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Physiology I > Exam #2: Cardiac Cycle > Flashcards

Exam #2: Cardiac Cycle Flashcards

1
Q

During ventricular diastole, what is the state of the AV and SL valves?

A

AV valves are open and SL valves are closed

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2
Q

During ventricular systole, what is the state of the AV and SL valves?

A

AV valves are closed and SL valves are open

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3
Q

During ventricular diastole, within what part of the heart is pressure greatest and what does this mean for the state of the AV valves?

A

Atrial pressure is greater than ventricular pressure

  • AV valves are open
  • Blood is flowing from atria to ventricles
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4
Q

During ventricular systole, within what part of the heart is pressure greatest and what does this mean for the state of the AV valves?

A

Ventricular pressure is greater than atrial pressure

- AV valves are closed

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5
Q

During ventricular diastole, within what part of the heart is pressure greatest and what does this mean for the state of the SL valves?

A

Vessel pressure is greater than ventricular pressure

- SL valves are closed

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6
Q

During ventricular systole, within what part of the heart is pressure greatest and what does this mean for the state of the SL valves?

A

Ventricular pressure is greater than vessel pressure

  • SL valves are open
  • Blood flows from ventricles to rest of body
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7
Q

What are the seven phases of the cardiac cycle?

A 
A. Atrial systole
B. Isovolumic ventricular contraction
C. Rapid ventricular ejection
D. Reduced ventricular ejection
E. Isovolumic ventricular relaxation
F. Rapid ventricular filling
G. Reduced ventricular filling
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8
Q

With atrial systole (phase A), which valves are open or closed?

A
  • AV valves open

- SL valves closed

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9
Q

What EKG wave, heart sound and jugular pulse wave are seen during atrial systole (phase A)?

A
  • P wave on EKG
  • S4 heart sound
  • A-wave of jugular pulse
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10
Q

How and when does MOST of the ventricular filling occur? What percentage of filling does atrial contraction account for?

A

MOST of ventricular filling occurs passively before atrial contraction
- Only 25% of atrial contraction accounts for ventricular filling at rest (40% during exercise)

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11
Q

When are ventricular blood volumes maximal during the cardiac cycle? What is this called?

A 
Atrial systole (phase A)
- End-Diastolic Volume (EDV)
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12
Q

With isovolumic ventricular contraction (phase B), which valves are open or closed?

A

ALL valves closed

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13
Q

What heart sound and jugular pulse wave are seen during isovolumic ventricular contraction (phase B)?

A
  • S1 heart sound (LUB)

- C-wave of jugular pulse

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14
Q

What heart sound is the “lub”, and with which phase does it occur? What creates the sound (think valves)?

A

S1 heart sound during isovolumic ventricular contraction (phase B)
- Due to closing of AV valves

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15
Q

With rapid ventricular ejection (phase C), which valves are open or closed?

A
  • SL valves open

- AV valves closed

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16
Q

During which phase is during maximal outflow velocity reached?

A

Rapid ventricular ejection (phase C)

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17
Q

When do the atria begin to refill with deoxygenated blood from the body via the vena cava?

A

Rapid ventricular ejection (phase C)

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18
Q

With reduced ventricular ejection (phase D), which valves are open or closed?

A
  • SL valves still open

- AV valves remain closed

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19
Q

What EKG wave is seen during reduced ventricular ejection (phase D)?

A

T wave

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20
Q

During which two phases is there essentially a “delay” of activity within the ventricles? Describe this delay in each.

A
  • Reduced ventricular ejection (phase D): delayed ventricular pressure decreasing - ventricular pressure decreases BUT SL valves are still open as blood is ejected to body due to inertial energy
  • Reduced ventricular filling (phase G): delayed ventricular pressure increasing - as ventricles continue to passively fill with blood from atria, they become less compliant and ventricular pressure increases BUT AV valve is still open to allow continued filling
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21
Q

With isovolumic ventricular relaxation (phase E), which valves are open or closed?

A

ALL valves closed

22
Q

What heart sound is heard during isovolumic ventricular relaxation (phase E)?

A

S2 heart sound (DUB)

23
Q

What is the blood volume during isovolumic ventricular relaxation (phase E)? What is this called?

A

ESV = ~50 mL (blood volume is at its lowest)

24
Q

What heart sound is the “dub”, and with which phase does it occur? What creates the sound (think valves)?

A

S2 heart sound during isovolumic ventricular relaxation (phase E)
- Due to closing of SL valves

25
Q

With rapid ventricular filling (phase F), which valves are open or closed?

A
  • AV valves open

- SL valves closed

26
Q

What heart sound and jugular pulse wave are seen during rapid ventricular filling (phase F)?

A
  • S3 heart sound

- V-wave of jugular pulse

27
Q

With reduced ventricular filling (phase G), which valves are open or closed?

A
  • AV valves still open

- SL valves remain closed

28
Q

What is the longest phase of the cardiac cycle?

A

Reduced ventricular filling (phase G)

29
Q

How does an increase in HR affect reduced ventricular filling (phase G)?

A

Increase in HR, decreases time available for this phase (Phase G)
- This in turn reduces/eliminates ventricular filling = reduced preload and stroke volume

30
Q

What is stroke volume?

A

Volume of blood ejected with one ventricular contraction

31
Q

How do you calculate stroke volume (SV)?

A

SV = EDV - ESV

32
Q

What is ejection fraction?

A

Effectiveness of ventricles in ejecting blood

33
Q

What does ejection fraction indicate?

A

Contractility

34
Q

How do you calculate ejection fraction (EF)?

A

EF = SV/EDV x 100%

35
Q

What is cardiac output?

A

Total volume of blood ejected per unit time

36
Q

How do you calculate cardiac output (CO)?

A

CO = HR x SV

37
Q

What is cardiac index?

A

CO normalized for body surface area

38
Q

How do you calculate cardiac index (CI)?

A

CI = CO/SA

39
Q

What does an S3 heart sound indicate?

A

Rapid ventricular filling

40
Q

What is the S2 “physiological Split”?

A

A2 (aortic valve closing) then S2 (pulmonary valve closing)

41
Q

How does inspiration affect the S2 split?

A

Inspiration increases A2-P2 split (makes it wider)

42
Q

How does expiration affect the S2 split?

A

Expiration decreases A2-P2 split (makes it narrower)

43
Q

What does a widened S2 split indicate in terms of ventricular function?

A

Delayed right ventricular emptying

44
Q

What are three examples of potential causes for a widened S2 split?

A
  • Pulmonic stenosis
  • RV failure
  • RBBB
45
Q

What are two examples of potential causes for a narrowed S2 split?

A
  • Aortic stenosis

- LBBB

46
Q

What is a paradoxical S2 split?

A

S2 then A2

- Ex. Severe aortic stenosis

47
Q

What is a systolic murmur associated with? When does a systolic murmur occur?

A

Systolic murmur: associated with ejection of blood through damaged valves during ventricular systole (contraction)
- Occurs after S1

48
Q

What is a Mid-Systolic murmur due to?

A

SL valve stenosis

49
Q

What is a Holosystolic murmur due to?

A

AV valve regurgitation

50
Q

What is a diastolic murmur associated with? When does a diastolic murmur occur?

A

Diastolic murmur: associated with valvular issues during ventricular diastole (relaxation/filling)
- Occurs after S2

51
Q

What is a Diastolic murmur due to?

A

AV valve stenosis

52
Q

What is a Delayed Diastolic murmur due to?

A

SL valve regurgitation

Physiology I (9 decks)

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