Cardiac Output/SV/Valves

Question 1

at what part of the cardiac cycle is the heart filling & contracting?

Answer 1

preload

Question 2

what valves are open during preload? what valves are closed?

Answer 2

open: AV valves
- mitral
- tricuspid

closed: semilunar valves
- aortic
- pulmonic

Question 3

at what part of the cardiac cycle are the ventricles relaxed & the atria contracted? which valves are involved with the force of blood flow during this part of the cardiac cycle?

Answer 3

diastole

> Blood is forced through open mitral & tricuspid valves

Question 4

during systole, the ___ are relaxed as they fill with blood. the ___ & ___ valves are closed as ventricular pressure rises

Answer 4

atria

• mitral
• tricuspid

Question 5

after ventricular pressure rises, the ___ & ____ valves open and the ventricles contract, allowing blood to flow through the circulatory system

Answer 5

aortic

pulmonic

Question 6

S1 is the sound of the _____ valves closing.

Answer 6

AV valves: mitral & tricuspid

Question 7

blood pressure _____ when ventricles start to contract

Answer 7

rises

Question 8

cardiac output is the amount of ____ ____ ___in each ____ over 1 minute

Answer 8

blood pumped out

-ventricle

Question 9

the normal cardiac output in healthy people = ___ L/min

Answer 9

4 - 8

Question 10

cardiac output depends on ___ & ____

Answer 10

Heart rate (HR)
Stroke volume (SV)

Question 11

____ is what the heart can do above baseline

Answer 11

cardiac reserve

Question 12

in runners, their ____ is higher, allowing their heart to beat more effectively

Answer 12

cardiac reserve

Question 13

____ is the blood pumped out by a ____ with each beat

Answer 13

stroke volume

ventricle

Question 14

these factors affect stroke volume

Answer 14

• preload
• afterload
• contractility

Question 15

contractility is the ability of muscle cells to contract after _____

Answer 15

depolarization

Question 16

during ____, there is stretching of the muscle fibers in the _____ at the end of diastole

Answer 16

preload

-left ventricle

Question 17

EF < 40% is indicative of ___

Answer 17

systolic CHF

Question 18

if there is increased preload, the ____ ___ heart muscle will have better contractility (in a healthy pt), and there will more blood pumped into the _____

Answer 18

greater the

-aorta

Question 19

afterload is the amount of pressure in the LV that the heart must work against to pump blood to ___

Answer 19

the circulatory system

Question 20

patients w/ prolonged immobilization have poor venous return to the heart. this is influenced by ____ ______

Answer 20

venous pressure

Question 21

end diastolic volume (EDV) is the amount of blood in ___ during the end of diastole, also known as ___

Answer 21

ventricle

-preload

Question 22

end systolic volume is the amount of blood left in the ventricle _____ _____

Answer 22

after contraction

Question 23

____ increases afterload, increasing ESV, which increases the force of contraction

Answer 23

hypertension

Question 24

in patients with SVT, there is ___ ____ time, resulting in HR up to 150 bpm, thereby decreasing EDV and lowering _____ ____

Answer 24

less diastolic

-stroke volume

Question 25

a runner with a resting HR of 60 bpm likely has ____ ___

Answer 25

increased EDV

Question 26

stroke volume = ____ - ______

Answer 26

EDV - ESV

Question 27

in anaphylaxis, BP is lowered because of ____ __ ____

Answer 27

dilation of vessels

Question 28

what is ejection fraction?

Answer 28

the percentage of blood ejected from the ventricles with each beat

Question 29

____ heart failure is common in LVH

Answer 29

diastolic

Question 30

the fibrous ____ consists of _ interconnecting rings surrounded by connective tissue which is the insertion point for __ in the heart

Answer 30

skeleton - 4 - valves

Question 31

the ___ valves prevent backflow of blood from ventricles to atria during systole

Answer 31

AV ( atrioventricular )

Question 32

the __ ___ prevent AV valves from opening up & letting blood flow backwards. ___ ___ anchor them to the walls of the heart

Answer 32

chordae tendineae | -papillary muscles

Question 33

_____ ___ is what makes the mitral & tricuspid valves close in the ventricles

Answer 33

increased pressure

Question 34

____ blood flow is the force that makes the semilunar valves close at the end of ____ in the cardiac cycle

Answer 34

retrograde | -systole

Question 35

the ____ & ____ valves are open during ventricular | systole, closed during ventricular diastole

Answer 35

pulmonary | aortic

Question 36

the ____ valves have 3 cup-like cusps that are considered the "hidden sinuses of valsalva"

Answer 36

semilunar valves: aortic & pulmonary

Question 37

at the end of systole, the pressures in the ____ & ___ are higher than that in the ventricles

Answer 37

aorta | pulmonary trunk

Question 38

early diastole is when ____ pressure is low

Answer 38

ventricular

Question 39

when the valve is unable to fully open, this is called:

Answer 39

stenosis

Question 40

when the valve is unable to fully close, this is called ____

Answer 40

Insufficiency or regurgitation

Question 41

the sounds of S1 & S2 are produced by the:

Answer 41

* Vibration of valves immediately after closure | * Vibration of adjacent heart walls & major vessels

Question 42

A Widened S1 split occurring between M1 & T1 can be pathologic for:

Answer 42

stenosis

Question 43

A normal split S2 is when the tricuspid valve trails closure of the mitral valve slightly, which produces a softer sound. This can be caused by:

Answer 43

inspiration

Question 44

S3 is a weak ___ sound occasionally heard during middle third of diastole. This is represented: S1, S2, S3 / Ken-TUC-ky

Answer 44

rumbling

Question 45

S4 is the sound of active ventricular filling and the atria are contracting against __ ventricles to compensate. This is represented by S4, S1, S2 / Ten-nee-SEE

Answer 45

stiff

Question 46

S3 is the sound of ___ blood being dumped into the heart

Answer 46

extra | > like pouring water in a paper bag

Question 47

rheumatic fever typically affect the ___ or ___ valves. the most common bacteria to cause this is: ____.

Answer 47

-mitral -aortic > streptoccoccus

Question 48

why are rheumatic valve lesions an easily missed diagnosis?

Answer 48

due to over treating of Strep pharyngitis

Question 49

what is the physiological process involved in rheumatic valve lesions?

Answer 49

large hemorrhagic lesions eventually become scar tissue, permanently fusing portions of leaflets > eventually leads to stenosis & regurgitation

Question 50

what is the most frequent valve abnormality that can cause LVH?

Answer 50

aortic stenosis

Question 51

along with a harsh & loud systolic murmur heard against the aortic walls, what is another associated PE finding for aortic stenosis?

Answer 51

thrill

Question 52

in this ____ murmur, blood flows backward from high pressure aorta into low pressure L ventricle producing a high pitched “blowing" & swishing sound. this is due to: ______ ______

Answer 52

diastolic | -aortic regurgitation

Question 53

when is aortic regurgitation heard the best during the cardiac cycle & over what location on the precordium?

Answer 53

Loudest 1st 1/3 diastole | • Heard maximally over L ventricle

Question 54

Left ventricle with a stenosed ______ ____ has very little blood in it; therefore, no reverberation of blood occurs

Answer 54

mitral valve

Question 55

this valve abnormality produces a weak & low frequency murmur which may have an opening snap, heard after the first 1/3 of diastole

Answer 55

mitral stenosis

Question 56

mitral regurgitation is a common systolic murmur that produces a _____ ______ "blowing” & swishing sound

Answer 56

high frequency

Question 57

the sound produced by mitral regurgitation is due to blood flowing backwards through the mitral valve into the ____ _____ during systole

Answer 57

left atrium

Question 58

tricuspid regurgitation is most often caused by ___ ____ _____

Answer 58

right ventricular hypertrophy

Question 59

tricuspid regurgitation is a high pitched _____ murmur in which blood flows back in to the ___ ____ during ____ contraction

Answer 59

holosystolic - right atrium - right ventricular

Question 60

this loud, harsh midsystolic (ejection) murmur is due to ____ _____ on the right ventricle. It is most often found in ____ & considered congenital.

Answer 60

increased afterload | -kids

Question 61

a harsh, machine-like murmur heard continuously in systole & diastole is due to ___ ____ ____

Answer 61

patent ductus arteriosus

Question 62

patent ductus arteriosus is a ______ abnormality in which blood is shunted from the left side of the heart to the right side of the heart via the pulmonary trunk to the aorta

Answer 62

congenital

Question 63

____ ____ ___ is a congenital abnormality in which blood flows from high pressure LV into low pressure RV through defect

Answer 63

ventricular septal defect

Question 64

VSD is a loud _____ murmur often harsh & associated w/ a thrill. it is best heard in the L 3rd, 4th, and 5th ICS

Answer 64

holosystolic