cardiac cycle Flashcards
Which sound can you auscultate in the 2nd R/L intercostal space?
L- pulmonic
R- aortic
What sound can you auscultate at the 4th parasternal space?
tricuspid valve
What can you auscultate at the 5th midclavicular line?
mitral
If they have a regurg or stenosis, where do you listen?
2nd parasternal ICS
What is the S1 sound?
close the mitral and tricuspid valve (onset of systole) best heard at the cardiac apex
What is the S2 sound?
closure of pulmonary and aortic valve
Where is the S2 sound heard the best?
P2= =pulmonic valve at the 2nd L parasternal ICS, and A2= 2nd R parasternal ICS
S1 is the onset of which phase of the cardiac cycle?
systole
S2 is onset of which part of the cardiac cycle
onset of diastole
What would widen the P2?
Inspiration, ASD (pulmonic valve), pulmonary stenosis, Right bundle branch block
What is the paradoxical split?
P2 comes before A2, severe aortic stenosis, left bundle branch block. anything that increases the afterload against the aortic valve
narrowing of s2 split in inspiration is indicative of of what?
paradoxical splitting ( severe aortic stenosis)
When is S3 pathologic?
heart failure, mitral regurg, aortic regurg
When is S3 normal?
young, fit, pregnancy
What is S3 produced by?
rapid passive ventricular filling increase in left ventricular volumes, heard at the apex
When is the s3 heard?
early diastole, after S2 gallop.
What is S4 produced by?
atrial kick, increased left ventricular pressures.
When is it heard?
Late diastole, before S1
When is it physiologic? S3
elderly
When is S4 pathological?
heart failure (diastolic), hypertension, aortic stenosis
Which phase of the cardiac cycle has the highest oxygen consumption
isovolumetric contraction
In isovolumetric contraction, what changes?
pressure, ventricular depolarization (ECG)
A wave on JVP
atrial systole
c wave on JVP
ventricular contraction, tricuspid valve pushes into atrium
x wave descent on JVP
atrial relaxation
y descent
ventricular filling
cannon a waves pathology
premature atrial kick, 3rd degree av block: atria and ventricle not syncing up
When v wave is higher than a wave- what condition
regurgitation
aortic regurgitation, there is an incompetent aortic valve that results in regurgitation of blood from the aorta back into the left ventricle; as a result, diastolic blood pressure is/ vs systolic
decreased,
To compensate for the reduced efficiency of left ventricular ejection (due to backflow) in aortic regurgitation, the heart will contract harder, thus increasing the systolic blood pressure.
What happens to the dicrotic notch in aortic regurg?
The dicrotic notch results from a sudden pressure increase when the aortic valve closes after ventricular systole. In aortic regurgitation, the dicrotic notch classically disappears because the aortic valve fails to close properly
