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ESA 2 > CVS 2.1 - The Heart as a Pump > Flashcards

CVS 2.1 - The Heart as a Pump Flashcards

1
Q

In which system of circulation is pressure high and in which is low? Why is this important?

A
  • Systemic circulation = high
  • Pulmonary circulation = low
  • Output must be equal
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2
Q

What is systole?

A

Contraction and ejection of blood from the ventricles

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3
Q

What is diastole?

A

Relaxation and filling of the ventricles

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4
Q

Describe the structure of cardiac muscle. How is its structure related to its function?

A
  • Distinct cells that are interconnected electrically

- Electrical signals can pass through freely so that beating can be synchronised

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5
Q

Describe the length of action potentials in cardiac muscle. What happens as a result of an action potential here?

A
  • AP = long and lasts for one contraction

- AP spreads from cell to cell which contract in response causing an increase in intracellular Ca2+

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6
Q

What is the function of valves in the heart?

A

Allow blood to flow in one direction by opening or closing depending on different pressures

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7
Q

Which valves separate atria from ventricles?

A
  • Tricuspid valve (right)

- Mitral valve (left)

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8
Q

Which valves lead to output vessels?

A
  • Pulmonary valve

- Aortic valve

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9
Q

Describe the pumping system of the heart

A

Two pumps acting in series

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10
Q

What is the function of the valve cusps?

A
  • Allow blood flow when pushed open

- Prevent back flow of blood when pushed closed

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11
Q

Where do the mitral and tricuspid valves attach? What is the function of this?

A
  • Chordae tendinae

- Attach to papillary muscles which prevent the inversion of valves during systole

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12
Q

How long does the AVN delay the action potential signal for?

A
  • ~120 ms
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13
Q

What are the stages of the cardiac cycle? (7)

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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14
Q

Describe the events of atrial contraction

A
  • Pressure increases in the atria due to contraction
  • Mitral and tricuspid valves are open
  • Aortic and pulmonary valves are closed
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15
Q

Which wave on the Wigger curve represents atrial contraction?

A

A wave

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16
Q

Which ECG wave represents atrial contraction?

A

P wave

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17
Q

What does atrial contraction result in? What does this mean?

A
  • End diastolic volume (~120ml)

- Maximum amount of blood the ventricles can hold

18
Q

Why does atrial contraction only provide the final 10-20% of blood to the ventricle?

A
  • Ventricles are already 80-90% full from the previous cardiac cycle
  • Ventricles passively fill with blood when the valves are open
19
Q

Describe the events of isovolumetric contraction

A
  • Ventricular contraction begins which increases pressure
  • Intraventricular pressure becomes HIGHER than aortic pressure
  • There is NO CHANGE in ventricular volume
20
Q

Describe the positions of the valves during isovolumetric contraction

A
  • Mitral and tricuspid valves = closed

- Pulmonary and Aortic valves = closed

21
Q

Which wave on the Wigger curve represents isovolumetric contraction?

A
  • C wave (closing of mitral valve)
22
Q

Which ECG wave represents isovolumetric contraction?

A

QRS complex

23
Q

Describe the events of rapid ejection

A
  • Begins when intraventricular pressure becomes HIGHER than aortic pressure
  • Rapid decrease in ventricular volumer as blood is pushed through to the aorta
  • Decrease in atrial pressure causes atria to be pushed down which also decreases ventricular volume
  • Blood is still flowing into atria from venous return
24
Q

Describe the position of the valves during rapid ejection

A
  • Mitral and tricuspid valves = closed

- Aortic and Pulmonary valves = open

25
Q

Which wave on the Wigger curve represents rapid ejection?

A
  • X descent
26
Q

Describe the events of reduced ejection

A
  • Repolarisation of ventricles = decreased tension

- Gradual increase in atrial pressure due to venous return

27
Q

Describe the position of the valves during reduced ejection

A
  • Mitral and Tricuspid = closed

- Aortic and Pulmonary = Open

28
Q

Which wave on the Wigger curve represents reduced ejection?

A

V Wave

29
Q

Which ECG wave represents reduced ejection?

A

T wave

30
Q

Describe the events of isovolumetric relaxation

A
  • Rapid decrease in ventricular pressure
  • Ventricular volume remains constant due to closed valves
  • Intraventricular pressure becomes LOWER than aortic pressure
  • Brief back flow of blood from aorta
31
Q

What does isovolumetric relaxation result in? What is this?

A
  • End Systolic Volume

- The volume of blood left in the ventricles

32
Q

Describe the position of the valves during isovolumetric relaxation

A
  • Mitral and Tricuspid = Closed

- Pulmonary and Aortic = Closed

33
Q

Define stroke volume. How is it calculated?

A
  • Amount of blood ejected in each cycle, from each ventricle

- End Diastolic Volume - End Systolic Volume

34
Q

Describe the events of rapid filling

A
  • Intraventricular pressure is LOWER than atrial pressure
  • Causes mitral valve to open which decreases atrial pressure
  • Volume in ventricle increases
35
Q

Describe the position of the valves during rapid filling

A
  • Mitral and Tricuspid valves = Open

- Pulmonary and Aortic valves = Closed

36
Q

Which curve on the Wigger graph represents rapid filling?

A

Y Curve

37
Q

Describe the events of reduced filling

A
  • Rate of ventricular filling slows (diastasis)

- Ventricle reaches relaxed volume

38
Q

Describe the position of the valves during reduced filling

A
  • Mitral and Tricuspid valves = Open

- Pulmonary and Aortic valves = Closed

39
Q

During which stages of the cardiac cycle can the S1, S2 and S3 sounds be heard respectively?

A
  • S1 = Isovolumetric Contraction (LUB sound)
  • S2 = Isovolumetric Relaxation (DUB sound)
  • S3 = Rapid Filling (Unusual. Common in children/pathology)
40
Q

What happens to make the S1 sound?

A

Closure of the mitral valve

41
Q

What happens to make the S2 sound?

A

Closure of the aortic valve

ESA 2 (63 decks)

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