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My Cardiology > Cardiac Cycle > Flashcards

Cardiac Cycle Flashcards

1
Q

What phenomenon causes the heart valves to open or close

A

pressure difference

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2
Q

What phenomenon causes closure of the mitral valve

A

rise in ventricular pressure above

atrial pressure

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3
Q

Closure of the mitral valve terminates __________ phase and begins __________ contraction

A

the ventricular filling phase and

begins iso-volumetric contraction

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4
Q

What is Isovolumetric contraction

A

no change in ventricular volume

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5
Q

Which valves are closed during Isovolumetric contraction

A

mitral and aortic

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6
Q

Opening of _______ valve terminates isovolumetric contraction and
begins the ejection phase

A

aortic

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7
Q

What occurs during the ejection phase

A

ventricular volume decreases; ventricular and aortic pressures increase initially but decrease
later in phase

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8
Q

Closure of _______ valve terminates the ejection phase and begins
isovolumetric relaxation

A

aortic

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9
Q

Closure of the _______ valve creates the dicrotic notch

A

aortic

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10
Q

What is Isovolumetric relaxation

A

no change in ventricular volume

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11
Q

Opening of the ______valve terminates isovolumetric relaxation and
begins the ______ phase

A

mitral ; filling

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12
Q

Normally the

valves on the _____ side of the heart close first

A

left

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13
Q

What phenomenon causes systolic sounds

A

e sudden closure of the heart valves

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14
Q

What phenomenon causes S1

A

the closure of the mitral and tricuspid valves

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15
Q

What phenomenon causes S2

A

the closure of the aortic (A2 component) and pulmonic valves

P2 component

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16
Q

What phenomenon causes S3

A

the opening of the AV valves during the

rapid filling of the ventricle

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17
Q

What phenomenon causes S4

A

the atrium contracts against a stiff ventricle

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18
Q

The ______ pulse is generated by changes on the right side of the heart

A

jugular

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19
Q

Which wave of the jugular pulse has:
• Highest deflection of the venous pulse and produced by the contraction of the right atrium
• Correlates with the PR interval
• Is prominent in a stiff ventricle, pulmonic stenosis, and insufficiency
• Is absent in atrial fibrillation

A

a wave

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20
Q

Which wave of the jugular pulse has:
• Mainly due to the bulging of the tricuspid valve into the atrium (rise in
right atrial pressure)
• Occurs near the beginning of ventricular contraction (is coincident
with right ventricular isovolumic contraction)
• Is often not seen during the recording of the venous pulse

A

c wave

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21
Q

Which wave of the jugular pulse has:
Produced by a decreasing atrial pressure during atrial relaxation
• Separated into two segments when the c wave is recorded
• Alterations occur with atrial fibrillation and tricuspid insufficiency

A

x descent

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22
Q

Which wave of the jugular pulse has:
• Produced by the filling of the atrium during ventricular systole when
the tricuspid valve is closed
• Corresponds to T wave of the EKG
• A prominent v wave would occur in tricuspid insufficiency and right
heart failure

A

v wave

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23
Q

Which wave of the jugular pulse has:
• Produced by the rapid emptying of the right atrium immediately after
the opening of the tricuspid valve
• A more prominent wave in tricuspid insufficiency and a blunted wave
in tricuspid stenosis.

A

y descent

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24
Q

define cardiac afterload

A

the load that myocytes must contract against to generate CO

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25
Q

what two principles are illustrated by Laplace’s law

A

Wall stress increases with increased ventricular pressure and increased ventricular radius

  1. Wall stress decreases with increased ventricular thickness
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26
Q

What is Laplace’s equation

A

σ = P × r/2h

P is ventricular pressure, r is ventricular chamber radius, and h is ventricular wall
thickness.

27
Q

Define preload

A

The amount of “stretch” felt by the filled LV at the end of relaxation (diastole) before
contraction (systole)

28
Q

What two mechanisms can influence force generation in cardiac muscle

A

Change in muscle fiber length

Change in contractility or inotropy (independent of fiber length)

29
Q

Is diastole or systole normally longer

A

diastole

30
Q

pressure is greater on which side of the heart

A

left side

31
Q

atrial systole is preceded by which wave in the ECG

A

P wave

32
Q

what happens during atrial systole

A

increase in pressure

contraction of the atria

33
Q

What happens during isovolumetric ventricular contraction

A

Closure of AV valves
Ventricular pressure ↑
Contract as closed cavities

34
Q

What happens during ventricular systole proper

A

Opening of semi lunar valves (LV 120mmHg/RV 25mmHg)
Ejection of blood (rapid and reduced)
Stroke volume (70-80 ml)

35
Q

isovolumetric ventricular contraction occurs during which wave on the ECG

A

QRS complex

36
Q

What causes the AV valves to close during systole (think pressure)

A

When the ventricular pressure exceeds the atrial pressure

37
Q

When is the first heart sound (S1) heard and what causes it

A

During isovolumetric ventricular contraction, closure of the AV valves cause the sound (may be split)

38
Q

General changes during cardiac cycle

A 
Electrocardiographic changes- ECG
Pressure
Volume
Flow 
Phonocardiographic- Heart sounds
Jugular venous pressure
Aorta with systole and diastole
39
Q

isovolumetric ventricular relaxation coincides with which wave on the ECG

A

End of the T wave because it is when the ventricles have completely repolarized

40
Q

Which valve closes during isovolumetric ventricular relaxation

A

Aortic valve

41
Q

What is the term for when blood flow in the aorta is positive

A

Dicrotic notch/ incisura

42
Q

When is it normal to heara third heart sound (S3)

A

only in children

43
Q

What does the third heart sound represent

A

Blood flowing from the atria into the ventricles

44
Q

True or False:

Length of diastole ↓ with ↓ in heart rate

A

False.

Length of diastole ↓ with ↑ in heart rate

45
Q

Which phase is the longest phase of the cardiac cycle

A

Diastasis (reduced ventricular filling)

46
Q

What marks the end of diastole

A

Atrial systole

47
Q

When are the two physiological heart sounds heard

A

During phase B and E :

Isovolumetric ventricular contracion and isovolumetric ventricular relaxation

48
Q

Which heart sound is the loudest and longest

A

S1

49
Q

The S1 heart sounds has what kind of sound quality

A

Crescendo-decrescendo quality

50
Q

Where is the S1 heart sound heard best

A

over the apical region of the heart.

51
Q

Describe the frequency and intensity

A

Higher frequency vibrations and lower intensity

52
Q

The second heart sound is spit during inspiration or expirationi

A

Inspiration

53
Q

What is termed a protodiastolic gallop or ventricular gallop

A

S 1 -S 2 -S 3

54
Q

What is termed gallop rhythm, a presystolic gallop or atrial gallop

A

S 4 -S 1 -S 2

55
Q

What causes the “a” wave in the venous pressure cycle

A

Atrial systole/contraction

56
Q

Which wave on the ECG is preceded by the “a” wave in the venous pressure cycle

A

QRS complex

57
Q

“av” wave in the venous pressure cycle is as a result of

A

relaxation of the right atrium and closure of the tricuspid valve

58
Q

What causes the “c” wave in the venous pressure cycle

A

Reflects the pressure rise in the right ventricle early during systole

59
Q

The end of which wave on the ECG is corresponds to the “c” wave in the venous pressure cycle

A

QRS complex

60
Q

What causes the “v” wave in the venous pressure cycle

A

Filling of the RA against a closed tricuspid valve, which causes right atrial pressure to rise

61
Q

The end of which wave on the ECG is corresponds to the “v” wave in the venous pressure cycle

A

T wave

62
Q

What causes the “x” wave in the venous pressure cycle

A

Ventricle contracts and shortens during the ejection phase later in systole.

63
Q

What causes the “y” wave in the venous pressure cycle

A

Fall in right atrial pressure during rapid ventricular filling

My Cardiology (21 decks)

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