Quiz 3 (cardiovascular physiology and auscultation of Heart sounds) Flashcards
….. of the heart means “to listen to” and study the various sounds arising from the heart duirng its pumping activity
Auscultation
heart sounds may be heard by placing your ear on the chest or by using a…
stethoscope
the vibrations producing the sounds can be visually displayed through the use of a heart sound microphone and physiological recorder to produce a
Phonocardiogram
- produced at the beginning of systole when the atrioventricular (A-V) valves
close and the semilunar (S-L) valves open. This has a lower pitched tone commonly termed
the “lub” sound of the heartbeat.
1st heart sound
occurs during the end of systole and is produced by the closure of the S-L
valves, the opening of the A-V valves, and the resulting vibrations in the arteries and
ventricles. Due to the higher blood pressures in the arteries the sound produced is higher
pitched. It is commonly referred to as the “dub” sound
2nd heart sound
occurs during the rapid filling of the ventricles after the A-V valves open
and is probably produced by vibrations of the ventricular walls.
3rd heart sound
occurs at the time of atrial contraction and is probably due to the
accelerated rush of blood into the ventricles.
4th Heart sound
the pressure exerted by the blood against
the vessel walls, the arterial blood pressure being the most frequently measured pressure and the most
useful
blood pressure
: the highest pressure in the artery–produced during the heart’s
contraction (systolic) phase. Normal for a 20-year-old male is 120mm Hg.
Systolic Blood Pressure:
the lowest pressure in the artery–produced during the heart’s
relaxation (diastolic) phase. Normal for a 20-year-old male is 80mm Hg
Diastolic Blood Pressure:
the difference between the systolic and diastolic pressures. Normal value is
40mm Hg.
- Pulse Pressure:
Diastolic pressure + 1/3 of the pulse pressure. This is the average effective
pressure forcing blood through the circulatory system. Normal value is 96-100mm Hg
Mean Blood Pressure:
The mean blood pressure is a function of two factors
cardiac output (CO), the amount of blood pumped out of the left ventricle per unit of time, and total peripheral resistance (TPR):
Equation of mean B.P
Mean B.P (mm Hg) = cardiac output (ml/min) x total peripheral resistance (TPR units)
Equation of cardiac output
cardiac output (ml/min) = heart rate (beats/min) x stroke volume (ml/beat)
Peripheral resistance depends on…
the caliber (diameter) of the blood vessels and the viscosity of the blood.
Any factor that increases either the cardiac output or the total peripheral resistance causes….
an almost
immediate reflex rise in blood pressure
the force of
contraction of the heart
systolic B.P.
the condition of the systemic blood vessels
diastolic pressure
an increase in the diastolic pressure indicates a….
decrease in vessel elasticity
a cannula is
inserted into the artery and the direct, head-on pressure of the blood is measured with a transducer or
mercury manometer.
direct method
, pressure is applied externally to an artery and the pressure is
determined by listening to arterial sounds (using a stethoscope) below the point where the pressure is
applied.
indirect method
the detection of the sounds is termed “auscultation.
auscultatory method
in which one simply palpates or feels
the pulse as pressure is applied to the artery.
palpatory method,
In either of these indirect methods, pressure is applied to the
artery using an instrument called the
sphygmomanometer
Human blood pressure is most commonly measured in the …… of the upper arm.
brachial artery
the pressure when the radial pulse first reappears–
systolic blood pressure (the highest pressure in the systemic artery)
a stethoscope
is used to listen to the changes in sounds from the
brachial artery
As the pressure decreases you
will be able to hear four phases of sound changes; these were first reported by Korotkoff in 1905
and are called the
Korotkoff sounds:
Appearance of a fairly sharp thudding sound which increases in intensity during
the next 10mm Hg of pressure drop. The pressure when the sound first appears is the
systolic pressure
phase 1
The sounds become a softer murmur during the next 10-15 mm Hg drop in
pressure.
phase 2
The sounds become louder again and have a sharper thudding quality during the
next 10-15 mm Hg of pressure drop.
phase 3
The sounds suddenly become muffled and reduced in intensity. The pressure at
this point is termed the diastolic pressure. This muffled sound continues for another
5 mm Hg pressure drop, after which all sound disappears. The point where the sound
ceases completely is called the end diastolic pressure. It is sometimes recorded along
with the systolic and diastolic pressures in this manner: 120/80/75.
phase 4
usually the systolic pressure is about….. lower than that obtained with the direct method.
3-4 mm
TPR equation
TPR= mean blood pressure/ cardiac output
TPRest equation
TRPest= [systolic pressure + (2 x diastolic pressure)]/3 / pulse pressure x heart reate
In general, an increase in total peripheral resistance results from the……… whereas a decrease in total peripheral resistance results
from the……..
-vasoconstriction of blood vessels
-vasodilation of blood vessels.
A
normal reflex response to such a cold stimulus is an
increase in blood pressure
Venous pressure equation
venous pressure= specific gravity of blood x atrial pressure in mm / specific gravity of Hg
which prevent blood from flowing backward in veins where gravity
opposes the upward flow of blood.
venous valves
slowing of the heart
bradycardia
when the face is submerged in cold water, receptors in the…….trigger the trigeminal nerve which tells the body to slow down the heart rate to decrease the body’s oxygen requirement.
nose
…….. has been well validated and measures a sort of general endurance; that is, it does not measure strength, or muscular endurance, or cardiorespiratory endurance in any special way.
The Harvard Step Test
index equation
index= duration of exercise in seconds x 100/ 2 x sum of the 3 pulse counts in recovery
This test is based on the observation that for the same number of steps, a less fit person will have a relatively higher pulse rate during the two-minute period of recovery immediately after exercise.
The tuttle pulse ratio test
defined as the total number of pulse beats counted for one minute.
tuttle’s pulse ratio
useful in the detection of pathological hearts and heart abnormalities.
tuttle pulse ratio test
The established norms for the Tuttle pulse-ratio test are:
boys, ages 10 to 12 years - 33 steps
boys, ages 13 to 18 years - 30 steps
adult man - 29 steps
adult women - 25 steps.
S0 eqaution
S0= S1+ (S2-S1)(2.5-r1)/ r2-r1
S1 = The number of steps used in the first test
S2 = The number of steps used in the second test
S0 = The number of steps required to obtain a 2.5 ratio
r1 = The pulse ratio for S1 r2 = The pulse ratio for S2
primordial oxygen-conserving reflex by which the heart rate of air-breathing vertebrates, including humans, slows down in response to water immersion
diving bradycardia
what are the four major ascualtation areas?
- aortic area
- tricuspid area
- pulmonary area
- mitral area
the amount of blood pumped out of the left ventricle per unit of time
cardiac output
this test is used to demonstrate the effect of a sensory stimulus on blood pressure
The cold pressor test
