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CP Exam 2 > Lecture 5: Cardiac Cycle and Sound > Flashcards

Lecture 5: Cardiac Cycle and Sound Flashcards

1
Q

What is systole and what phases occur during it?

A

Systole–> ventricular contraction

-Isovolumentric ventricular contraction and ventricular ejection

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2
Q

What is diastole and what phases occur during it?

A

Diatole–> ventricular relaxation

Isovolumetric ventricular relaxation

Ventricular filling

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3
Q

Aortic pressure

A

120/80

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4
Q

Ventricular pressure

A

120/0

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5
Q

Ventricular volume

A

120/~50

Thus, the volume of the ventricle is never at 0.

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6
Q

Atrial pressure

A

15/4

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7
Q

What is atrial systole?

A

Atrial systole is the contraction of of the atria.

Contraction of the atria is initated by the firing of the SA node, causing it to depolarize first.

As a result, they are the first to contract, increasing pressure in the atria.

When RA pressure > RV pressure: AV valves open–> [blood]–> RV.

Filling of the ventricle SLIGHTLY increases ventricular pressure.

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8
Q

When the RA pressure > RV pressure; what occurs?

A

Ventricular filling.

Blood moves from the atria –> ventricle.

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9
Q

What is represented by the P wave?

A

Atrial depolarization and contraction.

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10
Q

What is ventricular systole?

A

Contraction of the ventricles, causing an increase in pressure.

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11
Q

What occurs when peak systolic pressure is reached?

A

It begins to fall even though the ventricle is still contracting, because blood is still leaving.

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12
Q

Why do we see atrial pressure increase during ventricular systole?

A

Filling of the atria with blood because blood is returning to the heart, but cannot move into the ventricule bc RA<rv.>
</rv.>

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13
Q

What is ventricular diastole?

A

Relaxation of the ventricles, causing a decrease in ventricular pressure

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14
Q

Where does ventricular diastole occur on the ECG and on the AP?

A

T-wave (ventricular repolarization)

Phase 3

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15
Q

What ion is inside the myocyte to cause contraction?

A

Ca2+

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16
Q

Where can we see a ventricular systolic pressure of 120 on the EKG?

A

ST segment

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17
Q

What does a ventricular diastolic pressure of 0 mean?

A

Atrial pressure> ventricular pressure.

Thus, ventricular pressure will begin to increase as soon as blood begins to flow in.

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18
Q

Systole/diastole: atrial pressure >ventricular pressure

A

Diastole

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19
Q

Systole/diastole: ventricular pressure > atrial pressure

A

Ventricular pressure

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20
Q

How does contraction affect pressure?

A

Contraction will increase pressure.

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21
Q

Describe the process of ventricular filling (ventricular diastole=relaxation)

A
  1. Atrial systole is occuring–> atria is contracting, which is initiated by the firing of the SA node. Atria depolarizes first and then contracts; causing an increase in atrial pressure
  2. When [atrial pressure > ventricular pressure]: AV valves open–> [blood]–> ventricule
  3. Ventricular filling causes a slight increase in ventricular pressure.
  4. Ventricle relaxes to accommadate blood.
  5. At the end of diastole, atrial kick forces the last bit of blood out before systole begins. Thus, the last bit of blood moves out d/t contraction, not the pressure gradient.

In this stage, semilunar valves are closed because the pulmonary artery/aorta pressure > ventricular pressure.

22
Q

Describe the process of isvolumetric ventricular contraction (ventricular systole)

A

Now that the the ventricle is full of blood, we have to increase pressure in the ventricle so it is greater than pressure in the outflow tracts.

-AV valves and the semilunar valves are BOTH closed.

Ventricular pressure > atrial pressure: AV valves closed.

Pulmonary artery/aortic pressure> ventricular pressure: Semilunar valves are closed.

Ventricular muscle begins to contract, so that we can build up pressure. However, there is no change in volume.

Phase ends when ventricular pressure > outflow pressure.

23
Q

Describe the process of ventricular ejection (ventricular systole)

A
  1. Ventricular pressure > Outflow pressure: semilunar valves open–> [blood]–> outflow.
  2. Ventricular pressure increases as contraction occurs, keeping the AV valves closed.
  3. Atrial pressure increases slightly because they are begining to fill with blood.
  4. As blood goes into the outflow tract, aortic pressure increases.
  5. Eventually, ventricular volume decreases, ventricular pressure decreases and aortic pressure decreases, even though blood is still being pumped into it as ejection slows down.
  6. When outflow pressure > ventricular pressure; semilunar valves close
  7. Aortic and ventricular pressures diverge rapidly.
24
Q

What is the dicrotic notch?

A

Dicrotic notch is produced when the ventricular pressure drops below that of the aortic (outflow) pressure and the aortic valves CLOSE.

Ventricle begins to relax.

Here, the two pressures will begin to diverge rapidly

Atrial pressure shows a similar wiggle because now that the ventricle is begining to relax, the force on the AV valve (Which kept it closed) is released.

25
Q

What causes the atrial wiggle in the atrial pressure that we see at the dicrotic notch, when the ventricular pressure < aortic (outflow pressure)?

A

Now that the ventricle has ejected all of the blood, it is relaxing, decreasing the force that held the the AV valve shut.

26
Q

Describe the processes of isovolumetric ventricular relaxation (ventricular diastole).

A

In this stage, all the valves are shut and there is no change in the volume of the ventricle.

  1. Aortic (outflow) pressure > ventricular pressure because the aortic pressure is being controlled by peripheral run-off: semilunar valves closed

—but—

Ventricular pressure > atrial pressure: AV valves closed.

  1. Ventricles continue to relax
  2. Decrease in ventricular pressure
  3. Ventricular pressue < atrial pressure
  4. AV valves open, marking the begining of ventricular filling.
27
Q

During diastole, the aortic pressure continues to drop (and will continue to do so thoughout, why?

A

Blood is leaving the aorta and flowing into smaller vessels in the periphery.

The rate of the peripheral run off is determined by the resistance to blood flow.

28
Q

What pressure does the L and R ventricle have to be at for the blood to enter FROM the atria?

A

Ventricular pressure has to be the LOWEST of all pressure during diastole for blood to enter the ventricle

29
Q

When the AV valve opens, what is the ventricular pressure and volume?

What is the affect of this?

A

Ventricular volume and pressure are both very low.

Thus, blood will flow into the ventricles rapidly.

30
Q

What are the three waves on the jugular pressure wave?

A

A wave

C wave

V wave

31
Q

Describe the jugular pressure wave.

A

A wave–> caused by the contraction of the atria, pushing back on the jugular vein

C wave–> due to isovolumentric contraction of the ventricles, causing the atria to bulge backwarfs

V wave–> pressure wave created as blood goes back to the heart, but cannot enter the ventricles.

32
Q

What comes first: contraction of electrical activity?

A

Electrical activity–> contraction

33
Q

What ECG wave occurs when Na+ influx is occuring in the atrial myocytes?

Compared to the increase in atrial pressure, when does it begin?

A

P wave.

P wave will begin right before the increase in atrial pressure.

34
Q

What does the difference in time represent from the P wave onset and the increase in atrial pressure?

A

The time it takes for the atria to contract.

35
Q

What is the PR interval?

A

The pause between the depolarization of the atria and ventricles, caused by the slow conduction velocity of the AV node.

36
Q

What happens once the AV node transmits the AP to the ventricles?

A

Bundle branches and purkinje fibers transmit the AP to the ventricle, depolarizing the septum and free wall of the both ventricles from the apex, up.

37
Q

On the ECG, ventricular depolarization is represented by what?

A

QRS complex.

38
Q

What comes first: QRS complex or the increase in ventricular pressure?

A

QRS complex.

39
Q

Does ventricular contraction occur through the QT interval and ST segment?

A

Yes

40
Q

What phase is the ST segment?

A

Phase 2

41
Q

What is the T wave?

A

T wave- start of ventricular repolarization.

It begins before relaxation of the ventricle.

Ventricular pressure starts to fall as blood is ejected out of hte ventricle because there is less blood to push out, so there is a decrease in pressure–> [relaxation].

42
Q

What are the 4 heart sounds?

A

S1- AV valves close

S2- Semilunar valves close

S3- rapid filling of the ventricles (mostly seen in kids)

S4- Atrial contraction (last bit of blood squeezing into the ventricle)

43
Q

S1

A

Lub- caused by AV valves closing.

The sound is due to blood in the atria hitting the closed valve as it tries to enter the ventricle, causing cardiac tissue to vibrate.

44
Q

S2

A

Semilunar valve closing.

Blood in the outflow tracts backflow and bounce off the close valve.

45
Q

S2 Dubà Semilunar valves closingà blood in the aorta and pulmonary artery backflow and bounces off of the closed valves.

Why does the blood backflow?

A

Gravity pulls the blood down when the valves close.

46
Q

What are the 4 heart sounds a result of?

A

Blood moving in the right direction.

47
Q

When do we hear a murmur?

A
  1. Blood is moving a direction is shoulding
  2. Blood is having a hard time moving in a direction that it should
48
Q

Murmurs can be heard in systole, diastole, or both

A

BOTH

49
Q

What causes a systolic murmur?

A
  • Blood is moving back into the atria, due to regurgitation (mitral regurgitation)
  • Blood cannot get into the aorta/pulmonary artery d/t stenosis.
50
Q

What causes a diastolic murmur?

A
  • Blood is moving back into the aorta or pulmonary artery due to aortic regurgitation.
  • Blood cannot get into the ventricle due to stenosis.

CP Exam 2 (27 decks)

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