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Cardiovascular > EXAM #1: CARDIAC CYCLE > Flashcards

EXAM #1: CARDIAC CYCLE Flashcards

1
Q

What is the first event in the cardiac cycle?

A

Atrial contraction

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2
Q

When does the second phase of the cardiac cycle start?

A

AV valves close

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3
Q

What is the second phase of the cardiac cycle?

A

Isovolumetric contraction

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4
Q

What is the third phase of the cardiac cycle?

A

Ventricular ejection

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5
Q

What marks the beginning of ventricular ejection?

A

Semilunar valve opening

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6
Q

What is the 4th phase of the cardiac cycle?

A

Isovolumetric relaxation

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7
Q

What marks the beginning of isovolumetric relaxation?

A

Aortic valve closes

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8
Q

What is the fifth phase of the cardiac cycle?

A

Rapid ventricular filling

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9
Q

What marks the beginning of rapid ventricular filling?

A

AV valve opening

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10
Q

What is the sixth phase of the cardiac cycle?

A

Diastasis

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11
Q

What does CVP stand for?

A

Central Venous Pressure

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12
Q

What are three common causes of increased CVP?

A

1) Heart Failure
2) Tricuspid valve disorder
3) Pulmonary arterial HTN

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13
Q

What is a common cause if tricuspid valve disorders?

A

CHF–dilation of the RV

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14
Q

What causes pulmonary arterial HTN?

A

1) Pulmonary vein HTN

2) Abnormalities in the pulmonary tree

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15
Q

Draw the normal jugular venous pressure waveform and label the distinct parts of the wave.

A

N/A

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16
Q

What does the “a” wave of the jugular venous pressure waveform represent?

A

Atrial systole

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17
Q

What does the “c” wave of the jugular venous pressure waveform represent?

A

Ventricular contraction and ballooning of the tricuspid valve into the RA

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18
Q

What does the “x” wave of the jugular venous pressure waveform represent?

A

Atrial relaXation and a fall in RA pressure

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19
Q

What does the “v” wave of the jugular venous pressure waveform represent?

A

Venous filling of the RA

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20
Q

What does the “y” wave of the jugular venous pressure waveform represent?

A

RA emptYing i.e. rapid ventricular filling

21
Q

What is the “h” wave of the jugular venous pressure waveform represent?

A

Continued filling of the RA during diastole

22
Q

What vessel should be cannulated for measurement of the jugular venous pressure/ CVP?

A

Right Internal Jugular

23
Q

What does a large “a” wave on the jugular venous pressure waveform represent?

A

Reduced RV compliance or elevated RV EDV i.e.

1) Tricuspid stenosis
2) Complete heart block

24
Q

What will cause the absence of the normal “x” wave on CVP monitoring?

A

Tricuspid regurgitation i.e. blood flowing back into the RA during ventricular systole

This can be caused by severe CHF

25
Q

What causes S1?

A

Closure of the AV valves (Lub)

26
Q

What causes S2?

A

Closure of the semilunar valves (Dub)

27
Q

What causes physiologic splitting of S2?

A

Respiration

*Inspiration causes pulmonary valve to say open longer b/c bigger EDV from decreases intrathoracic pressure

28
Q

How do you identify a widened splitting of S2?

A

Splitting is audible during expiration and widens during inspriation

29
Q

What causes a widened splitting of S2?

A

1) RBBB
- Delay in RV contraction
- Delay in pulmonic closure
2) COPD leading to straining of the RV
3) Pulmonic stenosis

30
Q

What is Fixed Splitting of S2?

A

Widened split of S2 that is CONSTANT with respiration

31
Q

What causes fixed fixed splitting of S2?

A

Atrial Septal Defect

*More blood is brought in but it is shunted to the LA via the septal defect

32
Q

What is Paradoxical Splitting of S2?

A

1) P2 component occurs before A2

2) Gets BETTER in inspiration

33
Q

What causes Paradoxical Splitting of S2?

A

1) LBBB

2) Aortic stenosis

34
Q

What is an “opening snap” associated with?

A

Mitral Valve Stenosis

  • Opening should be silent
  • Calcified/ stiffened–>a sharp-high pitched sound occurs
35
Q

When does the opening snap of mitral valve stenosis occur?

A

After the end of S2

36
Q

What is an S3?

A
  • Heart sound heard during rapid ventricular filling

- Caused by rapid flow of blood from the atria into the ventricles

37
Q

What causes an S3?

A
  • Normal in kids

- Adults= volume overload e.g. CHF

38
Q

What is S4?

A

Late diastolic sound, corresponds with atrial contraction

Occurs prior to S1**

39
Q

What causes S4?

A

Atrial contraction against a stiff (poorly compliant) LV e.g.

1) LVH
2) MI

40
Q

What is the mnemonic to remember the locations of the cardiac valves on auscultation of the chest?

A

“All Physicians Take Money”

A= Aortic
P= Pulmonary 
T= Tricuspid 
M= Mitral
41
Q

What are the three types of systolic murmurs?

A

1) Ejection
2) Pansystolic
3) Late systolic

42
Q

What are the ejection type mumurs?

A

1) Aortic stenosis

2) Pulmonic stenosis

43
Q

What are the pansystolic murmurs?

A

1) Mitral regurgitation
2) Tricuspid regurgitation
3) Ventricular Septal Defect

44
Q

What is the late systolic murmur?

A

Mitral valve prolapse

45
Q

What feature of aortic stenosis signifies severity?

A

Location of the peak

  • Early= mild
  • Late= severe
46
Q

What commonly causes mitral regurgitation?

A

Heart Failure

47
Q

Describe the intensity of mitral regurgitation.

A

Constant

48
Q

How is the murmur associated with aortic reguritation described?

A

Early decrescendo

49
Q

Where is aortic regurgitation best heard?

A

3rd or 4th left ICS

Think that the blood is going from the aorta back into the LV

Cardiovascular (38 decks)

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