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Kaplan Physio: Cardiovascular > Cardiac Cycle and Valvular Heart Disease > Flashcards

Cardiac Cycle and Valvular Heart Disease Flashcards

1
Q

In young healthy individuals is atrial contraction a significant source of ventricular filling?

A

no

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2
Q

When is atrial contraction a significant source of ventricular filling?

A

when ventricular filling is reduced because of reduced compliance

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3
Q

What is the S1 sound produced by? (sound associated with it)

A

the “lub” sound

closure of mitral and tricuspid valves

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4
Q

What is the S2 sound produced by? (also sound associated with it)

A

the “dub” sound
closure of the aortic(A2) and pulmonic sounds (P2 component)

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5
Q

What is physiological splitting of S2?

A

during inspiration due to increased output of rt heart physiological splitting in which the pulmonic valve closes later than the aortic valve occurs

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6
Q

What is a widened split?

A

Upon inspiration, the natural physiological split, or delay in pulmonic valve closure is even more delayed

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7
Q

Meaning of a widened split?

A

pulmonic stenosis

right bundle branch block

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8
Q

What is a fixed split?

A

When you hear S2 split both upon inspiration and expiration

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9
Q

Meaning of a fixed split?

A

ASD; L-R shunt

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10
Q

What is paradoxical splitting?

A

When the pulmonary valve closes before the aortic valve; you are technically hearing P2 close first even though it has a natural delay so P2 upon inspiration gets closer to timing for aortic valve to close and now you hear 1 sound

You are hearing the aortic valve close later instead of sooner

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11
Q

What is the meaning of paradoxical splitting?

A

left bundle branch block

advanced aortic stenosis

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12
Q

What is the S3 sound?

A

It occurs just after the opening of the AV valves during rapid filling of the ventricle

Usually produced by expansion compliant ventricle

normal in children

in older adults signifies volume overload

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13
Q

What is S4 sound?

A

coincides with atrial contraction; is produced when atrium contracts against a stiff ventricle

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14
Q

What are examples of when you hear an S4 sound?

A

concentric hypertrophy, aortic stenosis, and myocardial infarction

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15
Q

Where is the aortic auscultation point?

A

second intercostal space on rt side, and mid-clavicular line

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16
Q

What is the pulmonic ausculatation point?

A

second intercostal space on the left side, about mid-clavicular line

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17
Q

What is the tricuspid auscultation point?

A

fifth ICS just at left sternal border

18
Q

Where is the mitral ausculation point?

A

sixth ICS on the left side, about mid-clavicular line

19
Q

Which venous wave has the highest deflection of the venous pulse and is produced by contraction of the right atrium?

A

a wave

20
Q

What is the c wave of the venous pulse curve caused by mainly? What event does it begin at?

A

due to bulging of the tricuspid valve into the atrium (rise in atrial pressure)

occurs near beginning of ventricular contraction

21
Q

What is x descent produced by on venous pulse curve?

A

produced by a decreasing atrial pressure during atrial relaxation

22
Q

What is the v wave?

A

produced by filling of the atrium during ventricular systole when the tricuspid valve is closed

23
Q

What is y descent?

A

produced by the rapid emptying of the right atrium immediate after the opening of tricuspid valve

24
Q

Describe what each venous pressure curve represents and why?

A

From top to bottom:

A Normal
B A fib
C tricuspid regurgitation
D tricuspid stenosis

25
Q

Formula for stroke volume

A

Stroke volume = end-diastolic volume – end-systolic volume

26
Q

If increased contractility is the only variable that changes in a pressure volume loop; where will the loop shift?

A

to the left

27
Q

What falls during excercise? preload, ESV, peak systolic pressure, or SV?

A

ESV

28
Q

A stenotic valve is a resistor and therefore when can you hear the mumur?

A

when valve is open

29
Q

A regurgitant valve allows back-flow of blood. When can you hear this type of murmur?

A

when the valve is normally closed

30
Q

What type of murmur would you hear for aortic stenosis?

A

crescendo decrescendo

31
Q

What valvular conditions is being seen here?

A

aortic stenosis

32
Q

What valvular condition is being seen here?

A

aortic stenosis

33
Q

What valvular condition is being seen here?

A

aortic regurgitation

retrograde flow from aorta to left ventricle produces a low aortic diastolic pressure

large aortic PP

34
Q

What is being seen here?

A

Aortic regurgitation (insufficiency)

all volumes are increased (SV, ESV, EDV) though end diastolic pressure pretty much the same (eccentric hypertrophy)

No true isovolumetric relaxation

35
Q

A short S2: OS (opening snap) interval is a reliable indicator of what valvular condition?

A

severe mitral stenosis

36
Q

If you hear a click instead of an opening snap? What valvular condition may this indicate?

A

MVP

37
Q

What condition can be seen here?

A

mitral stenosis

elevated atrial pressure and volume

38
Q

What condition can be seen here?

A

mitral stenosis

39
Q

What condition is being seen here? What type of murmur would you hear?

A

mitral insufficiency regurgitation

atrial volumes and pressures are increased
ventricular volumes and pressure are increased during diastole

pansystolic or holosystolic murmer

40
Q

What condition is being seen here?

A

mitral insufficiency regurgitation

no true isovolumetric contraction

ventricular volumes are pressures are increased during diastole

41
Q

What condition is being seen here?

A

mitral insufficiency regurgitation

no true isovolumetric contraction

ventricular volumes are pressures are increased during diastole

Kaplan Physio: Cardiovascular (5 decks)

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