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Cardiovascular 4 > Cardiac Cycle/Murmurs > Flashcards

Cardiac Cycle/Murmurs Flashcards

1
Q

During which phase (systole or diastole) are the AV valves closed to prevent the backflow of blood?

A

systole

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2
Q

True or False: AV valves open and close passively are are wimpy like Brainy from Hey Arnold.

A

True.

breathes breathes breathes

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3
Q

True or False: the papillary muscles help the AV valves close via the chordae tendinae.

A

FALSE. The AV valves are passive.

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4
Q

So what’s the fxn of the papillary muscles?

A

They pull the vanes of the valves inwards towards the ventricles to prevent their buldging too far backward into the atria.

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5
Q

What % of blood flows into the ventricles PASSIVELY from the atria?

A

80%

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6
Q

What causes the additional 20% of the ejected blood to flow from the atria to the ventricles?

A

atrial contraction

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7
Q

Rapid ventricular filling (passively) occurs how long in the filling phase?

A

first 1/3

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8
Q

What causes the “a” wave on the atrial pressures?

A

“a”trial contraction

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9
Q

What causes the “c” wave on the atrial pressures?

A

‘c”losure of the AV valves

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10
Q

What causes the “v” wave on the atrial pressures?

A

“v”entricular contraction

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11
Q

This is the period where the ventricles are actively contracting but there is no ejection.

A

Isovolumetric contraction

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12
Q

After the ventricles get a pressure higher than the aorta, blood is squirted into the aorta, leading to this phase.

A

Rapid ejection phase.

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13
Q

After the blood is squirted itno the aorta, the pressures are higher than the LV, closing the aortic valve, and leading to this phase of the cardiac cycle.

A

Isovolumetric relaxation

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14
Q

What causes the S1?

A

Closure of the AV valves

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15
Q

What electrical disordere can cause S1 to split?

A

RBBB

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16
Q

Conditions that shorten the PR interval (MS, high CO or tachycardia) can cause which one: accentuated or reduced S1?

A

Accentuated

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17
Q

Which conditions can prolong the PR interval, causing a reduced S1 sound?

A

1st degree AV block, MR, MS, stiff LV

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18
Q

What causes the late pulmonic closure to cause the splitting of S2?

A

expansion of the chest during inspiration creates a negative pressure in the chest –> increased capacitance of the pulmonary vessels –> delay in diastolic back pressure onto pulomary valve –> P2 delayed

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19
Q

What causes the early atrial valve closure to cause the splitting of S2?

A

increased capacity of intrahtoracic veins from neg pressure –> reduced venous return to LA and LV –> reduced LV filling –> shortened LV filling –> early A2 during inspiration

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20
Q

The intensity of S2 depends on what factor of the blood?

A

velocity

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21
Q

RBBB or PS can cause what abnormal splitting of S2?

A

Widened splitting

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22
Q

ASD can cause what abnormal splitting of S2?

A

Fixed splitting

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23
Q

LBBB or AS can cause what abnormal splitting of S2?

A

Paradoxical splitting

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24
Q

Where in the the cardiac cycle is S3 found?

A

Early diastole

“Ken——tuck–y”

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25
Q

Is S3 sharp or dull?

A

dull

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26
Q

What causes S3?

A

tensing of the chordae tendineae during rapid filling and expansion of the ventricle.

like plucking a guitar string… bongggggg

27
Q

True or False: S3 is normal in kids and young adults cuz the ventricle is supple and capable of rapid expansion.

A

True

28
Q

Contraction of the atria against a stiffened ventricle can cause what heart sound?

A

S4

29
Q

Where in diastole does S4 occur?

A

Late diastole

30
Q

What are the characteristics of a 1/6 grade murmur?

A

barely audible

31
Q

What are the characteristics of a 2/6 grade murmur?

A

faint but immediately audible

32
Q

What are the characteristics of a 3/6 grade murmur?

A

easily heard

33
Q

What are the characteristics of a 4/6 grade murmur?

A

easily heard with palpable thrill

34
Q

What are the characteristics of a 5/6 grade murmur?

A

very loud with stethoscope light on chest

35
Q

What are the characteristics of a 6/6 grade murmur?

A

audible without the stethoscope on the chest

36
Q

What are the 3 ways to decrease the preload to the heart?

A

valsalva, sitting–>stranding, amyl nitrate

37
Q

What are the 5 ways to increase the preload to the heart?

A

standing–>squatting, passive leg elevation, Muller, isometric hand grip, vasopressors

38
Q

What are the 3 systolic ejection murmurs?

A
  1. aortic/pulmonary stenosis
  2. HCM
  3. innocent murmurs
39
Q

Where is the radiation in AS?

A

carotids

40
Q

Does HCM murmurs get louder or quieter if you decrease preload?

A

Louder

41
Q

Why are innocent murmurs “innocent?”

A

theyre just high-flow states like youth, pregnancy, fever, anemia, hyperthyroidism, etc.

42
Q

What are the 3 pansystolic murmurs?

A
  1. MR
  2. TR
  3. VSD
43
Q

Any murmur on the R side of the heart gets louder or softer during inspiration?

A

Louder

44
Q

Do pansystolic murmurs change the intensity throughout S1-S2 or remain the same?

A

remain the same

45
Q

Does MR get louder when u increase or decrease preload?

A

Increase

46
Q

What is the sign called of TR where it gets louder during inspiration?

A

Carvallos sign

47
Q

What is the triad for severe TR?

A

carvallos sign, pulsatile JVD, and pulsatile liver

48
Q

Where is VSD best heard?

A

4-6th L intercostals

49
Q

Does VSD increase with inspiration?

A

No

50
Q

What is the 1 mid-to-late systolic murmur?

A

MVP

51
Q

What causes MVP?

A

Bowing of abnormally redundant and elongated valve leaflets into the left atrium.

52
Q

What happens mid-systolic which is indicative of MVP?

A

click

53
Q

What are the 2 EARLY diastolic murmurs?

A

AR and PR

54
Q

What is the shape of AR?

A

Decrescendo after A2

55
Q

This is an assocation with AR that may happed due to high flow across the aortic valve.

A

Systolic ejection murmur

56
Q

This is an assocaition with AR that is a diastolic rumble from a functional MS.

A

Austin Flint murmurs

most likely a test question lol. there were like 5 slides just on this 1 thing.

57
Q

This is a sign of AR where theres a systolic murmur over femoral artery when steth is compressed proximally and a diastolic murmur when compressed distally.

A

Duroziez sign

58
Q

What is the main cause of PR?

A

pulmonary arterial HTN

59
Q

This is a type of murmur in PR from pulmonary HTN and has a loud component of S2.

A

Graham steel murmur

60
Q

This is the cause of PR when u hear an afterpulmonic component of S2 with a crescendo-decrescendo pattern.

A

Deformity in the pulmonic valve.

61
Q

What are the 2 mid-to-late diastolic murmurs?

A
  1. AV valve stenosis

2. increased flow across the AV valves

62
Q

What happens after S2 in MS? give me the shape of the murmur

A

opening snap –> fade down –> re-appears when atria contract before S1

63
Q

What is MS almost always a sequela of?

A

rheumatic fever

Cardiovascular 4 (9 decks)

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