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Year 2 Cardiovascular > Cardiac cycle > Flashcards

Cardiac cycle Flashcards

1
Q

what is the first event in the cardiac cycle?

A

atrial contraction

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2
Q

is there isovolumic contraction during AV valve opening?

A

no

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3
Q

will there be isovolumic contraction with aortic regurgitation?

A

no

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4
Q

how is central venous pressure assessed?

A

right atrial pressure

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5
Q

what are three common causes of increased CVP?

A

heart failure
tricuspid valve disorders
pulmonary arterial HTN

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6
Q

what two waves are most prominent on a jugular venous wave form? what do they correspond to?

A

X - fall in RA pressure after a wave peak

X’ - descent of cardiac base, atrial relaxation

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7
Q

what is the dominant motion of the normal JVP?

A

X - X’ descent

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8
Q

what do normal jugular venous pulsations provide information about?

A

right heart pressure
congestion
abnormal RA pressure
hydration status

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9
Q

what is the cause of a very high A wave in jugular venous pulsations?

A

RA contracting against a closed RV

complete heart block 
TV disorders (stenosis)
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10
Q

what is the cause of a CV wave in jugular venous pulsations?

A

ventricularization of RA pressure

TV regurgitation (CHV)

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11
Q

S1 corresponds to what?

A

closure of mitral and tricuspid valves

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12
Q

S2 corresponds to what?

A

aortic (A2) and pulmonic (P2) closure

varies with respiratory cycle

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13
Q

what is the cause of physiological splitting of S2?

A 
inspiration 
increased venous return to RV 
increased RVEDV 
increased time to expel blood from RV 
pulmonic valve stays open longer
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14
Q

when is widened splitting of S2 heard? why?

A

expiration

  1. RBBB - delay in RV contraction - delay in pulmonic closure
  2. pulmonic stenosis - more time to open - delay in closure
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15
Q

when does fixed splitting of S2 occur? why?

A

atrial septal defect

high capacitance, low resistance of pulmonary vasculature
delayed back pressure responsible for pulmonic valve closure
P2 is delayed

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16
Q

what are the causes of paradoxical splitting of S2? when does it occur, and why?

A

LBBB
advanced aortic stenosis

expiration - abnormal delay in closure of aortic valve (A2 follows P2)

17
Q

does timing of opening snap in mitral stenosis change with respiration?

A

no

18
Q

what is the third heart sound S3?

A
  1. early diastole following opening of AV valves during rapid ventricular filling
  2. produced by tension of chordae tendinae during rapid filling
19
Q

what is the fourth heart sound S4? when in the cardiac cycle is it heard?

A

produced when trying to fill a stiff ventricle - coincides with atrial contraction

presystolic (late diastole)

20
Q

in which situations is S4 heard?

A

low compliance / hypertrophy / acute MI

21
Q

where is an early diastolic murmur heard?

A

left sternal border

22
Q

what type of murmur is heard at the left sternal border?

A

early diastolic murmur

23
Q

where is a pansystolic murmur heard?

A

tricuspid area

mitral area

24
Q

what types of murmurs are heard at the tricuspid area?

A

pansystolic

mid to late diastolic

25
Q

what type of murmur is heard at the mitral area?

A

pansystolic

26
Q

ejection type murmurs are due to what causes?

A

aortic stenosis

pulmonic stenosis

27
Q

pansystolic type murmurs are due to what causes?

A

mitral regurg
tricsupid regurg
VSD

28
Q

late systolic type murmurs are due to what cause?

A

mitral valve prolapse

29
Q

aortic and pulmonic stenoses cause what type of murmur?

A

ejection type

30
Q

mitral and tricuspid regurg, and VSD cause what type of murmur?

A

pansystolic

31
Q

mitral valve prolapse cause what type of murmur?

A

late systolic

32
Q

aortic stenosis is heard best at what area? what does it sound like?

A

2nd ICS pt leaning forward

harsh quality between S1 and S2

33
Q

mitral regurg is common in patients with what condition?

A

heart failure

34
Q

mitral regurg is heard best at what area? what does it sound like?

A

apex, radiates to axilla

holo-systolic of constant intensity, plateau shaped extending from S1 to S2

35
Q

aortic regurg is heard best at what area? what does it sound like?

A

3rd or 4th ICS

high pitched and blowing in quality

36
Q

what can increase aortic regurg heart sounds?

A

tightening of fists

Year 2 Cardiovascular (43 decks)

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