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The Heart > Cardiac Cycle > Flashcards

Cardiac Cycle Flashcards

1
Q

What are the basic 3 events in the cardiac cycle

A

LV contraction

LV relaxation

LV filling

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2
Q

What parts of the cardiac cycle are in left ventricle contraction

A

Isovolumetric contraction

Maximal elejection

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3
Q

What parts of the cardiac cycle are in left ventricle relaxation

A

Start of relaxation and reduced ejection

Isovolumetric relaxation

Rapid LV filling and LV suction

Slow LV filling (diastasis)

Atrial booster

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4
Q

What is ventricular contraction

A

Systole

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5
Q

What happens at systole

A

Wave of depolarisation arrives

Opens the L-calcium tubule

Ca2+ arrive at contractile proteins

LVp rises > LAp

MV closes

LVp rises (isovolumetric contraction) > Aop

AoV opens and ejection starts

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6
Q

In systole is the L ventricle or atria have more pressure

A

Left ventricle pressure

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7
Q

In isovolumetric contraction does the L ventricle or atria have more pressure

A

Left ventricle pressure

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8
Q

What valve opens in systole to start ejection

A

Aortic valve

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9
Q

What is diastole

A

Ventricular relaxation

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10
Q

Describe diastole

A

LVp peaks then decreases

Influence of phosphorylated phospholambdam cytosolic calcium is taken up into the SR

Phase of reduced ejection

Ao flow is maintained by aortic distensibility

LVp < AoP

Ao. valve closes

Isovolumetric relaxation the MV opens

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11
Q

In diastole is the left ventricle pressure more than the aortic pressure

A

Less than

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12
Q

Describe ventricular filling

A

LVp < LAp

MV opens

Rapid filling starts

Ventricular suction contributes

Diastasis (seperation) LVp = LAp filling temporarily stops

Filling is renewed when A contraction raises LAp creating pressure gradient

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13
Q

In ventricular filling is the left ventricle or atria have more pressure

A

Atria

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14
Q

What does ventricular suction contribute to

A

Ventricular filling

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15
Q

What is physiologic systole

A

Isovolumetric contraction

Maximal ejection

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16
Q

What is cardiologic systole

A

From M1 to A2

Only part of isovolumetric contraction - includes maximal and reduced ejection phases

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17
Q

What is physiologic diastole

A

Reduced ejection

Isovolumetric relaxation

Filling phases

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18
Q

What is cardiologic diastole

A

A2 to M11 interval - filling phases included

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19
Q

Define preload

A

Load present before LV contraction has started

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20
Q

Define afterload

A

Load after the ventricle starts to contract

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21
Q

Define starlings Law

A

Within physiologic limits, the larger the volume off the heart, the greater energy of its contraction and the amount of chemical change at each contraction

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22
Q

In starlings law what is LV filling pressure

A

Left atrium pressure - left ventricle diastolic pressure

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23
Q

In the cardiac sarcomere at 80% of the optimal length, what % of the maximal force is produced

A

10%

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24
Q

What is the maximal length of the cardiac sarcomere

A

2.2 um

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25
Q

When the sarcomere lengthens to 85% of Lmax what is effected

A

Physiologic LV volume

26
Q

What is the relationship of the sarcomere

A

Length-dependent activation

All or none

27
Q

Define contractility (inotropic state)

A

State of the heart which enables it to increase its contraction velocity, to achieve higher pressure, when contractility is increased independent of load

28
Q

Define elasticity

A

Myocardial ability to recover its normal shape after removal of systolic stress

29
Q

Define compliance

A

Relationship between the change in stress and resultant strain (dP/dV)

30
Q

Define diastolic distensibility

A

Pressure required to fill the ventricle to the same diastolic volume

31
Q

Define myocardial work

A

Pressure-volume loop reflects contractility in the end-systolic pressure volume relationship, while compliance is reflected at the end diastolic pressure volume relastionship

32
Q

When is compliance reflected

A

End diastolic pressure volume relationship

33
Q

When is contractility reflected

A

End-systolic pressure volume relationship

34
Q

What type of contraction does the heart perform

A

Isometric conditions found during isovolumetric contraction (isotonic are impossible)

35
Q

What does sympathetic stimulation do

A

Increases HR (positive chronotropic)

Increases force of contraction (positively inotropic)

Increases CO

36
Q

What does parasympathetic stimulation do

A

Decreases HR (negatively chronotropic)

Decreases force of contraction (negatively inotropic)

Increases CO

37
Q

What is sympathetic stimulation controlled by

A

Adrenaline and noradrenaline + type 1 beta adrenoreceptors

Increased adenylyl cyclase = increase cAMP

38
Q

What does increased sympathetic stimulation do

A

Increases HR (up to 180-250bmp)

Increases force of contraction

Large increase in CO (by up to 200%)

39
Q

What does decreased sympathetic stimulation do

A

Decreases HR and force of contraction

Decreases CO (by up to 30%)

40
Q

What is parasympathetic stimulation controlled by

A

Acetylcholine

M2 receptors - inhibit adenyl cyclase = reduced cAMP

41
Q

What does increased parasympathetic stimulation lead to

A

Decreased HR (temporary pause or as low as 30-40bpm)

Decreased force of contraction

Decreased CO (by up to 50%)

42
Q

What does decreased parasympathetic stimulation do

A

Increased HR

43
Q

What is the pressure in the right atrium

A

0-4mmHg

44
Q

What is the pressure in the right ventricle during systole

A

25mmHg

45
Q

What is the pressure in the right ventricle during diastole

A

4mmHg

46
Q

What is the pressure in the pulmonary artery during systole

A

25mmHg

47
Q

What is the pressure in the pulmonary artery during diastole

A

10mmHg

48
Q

What is the pressure in the left atrium

A

8-10mmHg

49
Q

What is the pressure in the left ventricle during systole

A

120mmHg

50
Q

What is the pressure in the right ventricle during diastole

A

10mmHg

51
Q

What is the pressure in the aorta during systole

A

120mmHg

52
Q

What is the pressure in the aorta during diastole

A

80mmHg

53
Q

Describe the filling phase

A

Ventricles fill with blood during diastole and atrial systole

54
Q

Describe outflow phase

A

Ventricles continue to contract, pushing blood into the aorta and pulmonary trunk (systole)

55
Q

Describe isovolumetric relaxation

A

Ventricles relax, ready to re-fill with blood in the next filling phase

56
Q

Describe what happens in the filling phase

A

Ventricle pressure is higher than the atria causing the atrioventricular valves (mitral/tricuspid) valves to close

57
Q

How long does isovolumetric contraction last

A

50ms - while pressure builds up

58
Q

At the beginning of diastole what valves are open

A

Atrioventricular valves an

59
Q

What happens during diastole

A

Tricuspid and mitral valves are open

Contraction of atrium moves blood into the ventricle

(Can move straight through)

Tricuspid/mitral valve prevents blood from flowing back

60
Q

Describe diastole

A

Ventricles filled with blood

Atrioventricular valves close

Semilunar valves open

Contraction of ventricles

The Heart (12 decks)

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