries?

A

Stretches their walls
Pressure increases to 120mm Hg

54
Q

What causes the incisure/dicrotic notch in the aortic pressure curve?

A

Short period of backflow of blood into ventricle immediately before closure of the aortic valve

55
Q

What maintains a high pressure in arteries even during diastole?

A

Elastic walls

56
Q

Why does pressure in the aorta decrease slowly throughout diastole?

A

Elastic recoil pushes the blood continually into peripheral vessels

57
Q

What is diastolic pressure?

A

80mmHg

58
Q

What stops the bulging in the atria?

A

Chordae tendineae abruptly stop the back bulging

59
Q

What is the loudest heart sound and how long does it last?

A

S1 - lasts 0.14 secs

60
Q

How long does S2 last?

A

0.11 sec

61
Q

When does S1 occur on an ECG?

A

Directly after a QRS complex

62
Q

What is Auscultation?

A

Listening to heart sounds with a stethoscope

63
Q

What semilunar valve usually has a louder sound?

A

Aortic valve

64
Q

When may the quieter semilunar valve be louder than the louder one?

A

Pulmonary valve is louder during pulmonary hypertension

65
Q

Where can one hear the aortic valve?

A

2nd right intercostal space, just lateral to the body of the clavicle

66
Q

Where can one hear the pulmonic valve?

A

2nd left intercostal space, just lateral to the body of the sternum

67
Q

Where can one hear the tricuspid valve?

A

5th left intercostal space, just inferior to fifth right costal cartilage and lateral to superior xiphoid process

68
Q

Where can one hear the mitral valve?

A

Apex of heart
5th left intercostal space, midclavicular line

69
Q

What is pulmonary hypertension?

A

Abnormal increase in pressure in pulmonary circulation

70
Q

What is a phonocardiography?

A

Detection of heart sounds with a microphone

71
Q

What is S3 generated by?

A

Caused by inrushing blood from atria during middle third of diastole

72
Q

When, in a human, can S3 usually be heard?

A

Younger people under the age of 40

73
Q

What might it mean if an abnormal demographic presents with S3?

A

Hole in septum (murmur)

74
Q

What causes S4?

A

generated by inflow of blood into ventricles following atrial contraction

75
Q

What is a heart murmur?

A

Abnormal heart sound generated during a cardiac cycle

76
Q

What is aortic stenosis?

A

The aortic valve, abnormally small space to eject blood, rapid movement of blood

77
Q

What murmur is heard during aortic stenosis?

A

Loud, whistling sound during systole

78
Q

What is aortic regurgitation?

A

Aortic valve doesn’t close properly causing leakage of blood into left ventricle

79
Q

What sound is heard during aortic regurgitation?

A

Low, rumbling sound during diastole

80
Q

What happens at A in the Left Ventricle Pressure-Volume LOOP

A

Opening of mitral valve and beginning of filling, esv

81
Q

What happens from A-B in the Left Ventricle Pressure-Volume LOOP?

A

Pressure falls as diastole progresses, blood volume increases (rapid filling)

82
Q

What happens from B-C in the Left Ventricle Pressure-Volume LOOP?

A

Pressure and volume increase as diastasis progresses

83
Q

What happens at C in Left Ventricle Pressure-Volume LOOP?

A

Mitral valve closes
EDV

84
Q

What happens from C-D in the Left Ventricle Pressure-Volume LOOP?

A

Systole begins, isovolumetric contraction

85
Q

What happens in D in Left Ventricle Pressure-Volume LOOP?

A

Aortic valve opens, diastolic pressure

86
Q

What happens from D to E in Left Ventricle Pressure-Volume LOOP?

A

Pressure rises to systolic value, volume falls, rapid ejection

87
Q

What happens from E to F in the Left Ventricle Pressure-Volume LOOP?

A

Pressure and volume fall, reduced ejection

88
Q

What name is given to D to F in the Left Ventricle Pressure-Volume LOOP?

A

Stroke volume

89
Q

What happens at F in the Left Ventricle Pressure-Volume LOOP?

A

Aortic valve closes

90
Q

What happens from F to A in the Left Ventricle Pressure-Volume LOOP?

A

Diastole begins, Isovolumetric relaxation, pressure drops, volume is constant

91
Q

What is Preload in muscle?

A

Degree of tension on the muscle when it begins to contract

92
Q

What is preload in cardiac muscle?

A

Magnitude of the EDV and corresponding end diastolic pressure (point C)

93
Q

What is afterload in muscle?

A

Force against which the muscle is acting

94
Q

What is the afterload in cardiac physiology?

A

Blood pressure in aorta which the ventricle must exceed to open the aortic semilunar valve to eject blood
Aortic blood pressure
Point D

95
Q

What is contractility/ionotrophy?

A

Strength of contraction at a given preload and afterload

96
Q

How does one calculate contractility?

A

Slope of Ventricular pressure curve - index of ionotrophy

97
Q

Name a drug that increases ionotropy of heart

A

Adrenaline

98
Q

What condition may reduce contractility?

A

Cardiac failure

99
Q

How does one calculate contractility?

A

Slope of Ventricular pressure curve - index of ionotrophy
Maximum dP/dt

100
Q

What is diastolic pressure?

A

Pressure exerted by EDV on the walls of ventricle prior to contraction

101
Q

What is the limit of the stretch of heart muscle?

A

150 ml EDV

102
Q

What does the Frank-Starling Law state?

A

Systolic pressure increases linearly with EDV

103
Q

What happens to cardiac muscle fibres at high EDVs?

A

Pressures generated fall due to overstretch of actin and myosin

104
Q

What is the stroke work output?

A

Physical work done by ventricle to eject stroke volume

105
Q

What is the work done by the heart?

A

Volume-pressure work or EXTERNAL work

106
Q

What is the external work equal to?

A

The area of the pressure-volume loop

107
Q

What is re-entry?

A

If cells become excitable again independent of the SA node

108
Q

What causes re-entry?

A

Increase tissue mass (dilated heart) causing a long pathway for impulses
Decreased rate of conduction
Shortened refractory period in response to various drugs

109
Q

What may cause a decrease in the rate of conduction?

A

Blockage of the Purkinje system
Ischemia of the muscle
High blood K+ levels

110
Q

What does re-entry result in?

A

Abnormal patterns of cardiac contraction or abnormal cardiac rhythms that ignore the pace-setting effects of the sinus node
Fibrillation

111
Q

How long does it take for ventricular fibrillation to become fatal?

A

1-3 mins

112
Q

How can you treat v-fib?

A

Defibrillator

113
Q

How does an AED work?

A

Stop fibrillation by simultaneously placing entire myocardium into a refractory state, allows autorhythmic cells in heart to regain pacemaker control

FM1020 Physiology (12 decks)

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