Cardiac cycle

Question 1

Left ventricle

Answer 1

thick-walled and circular
generates greater pressures
prominent papillary muscles seen in LV which anchor the mitral valve leaflets

Question 2

right ventricle

Answer 2

thin-walled and crescentic lower pressures

Question 3

what does raised pulmonary artery wedge pressure indicate?

Answer 3

vasoconstriction
fluid overloaded
right to left shunt VSD
left ventricular failure
mitral valve failure
pulmonary hypertension

Question 4

what does decreased pulmonary artery wedge pressure indicate?

Answer 4

vasodilation

hypovolaemia

Question 5

right atrial pressure

Answer 5

is equivalent to the central venous pressure and jugular venous pulse

Question 6

central venous pressure waveform

Answer 6

a wave
c wave
x descent
v wave
y descent

Question 7

a wave

Answer 7

atrial contraction

Question 8

c wave

Answer 8

tricuspid valve bulging back into RA

Question 9

x descent

Answer 9

atrial relaxation

Question 10

v wave

Answer 10

atrial filling with closed tricuspid valve

Question 11

y descent

Answer 11

atria empties into ventricle

Question 12

what is an arterial line used for?

Answer 12

measure pressure

no blood in the line

Question 13

what is the dicrotic notch?

Answer 13

when the aortic valve closes

Question 14

what is isovolumetric contraction?

Answer 14

occurs in early systole during which the ventricles contract with no corresponding volume change

Question 15

what is isovolumetric relaxation?

Answer 15

beginning of diastole

Question 16

perfusion of heart

Answer 16

rise in LV pressure during systole acts to occlude coronary vessels running through it so most perfusion occurs in diastole

Question 17

what causes coronary vasoconstriction?

Answer 17

increases pp O2
decreased pp CO2 - alkalosis
alpha 1 stimulation
ADH
Angiotensin
Thromboxane

Question 18

what causes coronary vasodilation?

Answer 18

decreased ppO2
increased ppCO2 - acidosis
lactate
adenosine
beta 2 stimulation
prostacyclin

Question 19

heart sounds

Answer 19

2 major sounds
due to valve closure
s1 = represents closure of mitral and tricuspid valves
s2 = represents closure of aortic and pulmonary valves
left sided valves normally close fractionally ahead of the right.

Question 20

heart murmurs

Answer 20

usually associated with heart pathology
blood flow normally laminar but when there is turbulent flow it produces abnormal sound due to vibrations in the surrounding structures

Question 21

what are the types of valvular murmurs?

Answer 21

stenotic valve

regurgitant/ incompetent valve

Question 22

stenotic valve

Answer 22

stiff or narrowed valve that doesn’t open completely

blood forced through narrowed opening - ejection murmur

Question 23

regurgitant/ incompetent valve

Answer 23

valve edges are scarred - don’t close completely so there is some backflow of blood

Question 24

what could non-valvular murmurs be a sign of?

Answer 24

pregnancy
ASD
VSD
PDA

Question 25

what is ASD?

Answer 25

atrial septal defect

Question 26

what is VSD?

Answer 26

ventricular septal defect

Question 27

what is PDA?

Answer 27

patent ductus arteriosus

Question 28

when do stenotic mitral and tricuspid valve murmurs occur?

Answer 28

diastole

Question 29

when do incompetent mitral and tricuspid valve murmurs occur?

Answer 29

systole

Question 30

when do stenotic aortic and pulmonary valve murmurs occur?

Answer 30

systole

Question 31

when do stenotic aortic and pulmonary valve murmurs occur?

Answer 31

diastole

Question 32

murmur in aortic stenosis

Answer 32

systolic crescendo-diminuendo with radiation to carotids

Question 33

clinical presentation of aortic stenosis

Answer 33

dyspnoea
fainting/ syncope
chest pain
palpitations

Question 34

treatment for aortic stenosis

Answer 34

catheterisation

valve replacement

Question 35

when do the waves on the ECG happen?

Answer 35

just before pressure changes

Question 36

what is the ideal resting cardiac output?

Answer 36

5L/min

Question 37

emptying of ventricles

Answer 37

ventricles are not completely emptied during ventricular systole

Question 38

what is an indication of valve stenosis?

Answer 38

significant difference between highest pressure in ventricles and aorta

Question 39

mechanical valves

Answer 39

last 20 years
require anticoagulants for life
very expensive
given to younger people

Question 40

tissue valves

Answer 40

last 10 years
given to older people
cheaper