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Cardiopulmonary Exam 1 > Cardiac Cycle: Major events with ECG, Valves, and heart sounds > Flashcards

Cardiac Cycle: Major events with ECG, Valves, and heart sounds Flashcards

1
Q

Atrial Systole

Major events, EKG, Valves, Heart sounds

A 
Atrial contraction (P waves) 
final phase of ventricular filling (PR interval)

Mitral valve open

Fourth sound of the heart

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2
Q

Isovolumertric Ventricular Contraction

Major events, EKG, Valves, Heart sounds

A

Ventricles contract (QRS complex)
Ventricular pressure increases
Ventricular volume is isovolumetric

mitral valve closes

first heart sound

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3
Q

Rapid Ventricular Ejection

Major events, EKG, Valves, Heart sounds

A

Ventricles contract
Ventricular pressure reaches maximum
Blood is ejected from ventricle into pulmonary trunk
Ventricular volume decreases but AORTIC pressure increases and reaches maximum

ST segment

Aortic valves close!

no heart sound

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4
Q

Reduced Ventricular Ejection

Major events, EKG, Valves, Heart sounds

A

Slow rate of ventricular blood ejection in arteries
Ventricular volume reaches minimum
Aortic pressure starts to fall as blood runs off into arteries

T wave

no valve/heart sounds

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5
Q

Isovolumetric Ventricular relaxation

Major events, EKG, Valves, Heart sounds

A

Ventricles relaxed
Ventricular pressure decreases
Ventricular volume is constant

Aortic valves closes

second heart sound

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6
Q

Rapid Ventricular Filling

Major events, EKG, Valves, Heart sounds

A

Ventricles relaxed
Ventricles fill passively with blood from atria
Ventricular volume increases
Ventricular pressure low and constant

mitral valve opens, third heart sound

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7
Q

Reduced Ventricular Filling, or Diastasis

Major events, EKG, Valves, Heart sounds

A

Ventricles relaxed

Final phase of ventricular filling

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8
Q

What pressure does the L and R ventricle have to reach before valves will open?

A

Normal is 120/70

normal pulmonary a. is 25/15

ventricular pressure must exceed the diastolic pressure on each side to open the valve (above 70 and 15)

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9
Q

what happens when the aortic and pulmonic valve exceed the pressure in the ventricles?

A

their respective valves close

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10
Q

what is the second heart sound associated with?

A

the closing of the pulmonary and aortic valves when the blood “backflows” off the valves

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11
Q

where and what is the “diacrotic notch”

A

this is the point on the cardiac pressure cycle where the aortic valve closes, and aortic pressure curve diverges from the ventricular pressure curve. the left atrial pressure curve also wriggles here as well.

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12
Q

Where is the second heart sound?

A

at the diacrotic notch on the cardiac diagram

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13
Q

Isometric contraction/isometric relaxation

A

isometric contraction occurs when the mitral valves close and the aortic valves aren not yet thrust open

isometric relaxtion occurs when the the aortic valve subsequently closes and the valves are not yet thrust
open

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14
Q

What pressure does the L and R ventricle have to be at for the blood to enter from the atria?

A

atria both have 15/4 systole-diastole
R. Ven: 25/0 systole-diastole
L. Ven 120/0

ventricular pressures have to be lower than other pressure during diastole for blood to move from high to low pressure

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15
Q

third heart sound

A

occurs during the rapid filling period of the ventricles

may be heard in children but not adults

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16
Q

Peripheral Run Off

A

this is when the aortic pressure curve drops during the rapid filling phase in the ventricles. it occurs because blood from the aorta is pushed into peripheral tissues from the arteries

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17
Q

what determines peripheral run off

A

resistance to blood flow

18
Q

a wave

A

jugular pressure

a wave is the pressure wave created by atrial contraction. because there is no valve between the atria and the great vessels, the pressure is reflected backward.

19
Q

c wave

A

jugular pressure

is the pressure wave created by the periodic isovolumetric contraction in the ventricles- there is bulging of the wall back into the atria

20
Q

v wave

A

jugular pressure

pressure wave created as blood returns back to the heart but cant enter the ventricle

21
Q

4th heart sound

A

heard during atrial contraction

it is the result of the last little bit of blood being squeezed into the ventricle

like the third heart sound, heard in children but not adults

22
Q

1st, 2nd, 3rd, and fourth heart sounds: where and what

A

1st: when blood rushes against closed AV valves
2nd: when blood rushes against closed aortic/pulmonic v
3rd: when blood is running into the ventricles
4th: atrial contraction

23
Q

murmur is heard when either

A

blood is moving in a direction it shouldnt be moving or when blood is having a hard time moving in the right direction

24
Q

A systolic murmur is heard when….

A

either blood is moving BACK into the atria causing by mitral regurgitation

OR

blood can’t get into the aorta or pulmonary a due to stenosis of the valve

25
Q

A diastolic murmur is heard when….

A

blood is moving back into the aorta or pulmonary artery caused by aortic regurgitation

OR

blood cant get into the ventricle due to stenosis

26
Q

PR interval depends on ___ and can be altered by

A

mainly how long AP takes to travel through AV node

can be altered by ischemia or infarction
structural defect
autonomic stimulation
drugs altering conduction

27
Q

QRS Interval and Complex

what does the normal QRS signify and how is it altered

A

normal QRS indicates an AP traveling through the purkinje fibers and normal path through myocaridum

can be altered if signal doesn’t originate in the AV
ischemia or infarction
hypertrophy: thicker wall, dilated ventricle

28
Q

QT INTERVAL

A

Dependent on phase 2 plateau

Can be altered by 
heart rate 
Drugs 
timed K channels function alteration
Ca channel function alternation
29
Q

ST is an “ “ line

A

isoelectric line

if it differs from the “baseline”, it’s actually the baseline which has been shifted making the ST appear depressed or elevated

30
Q

Ischemia

A

an ischemic region of the heart will remain depolarized in phase 4

the extracellular tissue is less positive than on the other side of the heart

31
Q

an electrode facing the ischemic ventricle will register a

A

negative potential voltage during phase 4

32
Q

During the ST segment, the voltage an ischemic heart will appear

A

positive, interpreted as an elevated ST

33
Q

A patient will have an -_______ - ST line during exercise

A

depressed

34
Q

A patient will have an - ________ - ST line after a mycardial infarction

A

elevated

35
Q

T wave is altered by

A

electrolyte disturbance, drugs, altered depolarization sequence

36
Q

Sinus or Supraventricular Arrhythmia

A

depolarization initiated above ventricles
originating in SA, AV nodes, or atrial muscle

since it triggers AP through bundle of HIS, QRS is normal. may be short or longer than normal

37
Q

Bradyarrhythmia

A

3rd degree AV block

slow AV nodal firing known as sick sinus syndrome if symptomatic

can be sometimes caused by atrial fibrillation or flutter

normal QRS

38
Q

SSS

A

Slow SA nodal firing: sick sinus syndrome, 3rd degree bradyarrhythmia

can be sometimes caused by atrial fibrillation or flutter

normal QRS

39
Q

a slower than normal phase 4 depolarization of SA node indicates

A

bradyarrythemia

40
Q

after ischemia, an electrode will still pick up a negative signal during phase 4: why is that?

A

part of the ischemic tissue has not fully repolarized, so there will still be a differential

Cardiopulmonary Exam 1 (21 decks)

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