Cardiac Cycle II Flashcards
what happens at the beginning of isometric relaxation
aortic/pulmonic valve closure
why does the Q wave dip downward
because the left side of the heart is depolarized first
when would you hear an accentuated S1
exercise, sympathetic stimulation, mild mitral stenosis
when would you hear a diminished S1
AV, high diastolic filling pressure (stiff ventricle), severe AV stenosis
during what action does physiological splitting of S2 occur
inspiration (pulmonic valve stays open longer)
what do you suspect if there is an audible separation during expiration that disappears during inspiration
(delay in aortic closure) left bundle branch block (LBB), advanced aortic stenosis
what is the name of the sound cause from the opening of the MV valve
opening snap
what is the name of the sound that may be heard during rapid filling of the ventricle
S3
what is the sound that may be heard from aortic stenosis or aortic dilation (just before S1)
ejection click
an incompetent valve is also known as
regurgitation
what events happen between S1 and S2? what murmurs?
- AV valves close (regurgitation)
- semilunar valves open (stenosis)
- blood may be shunted (ventricular septal defect)
what kind of shunt is a ventricular septal defect
left to right
aortic and pulmonic stenosis are what type of murmur
ejection ype
mitral/tricuspid regurgitation, ventricular septal defect is what type of murmur
pansystolic
a mitral valve prolapse is what kind of murmur
late systolic
what happens between S2 and S1? murmur?
- semilunar valves close (regurgitation)
- AV valves open (opening snap)
- blood moves across AV valve for diastolic filling (stenosis)
- ventricles fill with blood (S3)
- Atrial kick (S4)
aortic/pulmonic regurgitation is an example of what kind of murmur
early decrescendo
mild mitral or tricuspid stenosis an an example of what kind of murmur
mid-to-late
severe mitral or tricuspid stenosis is an example of what kind of murmur
prolonged mid-to-late
sound due to early diastolic fillling, may or may not be pathologic
S3
sound due to late diastolic filling, always pathologic
S4
what does a large gap in the systolic vs diastolic pressure indicate in aorta
aortic incompetence
taking a long time to reach high systolic pressure in aorta is indicative of
aortic stenosis
FOR JVP, what is the a wave
contraction of atria
For JVP, what is c wave
contraction of ventricle
In JVP, an elevated a wave, and slow y descent indicates
tricuspid stenosis
In JVP, an absent a wave is
atrial fibrillation
In JVP, a cannon A wave is indicative of
AV block
In JVP, a giant V and absent x is indicative of
tricupsid incompetence
Give an example of a chronotropic agent and explain what it does
NE-> B1 receptors. Increases Na entry to the cell and inccreases the phase 4 slope
Give an example of a negative chronotropic agent
Arch-> muscarinic receptors, increase potassium permeability. Phase 4 becomes less steep
What happens if you change the RMP
The 0 upstroke becomes less steep
The ______ _______ is always faster than the muscle
Intrinsic system
Atrial and ventricular myocardium has a _____ conduction velocity
Medium
Junctional tissue has a ______ conduction velocity
Slow
Purkinje fibers have a _______ conduction system
Fast
