Cardio 1.1

Question 1

Where do we find valvule mitrale?

Answer 1

Valvule mitrale = left side
coming from lungs into the left ventricle befofe being expulsed into the aorta

Question 2

Where do we find valvule tricuspide?

Answer 2

On the right
this is where all the blood from the vena cava comes from

Question 3

Systole vs Diastole?

Answer 3

Systole (contraction) auriculaire
Collection of blood from the lungs in the atrium before contracting to send to ventricle
The ventricle fills passively. This contraction only does 15%

Systole (contraction) ventriculaire
Diastole (relaxation) ventriculaire

Question 5

True or False,

There is no loss in volume during Systole ventriculaire stage 1.

Answer 5

TRUE

Volume does not change because at this point the mitral valve and aortic valve are closed untin a certain pressure is achieved

Question 6

When does the aortic valve open?

Answer 6

It only opens once the pressure in the left ventricle passes the pressure in the aortic valve

Question 7

What are the 2nd and 3rd phases of systole ventriculaire?

Answer 7

Ejection rapide

And

Ejection lente

Question 8

When does the mitral valve open?

Answer 8

During diastole ventriculaire

When the pressure in the left ventricle has reached a lower pressure than that of the left atrium the mitral valve will open to allow for the blood from the lungs to come in.

Question 9

PVC?

Answer 9

Pression veineuse centrale

Pressure that we can measure in the juggular vein in a patient

Question 10

PVC (pression veinesue centrale) different Stages

Answer 10

Onde A: contraction auriculaire
Onde C: contraction ventriculaire avec élévation des valves AV
**Descente x: ** éjection
ventriculaire avec dépression
des valves AV
Onde V: Remplissage auriculaire
Descente y: Vidange auriculaire
et Remplissage ventriculaire

Question 11

Coeur droit vs. coeur gauche cycle cardiac?

Answer 11

Cycle cardiaque identique avec pression systolique plus basse
pour le coeur droite!!

Question 12

Bruits cardiaques

Answer 12

We can only hear the closure of the valves

B1: Fermeture des valves AV (mitrale et tricuspide)

**B2: ** Fermeture des valves semi-lunaires (aortique et pulmonaire

En conditions normales, seuls B1 et B2 sont audibles chez l’adulte

Question 13

Points to hear cardiac noises

Answer 13

Foyer mitral: 5e espace
intercostal, ligne mid-claviculaire
Foyer tricuspide: 5e espace
intercostal, parasternal gauche

Foyer aortique: 2e espace intercostal, parasternal droit
Foyer pulmonaire: 2e espace intercostal, parasternal gauche

Question 14

What is Débit cardiaque (Q)?

Answer 14

Volume d’éjection (VE)
x
Fréquence cardiaque (FC)

L/Minute

Question 15

True or False,

The Debit cardiac of the left heart is larger due to its relation to systemic circulaiton

Answer 15

FALSE

En situation normale:
Débit cardiaque systémique (Qs) =
Débit cardiaque pulmonaire (Qp)

Question 16

What determines Stroke Volume (volume d’ejection)?

Answer 16

– Précharge (preload) –remplissage ventriculaire
– Post-charge (afterload) – résistance vasculaire
– Contractilité – inotropie

Question 17

ESV
vs
EDV

Answer 17

ESV: “end-systolic volume”
EDV: “end-diastolic volume”

Question 18

Review on Page 44, 45

Go to page and walk through the two diagrams

Answer 18

**Left side: **
The figure on the right shows four steps of the cardiac cycle.
the first step involves the filling of the left ventricle with blood from the lungs coming through the mitral valve the second step represents the closure of the mitral valve followed by a contraction of the left ventricle without the opening of the mitral or aortic valves
once the pressure in the left ventricle has reached thought of the aorta the aortic valve opening will occur which leads to the quick ejection of the blood from the left ventricle into the aorta this is represented by phase C once the pressure from The ventricle is reduced due to the relaxation of The ventricle muscle the aortic valve is closed and we have a relaxation of the left ventricle this relaxation allows the mitral valve to open and for the cycle to Begin Again by filling the left ventricle with blood coming from the mitral valve

**Right Side: **
This graph represents the change in pressure in the left ventricle as a function of the volume in the left ventricle as the volume increases during the filling stage from the mitral valve the pressure only increases a little bit as we go from ESV to edv once the pressure has reached a certain amount in the LV the mitral valve will close and so begins left ventricle contraction followed by aortic valve opening followed by a reduction in blood volume until we get 2.3 which is the aortic valve closing and the ISO volumetric relaxation of the left ventricle muscle

Question 19

What happens to the ejection volume if we decrease the preload volume?

Answer 19

It also decreases ->Débit cardiaque systémique (Qs) =
Débit cardiaque pulmonaire (Qp**)

Loi de Frank-Starling

Question 20

Comment augmenter la précharge?

Answer 20

Augmentation du volume sanguin circulant
(e.g. augmentation de l’apport hydrosodé)

– Vasoconstriction veineuse (e.g. pharmacologique)

Avec certains limites

Question 21

What is postcharge?

Answer 21

The resistance towards which the ventricle must contract to eject the blood
+- La pression arterielle

The resistance against which the LV must contract in order to achieve enough pressure to open the aortic valve

Question 22

What does an increased post charge lead to and why?

Answer 22

post charge = the pressure in the aorta holding the aortic valves closed -> hypertension for example

An increased post charge (due to an increased aortic pressure) will lead to reduced ejection volume (p48)

Question 23

What is a reduction in inotropy and what does it lead to?

Answer 23

Inotropy (ions) it has to do with the contraction of the muscle

This leads to a reduction in contraction of the LV which of course leads to reduced ejection volume

Question 24

Travail cardiaque

What it is and what increases it. Why is it bad? What is the best way to

Answer 24

travail cardiaque par battement est estimé par la surface de la courbe de pression-volume

’augmentation de la précharge, postcharge et contractilité augmente le travail cardiaque et la consommation d’oxygène

that means that to do the same work, the heart must produce more oxygen = bad

best way to decrease it while helping a patient is by reducing the afterload i.e the hypertension

A lower afterload means more ejected volume with less cardiac strain!

Question 25

Ejection fraction?

Answer 25

La fraction d’éjection (FE) =
volume d’éjection systolic (LVD - LVS; resting state volume - after contraction volume) ÷ volume télédiastolique (LVD; total volume at rest)

Essentially it is the amount of blood that leaves the heart after each beat

usually around 67% (this means that around 33% stays in the heart)

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