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Physiology I Block 4 > Heart Valves and Heart Sounds; Valvular and Congenital Heart Defects > Flashcards

Heart Valves and Heart Sounds; Valvular and Congenital Heart Defects Flashcards

1
Q

lub is

A

first heart sound

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2
Q

dub is

A

second heart sound

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3
Q

the sound itself we are hearing is not valve closing, it is

A

the tissue vibrations that result from the valve closing

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4
Q

first heart sound associated with what closing

A

AV valves closing

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5
Q

AV valves close start

A

systole

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6
Q

second heart sound associated with what closing

A

Semilunar valves

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7
Q

semilunar valves close start

A

diastole

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8
Q

sometimes pulmonary valve closes later than

A

tricuspid valve- this is normal

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9
Q

right bundle branch block, which ventricle contract first

A

left

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10
Q

right bundle branch block can cause splitting of

A

S2 sound

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11
Q

4th heart sound indicates

A

stiff ventricle

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12
Q

3rd heart sound is associated with

A

heart failure

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13
Q

draw out areas of auscultation

A

pg 3

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14
Q

murmur in aotic area you would still hear

A

in other areas - it is just loudest over area you are listening to

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15
Q

most common causes of valvular defects is:

A

rheumatic valve injury

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16
Q

rhematic valve injury can be caused by

A

rheumatic fever, strep throat

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17
Q

rheumatic fever usually occurs about 2-4 weeks after

A

strep throat

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18
Q

rheumatic fever is autimmune disease in which

A

autoimmune against self, including heart valves, heart valves can be damaged

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19
Q

scarring of valves can be caused due to

A

rheumatic fever

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20
Q

which valves are particulary at danger to scarring from for example rheumatic fever

A

mitral valve & aortic valve

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21
Q

why are mitral valve & aortic valve morelikely to be damaged by rheumatic fever

A

they are under higher pressure

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22
Q

stenosis:

A

valve is narrowed b/c of the scarring

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23
Q

what can happen from scarring

A

narrowing of valve

valve doesn’t close all the way

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24
Q

when valve doesn’t close all the way what can happen

A

regurgitation

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25
Q

stenosis:

A

Murmur occurs when valve is open due to high velocity blood flow causing turbulence

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26
Q

what is murmur

A

rumbling (like when water goes over rocks)

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27
Q

any time blood flow in body is turbulent, you’ll hear

A

murmur

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28
Q

stenosis valves cause murmur b/c

A

have same amount of blood going through normal vavle vs. narrowed valve, the high velocity of blood flow in narrow valve causes turbulence

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29
Q

anytime a stenosed valve is open you will hear a

A

murmur

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30
Q

a reguritant valve:

A

doesn’t close properly and blood goes backwards

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31
Q

anytime blood goes backwards you will hear a

A

murmur

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32
Q

regurgitation occurs when valve is

A

clsoed

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33
Q

insufficiency or regurgitation:

A

Murmur occurs when valve is closed because of backward moving blood causing turbulence

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34
Q

what kind of murmurs are there

A

systolic or diastolic

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35
Q

aortic valve, during systole blood is

A

ejected out of aortic valve

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36
Q

if aortic valve is stenosed, what murmur?

A

systolic

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37
Q

if aortic vavle doesn’t closed properly, what murmur?

A

diastolic, b/c it doesn’t close properly

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38
Q

mitral vs. tricuspid murmus, which more common?

A

mitral

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39
Q

mitral valve open during

A

diastole (ventricles filling)

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40
Q

if mitral valve stenosed when open during ____ hear murmur

A

diastole

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41
Q

mitral valve diastole murmur will be very

A

faint, hard to hear

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42
Q

if mitral valve is regurgitatnt, during

A

systole

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43
Q

heart contracting, mitral regurgitation, what kind of murmur

A

systolic murmur

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44
Q

mitral regurigtation will cause what kind of murmur

A

systolic

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45
Q

aortic regurgitation

A

heart contracts, blood comes back in when heart relaxes

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46
Q

what kind of murmur with aortic regurgitation

A

diastolic

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47
Q

what are some causes of aortic regurgitation

A

congenital (two instead of three valve cusps)
syphilis infection, marfan syndeom
valvular deterioration due to infective endocarditis

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48
Q

infective endocarditis, can cause aortic regurgitation, describe

A

especially bacterial
all blood vessels are coverd with endothelial cells, bacterial infections can cause infection of inner lining of heart and vavles, can cause growth on valves which can make the valves regurgitate

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49
Q

what happens to ventricular filing with aortic regurgitation

A

more blood in ventricle, b/c blood going backward and forwards, will stretch the heart

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50
Q

what happens to preload in aortic regurgitation

A

increase

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51
Q

what happens to left atrial pressure in aortic regurgitation

A

increases - increase amount of blood so right heart is pumping fine, blood builds up in left, pressure just gets higher and higher

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52
Q

what happens to stroke volume in aortic regurgitation

A

increase

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53
Q

what happens to systolic aortic pressure in aortic regurgitation

A

increase a lot

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54
Q

what happens to diastolic aortic pressure in aortic regurgitation

A

decreases

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55
Q

what happens to pulse pressure in aortic regurgitation

A

very strong

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56
Q

diastolic murmur and normal pulse, what might it be

A

pulmonary regurgitation

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57
Q

what happens to right atrial pressure in aortic regurgitation

A

normal

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58
Q

what can cause aortic stenosis

A

congenital
acquired like rheumatic heart disease
calcification of valves - idiopathic

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59
Q

in aortic stenosis each time heart contracts blood is being ejected out of

A

smaller than normal hole

60
Q

during systole what happens in aortic stenosis

A

very turbulent

61
Q

during diastole in aortic stenosis what happens

A

everything is fine

62
Q

during aortic stenosis what kind of murmur

A

systolic

63
Q

what happens to afterload in aortic stenosis

A

increases a lot

64
Q

what happens to left ventricular pressure in aortic stenosis

A

increase, it has to pump much higher to pump same amount of blood

65
Q

what happens to aortic pressure in aortic stenosis

A

normal or even less than normal, b/c less blood is being pumped out of the valve

66
Q

in aortic stenosis does heart empty completely

A

no, a lot of blood left in it

67
Q

what happens to ventricular filling in aortic stenosis

A

increased, heart will be stretched b/c lo tof blood left over

68
Q

what happens to preload in aortic stenosis

A

increase

69
Q

what happens to left atrial pressure in aortic stenosis

A

increase

70
Q

what happens to stroke volume in aortic stenosis

A

decrease

71
Q

what happens to pulse pressure in aortic stenosis

A

weaker than normal, b/c stroke volume is much less

72
Q

put probe into left ventricle what happens in aortic stenosis

A

pressures go to 200 from 0, that’s a lot

73
Q

put probe in left atria what happens in aortic stenosis

A

pressures go to 70 or 80

74
Q

what happens to systolic aortic pressure in aortic stenosis

A

decrease

75
Q

what happens to diastolic aortic pressure in aortic stenosis

A

decrease

76
Q

during systole in mitral regurgitation what happens

A

blood goes out at aorta, significant percentage goes backwards back into atria

77
Q

any time there is enlarged ventricle, what does it do to valves

A

can cause valves to stretch

78
Q

heart muscle grows, what doesn’t

A

valves, if they stretch they will be pulled apart

79
Q

if there is problem with papillary muscle, what can happen

A

when heart contracts the valve bulges up into atria and get regurgitation

80
Q

mitral regurgitation is what kind of murmur

A

systolic

81
Q

aortic regurgitation what will you hear during diastole

A

blowing - don’t hear individual heart sounds

82
Q

what happens to atrial pressure in mitral regurgitation

A

increase

83
Q

if left side pumps 5 L /min and right side pumps 5.5 L /min what happens

A

pressure and filling will increase on left side until it can put enough blood in the ventricle to match what the right side is pumping

84
Q

what happens to ventricular filling in mitral regurgitation

A

increase

85
Q

hat happens to preload in mitral regurgitation

A

increase

86
Q

what happens to stroke volume in mitral regurgitation

A

usually doesn’t change dramatically

87
Q

what happens to systolic aortic pressure in mitral regurgitation

A

small decrease

88
Q

why doesn’t stroke volume change much in mitral regurgitation

A

put a lot more blood in so even though some is going backwards, enough will go forwards

89
Q

what happens to diastolic aortic pressure in mitral regurgitation

A

small decrease

90
Q

mitral stenosis almost always results from

A

rheumatic fever

91
Q

what happens to left atria pressure in mitral stenosis

A

increase

92
Q

left side failure causes what kind of problems

A

pulmonary

93
Q

right side failure causes what kind of problems

A

peripheral problems

94
Q

review mitral stenosis

A

pg 17

95
Q

pressure overloads on heart lead to

A

concentric hypertrophy

96
Q

what does concentric hypertrophy mean

A

heart muscle gets bigger

97
Q

voume overload of heart cause

A

eccentric hypertrophy

98
Q

what does eccentric hypertrophy mean

A

chamber size is bigger so more volume can fit

99
Q

heart tissue doesn’t

A

proliferate

100
Q

how does heart tissue grow

A

can put more sarcomeres in, it can’t proliferate

101
Q

heart disease causes increase in blood volume in heart due to

A

renal retentino of fluid

102
Q

when muscle hypertrophy, blood supply to them doesn’t usually

A

match up with the increase in tissue

103
Q

failure of the left ventricle causes the development of

A

pulmonary edema

104
Q

one of the main causes of atrial fibrillation is

A

enlarged atria

105
Q

what are the dyamics of mitral stenosis and mitral regurgitation

A

Pulmonary Edema in Mitral Valvular Disease
Enlarged Left Atrium and Atrial Fibrillation
Compensation in Early Mitral Valvular Disease

106
Q

what is the compensation in early mitral valvular disease

A

increase in blood volume

increase in pulmonary artery pressure leading to right side failure

107
Q

patent ductus arteriosus is a ____ to _____ shunt

A

left to right

108
Q

tetralogy of fallot is a ____ to _____ shunt

A

right to left

109
Q

patent ductus arteriosus is a ____ defect

A

congenital

110
Q

tetralogy of fallot is a ______ defect

A

congenital

111
Q

besides shunts, what is the other major type of congenital anamoly

A

stenosis of channel

112
Q

left to right shunt means blood flows from

A

left side of heart or aorta to the right side of th eheart failing to flow through systemic circulation

113
Q

left to right shunt, basically what is the main issue

A

goes back to lungs and not back to the body

114
Q

what has superoxygenated blood

A

left to right shunt

115
Q

right to left shunt, blood flows from

A

right side of heart into left side of heart, failing to flow through the lungs

116
Q

what doesn’t have oxygenated blood

A

right to left shunt

117
Q

right to left shunt, what is the main issue

A

blood isn’t getting oxygenated

118
Q

what happens during fetal life in regards to lungs

A

lungs collapse - baby gets oxygen from mother

119
Q

resistance to blood flow in lungs is very

A

high

120
Q

ductus arteriosus

A

allows baby to get oxygenated blood to body from mom, oxygenated through placenta

121
Q

when baby is born, what is supposed to ductus arteriosus

A

lungs open up, right heart contracts and blood goes through pulmonary arteries to lungs, the ductus arteriosus is supposed to close

122
Q

how long does it take for ductus arteriosus to close

A

hours to days

123
Q

patent ductus arteriosus, what happens

A

pressure in aorta is high, pressure in pulmonary arteries is much lower, when heart contracts and blood ejected out aorta, it wants to go through the ductus arteriosus b/c of the low pressure (low resistance) to go through lungs

124
Q

why is patent ductus arteriosus a problem

A

can get 4x as much blood going through lungs as going to periphery, so blood to periphery decreased
diminished cardiac and respiratory reserve

125
Q

what kind of murmur in ductus arteriosus

A

never stops making sound, but louder in systole than diastole (machinery murmur)

126
Q

as children age, if patent ductus arteriosus doesn’t close what happens to it

A

it is going to get bigger and bigger and bigger

127
Q

diminished cardiac and respiratory reserve in patent ductus arteriosus, describe

A

putting 3-4x the blood throuugh lungs, right atrial pressure and preload

128
Q

what happens to left atrial pressure and preload on heart with patent ductus arteriosus

A

a lot more blood (up to 4x as much) going back to the right side, causes the left atria and ventricles to enlarge

129
Q

Stroke volume in left side during patent ductus arteriosus

A

higher

130
Q

diastolic pressure in left side in patent ductus arteriosus

A

much lower

131
Q

what does PDA stand for

A

patent ductus arteriosus

132
Q

pulse in child with PDA, strong or weak

A

stronger

133
Q

why is pulse strong in child with PDA?

A

systolic pressure is stronger, diastolic pressure is weaker

134
Q

how does person with PDA die?

A

ventricle will just keep enlarge, there is a limit to how big it can get.
atria pressure keep increasing on left side. this will cause problem in lungs
fluid in lungs, pulmonary congestion, pulmonary edema

135
Q

most common cause of blue babies

A

Tetralogy of Fallot

136
Q

ventricular septal defect is found in

A

Tetralogy of Fallot

137
Q

the aortic blood in Tetralogy of Fallot is mainly

A

unoxygenated venous blood

138
Q

in Tetralogy of Fallot aorta receives blood from

A

both ventricles

139
Q

what happens to pulmonary artery in Tetralogy of Fallot

A

stenosis

140
Q

stenosis of pulmonary artery in Tetralogy of Fallot means that

A

much lower than normal amounts of lbood pass from right ventricle into lungs

141
Q

septal defect in Tetralogy of Fallot means

A

LV blood flows into RV or directly into aorta

142
Q

what happens to right ventricle in Tetralogy of Fallot

A

enlarged

143
Q

why is right ventricle enlarged in Tetralogy of Fallot

A

afterload is increased on right side b/c stenosed valve & right heart blood is giong out the aorta which is high pressure system

144
Q

blue skin another word for it

A

cyanotic

145
Q

what can cause Tetralogy of Fallot

A

german measles
genetics: identical twins
if parents had it

146
Q

what 4 things always happen in Tetralogy of Fallot

A

Aorta received blood from both ventricles

Stenosis of pulmonary artery

Septal defect

Enlarged right ventricle

Physiology I Block 4 (13 decks)

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