chapter 23, heart valves and heart sounds, valvular and congenital defects

Question 1

duration of first and second heart sound

Answer 1

first- .14, second-.11

Question 2

third heart sound

Answer 2

heard at the beginning of the middle third of diastole ( it may be the oscillation of blood back and forth between the walls of the ventricles initiated by inrushing blood from the atria)

Question 3

4th heart sound

Answer 3

when atria contract which causes the inrush of blood into the ventrilces.

Question 4

auscultation

Answer 4

listening to sounds with stethascope

Question 5

phonocardiogram

Answer 5

microphone specially designed to detect low frequency sounds

Question 6

what causes the greatest number of valvular lesion?

Answer 6

rheumatic fever ( from streptococci A)

Question 7

why does rheumatic fever affect the left heart valves more?

Answer 7

the high-pressure stresses that act on them

Question 8

what is a stenoses

Answer 8

valves with leaflets adhering to each other and blood cannot flow through them properly

Question 9

regurgitation

Answer 9

when valve edges are destroyed and dont close all the way. ( backflow)

Question 10

Systolic murmur of aortic stenosis

Answer 10

blood pressure rises in the left ventricle as much as 300 mm Hg. This creates a nozzle effect during systole which causes severe turbulance from the ventricle into the aorta. The sound vibrations can often be felt by the lower neck and upper chest. This is called a “thrill”

Question 11

Diastolic murmur of aortic regurgitation

Answer 11

this results a turbulence of blood rushing back into the ventricle during diastole

Question 12

systolic murmur of mitral regurgitation

Answer 12

blood flows back into the left atrium during systole.

Question 13

name the pneumonic for the detecting wich valve is effected

Answer 13

all people try meat. ( going from right to left)

Question 14

diastolic murmur of mitral stenosis

Answer 14

during the first 1/3 no murmur may be heard since there is not enought blood in the ventricle to really make any noise. After partial filling the ventricle has enough blood to produce low rumbling murmurs

Question 15

which murmurs are loudest and quietest?

Answer 15

loudest is aortic stenotic lesions, quietist are mitral stenotic lesions

Question 16

which murmurs occur only during systole?

Answer 16

aortic stenosis, and mitral regurgitation

Question 17

which murmurs occur only during dyastole?

Answer 17

aortic regurgitation and mitral stenosis

Question 18

how is the net stroke volume reduced in regards to murmurs?

Answer 18

aortic stenosis doesnt allow the ventricles to completely empty, Aortic regurgitation allows what was pumped to go back to the ventricle

Question 19

what does aortic stenosis and aortic regurgitation do to the left ventricle?

Answer 19

causes hypertrophy

Question 20

since there is less stroke volume the body the arterial pressue does this

Answer 20

decreases

Question 21

with a decrease in arterial pressure, the body does what to elevate the pressure?

Answer 21

slows down renal output causing the blood to increase and returning the pressure back to normal

Question 22

how does an increase in atrial pressure cause atrial fibrillation?

Answer 22

the stretched atria increase the distance the electrical impulses have to travel. This eventually can cause fibrillation

Question 23

name 1 abnormal circulatory dynamic in congenital heart defects

Answer 23

stenosis of the channel of blood flow at some point in the heart or in a closely allied major blood vessel

Question 24

name 1 abnormal circulatory dynamic in congenital heart defects

Answer 24

a left to right shunt, failing to pass to the systemic circulation ( blood going the wrong direction)

Question 25

name 1 abnormal circulatory dynamic in congenital heart defects

Answer 25

a right to left shunt failing to pass through the lungs

Question 26

name a left to right shunt

Answer 26

patent ductus arteriosus ( a left to right shunt)

Question 27

what affects does the patent ductus arteriosus cause?

Answer 27

decreased cardiac reserve, and respiratory reserve

Question 28

what was one of the first successful heart surgeries?

Answer 28

closing the patent ductus arteriosus

Question 29

Whats a tetrology of fallot?

Answer 29

most common cause of blue baby. This condition causes 4 conditions simultaneously and causes a right to left shunt

Question 30

name the 4 conditions in tetrology of fallot

Answer 30

1. Aorta originates from right venticle /or there is a hole in the ventricular septum. 2. pulmonary artery is stenosed( most of the blood passes through the hole in the septum and goes through the aorta. 3. blood flows either through the septal hole into the right ventricle and into the aorta( if the aorta is switched) or it mixes with the blood and goes through the aorta. 4. right ventricle hypertrophies because of the high pressure from the stenosis.

Question 31

how to diagnose tetralogy of fallot ( 4 ways)

Answer 31

1.skin is cyanotic( blue), 2. measurment of high systolic pressure in the right ventricle. 3. radiograph with large right ventcile, 4. angiograms showing irregular blood flow via septal hole

Question 32

whats one of the most common causes of congenital heart defects?

Answer 32

viral infection in the mother during the first trimester of pregnancy