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I've got hypertension > Lecture 2 > Flashcards

Lecture 2 Flashcards

1
Q

Describe the cardiac process

A

Excitation, relaxation, valves open, valves closed at the right time and in the right direction

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2
Q

What is the cardiac cycle?

A

it is the complete set of contraction and relaxation of the heart

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3
Q

What happens during diastole?

A

the ventricles are relaxed

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4
Q

What happens during systole?

A

the ventricles are are contracting

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5
Q

Whereabouts are we starting in the cardiac cycle?

A

from isovolumetric relaxation

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6
Q

What are the valves during isovolumetric relaxation?

A

all the valves are shut

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7
Q

What is happening to the volume of the blood in the heart during isovolumetric relaxation?

A

there is no blood flow so there is no change in the blood flow in the ventricles

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8
Q

What is the minimal ventricular volume/end-systolic volume (ESV)?

A

this is the smallest amount of blood that remains in the heart after all the blood has been ejected

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9
Q

What is happening to the ventricles during isovolumetric relaxation?

A

they are relaxing

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10
Q

What is happening to the pressure of the ventricles and atria during isovolumetric relaxation?

A

The atrial pressure is lower than the ventricular pressure

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11
Q

What is happening to the volume in the atria during isovolumetric relaxation?

A

They are filling with blood returning to the heart.

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12
Q

During isovolumetric relaxation, why does the pressure in the atria rise? What two things does this cause?

A

As the atria fill with blood, atrial pressure rises above ventricular pressure and then the valves open passively and so ventricular filling begins

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13
Q

What phase is after isovolumetric relation?

A

ventricular filling

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14
Q

What percentage of ventricular filling occurs passively down pressure gradient?

A

about 90%

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15
Q

What two phases of the cardiac cycle are included in diastole?

A

isovolumetric relaxation and ventricular filling

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16
Q

At the end of diastole (end of ventricular filling), what contracts? How is this shown on an ECG?

A

At the end of diastole, there is atrial depolarisation which is when the atria contract to push the last of the blood down into the ventricles. This is seen as the P wave on the ECG

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17
Q

What pressure do the atria rise to during atrial contraction?

A

about 5 mmHg

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18
Q

What percentage of blood is sent from the atria to the ventricles during atrial topup?

A

10%

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19
Q

What is the end-diastolic volume?

A

This is the amount of blood in the ventricles after diastole (filling)

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20
Q

What is the next stage in the cycle after ventricular filling?

A

Isovolumetric contraction

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21
Q

What happens during isovolumetric contraction in the ventricles

A

they are contracting

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22
Q

During isovolumetric contraction, the ventricles are contracting. What does this mean must have happened and how is it showed on the QRS complex?

A

The ventricles must have depolarised as shown on the QRS complex on the ECG

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23
Q

What happens to the pressure in the ventricles during isovolumetric contraction?

A

the pressure is rising

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24
Q

What happens to the AV valves during isovolumetric contraction?

A

because the pressure in the ventricles is greater than in the atria, the AV valves shut

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25
Q

What happens during ventricular ejection?

A

The ventricular pressure have exceeded the aortic pressure and the aortic valve opens. The blood is ejected into the aorta.

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26
Q

What happens to the arterial blood volume and arterial pressure during ventricular ejection?

A

they both increase

27
Q

What fraction of total blood ejection occurs in the first third of the ejection time?

A

2/3

28
Q

Why is the left ventricular pressure and aortic pressure about the same during ventricular ejection?

A

because the aortic valve is fully open and it is now one continuous volume

29
Q

At the end of systole, the heart has squeezed, the ventricles are contracting ___________. What happens to the pressure in the left ventricle and aorta?

A

slower

it decreases

30
Q

Repolarisation of the ventricles at the end of ventricular ejection is seen as what on the ECG?

A

T wave

31
Q

As the ventricle relaxes, the left ventricular pressure falls __________ aortic pressure which causes what to happen?

A

below

the semilunar valves to close

32
Q

Greater pressure in the atrium than in the ventricles leads to the opening of the AV valves BECAUSE at rest, the majority of ventricles filling happens before the atria contract

A

both are true but the second doesn’t cause the first

33
Q

What is the shorted phase of the cardiac cycle?

A

isovolumetric relaxation

34
Q

Describe what happens to the ventricular volume during diastole

A

It is constant during isovolumetric relaxation. There is early rapid ventricular filling and late slow ventricular filling. There is a top up after atrial contraction and it is at its maximum at the end of diastole (EDV)

35
Q

Describe what happens to the ventricular volume during systole

A

It is constant during isovolumetric contraction.
There is a rapid fall during early ejection and slow fall during late ejection. It is at its minimum at end-systole (ESV)

36
Q

Describe what happens to the ventricular pressure during diastole

A

It drops to a minimum at the beginning of diastole

It rises a little during ventricular filling after atrial contraction (A-wave)

37
Q

Describe what happens to the ventricular pressure during systole

A

it rises dramatically during isovolumetric contraction
it continues to rise to a maximum during ejection phase
It falls during late systole

38
Q

Describe what happens to arterial blood pressure during diastole. Why is this?

It continues to _________ during diastole to a ___________ because the blood is moving away from the aorta around the body
It continues to _________ while the semi-lunar valves are __________ (the ventricles are filling and they are not ejecting blood anymore). This occurs right down to the point of isovolumetric __________ (lowest pressure)

A

It continues to fall during diastole to a minimum because the blood is moving away from the aorta around the body
It continues to drop while the semi-lunar valves are closed (the ventricles are filling and they are not ejecting blood anymore). This occurs right down to the point of isovolumetric contraction (lowest pressure)

39
Q

What is the minimum blood pressure at the end of diastole called?

A

diastolic blood pressure

40
Q

What happens to the arterial pressure during systole?

A

At the beginning of systole, the pressure in the left ventricle exceeds the arterial pressure which forces the semilunar valves open. This means that there is one continuous volume from the ventricle to the aorta so any pressure in the ventricle is going to be matched by that in the aorta so they go up together.

41
Q

Describe what happens to cause the dicrotic notch

A

As the heart begins to relax, the pressure in the ventricles and in the aorta drop together, but because the heart can’t squeeze out that blood anymore and because the aorta can take blood around the body, the pressure in the ventricle drops more quickly. The blood is moving through the aorta but it can’t move through quick enough because of total peripheral resistance so the pressure in the aorta is higher than that in the ventricle which causes the semi-lunar valves to shut - this causes a little blip in the aortic blood pressure called the dicrotic notch

42
Q

Systolic blood pressure is when the blood pressure is highest/lowest

A

highest

43
Q

Diastolic blood pressure is when the blood pressure is highest/lowest

A

lowest

44
Q

When does the volume in the heart increase? What does this do to the pressure?

A

It increases during diastole

it increases but only a little bit

45
Q

The volume in the ventricles decreases at an ___________ rate

A

decreasing

46
Q

What is the aortic pressure during diastole? How does this compare to the left ventricular pressure?

A

aortic pressure 80 mmHg

LV 5mmHg

47
Q

What is the aortic pressure during systole? How does this compare to the left ventricular pressure?

2

A

aortic pressure 120mmHg

LV 120mmHg

48
Q

What is the end-diastolic volume (in mLs)?

A

130 mL

49
Q

What is the end-systolic volume (in mLs)?

A

60 mL

50
Q

What is the stroke volume (in mLs)?

A

70 mL

51
Q

What is the ejection fraction?

A

55%-60%

52
Q

Are the left and right volumes equal?

A

yes

53
Q

What is different in terms of the resistance between the left and right sides of the heart?

A

The pulmonary resistance is lower than the total peripheral resistance

The RV and pulmonary artery pressure are lower than the LV and aortic pressure

54
Q

What is the pressure at rest of the RV and pulmonary artery during systole?

A

25 mmHg

55
Q

What causes the first heart sound (lub)

A

The closure of the AV valves

56
Q

What causes the second heart sound?

A

closure of the semilunar valves (dub)

57
Q

What causes the third heart sound. Who can this be heart in?

A

this is heard in the young and it is caused by passive ventricular filling in early diastole

58
Q

What causes the fourth heart sound?

A

This is in a heart that is not working properly

it is caused by ventricular filling following atrial contraction

59
Q

What causes the P wave on the electrocardiogram?

A

atrial depolarisation which precedes atrial contraction

60
Q

What causes the QRS complex on the electrocardiogram?

A

ventricular depolarisation which precedes ventricular contraction

61
Q

What causes the T wave on the electrocardiogram?

A

Ventricular repolarisation which precedes ventricular relaxation

62
Q

At rest, the heart rate is about 60bpm. What fraction of this is spent in diastole and which fraction is spent in systole?

A

2/3 is spent in diastole

1/3 is spend in systole

63
Q

What happens to the duration of both systole and diastole at higher heart rates?

A

the duration of both decrease but diastole shortens more than systole so you now spend 2/3 in systole and 1/3 in diastole

64
Q

What happens with the duration of systole and diastole when heart rate is increased?

A

Both shorten, with diastole more than systole

I've got hypertension (47 decks)

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