module 10 vavles

Question 1

annulus

Answer 1

where valve connects to heart wall

Question 2

commissure

Answer 2

point where leaflets meet

Question 3

chordae tendineae

Answer 3

hold valve

- ensure doesnt fold up into atria

Question 4

papillary muscle

Answer 4

connects chordae tendineae to ventricular wall

medial and lateral

Question 5

mitral incompetence

Answer 5

left atrial dilation results d/t inc. LA pressure and volume caused by mitral regurgitation

Question 6

open stenosis

Answer 6

poor closure

- blood backflows into atrium

Question 7

closed stenosis

Answer 7

valve does not fully open during diastole

Question 8

mitral valve stenosis

Answer 8

fusion of mitral valve leaflets at the commissures during the healing process of acute rheumatic fever
- dec area of opening
- ince. pressure gradient
LA enlargement predisposes to atrial fibrillation
- stasis of blood -> thrombi

Question 9

pressures with stenosis

Answer 9

normally pressure between atria and ventricle equal during ventricular diastole

• with stenosis atrial pressure > ventricular
• > chronic pulmonary HTN -> RSHF

Question 10

s/s of mitral valve stenosis

Answer 10

dyspnea on exertion
-> CHF
atrial dysrhythmia (a-fib)
2nd to pulmonary 
- orthopnea
- cough 
- abnml brath sounds
- dec. O2 saturations

Question 11

Aortic stenosis

Answer 11

rheumatic fever 
age-related calcification 
Hallmark: calcium deposits on aortic cusps 
obstruction of aortic outflow form LV during systole
inc. pressure of LV
slow progression -> LV hypertrophy
-> ischemia/angina
-> LSHF

Question 12

aortic stenosis s/s

Answer 12

syncope
fatigue
dec. BP
faint pulses
S4
angina pectoris 
dyspnea on exertion

Question 13

rheumatic heart disease

Answer 13

acute inflammatory disease following strep infection (Beta)
antibodies that attack strep, deposit in heart
- primarily in children 
affects CT in joints, heart, skin
-> endocardial inflammation
-> valvular swelling
-> erosion
-> platelet clumping on leaflets
-> scarring and shortening of valves

Question 14

Mitral valve regurgitation

Answer 14

usually due to rheumatic fever
almost always assoc. with mitral stenosis
LA volume overload by retrograde flow from LVSV into LA
inc. afterload -> inc. regurgitation 
LV and VA dilate and hypertrophy 
-> LSHF
chronic weakness and fatigue
systolic murmur

Question 15

aortic regurgitation etiologies

Answer 15

acute infective endocarditis
trauma
dissection of a thoracic aneurysm 
chronic (prior rheumatic fever, persistent systemic HTN)
degenerative aortic dilation
syphilitic aortitis
rheumatoid arthritis 
marfan syndrome

Question 16

aortic regurgitation steps

Answer 16

LV overload

• > hypertorphy and dilation
• > inc. SV -> inc. systolic BP, dec. diastolic BP
• > LSHF

Question 17

aortic regurgitaiton s/s

Answer 17

head bob with systole
high pitch murmur
palpitations
pounding heart

Question 18

Mitral valve prolapse

Answer 18

leaflets billow back into the atrium during ventricular systole.
-> some parting and regurgitation
women > men

Question 19

mitral valve prolapse s/s

Answer 19

usually asymptomatic
midsystolic click or systolic murmur
palpitations
abmnl rhythm 
dizzy
fatigue
dyspnea
chest pain
depression 
anxiety

Question 20

complications of mitral valve prolapse

Answer 20

infective endocarditis
sudden cardiac arrest
cerebral embolic events
progression to mitral regurgitation