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BRS - Cardio > Cardiac Cycle > Flashcards

Cardiac Cycle Flashcards

1
Q

What are the 2 phases of a heart beat?

A

Systole + Diastole

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2
Q

What is systole?

A

Ventricular contraction - ventricles generate pressure + eject blood into arteries

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3
Q

What is diastole?

A

Ventricular relaxation - ventricles fill with blood

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4
Q

How long does diastole last?

A

Approx. 2/3 of heart beat

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5
Q

How long does systole last?

A

Approx. 1/3 of beat

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6
Q

How many sub phases is diastole split into?

A

4

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7
Q

How many sub phases is systole split into?

A

3

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8
Q

What sub phase does the cardiac cycle start with?

A

Atrial systole

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9
Q

What are the 4 sub phases of diastole?

A
  • Isovolumetric Relaxation
  • Rapid Passive Filling
  • Slow Passive Filling
  • Atrial Systole
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10
Q

What are the 3 sub phases of systole?

A
  • Isovolumetric Contraction
  • Rapid Ejection
  • Slow Ejection
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11
Q

What is end-diastolic volume?

A

the volume of blood in the ventricles before contraction

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12
Q

What is end-systolic volume?

A

the volume of blood in the ventricles after contraction

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13
Q

What is stroke volume?

A

the volume of blood pumped from the left ventricle per beat

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14
Q

How is stroke volume calculated?

A

end-diastolic volume - end-systolic volume

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15
Q

What is ejection fraction?

A

k

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16
Q

How is ejection fraction calculated?

A

(100*stroke volume) / end-diastolic volume

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17
Q

What heart sound does atrial systole produce?

A

4th heart sound, but only abnormally - occurs w/ congestive heart failure, pulmonary embolism, tricuspid incompetence

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18
Q

What is isovolumetric contraction?

A

interval between AV valves closing and SL valves opening + contraction of ventricles with no change in volume

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19
Q

What signifies isovolumetric contraction on an ECG?

A

QRS complex

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20
Q

What heart sound does isovolumetric contraction produce?

A

1st heart sound (“lub”) - due to closing of AV valves and associated vibrations

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21
Q

What is rapid ejection?

A

ventricles contract pressure within them which exceeds pressure in aorta and pulmonary arteries + SL valves open, blood is pumped out and the volumes of ventricles decrease

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22
Q

What signifies rapid ejection on an ECG?

A

gap between QRS complex + start of T wave (opening of SL valves also marks start of this phase)

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23
Q

What heart sound does rapid ejection produce?

A

no heart sounds

24
Q

What is reduced ejection?

A
  • reduced pressure gradient means SL valves start closing
  • blood flow from ventricles decreases + ventricular volume decreases more slowly
  • as pressures in ventricles < arteries, blood begins to flow back causing SL valves close
25
Q

What is reduced ejection?

A
  • reduced pressure gradient means SL valves start closing
  • blood flow from ventricles decreases + ventricular volume decreases more slowly
  • as pressures in ventricles < arteries, blood begins to flow back causing SL valves close
26
Q

What does reduced ejection signify?

A

end of sytole

27
Q

What heart sound does reduced ejection produce?

A

no heart sounds

28
Q

What is isovolumetric relaxation?

A

SL valves CLOSE + atrial pressure continues to rise (AV valves only open when atrial pressure > ventricular pressure)

29
Q

What is the dichrotic notch?

A

an upstroke in aortic pressure when its descending - due to rebound pressure on the closed aortic valve as distended aortic wall relaxes

30
Q

What heart sound does isovolumetric relaxation produce?

A

2nd heart sound (“dub”) - due to SL valves closing + associated vibrations

31
Q

What is rapid passive filling?

A

AV valves open + blood rapidly flows from atria to ventricles

32
Q

What signifies rapid passive filling on an ECG?

A

occurs in the isoelectric (flat) part of ECG after T wave

33
Q

What heart sounds are heard with rapid passive filling?

A

3rd heart sound - usually abnormal + may signify turbulent ventricular filling

34
Q

What could cause an abnormal 3rd heart sound?

A

turbulent ventricular filling - could be caused by severe hypertension or mitral incompetence

35
Q

What is reduced passive filling?

A

ventricular volume fills more slowly, ventricles still fill considerably without contraction of atria

36
Q

What is reduced passive filling also called?

A

diastasis

37
Q

How does pressure compare from the right to the left of the heart?

A

can reach a max of 120mg in the left side, can reach a max of 25mg in the right

38
Q

How do patterns of pressure changes compare from the right to the left of the heart?

A

essentially identical

39
Q

How does stroke volume compare from the right to the left of the heart?

A

both eject same volume despite lower pressures in the right

40
Q

Why does the right ventricle pump the same amount of blood as the left?

A

pumps into a lower pressure circuit

41
Q

What is the pressure difference in the systemic circuit vs. pulmonary circuit?

A

systemic circuit - 120/80

pulmonary circuit - 25/5

42
Q

Describe a general pressure volume loop shape (from A to D).

A

From A, heads up to B, curves to the left to C, drops down to D

43
Q

What are graph axis and points ABCD for a general pressure volume loop?

A 
x-axis = left ventricular volume
y-axis = left ventricular pressure
A = end-diastolic volume
B = aortic pressure encountered
C = end-systolic pressure
44
Q

What determines the preload that stretches the resting ventricular muscle?

A

blood filling the ventricles during diastole

45
Q

What blood pressures represent afterload?

A

blood pressures in greater vessels (aorta + PA)

46
Q

What blood pressures represent afterload?

A

blood pressures in greater vessels (aorta + PA)

47
Q

How can stroke volume be measured using the pressure volume loop?

A

horizontal linear distance between lines AB + CD

48
Q

How does stroke volume change with preload?

A

increase in preload = increase in stroke volume

49
Q

How does stroke volume change with afterload?

A

increase in afterload = decreases in stroke volume

50
Q

How is cardiac output calculated?

A

cardiac output = heart rate x stroke volume

51
Q

What 3 factors affect stroke volume?

A

preload, afterload, contractility

52
Q

What is contractility?

A

contractile capability (strength of contraction) of the heart

53
Q

How is contractility measured simply?

A

ejection fraction

54
Q

How can contractility be increased?

A

sympathetic stimulation

55
Q

How does increase in contractility affect ESPVR lines?

A

ESPVR line gets steeper than normal

56
Q

How does decrease in contractility affect ESPVR lines?

A

ESPVR line gets less steep than normal

57
Q

How does sympathetic stimulation increase contractility?

A

phosphorylate the Ca entry channel and Ca release channel => more release + more force

BRS - Cardio (15 decks)

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