Heart sounds & Blood flows

Question 1

what kind of sound does the heart make?

Answer 1

Lub-Dub

Question 2

S1

Answer 2

mitral and tricuspid closure (Lub)

• Marks the beginning of the systole (end of diastole)
• Loudest at the apex and lower left sternal border
• First sound can be heard easily with both the diaphragm and the bell

Question 3

S2

Answer 3

Aortic and pulmonary closure (DUB)

• Loudest at the base
• The diaphragm is invaluable

Question 4

S3

Answer 4

ABNORMAL
ventricular filling (relaxed)

• Heard in early diastole
• Generated when the ventricle is forced to dilate beyond its normal range
• Low frequency, use with the bell
• Congestive heart failure, most common cause of a S3

Question 5

S4

Answer 5

ABNORMAL
ventricular filling ( active)

• Low frequency sound in late diastole
• Caused by atrial kick into a non compliant ventricle
• Heard with the bell at the apex
• Seen with stiffened left ventricles

Question 6

Murmurs

Answer 6

generated by turbulent flow of blood

Question 7

Regurgitation

Answer 7

leaking heart valves

Question 8

Rubs

Answer 8

the pericardial friction rub can be heard in pericarditis, and inflammation of the pericardium

Question 9

Clicks

Answer 9

mitral stenosis, prolapse

Question 10

Stethoscope

Answer 10

Diaphragm: high frequency sound
Bell: low frequency sound (not easily be detected by the diaphragm)

Question 11

Local control of blood flow (intrinsic)

Answer 11

1. Active hyperemia
2. Reactive hyperemia

Question 12

Active hyperemia

Answer 12

• Increased local metabolism devours the nutrients (oxygen and glucose), causing the release of local vasodilators
• Local blood vessels dilate and flow increases

Question 13

Reactive hyperemia

Answer 13

• When the blood flow of tissue is blocked then the blood flow increase in response to the buildup of metabolic wastes
• Lasts long enough to “repay” oxygen debt
  - Resulting from the restoration of its temporarily
  blocked blood flow

Question 14

Systemic control of blood pressure

Answer 14

sense blood pressure and relay the information to the brain = proper blood pressure can be maintained

Question 15

Arterial baroreceptors

Answer 15

control the sympathetic drive to the heart and the peripheral blood vessels

Question 16

Negative feedback control of blood flow to tissues

Answer 16

Metabolism increases = waste production buildup

Question 17

why is autoregulation important?

Answer 17

critical in maintaining systemic blood pressure

Question 18

Skeletal muscle pump

Answer 18

During dynamic exercise, rhythmic contractions of the skeletal muscles squeeze venous blooc=d back toward the central circulation

Question 19

Controlling your blood pressure

Answer 19

Lifestyle changes:
- Don’t smoke
- Limit alcohol
- Manage stress

Question 20

Which of the following statements is true?

S1 sound during the closure of the mitral and tricuspid valve whereas S2 sounds produced due aortic and pulmonary valves

S1 sound during the closer of aortic and pulmonary valves whereas S2 sounds produce due to closure of the mitral and tricuspid valve

Answer 20

S1 sound during the closure of the mitral and tricuspid valve whereas S2 sounds produced due aortic and pulmonary valves

Question 21

Systolic murmur sound is produced due to______.

Failure of the mitral valve to close completely

Presence of opening between the left and right ventricle

Presence of patent ductus arteriosus

All the above

Answer 21

all the above

Question 22

Diastolic murmur sound is produced due to_____.

Aortic insufficiency

Mitral and tricuspid valves stenosis

Presence of patent ductus arteriosus

All the above

Only A and B

Answer 22

all the above

Question 23

Information about blood pressure is collected and sent to the brain by______.
Baroreceptors
Osmoreceptors
Endothelial cells
Chemoreceptors

Answer 23

Baroreceptors

Question 24

Which of the following would decrease mean arterial blood pressure?

Constriction of arterioles
Dilation of the arterioles
Increased blood volume
Increased peripheral resistance

Answer 24

Increased peripheral resistance

Question 25

If the blood pressure is elevated, the cardiovascular centers would compensate by

Increasing the heart rate
Sending sympathetic signals to the myocardial cells
Increasing cardiac output
Causing vasodilation

Answer 25

Causing vasodilation