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Structure And Function III > McCumbee - Ventricular Function > Flashcards

McCumbee - Ventricular Function Flashcards

1
Q

At rest, the atrial systole acounts for about 10-15% of the ventricular filling. In vigorous exercise, atrial systole is responsible for up to _____ %

A

40% of ventricular filling

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2
Q

Atrioventricular valves prevent the backflow of blood into the atria during ventricular systole, what are the two atrioventricular valves

A

Tricuspid valve

Mitral valve

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3
Q

Prevent the backflow of blood from the aorta and pulmonary arteries into the ventricles during ventricular diastole

A

Semilunar valves

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4
Q

Blood flows through the semilunar valves at _____ velocity than the AV valves

A

Greater

This is bc semilunar valves have smaller openings than AV valves

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5
Q

Phases of ventricular diastole

A

Isovolumic relaxation

Rapid ventricular filling

Reduced ventricular filling (diastasis)

Atrial systole

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6
Q

Ventricular systole, the period of ventricular contraction, is divided into which phases?

A

Isovolumic contration

Rapid ejection

Reduced ejection

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7
Q

Vibrations produced by the closure of the atrioventricular valves are responsible for what heart sound

A

S1 (first heard)

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8
Q

Four parts of rapid ejection phase

A
  1. Ventricular pressure continues to rise
  2. Pressures w/in aorta & pulm A. Increase
  3. Blood flow from ventricles into aorta and pulmonary artery peaks
  4. Ventricular volume decreases
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9
Q

About _____ % of stroke volume is ejected during rapid ejection

A

70

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10
Q

Closure of the __________ signals the start of diastole

A

Semilunar valves

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11
Q

A slight upward deflection in the pressure tracing during the falling phase caused by the closure of the semilunar valves. Used in pressure tracing to mark the end of the ventricular systole

A

Dicrotic notch

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12
Q

In the reduced ejection phase, the second heart sound (S2) is heard. It is caused by closure of

A

The semilunar valves

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13
Q

During the isovolumic relaxation, intraventricular pressure drops rapidly.
Why does intra aortic pressure not drop abruptly?

A

Resistance to blood flow from smaller arteries in the vascular tree

Elastic recoil of these vessels which helps maintain pressure

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14
Q

The volume of blood remaining in ventricles after ventricular contraction

A

End systolic volume

LVESV

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15
Q

S1 is produced by?

A

Closure of the atrioventricular valves at the onset of ventricular systole

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16
Q

S2 is produced by?

A

Closure of the semilunar valves at the end of the ventricular systole

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17
Q

S4 is heard during

A

Contraction of the atria during late diastole.

Commonly associated w/ resistance to filling and is often a sign of diastolic heart failure.

Rarely a normal sound

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18
Q

When does S3 occur?

A

In early diastole during the passive filling of the ventricle

Caused by blood hitting the ventricular wall

May be normal in a young person. Often sign of heart failure in adults over 40

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19
Q

A stenotic semilunar valve can cause an

A

Ejection murmur

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20
Q

Sounds generated by turbulent blood flow

A

Murmurs

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21
Q

The narrowing of the valve: blood flows at a higher velocity through the constricted opening

A

Stenosis

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22
Q

The backward flow of blood through a valve which fails to close properly

A

Regurgitation

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23
Q

Sounds created by turbulent blood flow in blood vessels are normally called

A

Bruits

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24
Q

Pressure changes in the right atrium can be observed through lookin at distention of the right internal jugular vein caused by:

A

Retrograde blood flow

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25
Q

Normal Jugular pulse: pressure decline assoc’d with right atrial relaxation

A

X descent

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26
Q

Normal jugular pulse: venous distention caused by back pressure associated with right atrial contraction

Atrial systole

A

‘A’ wave

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27
Q

Normal jugular pulse: Interrupts x descent. Caused by tricuspid valves closing and bulging into right atrium at onset of isovolumic ventricular contraction

A

C wave

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28
Q

Normal jugular pulse: upward swing caused by filling of right atrium behind the closed tricuspid valve.

Venuous collection

A

V wave

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29
Q

Normal jugular pulse

is caused by the rapid flow of blood into the
right ventricle when the tricuspid valve opens at the end of the
isovolumic relaxation phase.

A

Y-descent

30
Q

Implications of the reduced duration of diastole during tachycardia?

A
  1. There is less time for venous return: this tends to reduce cardiac
    output.
  2. Because the coronary vessels of the myocardium are compressed
    during systole, most perfusion of myocardium occurs during diastole.
    Since the duration of diastole decreases with increasing heart rate,
    perfusion of the myocardium will be less effective in tachycardia.
31
Q

the stretch on ventricular muscle fibers just before contraction.
In the intact heart, preload results from the stretching of muscle fibers by the volume of blood contained within the ventricle at the end of diastole. For the beating heart, end diastolic volume (EDV) and the end diastolic pressure (EDP) are good indices of preload.

A

Preload

32
Q

the resistance that the ventricle has to overcome in order to
eject blood into the vasculature: the force that the sarcomere must overcome in order to shorten during systole

A

Afterload

33
Q

an intrinsic property of the myocardium that

accounts for changes in the strength of contraction when preload and afterload are unchanged.

A

Contractility

34
Q

volume of blood ejected from a ventricle during a

single contraction.

A

Stroke volume (SV)

35
Q

the volume of blood in the ventricle at the

end of ventricular filling. EDV is used as a measure of ventricular preload.

A

End diastolic volume

36
Q

the volume of blood left in the ventricle at

the end of ejection.

A

End systolic volume

37
Q

the fraction of the end-diastolic volume that is ejected

from the ventricle during systole.

A

Ejection fraction

38
Q

the volume of blood ejected by the ventricle per min.

A

Cardiac output

39
Q

the ratio of change in volume (ΔV) to change in
pressure (ΔP); the ability of a hollow organ to distend and increase
volume in response to increasing transmural pressure (inside pressure
minus outside pressure).

A

Compliance

40
Q

represents the
maximum pressure that the ventricle can develop for any given ventricular
volume at a given inotropic state.

A

End-systolic pressure-volume relationship (ESPVR)

41
Q

relationship
between pressure and volume in the ventricle at the moment the ventricle
is completely relaxed (End Diastole)

A

End-diasolitc pressure-volume relationship (edpvr)

42
Q

Cardiac rate

A

Chronotropy

43
Q

Relaxation of the myocardium

A

Lusitropy

44
Q

EF is normally greater that

A

55%

45
Q

The EF increases with _______ contractility

A

Increasing

46
Q

Change in volume

___——

Change in pressure

A

Compliance

47
Q

Change in pressure

———-

Change in volume

A

Elastance

48
Q

Elastance is the _____ of compliance

A

Reciprocal

49
Q

Compliance reflects what in a ventricle

A

The relative ease with which the ventricle can fill with blood

50
Q

In cardiac hypertrophy, the increased ventricular thickness ______-___ ventricular compliance

A

Decreases

51
Q

Ischemic heart injury is characterized by a transitory ________ of relaxation during diastol

A

Inhibition

52
Q

The slope of End Systolic Pressure-Volume Relationship graph is an index of ___-___

A

Myocardial contractility

53
Q

The slope of end systolic pressure-volume relationship will shift if _________

A

Contractile state changes

54
Q

The End-Systolic Pressure-Volume Relationship is relatively insensitive to

A

Changes in preload, afterload, or heart rate

55
Q

When contractility and preload are held constant, and increase in afterload results in

A

Reduced stroke volume and a higher end-systolic volume

56
Q

If preload and afterload are held constant, an increase in contractility will cause the slope of ESPVR to

A

Become steeper and move leftward

57
Q

Conditions that affect ventricular filling

A 
Total blood volume
Skeletal muscle pump
Body position
Atrial kick(exercise)
Venous tone
Intrapericardial pressure
Intrathoracic pressure
58
Q

Inspiration _____ the pressure gradient for venous return to the right atrium

A

Increases

59
Q

The buildup of intrapericardial fluid during a pericardial infection will ______ cardiac filling

A

Limit

60
Q

Circulating catecholamines and sympathetic stimulation _____ the contractility of cardiac muscle

A

Enhance

61
Q

Cardiac ischemia and acidosis ______ contractility

A

Decrease

62
Q

______ is the major determinant of afterload

A

Vascular resistance

63
Q

The work done by a ventricle to eject a volume of blood

Equal to stroke volume times the intraventricular pressure generated during ejection

A

Stroke work

64
Q

Cardiac work

A

Stroke work (x) heart rate

65
Q

The total mechanical energy generated by a single heart beat is given by

A

Pressure-volume area

Stroke work + Eleastic potential energy

66
Q

The ratio of useful energy produced by the heart to myocardial oxygen consumption

A

Mechanical efficiency of the heart

67
Q

The amount of a substance entering an organ at a given time minus the amount of substance leaving the organ at a given time is equal to the amount of substance used by an organ during the same time periord

A

Fick Principle

68
Q

What three measurements must you have to use the fick method to determine cardiac output?

A

O2 consumed by whole body

O2 concentration of pulm venous blood

O2 concentration of arterial blood

69
Q

A specialized soft catheter with multiple lumens and a balloon tip used in the thermodilution method of calculating cardiac output

A

Swan-ganz catheter

70
Q

Method for calculating cardiac output that uses a small thermometer in the pulmonary artery and a computer program to calculate the right cardiac output from change in blood temperature and the volume and temperature of a known saline solution that was injected into the right atrium

A

Thermodilution method

71
Q

The cardiac output per square meter of body surface area

A

Cardiac index

72
Q

Normal amount of pericardial fluid that is found in between the serous layers?

A

15-20mL

Structure And Function III (24 decks)

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