Physiology Of Circulatory System - Physical Examination, Blood Pressure Analysis, ECG - PP ----DONE

Question 1

Ausculation position for tricuspid valve

Answer 1

Left 4 ICS PSL

Question 2

Ausculation position for pulmonary valve

Answer 2

Left 2 ICS PSL

Question 3

Ausculation position for mitral valve

Answer 3

Left 5 ICS MCL

Question 4

When does the first heart sound, “lub”, occure?

Answer 4

When atrioventricular valves close

Question 5

When does the first heart sound, “dup”, occure?

Answer 5

When semilunar valves close.

Question 6

When will the Korotkoff sounds be heard?

Answer 6

Korotkoff sound will be heard until cuff pressure equals diastolic pressure, causing the sound to dissapear.

Question 7

When will the blood flow during a measurment of bloodpressure?

Answer 7

A blood pressure cuff is initiated above systolic pressure, occluding the artery. As cuff pressure is lowered, the blood will flow only when systolic pressure is above blood pressure, producing the sounds of Korotkoff.

Question 8

Where can baroreceptors be found?

Answer 8

• carotid sinus

- aortic arch

Question 9

What are baroreceptors?

Answer 9

Mechanoreseptors sensitive to the streching of the vessl wall in which they are located, high pressure receptors.

Question 10

What reduces the activity of the baroreceptors?

Answer 10

The factors leading to the reconstruction of the arteries and reducing its compliance (untreated hypertention, aging) are reducing the activity of baroreceptors.

Question 11

Ausculation position for aortic valve

Answer 11

Right 2 ICS PSL

Question 12

Baroreceptor reflex:

Answer 12

⇧BP⇛ ⇧ baroreceptor activation ⇛ ⇧ firing rate in afferent fibers of nerve IX (carotid artery baroreceptor) and X (aortic baroreceptor) ⇛ increased activity of nerve X ⇛ inhibited sympathetic activity ⇛ domination of parasympathetic ANS ⇛ ⇩ BP ⇩ HR

Question 13

What leads to the cracles during physical examination?

Answer 13

• Pulmonary congestion leads to a poor O2 exchange in lungs&raquo_space;> Hypoxia
• In physical examination - cracles
• There is water in the air sacs (alveoli)

Question 14

Respiratory sinus rhythm irregularity

Answer 14

• Inspiration ⇛ parasympathetic nerve inhibition (vagus - X) ⇛ ↑ sinus rhythm.
• Expiration ⇛ stimulation of vagus nerve ⇛ ⇛ ↓sinus rhythm.

Question 15

What creates a diploe?

Answer 15

Partially depolarized myocardium creates a diploe.

Question 16

When are diploes present? And when are they not formed?

Answer 16

• Diploes are present only when myocardium is in the process of of depolarization or repolarization.
• They are not formed when the entire myocardium is depolarized or repolarized.

Question 17

ECG

Answer 17

Presents electrical activity and conduction in the atria and ventricles.

Question 18

What causes the P wave?

Answer 18

P wave is caused by depolarization of the atria.

Question 19

PR interwal:

Answer 19

PR interwal (from beginning of P wave to the start of QRS complex) – time when potential is traveling from SA node to the end of Purkinje system

Question 20

PR segment:

Answer 20

PR segment (from the end of P wave to the beggining of the QRS)– time when atrial muscle is totally depolarised, and the wave of depolarization moves through the AV node, the AV bundle, the bundle branches, and the Purkinje system

Question 21

QRS:

Answer 21

• QRS complex is a potential caused by depolarization of the ventricles (≤ 110 ms).
• After QRS complex entire ventricular mass is depolarized

Question 22

ST segment:

Answer 22

ST segment – ventricles are totally depolarised, corresponds to the plateu

Question 23

T wave:

Answer 23

T wave is a time of ventricular repolarization, repolarization of atria occurs during QRS so we don’t see it in ECG

Question 24

QT interval

Answer 24

• QT interval – time between initiation of QRS and the end of T wave.
• It corresponds to the entire action potential.
• It is inversely proportonal to the HR.

Question 25

What happens with the QT if the ventricular repolarization is delayed?

Answer 25

If ventricular repolarization is delayed -QT is prolonged - delayed repolarization is associated with the genesis of ventricular arrhythmias

Question 26

What is associated with the genesis of ventricular arrhythmias?

Answer 26

If ventricular repolarization is delayed -QT is prolonged - delayed repolarization is associated with the genesis of ventricular arrhythmias

Question 27

TP segment:

Answer 27

TP segment – isoelectric line (ventricular diastole)

Question 28

P wave:

Answer 28

Atrial excitation (from SA node – spreads over the atria) – P wave

Question 29

Q wave:

Answer 29

Depolarization of the septum (from left side to the right side of septum) - Q wave

Question 30

R wave:

Answer 30

Depolarization of free wall ventricular muscle from subendocardium to the subepicardium (because LV mass is much greater than RV - dipole is on the left side) – upward defelction of R wave

Question 31

R wave and S wave:

Answer 31

Last portions of LV (basal portions) are depolarised – downward deflection of a R wave and S wave

Question 32

Phase 2 when the ST segment appears:

Answer 32

When ventricular muscle becomes totally depolarised tracing returns to a baseline and ST segment apears – phase 2

Question 33

read the rest, starting from page 23 on the PP

Answer 33

Good Luck