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CVS > CVS 2 The Heart As A Pump > Flashcards

CVS 2 The Heart As A Pump Flashcards

1
Q

Name the valves on the left side of the heart

A

Mitral
Aortic

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2
Q

Name the valves on the right side of the heart

A

Tricuspid
Pulmonary

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3
Q

How to valves prevent back flow?

A

Valve cusps are pushed open (due to differential pressure) to allow blood flow and close to seal

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4
Q

What prevent inversion of tricuspid and mitral valves?

A

Papillary muscles via chordae tendineae

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5
Q

What valve has two leaflets?

A

Mitral

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6
Q

Stroke volume definition

A

Amount of blood pumped out per beat

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7
Q

Systole meaning

A

Contraction and ejection of blood from ventricles

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8
Q

Disastole meaning

A

Relaxation and filling of ventricles

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9
Q

What type of pressure is systemic circulation under?

A

High

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10
Q

What type of circulation is under high pressure?

A

Systemic

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11
Q

What type of pressure is pulmonary circulation under?

A

Low

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12
Q

What type of circulation is under low pressure?

A

Pulmonary

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13
Q

What do the papillary muscles and chordae tendineae do?

A

Attach to the mitral and tricuspid valve to prevent inversion in systole

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14
Q

Explain the process of conduction

A

1- pacemaker cells in the SAN generate action potential
2- atrial systole
3- AP reaches AVN along the bundle of His
4- AP delayed (~120 ms) to ensure atria have finished contracting
5- AP spreads down septum
6- spreads through ventricular myocardium from inner (endocardial) surface to outer (epicardial) surface
7- purkinje fibres causes ventricles to contract from apex up - ventricular systole

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15
Q

What are the 7 stages in the cardiac cycle?

A

1- atrial contraction
2- isovolumetric contraction
3- rapid ejection
4- reduced ejection
5- isovolumetric relaxation
6- rapid filling
7- reduced filling

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16
Q

What letters are used for ECG wave?

A

PQRST

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17
Q

What causes the P wave?

A

Atrial depolarisation

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18
Q

What causes the QRS wave?

A

Ventricular depolarisation

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19
Q

What causes the T wave?

A

Ventricular repolarization

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20
Q

What causes the first heart sound?

A

Closure of mitral and tricuspid valve

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21
Q

What causes the second heart sound?

A

Closure of aortic and pulmonary valves

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22
Q

What is ventricular filling making a sound a sign of?

A

Pathology in adults
Normal in children

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23
Q

Types of abnormal valve function

A

Stenosis
Regurgitation

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24
Q

What is valve stenosis?

A

Valve doesn’t open enough
Causes obstruction of blood when valves open

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25
Q

Causes of stenosis

A

Degenerative - calcification or fibrosis
Congenital - bicuspid form of valve
Chronic rheumatic fever > inflammation

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26
Q

Degenerative meaning

A

Progressive loss of function

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27
Q

Congenital meaning

A

From birth

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28
Q

Effects of aortic valve stenosis

A

Less blood can get through valve
- Increased LV pressure > LV hypertrophy
- Left sided heart failure > angina and syncope
- Shear stress > microangiopathic haemolytic anaemia

29
Q

Syncope meaning

A

Fainting

30
Q

What is the main cause of mitral valve stenosis?

A

Rheumatic fever

31
Q

Effects of mitral valve stenosis

A
  • increased LA pressure
  • pulmonary oedema, dyspnea and pulmonary hypertension leading to RV hypertrophy
  • LA dilation > atrial fibrillation > thrombus formation
  • LA dilation > oesophagus compression > dysphagia
32
Q

Dyspnea meaning

A

Laboured breathing

33
Q

Dysphagia meaning

A

Difficulty swallowing

34
Q

What is a pulmonary oedema?

A

Fluid accumulation in the air spaces and parenchyma (tissue) of the lungs

35
Q

What is valve regurgitation?

A

Valve doesn’t close all the way
Causes back leakage

36
Q

Causes of aortic valve regurgitation

A
  • aortic root dilation - leaflets pulled apart
  • valvular damage
37
Q

Effects of aortic valve regurgitation

A
  • blood flows back into LV in systole
  • increased stroke volume
  • increased systolic pressure
  • decreased diastolic pressure
  • bounding pulse > Quinke’s sign
  • LV hypertrophy
38
Q

What is Quinke’s sign?

A

Capillary pulsations upon light compression to tip of fingernail

39
Q

Causes of mitral valve regurgitation

A
  • myxomatous degeneration > weakens tissue > prolapses of mitral valve
  • damaged papillary muscles due to heart attack
  • left heart failure > LV dilation > stretched valve
  • rheumatic fever > leaflet fibrosis > disrupts seal formation
40
Q

Myoxmatous degeneration meaning

A

Deterioration of connective tissue

41
Q

Effects of mitral valve regurgitation

A

Blood leaks back > increased pre load > LV hypertrophy

42
Q

Describe the pathway blood takes from the vena cava to the aorta

A

1- deoxygenated blood enters right atrium through superior and inferior vena cava
2- tricuspid valve opens
3- blood fills right ventricle
4- pulmonary valve opens
5- blood leaves via pulmonary artery to lungs
6- oxygenated blood enters left atrium through pulmonary vein
7- mitral valve opens
8- blood fills right ventricle
9- aortic valve opens
10- oxygenated blood leaves through aorta to the body

43
Q

What causes the dicrotic notch?

A

Aortic valve closes
Short period of increased pressure

44
Q

What is the approximate stroke volume?

A

70 ml blood per beat

45
Q

Valve positions of atrial contraction

A

MT open
AP closed

46
Q

Valve positions of isovolumetric contraction

A

MT closed
AP closed

47
Q

Valve positions of rapid ejection

A

MT closed
AP open

48
Q

Valve positions of reduced ejection

A

MT closed
AP open

49
Q

Valve positions of isovolumetric relaxation

A

MT closed
AP closed

50
Q

Valve position of rapid filling

A

MT open
AP closed

51
Q

Valve positions of reduced filling

A

MT open
AP closed

52
Q

How long does systole occur for?

A

~0.35 s

53
Q

How long does diastole occur for?

A

~ 0.55 s

54
Q

What is the dicrotic notch a marker of?

A

End of systole
Start of diastole
In arteries

55
Q

Main cause of mitral valve stenosis

A

Rheumatic fever

56
Q

How is electrical activity in the heart initiated?

A

Spontaneous depolarisation

57
Q

What is heard with an aortic valve stenosis?

A

Crescendo descrescendo murmur

58
Q

What is heard in aortic valve regurgitation?

A

Early decrescendo diastolic murmur

59
Q

What is heard in mitral valve regurgitation?

A

Holosystolic murmur

60
Q

What is heard in mitral valve stenosis?

A

Snap as valve opens
Diastolic rumble

61
Q

What chamber of the heart can cause dysphagia and how?

A

Left atrium
Can compress the oesophagus can dilated

62
Q

Auscultations of the heart valves

A

Apt. M #2245

  • Aortic - right side 2nd intercostal space on sternal edge
  • Pulmonary - left side 2nd intercostal space on sternal edge
  • Tricupsid - left side 4th intercostal space on lower sternal border
  • Mitral - left side 5th intercostal space in midcalvicular line
63
Q

What sided heart murmurs are louder in inspiration?

A

RILE

Right - Inspiration

64
Q

What sided heart murmurs are louder in expiration?

A

RILE

Left - Expiration

65
Q

Where can the aortic valve be auscultated?

A

Apt. M #2245

Right side
2nd intercostal space on sternal edge

66
Q

Where can the pulmonary valve be auscultated?

A

Apt. M #2245

Left side
2nd intercostal space on sternal edge

67
Q

Where can the tricupsid valve be auscultated?

A

Apt. M #2245

Left side
4th intercostal space
On lower left sternal border

68
Q

Where can the mitral valve be auscultated?

A

Apt. M #2245

Left side
5th intercostal space
In midclavicular line

CVS (20 decks)

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