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MSS - CV Exam 2 > Cardiac Cycle > Flashcards

Cardiac Cycle Flashcards

1
Q

driving force for blood flow?

A

pressure gradient

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2
Q

what happens during diastole?

A

ventricular filling

isovolumetric relaxation

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3
Q

what happens during systole?

A

isovolumetric contraction

ejection

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4
Q

diastole vs. systole?

A

diastole > systole

-changes with increasing HR**

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5
Q

beginning of isovolumetric contraction?

A

mitral and tricuspid valves close

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6
Q

end of isovolumetric contraction?

A

aortic and pulmonic valves open

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7
Q

beginning of isovolumetric relaxation?

A

aortic and pulmonic valves close

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8
Q

end of isovolumetric relaxation?

A

mitral and tricuspud valves open

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9
Q

isovolumetric contraction?

A

all valves closed***

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10
Q

isovolumetric relaxation?

A

all valves closed***

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11
Q

similarities and differences of left and right heart?

A

different - valves and pressures

same - phase and volume

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12
Q

echocardiography

A

linear dimension and velocity of ventricular contraction

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13
Q

blood volume and L vs. R heart?

A

both eject same volume

  • LV pressure much greater
  • peak velocity is much greater and generated more rapidly
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14
Q

pulmonary wedge pressures?

A

left atrial pressure

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15
Q

ejection fraction = ?

A

EF = SV/EDV

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16
Q

stroke volume = ?

A

SV = EDV - ESV

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17
Q

S1 heart sound?

A

closure of mitral and tricuspid valves

M1 and T1 - rarely split

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18
Q

S2 heart sound?

A

closure of aortic and pulmonary valves

A2 and P2 will split during inspiration**

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19
Q

what closes first: mitral or tricuspid?

A

mitral just before

bc left ventricular contraction begins just before right

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20
Q

what opens first: pulmonary or aortic valve?

A

pulmonary just before
bc right ventricle has shorter isovolumetric contraction***
-not as much pressure needed

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21
Q

what closes first: aortic or pulmonic valve?

A

aortic

-greater downstream pressure

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22
Q

pulmonary valve?

A

opens first and closes last

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23
Q

what opens first: tricupsid or mitral?

A

tricuspid opens first

  • right ventricular filling before left***
  • right isovolumetric relaxation shorter
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24
Q

Inspiration and S2 split?

A

negative intrathoracic pressure

  • greater VR to right side heart
  • additional time for RV ejection - later P2
  • reduced VR to left side heart
  • less time for LV ejection - earlier A2
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25
Q

S3

A

early diastole - after S2

ventricular filling phase

  • normal younger people
  • ventricular enlargement with heart failure

Ken-tuck-y

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26
Q

S4

A

late diastole - just before S1

strong atrial contraction
-pathology, ventricle wall stiffness and decreased compliance

Ten-nessee

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27
Q

3 tips right heart cath?

A

RA, RV, pulmonary wedge (LAP)

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28
Q

stages of contraction?

A

isovolumetric contraction
ventricular ejection
isovolumetric relaxation
ventricular filling

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29
Q

mitral insufficiency?

A

left atrial pressure increase

  • during systole
  • bc blood flows back into left atria
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30
Q

mitral stenosis?

A

increased left atrial presure

-during diastole

31
Q

aortic stenosis?

A

high ventricular pressure and low aortic pressure

  • during systole
  • bc blood can’t flow easily into aorta
32
Q

aortic insufficiency?

A

low aortic pressure

-during diastole

33
Q

dicrotic notch?

A

pressure wave with closure of aortic valve

34
Q

peak flow?

A

during ejection

35
Q

elastic recoil of aorta?

A

maintenance of pressure gradient

36
Q

pressure wave speed?

A

move faster than blood

37
Q

contributors to venous pulse?

A
  • retrograde action of heartbeat
  • respiratory cycle
  • contraction of skeletal muscles
38
Q

a wave?

A

RA contraction

39
Q

c wave?

A

RV pressure in early systole

-bulging of tricuspid valve into RA

40
Q

v wave?

A

RA filling

-tricuspid closed

41
Q

inspiration and jugular pulse?

A

decreased thoracic P

  • decreased JVP
  • increased VR
42
Q

standing?

A

venous pooling

-walking pumps blood and promotes VR decreasing venous pressure in foot

43
Q

bottom right?

A

mitral valve closes

44
Q

top right?

A

aortic valve opening

45
Q

top left?

A

aortic valve closing

46
Q

top right?

A

mitral valve opening

47
Q

net work performed by heart?

A

inside the loop

  • bottom - work done by blood on heart
  • top - work done by heary
48
Q

tension heat

A

greatest energy cost

  • ATP use during isovolumetric contraction
  • isometric - no “work” bc no movement
49
Q

tension heat = ?

A

k T delta(t)

k - energy conversion
T - ventricular wall tension (afterload)
delta(t) - time in systole

50
Q

with CAD?

A 
decreased HR (more time in diastole)
reduce wall tension (decreased BP)
51
Q

ventricular wall stress?

A

pulling fibers apart

52
Q

wall stress = ?

A

wall stress ~ P x r / 2h

P = transmural pressure
r = radius
h = wall thickness
53
Q

cardiac output = ?

A

CO = HR x SV

54
Q

cardiac index?

A

CO with body size taken into consideration

55
Q

preload?

A

EDV

56
Q

afterload?

A

pressure against what ventricles must generate force

57
Q

contractility?

A

inotropy

  • change in force generation
  • independent of preload
  • depends on Ca2+**
58
Q

passive tension in cardiac muscle?

A

increases at shorter sarcomere length

-less distensible elements

59
Q

active tension in cardiac muscle?

A

increase 1.9 - 2.4

  • increased regulatory protein affinity to Ca2+ (troponin C)
  • stretch activated Ca2+ channels on sarcolemma
  • increases sensitivity of RYR receptors to Ca2+ influx
60
Q

frank starling law?

A

degree of filling prior to contraction (preload) determinant for force generated

61
Q

failing heart?

A

flatter curve of frank starling curve

-decreased stroke volume for given EDV

62
Q

LV failure?

A

pulmonary edema

63
Q

RV failure?

A

peripheral edema

64
Q

preload?

A

isometric tension: isovolumetric contraction phase

65
Q

afterload?

A

isotonic tension: ejection phase

66
Q

increased afterload and velocity?

A

decreased velocity

67
Q

increased preload and velocity?

A

increased velocity

68
Q

increased afterload?

A

greater proportion of time in systole is isovolumetric contraction
-therefore, decreased SV and ejection fraction and increased ESV

69
Q

contractility?

A

inotrophy

  • independent of preload
  • depends on Ca2+ levels
70
Q

increased contractility?

A

curve up and to left

71
Q

normal steady state?

A

VR = CO

72
Q

mean systemic filling pressure?

A

MSFP

  • intersection of VR curve at X axis
  • determined by blood volume and vascular compliance

RAP = MSFP with no flow in system

73
Q

change in blood volume?

A

change in MSFP

74
Q

change in resistance to VR?

A

no change in MSFP

MSS - CV Exam 2 (7 decks)

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