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Cardio > Cardiac Cycle > Flashcards

Cardiac Cycle Flashcards

1
Q

List the 7 phases of the cardiac cycle?

A 
Atrial systole
Isovolumetric contraction
Rapid ejection
Reduced ejection
Isovolumetric relaxation
Rapid ventricular filling
Reduced ventricular filling (diastasis)
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2
Q

What parts of the EKG overlap atrial systole?

A

end of P wave (atrial depolarization) through R peak (ventricular depolarization)

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3
Q

During atrial systole, what are the pressures in the atria and ventricles?

A

both are increased due to increased ventricular volume

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4
Q

What occurs after atrial systole?

A

mitral and tricuspid valves close as pressure in ventricles exceeds the atria

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5
Q

What parts of the EKG overlap isovolumetric contraction?

A

end of R wave through S wave (ventricular depolarization)

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6
Q

During isovolumetric contraction, what is the pressure like in the ventricle?

A

very high, because both mitral valve and aortic valve are closed

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7
Q

What occurs after isovolumetric contraction?

A

aortic valve opens when pressure in the ventricle exceeds the aorta

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8
Q

When do aortic pressures peak? What does this cause?

A

during rapid ejection–leading to closure of the aortic valve

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9
Q

What occurs after rapid ejection?

A

reduced ejection–ventricular peak pressures decline and atria are in diastole getting filled up with venous return

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10
Q

What part of the EKG overlaps reduced ejection?

A

T wave (ventricular repolarization)

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11
Q

When the aortic valve closes, what does this due to blood flow?

A

there is a slight retrograde flow for a fraction of a second

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12
Q

What are the pressures in the atria and ventricles during isovolumetric relaxation?

A

rapid decline in ventricular pressure, increase in atrial pressure

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13
Q

What occurs just before rapid ventricular filling?

A

pressure in atria is greater than ventricle, so the mitral valve opens

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14
Q

When do you hear S1 heart sound?

A

systole

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15
Q

What is the S1 heart sound caused by?

A

vibrations from closure of AV valves (NO splitting)

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16
Q

When do you hear the S2 heart sound?

A

start of diastole

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17
Q

What is the S2 heart sound caused by?

A

vibrations from the closure of the aortic and pulmonary valves

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18
Q

When do you hear S2 split?

A

inspiration, pulls more blood into right heart and this will lead to a slight delay in the closure of the pulmonic valve

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19
Q

When would you hear an S3?

A

early diastole

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20
Q

What causes the S3 heart sound?

A

filling of ventricles (ventricular overload or mitral valve problems)

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21
Q

In what patients is it normal to hear S3?

A

children and pregnant women

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22
Q

When would you hear S4?

A

late diastole

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23
Q

What causes the S4 heart sound?

A

vibrations induced by stiffened ventricle during atrial contraction

24
Q

What does the surface area of the pressure volume loop tell you?

A

work

25
Q

What is the equation for work?

A

work= pressure X volume

26
Q

What is occurring during “a” - bottom horizontal line- of the pressure volume loop?

A

ventricular filling (diastole)

27
Q

What is point 1 - bottom right corner- of the pressure volume loop? What occurs at this time?

A

EDV (preload)

mitral valve closes

28
Q

What is occurring during “b” - right vertical line- of the pressure volume loop?

A

isovolumetric contraction (diastole)

29
Q

What is point 2 - top right corner- of the pressure volume loop?

A

afterload (pressure in aorta that the ventricle must push up against)

30
Q

What is occurring during “c” - top horizontal line- of the pressure volume loop?

A

ventricular ejection (systole)

31
Q

What is point 3 - top left corner- of the pressure volume loop? What occurs at this time?

A

ESPVR (maximum pressure the the ventricle can generate)

aortic valve closes

32
Q

What is occurring during “d” - left vertical line- of the pressure volume loop?

A

isovolumetric relaxation

33
Q

What is point 4 - bottom left corner- of the pressure volume loop? What occurs at this time?

A

ESV

mitral valve opens

34
Q

According to Frank Starling, what regulates ventricular contractility (ESPVR)?

A

EDPVR, or the left ventricular volume at the end of diastole

35
Q

When you simply say systolic or diastolic pressure, what are you referring to?

A

maximum/minimum pressure int he AORTA

36
Q

What is the ejection fraction?

A

fraction of the EDV ejected by the ventricle during systole

37
Q

What is the equation for EF? What is normal?

A 
EF= SV/EDV
normal= 55-75%
38
Q

What is CO?

A

volume of blood ejected by the ventricle in one minute

39
Q

What is the equation for CO?

A

CO = SV * HR

40
Q

What is preload?

A

ventricular pressure at the end of diastole (determined by the ventricular end diastolic volume)

41
Q

What happens to the pressure-volume loop if you increase preload only?

A

it just gets stretched out to the right

  • Increase SV (so increase BP)
  • Increase peak systolic pressure
42
Q

What compensatory changes occur if you increase preload?

A

increase in SV increases cardiac output which will increase afterload (slightly increase ESV)

43
Q

What is afterload?

A

ventricular pressure during contraction (diastolic aortic pressure that the ventricular muscle must pump against)

44
Q

What happens to the pressure-volume loop if you increase afterload only?

A

curve gets taller and skinnier and pulls in to the right

  • you get decreased ventricular contraction velocity and reduced SV since the heart will pump slower
  • ESV increased
45
Q

What compensatory changes occur if you increase afterload?

A

increase in ESV will increase EDV (preload) because blood will be added into the venous return

46
Q

What is contractility?

A

inotropy- strength of ventricular contraction independent of preload or afterload

47
Q

What does an increase in contractility do to the pressure-volume loop?

A

it stretches it out to the left and makes it taller

  • also makes slope of ESPVR greater
  • decreases ESV
  • increases SV (and blood pressure)
48
Q

What compensatory changes occur if you increase contractility?

A

-increase SV will increase CO and increase afterload

49
Q

What is aortic stenosis?

A

left ventricle is having to push extra hard (increase pressure) to get through the turbulent flow (resistance) in the aorta.

50
Q

What type of murmur is caused by aortic stenosis?

A

Leads to a crescendo-decrescendo murmur between S1 and S2 (when velocity of blood is increased due to narrow valve, you get more turbulence, so this is NOISY)

51
Q

What does aortic stenosis do to the pressure volume loop?

A
  • increase EDV
  • lowers SV
  • lowers EF
52
Q

What is aortic regurgitation?

A

aortic valve is leaking—get aortic run off (rapidly decreasing aortic diastolic pressure—flowing forward and backward back into ventricle)

53
Q

What type of murmur is caused by aortic regurgitation?

A

decrescendo diastolic murmur (after S2)

54
Q

What is mitral stenosis?

A

left atrium is having to push extra hard (increase pressure) to get through the bad valve into the left ventricle.

55
Q

What type of murmur is caused by mitral stenosis?

A

High velocity of blood flow and turbulence leads to a diastolic murmur (after S2)

56
Q

What is mitral regurgitation?

A

mitral valve allows backflow into atria (increasing pressure in atria) during ventricular contraction

57
Q

What type of murmur is caused by mitral regurgiation?

A

• Systolic murmur (after S1) due to the turbulent back-flow

Cardio (24 decks)

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