CVS PHYSIOLOGY

Question 1

What is pulse

Answer 1

It is pressure wave originating in aorta due to ejection of blood during LV systole and travels along arterial wall at 5m/s

Question 2

Parameters of assess performance of LV

Answer 2

Stroke volume

Velocity of ejection

Question 3

Waves of pulse

Answer 3

Percussion wave
Anacrotic notch
Tidal wave
DN dicrotic notch
Dicrotic wave

Question 4

Wave representing
LV ejection
Aortic recoil
Peripheral resistance

Answer 4

P wave
T wave
D wave

Question 5

Artery where character and contour are best felt

Answer 5

Carotid

Question 6

Upstroke of pulse coincide with what in phonogram

Answer 6

S1 and peak occurs before S2

Question 7

Pulse wave velocity depends on

Answer 7

Stroke volume

Question 8

Importance of arterial stiffness

Answer 8

Reflect true arterial damage
Predictor of Cardiovascular status
Marker of early TOD
Best marker in HTN

Question 9

What happens to pulse wave in aged people

Answer 9

Stiffness of arterial wall reduces vessel wall cushioning so pulse wave velocity increases

Question 10

Difference between stiff and compliant vessel

Answer 10

Pulse wave velocity increases in stiff while decrease in compliant
Reflected wave will arrive early in stiff vessel and DBP will be low leading to decrease Coronary perfusion
Stiff vessel augments SBP

Question 11

Radio femoral delay is present in

Answer 11

Coarctation of aorta

Question 12

Change in pulse from central to periphery

Carotid to femoral

Answer 12

Upstroke becomes deeper
Anacrotic notch becomes less apparent
Dicrotic notch becomes smoother

Question 13

Sinus tachycardia is seen in

Answer 13

It is heart rate more than 100 
Seen in 
Sepsis 
Hypovolemia 
Myocarditis 
Cardiogenic shock (Ant wall MI) 
High output state

Question 14

Sinus bradycardia is seen in

Answer 14

Beta blocker
Myxedema 
Hypothermia
Increased ict
Inferior wall MI

Question 15

Faget sign

It is seen in

Answer 15

Relative bradycardia ie with rise in body temperature heart rate decreases
Causes
Typhoid, Legionella, Q fever, Scrub Typhus
Drug fever, Lymphoma

Question 16

Rapid regular pulse is seen in

Answer 16

Supraventricular & Ventricular tachycardia

Question 17

Irregularly irregular and Regularly irregular pulse can be seen in

Answer 17

Irregularly irregular - A fib, A flutter, A tachycardia

Regularly irregular- Ventricular premature complex

Question 18

High volume pulse is characterized by

Answer 18

Amplitude of upstroke high
Dicrotic wave less prominent
High CO
Low PR

Question 19

Example where high volume pulse with low cardiac output is seen

Answer 19

Complete heart block -SV increase but HR decrease

Elderly due to arterial stiffness

Question 20

Waterhammer pulse is defined as

It is seen in

Answer 20

Brish upstroke
Large amplitude 
Rapid descent
Seen in 
AR 
Aortic sinus rupture
PDA

Question 21

Pulsus tardus is seen in

Its mechanism

Answer 21

Severe AS
Upstroke slow, peak delay

Ejection velocity increased but volume doesn’t increase leading to decreased lateral pressure
Slow rise of wave

Question 22

2peak in systole is seen in

Answer 22

Pulsus bisferiens
Severe AR
AR with mild AS
HCM

Question 23

Pulsus parvus et tardus

Answer 23

Seen in very severe AS

LV failure low peak slow rise

Question 24

What is dicrotic pulse
Mechanism
Seen in

Answer 24

2 peaks one in systole and other in diastole
Increase peripheral resistance leading to prominent dicrotic pulse
Seen in
LV dysfunction, cardiac tamponade

Question 25

Mechanism of pulsus bisferiens in hypertrophy cardiomyopathy

Answer 25

Rapid rise of pulse due to hypercontracility of ventricle

Systolic anterior motion of mitral leaflet, obstruct ejection