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CVS physio paper 1 > Part 2 cardiac cycle > Flashcards

Part 2 cardiac cycle Flashcards

1
Q

بسم الله الرحمن الرحيم وبه نستعين

Ventricles act as compression suction pump

A

comrpeesion in systole high pressure system for djection

Suction in diatsole low pressure system for filling

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2
Q

In each phase of the cycle there is changes on ?

A 
Atrial Pressure
Ventruclar voulme
venrticular pressure
Aortic pressure
Heart valves
Heart sounds
ECG
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3
Q

Atrial systole repesents?

A

firsth phase of new cycle

third phase of ventricular filling become more imp in increased HR

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4
Q

ATRIAL PRESSURE UN ATRIAL SYSTSOLKE ?

A

Increased = a Wave in juglar venous pressure cureve

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5
Q

Aortic pressure: is,,,,,,,,,,,,,,,,,,,,,,,, as semilunar valves are
still closed why?

A

decreased

no blood ejection, while there is
continuous escape of blood to the periphery.

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6
Q

Atrial systole responsible for sounds?

A

Yes ,4th heart sound not audibe normally

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7
Q

Atrial systole and pwave

A

p wave before atrial systole by 0,02 seconds the latter last for 0,1 second\

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8
Q

• During ventricular systole there are 3 phases:

A
  1. Isovolumetric contraction
  2. Rapid ejection
  3. Reduced ejection
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9
Q

• During which both types of valves are closed.

A

isovlumetric contraction 0,04 seconds

isovlumertic relaxation

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10
Q

And so isometric contarcvtion is responsible for switching of the ventricular
pressure from the low pressure system to the high pressure
system. how ?

A

contract ismoetrically increasing tension on the walls increasing intraventriculare pressure

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11
Q

Isovoumetric contracio0n and Jugular venous pressure?

A

increaing atrial pressure due to ?
Bulging of cusps into atira casuing
C wave in jugular venous pressure

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12
Q

Heart sound on isovolumetric contraction ?

A

First heart sounds shrae by 2 components?
Vlavlar compnent: closed valve
Musclear: contraction of muscles

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13
Q

Q wave and isovoulmetric contraction ?

A

Q wave begins beofr it 0,02seconds

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14
Q

Rapid ejection phase 0,16 second and jugular venous pressure ?

A

Pulling the AV Fibrous skeletion down increasing caivty decreasing the pressure
causing X descent in jugular venous pressure

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15
Q

Ventricular pressuer in rapid ejection phase?

A

the muscles contiume contracting increasing intraventricular pressure

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16
Q

Heart sounds in the rapid ejection phase ?

A

First one

due to vascular compnent : rush of blood into aorta and pulmonary artery

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17
Q

rapid ejection phase in ECG?

A

ST segment and begining of T wave

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18
Q

reduced ejection phase ?

A

0,1 second

Firsth half of t wave and its Top

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19
Q

Protodiastole

A 
0,02 to 0,04 second
between the systole and diastole 
dut to momentum of blood to aorta
when momentum is overcome 
the aortic valve is closed produng second heart sound
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20
Q

Second heart sound in ?

A

portodiastole

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21
Q

During ventricular diastole there are 4 phases:

A
  1. Isovolumetric relaxation.
  2. Rapid filling .
  3. Reduced filling.
  4. Next Atrial systole
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22
Q

Isovolumetric relaxation and jugular venous pressure

A

increased vr with closed valve inicreasing the pressure casuing V wave
in juglar venous pressure

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23
Q

Ventricular pressure in IVR ?

A

Decreasd in high rate to reach 0 to be filled by the atrial blood

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24
Q

incisura of aorta occur in —- phase

A

IVR

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25
Q

IVR

A

0,06 SECONDS
2ND HEART SOUND
End of T wave and start of TP segment

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26
Q

Rapid filling phase and JVP ?

A

Decreased pressure due to evacuation
Y descent in JVP
Ventricular pressure: remains very low during this phase
(~ 0 mm Hg).

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27
Q

Rapid filling phase ?

A

0,1 Second
S3 SOUND
TP isolectric line

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28
Q

diastasis

A

Blood passes from big veins through atria to
ventricles, without staying in the atria (that is why it is also called?
RED F P

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29
Q

This phase is the longest phase in the cardiac
cycle, and continues for 0.2 sec. or even
more, and is prolonged when the heart rate
decreases.

A

Reduced filling Phase

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30
Q

In case of tachycardia, the role of atrial systole in ventricular
filling becomes more important ?

A

and may cause, in this case,

filling up to 50 % of blood

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31
Q

EDV

ESV

A

EDV=130 Ml after atrial systole

ESV=50 Ml after reduced ejection phase

32
Q

Stroke volume (SV= EDV- ESV) = ~ 80 ml.

A

• It is the difference between end diastolic

volume and end systolic volume

33
Q

There is no a wave in ?

A

Atrial fibrillation

34
Q

In case of tricuspid stenosis there is ?

A

large a wvae

35
Q

tricupsid insufficienct there is ?

A

Giant c wave

36
Q

In case of heart block first degree there is prolongation of ?

A

pr interval

ac interval

37
Q

In complete heart block there is

A

Canon giant a Wave

38
Q

Pulse is ?

A

Presure wave not blood voulme wave trasmitted through the vessel due to ejection from LV
4-8 M/SEC IN AORTA AND LARGE ARTERIRES
RACH 16M/S IN SMALL ARTERIES

39
Q

Arterial pulsations reach to the capillaries, and end at the ?

A

post capillary

resistance

40
Q

Anacrotic limb due to ?

A

rapid ejection phase

41
Q

Catacrotic limb

A

Reduced ejection

Diastole

42
Q 
• Dicrotic notch: is a small
oscillation on the falling
phase of the pulse wave
caused by vibrations set up
by sudden closure of the
aortic valve (In the aorta and
in central arteries, the closure
of aortic valve causes a larger
oscillation known as ..........................).
A

incisura

43
Q

Factors affecting pulse pressure velocity?

A

elasticity
1-age
2-distance
3-atherosclerosis

44
Q

➢Arterial pulse volume is very high in atherosclerosis and in aortic
regurgitation and may be so much increased to be known as

A

Collapsing pulse = Corrigan =Water Hammer puls

45
Q

Arterial pulse volume is decreased in aortic stenosis and in

hemorrhage and may be very small leading to what is known as

A

thready pulse.

46
Q

Arterial pulse volume is very high in

A

atherosclerosis and in aortic

regurgitation

47
Q

Arterial pulse volume is decreased in

A

aortic stenosis and in

hemorrhage

48
Q

• The four sounds can be recoded in the

A

phonocardiogram.

49
Q

First Heart sound

A

0,16 second

Isovlmetric contraction:
valvular comnent
muscluar compnent

Rapid ejection phase:
Vascular compnent

50
Q

2nd heart sound

A

0,12 second shorter than s1
Isovolumetric relaxation
closure of semilunar valves
best heaerd at aortic and pulmonary compnent
splitting durin inspiration best heard at pulmonary compnent

51
Q

3rd sound?

A

due to rush of blood from atria to ventricule during rapid filling phase
heard in children ,thin people , Heart failure

52
Q

4th Heart sound

A

rush of blood from atria to ventricle during atrial systole
not heared masked by s1
accentuated in mitral and tricuspid stenosis

53
Q

Murmurs?

A

Abnormal sounds or noise heard due to turbulent flow due to diseased valves
القاعدة: الصمام المفتوح في المرحلة لازم يكون ضيق و الارتجاع في الاخر
ازاي؟
systolic murmurs
aortic or pulmonary stenosis
av valves regrgiutation insufficiency incompetence

Diastolic murmurs:
av valves stenosis

aortic or pulmonary regrgiutation insufficiency incompetence

54
Q

•Systolic Time Intervals (STI)
• Simultaneous recording of ,??? allows for measurement of the duration of
systolic time intervals (STI).

A

carotid pulse wave
ECG
phonocardiogram

55
Q

Total Electromechanical Systole (QS2):

A

is the period from the
onset of the QRS complex to the closure of the aortic valve as
determined by the onset of the second heart sound.

56
Q

beginning of the carotid pressure rise to the dicrotic notch.

A

left ventricular ejection time LVET

57
Q

Pre-Ejection Period (PEP):

A

is the difference between QS2 and LVET.
(PEP = QS2 – LVET). PEP represents the time for the electrical
and mechanical events that precede systolic ejection.

58
Q

The ratio PEP/ LVET can be used as a measure of left ventricular
function. Normally, this ratio is about 0.35, and is increased
without change in QS2 , in case of

A

left ventricular dysfunction.

59
Q

Posture and cop ?

A

cop decreses by 20% on standing

60
Q

Exercise and metnalitiy on cop ?

A

Exercise increase

Mental anxiety and dreaming of stressfyl conditions increasing cop

61
Q

COP FACTORS?

A

4P TMH

Posture
physical activity
pregnancy
pathological condition

Temperature
Meals
Hormones

62
Q

Measutment of COP?

A

On experimetnal animal :
In anasthetazied animals aorta pulmnarry trunk
In Hear-lung preparation Bell cardiometer

On Man:
Echocardiogarphy
Ficks methold
dye dilution technique

63
Q

CO= ? FICKS

A

O2 CONSUMPTION
________________
Artterial-Venous difference O2

64
Q

COP =SV X HR SO =

A

(EDV-ESV)X HR

65
Q

SV affected by?

A 
PRELOAD
Afterload
contractility:
1-blood supply
2-metabolism
'3-intact myocardium
66
Q

Intrinicsi regulation of cop ?

A

Homeometric regualtion : Preload and EDV

Heteroetirc regulation : the contractilityt at same ED

67
Q

Heterometric regulation

A 
Preload phenomenon
VR
Tranisnet
postural changes ,adjustment right and left cop , denervated transplanted heart
Fallling heart depend mainly on it
68
Q

Factora affecting EDV?

A

VR
COMPLIANCE OF HEART
Atrial contraction

69
Q

VR incrasieis in /

A

Skeletal pumping
increasing ciruclating blood
increasing intrathoracic negativity
Recumbency increasing the VR

70
Q

Homeometric regulation

A

Afterload phenomenon at same EDV

71
Q

Extirinsic regulation of COP ?

A

Physiological acting Exterinsic factors
Symp-ParaSymp -Neuro hormone

Humorally mediated Extirnsic factors
Factors acting on cAMP like glucagon + ino +chrnontropics
Digitalis
myocardial deprssion direct

72
Q

The most important factor that shifts to left?

A

is the adreanl stimulation of heart or circulating catecholamines

73
Q

Cardiac Resereve ?

A

قدرة القلب علي تعزيز المخرج عشان يرضي طلباته المتزايدة

الفرق بين أقصي و أقل مخرج قلبي

74
Q

short lived mechanisms of regulation of COP?

A

MOMENT TO MOMENT
depending on VR

within permissive limit 12 litrs/min
increasing sinus rhtym to 90bpm
increasing sv heterometric then homometric regulation

75
Q

Short term beyond permissive limit ?

A

Sympathatic adranal and catecholamins
+chorno tropic increasing HR 180bpm
+ Inotrioic increasing SV esv < 30 ml

76
Q

الحمدلله رب العالمين

A

CVS physio paper 1 (4 decks)

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