Cardiac Cycle

Question 1

What is the first phase of the Cardiac Cycle?

Answer 1

Atrial Contraction

Question 2

What effect does ACont have on SV?

Answer 2

Increases it by 15-20%

Question 3

What happens during Isovolumetric Contraction?

Answer 3

Pressure shoots up. Volume stays the same.

Question 4

What happens during Atrial Contraction?

Answer 4

Blood fills the right ventricle.

Question 5

What causes the ventricular ejection?

Answer 5

Ventricular pressure exceeds Aortic Pressure.

Question 6

What causes the closing of the isovolumetric relaxation?

Answer 6

Aortic pressure overcomes Ventricular pressure and aortic valve closes. Ventricle elaxes.

Question 7

What is different in mitral valve prolapse or leaky aortic valve?

Answer 7

Pressure does not drop as low. LV needs to work harder. Less relaxation

Question 8

What is another word for Right Atrial Pressure?

Answer 8

Central Venous PRessure

Question 9

What regulates RAP?

Answer 9

Ability of heart to pump blood out of RA
-TC valve function
-RV Function
-Pulmonary arterial Funct. 
Venous return

Question 10

What are common causes of increased CVP?

Answer 10

Heart failure
Tricuspid valve disorder
Pulmonary arterial hypertension

Question 11

What do the waves of the Jugular venous wave form mean?

Answer 11

A- Atrial Systole
X- Fall in RA pressure
C- Vent Contraction TV Closure
X- Atrial RelaXation (descent of cardiac base
V- Veous filling of RA
Y-Rapid Ventricular filing- RA EmptYing
H-Cont. Filling of the Right atrium during diastole.

Question 12

What is the relationship between Internal jugular vein and RA?

Answer 12

Very similar pressures. Able to guage RA pressure in Int. Jugular

Question 13

What does a large A wave in Jugular pressure mean?

Answer 13

Reduced RV compliance

Elevated RV end-diastolic pressure. Narowed valve or HEART BLOCK

Question 14

What does a C-V wave on the Jugular pressure chart mean?

Answer 14

Ventricularization of RA pressure in tricuspid valve regurgitation.

Question 15

What is the Cause of S1 S2 split?

Answer 15

Mitral and Tricuspid S1
Aortic and Pulmonic close
Split widened during inspiration

Question 16

What causes Widened splitting of S2?

Question 17

What causes Fixed splitting of S2?

Answer 17

Atrial Septal Defect: Volume overload in the Right heart
>High Capacitance
>Delayed back pressure
>P2 is delayed

Question 18

What is Paradoxical Splitting of S2?

Answer 18

Abnormal delay in closure of the aortic valve
LBBB>Delay in LV contraction> delay in aortic valve closure
Aortic stenosis> More time to open > Delay in closure

Question 19

Opening Snap of Mitral Stenosis?

Answer 19

.

Question 20

What causes the Third Heart sound?

Question 21

What causes the Fourth Heart sound?

Answer 21

Late diastole, Atrial contraction.
Pre-systolic sound
Trying to fill a stiff ventricle
Low compliance/ Hypertrophy/ Acute MI

Question 22

What types of murmurs do you hear at each Listening area?

Answer 22

A-Aortic Stenosis, Flow Murmur
P-Pulmonic Stenosis, Flow Murmur
T-Tricuspid regurg, VSD
M-Pansystolic-mitral regurg, Mid to late diastolic-Mitral stenosis 
LSB Aortic Regurg, pulmonic regurg

Question 23

Where is Mitral Regurgitation best heard ?

Answer 23

At the apex

Question 24

Where is Aortic stenosis best heard?

Answer 24

2nd intercostal space

Question 25

What is heard with Mitral Stenosis?

Answer 25

Pre-Systolic Accentuation of the diastolic murmur. Hear woosh right before S1.