cardiac cycle

Question 1

central venous pressure is regulated by what?

Answer 1

1. ability of heart to pump blood out of RA

2. tendency of blood to flow from periphery to RA

Question 2

what is the central venous pressure?

Answer 2

right atrial pressure

Question 3

what are conditions that increase central venous pressure?

Answer 3

1. heart failure
2. tricuspid valve disorders
3. pulmonary arterial HTN

Question 4

jugular venous pressure waveform: A wave

Answer 4

atrial systole

Question 5

jugular venous pressure waveform: X descent (1st part)

Answer 5

fall in RA pressure after a wave peak

Question 6

jugular venous pressure waveform: C wave

Answer 6

ventricular contraction

Question 7

jugular venous pressure waveform: X’ descent (2nd part)

Answer 7

atrial relaxation

Question 8

jugular venous pressure waveform: V wave

Answer 8

venous filling of RA

Question 9

jugular venous pressure waveform: Y descent

Answer 9

rapid ventricular filling; RA emptying

Question 10

jugular venous pressure waveform: H wave

Answer 10

continued filling of RA during diastole

Question 11

what is the dominant motion (most readily observed) of the the normal JVP?

Answer 11

X-X’ descent

Question 12

what does jugular venous pulsation tell you?

Answer 12

1. pressure in rght heart
2. signs of congestion
3. signs of abnormal RA pressure
4. hydration status

Question 13

severe tricuspid valve regurg will show what jugular venous pulsation?

Answer 13

CV wave

Question 14

which heart sounds is the closure of the mitral and tricuspid valve?

Answer 14

S1

Question 15

which heart sound is the closure of he aortic and pulmonic valve

Answer 15

S2

Question 16

what is the common cause of widened splitting of S2?

Answer 16

1. RBBB
2. pulmonic stenosis
3. COPD

Question 17

what is the common cause of fixed splitting of S2?

Answer 17

atrial septal defect

Question 18

what is the common cause of paradoxical splitting of S2?

Answer 18

1. LBBB

2. advanced aortic stenosis

Question 19

in mitral valve stenosis, what can you hear?

Answer 19

the opening snap

Question 20

why is S3 produced?

Answer 20

by the tension of the chordae tendinae during rapid filling

Question 21

causes of S3?

Answer 21

1. young ppl: thin chest wall, supply ventricle

2. old ppl: volume overload or advanced regurgitation

Question 22

when does S4 happen?

Answer 22

produced when trying to fill a stiff ventricle

Question 23

causes of S4?

Answer 23

1. low compliance
2. hypertrophy
3. acute MI

Question 24

where to listen for ejection type murmur?

Answer 24

Aortic area, pulmonic area

Question 25

where to listen for pansystolic murmur?

Answer 25

tricuspid area, mitral area

Question 26

where to listen for mid-to-late diastolic murmur?

Answer 26

tricuspid area

Question 27

where to listen for early diastolic murmur?

Answer 27

left sternal border

Question 28

if a systolic murmur is heard late b/w S1 & S2?

Answer 28

severe aortic stenosis

Question 29

common in patients with R heart failure, high pitched and blowing, heard best at the apex, holo-systolic murmur of constant intensity

Answer 29

mitral regurgitation

Question 30

diastolic decrescendo murmur, heard in 3rd/4th left ICS, high pitched and blowing

Answer 30

aortic regurgitation