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cardiac cycle Flashcards

1
Q

what is systole

A

Ventricular contraction

Ventricles generate pressure then eject blood into the arteries

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2
Q

what is diastole

A

Ventricular relaxation

The ventricles fill with blood

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3
Q

what is the 1st phase

A

systole

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4
Q

what is teh end diastolic volume

A

maximum blood in the heart just before the ventricle start to contract

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5
Q

End-systolic volume

A

residual volume left in the heart after contracting

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6
Q

what is teh Stroke volume (mL)

A

End-diastolic volume - End-systolic volume

how much blood is ejected

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7
Q

what is a clinical indicator of heart function

A

ejection fraction

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8
Q

how to work it out

A

stroke volume/End-diastolic volume

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9
Q

normal range of ejection fraction

A

52 - 72

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10
Q

patient in heart fraction

A

30 - 35

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11
Q

what is the start of teh cardiac cycle

A

artial systole

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12
Q

how is the start shown on an ecg

A

p wave = atrial systole

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13
Q

what does the atrial contraction do

A

Atria contract to ‘top-up’ the volume of blood in ventricle

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14
Q

what may you hear in the heart of a patient with congestive heart failure, pulmonary embolism or tricuspid incompetence

A

4th heart sound

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15
Q

next stage

A

Isovolumetric contraction

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16
Q

what is it shown on ecg

A

QRS

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17
Q

which is

A

start of ventricular depolarisation

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18
Q

what is start of ventricular depolarisation

A

This is the interval between AV valves (tricuspid & mitral) closing and semi-lunar valves (pulmonary & aortic) opening
(ventricular pressure increases near the aortic pressure)

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19
Q

what is the change in volume

A

no change in volume §

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20
Q

what causes the first heat sound (lub) to occur

A

closure of AV valves

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21
Q

what sort contractions occur at this point

A

isometric

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22
Q

what is the next stage

A

rapid ejection

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23
Q

when does it begin

A

As ventricles contract pressure within them exceeds pressure in aorta and pulmonary arteries. Semilunar valves open, blood pumped out and the volumes of ventricles decrease.

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24
Q

so what marks the start of this phase

A

Opening of the aortic & pulmonary valves mark the start of this phase

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25
what is the heart sound in this phase
no heart sound
26
what is the next stage
Reduced ejection
27
what does thsi phase signify
This phase marks the end of systole
28
what causes the semilunar valves to close
Reduced pressure gradient means aortic & pulmonary valves begin to close As pressures in ventricles fall below that in arteries, blood begins to flow back causing semilunar valves to close
29
describe the changes to the ventricular volume
Blood flow from ventricles decreases and ventricular volume decreases more slowly
30
what causes teh t wave
Ventricular muscle cells repolarize producing T wave
31
what is the next stage
Isovolumetric relaxation
32
when do the AV valves open
The aortic & pulmonary valves shut, but the AV valves remain closed until ventricular pressure drops below atrial pressure.
33
what causes the Dichrotic notch
caused by rebound pressure against aortic valve as distended aortic wall relaxes.
34
what heart sound can be heard
2nd - dub
35
why
due to closing of the SL valves
36
what is the rate of pressure decline in the ventricle caused by
rate of relaxation of the muscle fibre | regulated by ca atpases in sr membrane
37
do volume change
no- isometric
38
what stage occurs next
Rapid passive filling
39
when do AV valves open
when ventricular pressure falls below the atrial presuure
40
what part of ecg
Occurs during isoelectric (flat) ECG between cardiac cycles | no electrical activity
41
what is the heart sound heard
3rd heart sound – usually abnormal and may signify turbulent ventricular filling Can be due to severe hypertension or mitral incompetence (mitrial doesn;t close properly)
42
what is the next stage
Reduced passive filling
43
aka
This phase can be called diastasis
44
what happens
ventricle fills more slowly
45
how mcuh can V without atrial contraction
The ventricles are able to fill considerably without the contraction of the atria.
46
next stage
starts again atrial systole
47
how do the pressure change pattern in the right and left side of the heart compare
identical
48
what is teh differnce in bith sides
Quantitatively, the pressures in the right heart and pulmonary circulation are much lower (peak of systole – 25mmHg in pulmonary artery)
49
blood difference ejected
Despite lower pressures right ventricle ejects same volume of blood as left (it is simply pumping the same quantity of blood into a lower pressure circuit)!
50
what is the pulmonary capillary wedge pressure
indirect estimate of left atrial pressure | gives us idea of severity of left ventricular failure
51
what does an increase in left ventricular pressure cause atrial
increase pulminary oedema | life threating
52
how to measure the left atrial pressure
use right side of the heart | ventriular bloon right atrium ventricle
53
what happens when we reach aortic pressure
aortic valvue opens blood expelled from the heart
54
what is preload
the amount of blood coming back to teh heart stretching the ventricles
55
how to increase preload
increase in amount of blood returning to the heart
56
relationship between preload and force
larger preload, larger stretch more force | more blood ejected
57
what is the afterload
Afterload is the pressure that the heart must work against to eject blood during systole (ventricular contraction diastolic blood pressure
58
what does the afterload cause
shorteing of teh muscle fibres | less able to expel blood in teh ventricles
59
what represents the afterload
The blood pressures in great vessels (aorta and pulmonary artery) represent the AFTERLOAD
60
what is ESPVR
maximal pressure that can be developed by the ventricle at any given volume
61
Increases in preload result in
increased stroke volume
62
what is that known as
This is the Frank-Starling relationship
63
Increases in afterload result in
decreased stroke volume | afterload increases, the amount of shortening of muscle fibres that occurs decreases
64
when the after load increases what effect does it have on the aortic valve
Greater pressure required to open aortic valve afterload is the resistance that is required to be overcome to circulate blood so high pressure aorta = higher pressure in ventricle (i think)
65
what is cardiac output calculated
Heart rate * Stroke volume
66
what is stroke volume affected by
Preload Afterload Contractility
67
what is Contractility
Contractile capability (or strength of contraction) of the heart
68
what is it increases by
Sympathetic stimulation
69
how
Changes Ca2+ delivery to myofilaments
70
What happens to PV loops during exercise?
(1) Increased VR (vebous return) aided by muscle and respiratory pump increases EDV 2 Main factor: Sympathetic activation of the myocytes increases ventricular contractility, that decreases end-systolic volume. 3 combacted by The increase in arterial pressure that occurs during exercise increases afterload (and can lessen the reduction in end-systolic volume but offset by large increase in contractility)
71
summary
(4) Combination of increased cardiac contractility and increased VR generate increased SV (and EF) ejection fraction
72
what is this dependent on
If HR increases to very high rates, diastolic filling time can be reduced and this decreases EDV
73
what hormone can cause symoathetic innervation
Hormonal: Circulating adrenaline from adrenal gland
74
nueral
Neural: Noradrenaline released from nerves
75
how does an increase in preload shown on a pv grapgh
more wide- (more left ventricular volume) (increase size from the left) same pressures
76
decrease preload
more narrow- less ventricular volume (decrease size from the left) same pressures
77
increase afterload
thinner and higher | thinner from the right side is squashed
78
decrease afterload
normal
79
excersize
Venous return increases due to venoconstriction and skeletal muscle pump, and contractility is increased via sympathetic nervous system wider from both sides and higher
80
what increases afterload
hypertension vasoconstriction
81
increase preload
higher venous return

nuero (36 decks)

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