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FS Exam 4 > Cardiac Cycle > Flashcards

Cardiac Cycle Flashcards

1
Q

Systole

A

Contraction

Blood is ejecting

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2
Q

Diastole

A

Relaxation

Filling

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3
Q

How much does systole do and in what time?

A

ejects 2/3 of blood

total time = 1/3

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4
Q

How much does diastole do and in what time?

A

Coronary blood flow filling

total time = 2/3

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5
Q

As you increase heart rate, what is compromised?

A

Filling - diastole

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6
Q

Movement of blood depends on

A

Pressure Gradient

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7
Q

What generates the pressure

A

The heart - by contracting

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8
Q

Purpose of isovolumetric contraction

A

btw r and s - beginning of systole
causes increase in ventricular pressure
we need to exceed aortic pressure so blood can go from LV to body

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9
Q

End Systolic Volume

A

What is left in the heart after contracting

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10
Q

End Diastolic Volume

A

What we filled the heart/ventricle with

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11
Q

EDV - ESV

A

120-50 = 70

70mL is now in the aorta - this is stroke volume - how much we ejected from the heart

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12
Q

Isovolumetric relaxation purpose

A

drop pressure
we want to refill heart again so need gradient
need to lower ventricular pressure so its lower than atrial

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13
Q

As filling heart, which will be higher ventricular or atrial

A

atrial will always be higher during filling

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14
Q

When ventricular is higher than atrial, where will flow go? if valve open

A

back into atrium

Need to close valve so close AV valves

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15
Q

S1

A

Closure of mitral and tricuspid valves

lub

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16
Q

S2

A

closure of aortic and pulmonary valves

dub

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17
Q

S3

A

rapid ventricular filling
not typically audible in adults
Might indicate congestive heart in adults

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18
Q

S4

A

active ventricular filling

not typically audible in adults

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19
Q

Stroke volume

A

How much work the heart is doing

About 70mL

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20
Q

Cardiac Output

A

Flow out of the heart

HR * SV

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21
Q

Ejection Fraction

A

SV/EDV
of what you filled the heart with, how much are you actually ejected
Normally about 55%, 30% in heart failure

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22
Q

EF is an index for what

A

How hard the heart is working

or its contractility

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23
Q

Heart Rate - how regulated

A

Para and Sym
Can also be intrinsic on its own 100 bpm
Heart rate impacts CO - inc heart rate, compensating so can inc CO

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24
Q

Stroke Volume - how regulated

A

Sympathetic Nerves
Contractile Strength
EDV - fill heart more

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25
Q

Regulation of Heart Rate - nerves

A

None needed!

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26
Q

Regulation of Heart Rate with nerves - Symp

A

F/F - Increases HR via cardiac accelerator nerves (innervate SA node) and then NE binds to B1 adrenergic receptors and inc HR

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27
Q

Regulation of HR with nerves - Para

A

Dec HR via vagus nerve, Ach binds to muscarinic cholinergic receptors in SA node

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28
Q

Inspiration does what to HR

A

Increases HR

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29
Q

Exhalation does what to HR

A

Decreases HR

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30
Q

Atropine

A

Muscarinic Antagonist - Parasympathetic tone

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31
Q

Propanolol

A

Beta Blocker - Sympathetic

Preventing inc in HR

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32
Q

At rest, we rely more on sym or para

A

more on sympathetic then parasympathetic

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33
Q

End Diastolic Volume - Regulation of SV

A

Preload
Length tension relation and amount of filling
Changing the length by how much you are filling it with

34
Q

Aortic Pressure/Mean Arterial Pressure - Regulation of SV

A

Afterload
Pressure the heart pumps against to eject blood
Aortic pressure that heart is fighting against to get flow out

35
Q

Inc in afterload will… (SV)

A

SV will decrease

36
Q

Inc in preload will… (SV)

A

SV will increase

37
Q

Strength of Ventricular contraction - Regulation of SV

A

Contractility

How forcefully the heart contracts

38
Q

What is the major factor controlling Q

A

The amount of blood returning to the heart

The heart can do no more than pump out what it receives

39
Q

Inc contractility does what to SV

A

Increase SV

40
Q

Frank Starling Mechanism

A

EDV - Preload
Greater preload results in stretch of ventricles
Inc in stretch optimizes # of CB formation
And this leads to more force and more CO and more SV

41
Q

As you stretch the heart you will…

A

Fill it and optimize CB formation

42
Q

Ca affinity for TnC is greater with

A

sarcomere length

43
Q

The skeletal muscle pump

A

Milking action of muscle
Rhythmic muscle contractions force blood toward the heart
Decreased venous pressure sucking more blood through muscle

44
Q

Generally what does skeletal muscle pump do

A

Increase venous return back to the heart

Increase blood flow to muscle

45
Q

What prevents backflow of blood

A

One way valves

46
Q

EVD is also affected by

A

Venoconstriction

Respiratory pump - breathe in you are dec pressure and this facilitates bringing flow into the heart

47
Q

Mean Arterial Pressure

A

Afterload
Force opposing the ejection of blood from ventricles
Increasing the afterload increases the force required by the heart to eject blood into aorta
You are dec pressure gradient - making heart work harder

48
Q

Ventricular Contractility

A

Intrinsic ability of cardiac muscle to generate force at given fiber length
Independet of pre and after load
Usually associated with change in intracellular Ca

49
Q

Ventricular Contractility is induced by

A

Circulating EPI and NE

Direct sympathetic stimulation of heart

50
Q

B1 effects on tissues

A

Inc heart rate and glycogenolysis and lipolysis and contractility

51
Q

B2 effects on tissues

A

Inc bronchodilation and vasoconstriction

52
Q

A1 effects on tissue

A

Inc vasoconstriction

53
Q

A2 effects on tissue

A

Opposes B1 and B2 receptors

54
Q

CO =

A

HR x SV
HR - intrinsic and syp and para
SV - preload (EDV), afterload (MAP), contractility

55
Q

SV =

A

EDV - ESV

56
Q

Ways to evaluate contractility

A

Ejection Fraction
End Systolic Pressure Volume Relation
Change in pressure over change in time

57
Q

Ejection Fraction

A

SV/EDV
Used as index for evaluating heart failure
less than 30%

58
Q

End Systolic Pressure Volume Relation

A

Slope of a line connecting aortic valve closing to max isovolumetric pressure (max pressure achieved during systole)

59
Q

Change in Pressure over Change in Time

A

Contractility alters rate of pressure developed

60
Q

Increased Contractility does what to SV

A

Increases it

ESV Decreased

61
Q

Increased Preload (filling) does what with SV

A

Increases it

EDV increased

62
Q

Increased afterload (aortic pressure) does what to SV

A

Decreases it

ESV increased

63
Q

Greater SV = what for the heart

A

greater work for the heart, makes it more efficient - is a good thing

64
Q

What does efficiency of the heart mean

A

Work over expenditure

Expenditure = energy cost, or what you have to invest in it

65
Q

Wall tension and energy expenditure

A

Wall tension is where most of the energy from the heart is going - this puts more stress (bad) on the heart

66
Q

What are smaller fractions that are associated with energy expenditure

A

Kinetic energy and external work

67
Q

Stress on heart is determined by what

A
  1. Afterload (greater wall tension required)
  2. HR (more time in systole)
  3. Rate Pressure Product
68
Q

Rate Pressure Product

A

SBP x HR

How much investment you are making; the stress load (decreases with exercise)

69
Q

Ideal stress on heart

A

Low wall tension and less time in systole

70
Q

Heart Rate is affected by

A

Symp and Para NS (ANS)

71
Q

Contractility is affected by

A

Symp NS
MI - dec contractility
Heart Failure - dec contractility

72
Q

Preload is affected by

A 
Venous return and EDV
Blood volume
Postural change
Skeletal muscle contraction
Respiration
73
Q

Afterload is affected by

A

Hypertension
Arterial stiffness
Inc in TPR

74
Q

At a given velocity of shortening, muscle exerts….

A

more tension if we stretch it with more preload

75
Q

At a given afterload, shortening ____ if we stretch the muscle with more preload

A

Increases

76
Q

Input into RA =

A

Output from LV

77
Q

As you dec Rigth Atrial Pressure you will do what to venous return (flow)

A

Increase it

78
Q

Y intercept of Vascular Function Curve

A

RAP of zero - no more venous return

79
Q

X intercept of Vascular FUnction Curve

A

Pressure when CO is 0

Mean circulatory pressure

80
Q

Slope of Vascular Function Curve depends on

A

Venous Compliance

81
Q

If you dec RAP…

A 
you inc gradient for filling
inc venous return
increase preload
Inc SV
inc CO

FS Exam 4 (6 decks)

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