CARDIO

Question 1

Pulmonary Circulation Loop

Answer 1

A wave of blood is pumped from the right ventricle to the lungs and follows the lowest pressure back to the left atrium

Question 2

Simplified Congestive Heart Failure, or just “heart failure”

Answer 2

Left Ventricle can’t pump blood out, and it gets backed up.
Since the left ventricle receives blood from the lungs, that blood gets backed up in the lungs.
Plasma leaks out and fills the lungs.

Question 3

Lub

Answer 3

Mitral (Left A to V)
and Tricuspid (Right A to V)
Valves closing, as a result of ventricular contraction (systole)

Question 4

Dub

Answer 4

Aortic and Pulmonary semilunar valves closing at the start of diastole

Question 5

Diastolic pressure

Answer 5

pressure in ARTERIES when the ventricles are relaxed

Question 6

Which valves are open the longest?

Answer 6

AV - Tricuspid and Mitral, filling ventricles, during diastole

Question 7

Which valves make the first heart sound?

Answer 7

Closure of Tricuspid and Mitral AV valves - during Isovolumetric contraction - ventricles contracting forces AV valves to shut

Question 8

Which valves make the second heart sound?

Answer 8

Closure of Pulmonary and Aortic valves - once ventricles have ejected blood through them and pressure is higher in arteries than ventricles - valves snap shut.

Question 9

Do the pulmonary and aortic valves close during systole or diastole?

Answer 9

P and A valves snap shut once blood has been ejected from the ventricles through the pulmonary artery and aorta - causing back pressure in the arteries to snap the vales shut. So - the beginning of diastole.

Question 10

Isometric Pressure - Volume Relationship

Answer 10

Fill the left ventricle to a higher volume (increase preload) , it generates more pressure to empty with more force

*Starling length-tension law!

Question 11

4 Etiologies of Systolic Left Heart Failure

Answer 11

1. Inappropriately high workload
   * (HTN and lots of other stuff)
2. Restricted ability of heart to fill
   * (Pericardial disease, mitral stenosis, fibrotic disease)
3. Loss of heart muscle cells
   * (cells died in heart attack)
4. Poor ability of myocytes to contract
   * (poisons, infections, genetic mutations of myocyte proteins)

Question 12

Things that make the left ventricle work too hard

Answer 12

1. Pushing against too much pressure
   * HTN
   * Aortic Stenosis - pumped through smaller opening
   * Asymmetric Septal Hypertrophy
2. Valves that regurgitate - some blood gets diverted back into atrium when ventricle contracts, so it’s lost to systemic circulation
   * Mitral Regurge
   * Aortic Regurge

Question 13

How does systolic Left Heart Dysfunction affect the pressure-volume line?

Answer 13

Weakened heart muscles, harder to squeeze blood out, stroke volume reduced

Shifts RIGHT - because ventricles are RELAXING TOO SOON
goes from volume range of 50-100ml to 75-100ml

Question 14

3 ways the heart attempts to fix the right-shift Left Heart Dysfunction

Answer 14

1. Increase LV volume via LV hypertrophy
2. Improve contractility via catecholamines
3. Increase preload

Question 15

What compensation might make the right-shifted pressure-volume line move back to the left (in Left Systolic HF)?

Answer 15

Improved contractility (via catecholamines)

Question 16

How might increased LV volume change the pressure-volume graph?

Answer 16

Push it even further right, so that volumes range from 75-125

Question 17

Diastolic Left Heart Failure affects the pressure-volume line:

Answer 17

LEFT, UPWARD SHIFT

leads to an elevated end-diastolic ventricular pressure and reduced stroke volume

Can’t handle as much volume, so it fills less and pumps sooner

Question 18

Causes of Diastolic Left Heart Failure

Answer 18

• Often as a result of ventricular hypertrophy from systolic LHF

1. ischemic / infarcted tissue
2. stiff, fibrotic, hypertrophic ventricles with less compliance

Question 19

Accounts for 75% of all cardiovascular deaths

Answer 19

Atherosclerosis