S3_L2: The Heart as a Pump Flashcards
Enumerate the 5 phases of the cardiac cycle
- Atrial Systole
- Isovolumetric Ventricular Contraction
- Ventricular Ejection
- Isovolumetric Ventricular Relaxation
- Ventricular Filling
Determine whether the following factors increase or decrease the end-diastolic volume
- Increased negative intrathoracic pressure
- Increased venous tone & total blood volume
- Standing
- Increased pumping action of skeletal muscles
- Increased intrapericardial pressure
A. Increases
B. Decreases
- A
- A
- B
- A
- B
Oxygen consumption of heart is determined by what 3 factors?
- Intramyocardial tension
- Contractile state of the myocardium
- Heart rate
TRUE OR FALSE: Aortic pressure is 7x greater than pulmonary artery pressure
True
TRUE OR FALSE: Stroke work of the left ventricle is 7x the right ventricle
True
Enumerate the four factors that control cardiac output and state whether each factor is a cardiac or coupling factor.
- Heart Rate (cardiac factor)
- Myocardial Contractility (cardiac factor)
- Preload (coupling factor)
- Afterload (coupling factor)
The amount of blood pumped by the heart per minute
Cardiac output
TRUE OR FALSE: During isovolumetric contraction, there is a rise in atrial pressure.
True
TRUE OR FALSE: Cardiac outputs of both ventricles are equal
True
TRUE OR FALSE: Murmurs are heard due to narrowing of the orifice or regurgitation leading to a rippling effect, turbulent blood flow, and a vibration heard. This happens with valvular disease.
True
TRUE OR FALSE: Hearing an S3 is normal.
False
TRUE OR FALSE: (R) atrial systole occurs after (L) atrial systole.
False
TRUE OR FALSE: Sleep increases cardiac output
False
TRUE OR FALSE: The resting pressure in the pulmonary arteries is 10mmHg
True
TRUE OR FALSE: Pulse is weak during hemorrhage
True
TRUE OR FALSE: Myocardial contractility affects venous return
False
TRUE OR FALSE: If the aortic valve is stenosed, you would hear the murmur in systole.
True
TRUE OR FALSE: RV ejection begins before LV ejection
True
Because of pressure since RV only needs 10 mmHg as compared to LV’s 80 mmHg
TRUE OR FALSE: Aging produces a faster pulse wave
True
TRUE OR FALSE: The A wave corresponds to the blood regurgitation into the veins during atrial systole
True
TRUE OR FALSE: If the semilunar valves are stenosed, the bruit will be heard during systole
True
TRUE OR FALSE: Heart rate and pulse rate should be equal
True
TRUE OR FALSE: Blood regurgitates to the great veins during atrial systole.
True
TRUE OR FALSE: Blood flows from areas of high pressure to low pressure
True
How many phases does the cardiac cycle have?
5
What happens during late diastole?
Both AV valves are open (mitral and tricuspid)
The amount of blood pumped per beat
Stroke volume (SV)
Covers the heart
Pericardium
Enumerate the normal heart sounds
S1 and S2
Stenosis and regurgitation produce ___
Bruits
Exercise ___ the cardiac output
increases
70% of blood fills the ventricles passively because of the high pressure in the SVC, IVC, and pulmonary veins. Aortic & pulmonic valves are closed.
A. Early diastole
B. Late diastole
C. Ventricular ejection
D. Atrial systole
E. Isovolumetric ventricular contraction
F. None
B. Late diastole
Ventricular pressure is very low.
A. Early diastole
B. Late diastole
C. Ventricular ejection
D. Atrial systole
E. Isovolumetric ventricular contraction
F. None
B. Late diastole
Atria and ventricular filling
A. Early diastole
B. Late diastole
C. Ventricular ejection
D. Atrial systole
E. Isovolumetric ventricular contraction
F. None
B. Late diastole
Aortic and pulmonic valves open, part of ventricular systole, ejection is rapid then slowly declines as systole progresses. Intraventricular pressure rises to a maximum then declines (Peak of LV: 120 mmHg; peak of RV: 25 mmHg).
A. Early diastole
B. Late diastole
C. Ventricular ejection
D. Atrial systole
E. Isovolumetric ventricular contraction
F. None
C. Ventricular ejection
The remaining 30% of blood is pumped by the atria and an additional force is needed to pump the remaining 30% blood into the ventricles.
A. Early diastole
B. Late diastole
C. Ventricular ejection
D. Atrial systole
E. Isovolumetric ventricular contraction
F. None
D. Atrial systole
Rapid build up pressure of the ventricles to overcome the pressure in aorta (80 mmHg) and in the pulmonary artery (10 mmHg)
A. Early diastole
B. Late diastole
C. Ventricular ejection
D. Atrial systole
E. Isovolumetric ventricular contraction
F. None
E. Isovolumetric ventricular contraction
There is some regurgitation of blood to the great veins
A. Early diastole
B. Late diastole
C. Ventricular ejection
D. Atrial systole
E. Isovolumetric ventricular contraction
F. None
D. Atrial systole
The phase where both AV valves and semilunar valves are closed and the ventricular muscle initially shortens a little.
A. Early diastole
B. Late diastole
C. Ventricular ejection
D. Atrial systole
E. Isovolumetric ventricular contraction
F. None
E. Isovolumetric ventricular contraction
The phase where both AV valves and semilunar valves are open.
A. Early diastole
B. Late diastole
C. Ventricular ejection
D. Atrial systole
E. Isovolumetric ventricular contraction
F. None
F. None
Relaxation of the ventricles, ventricular pressure is higher than atrial pressure but the AV valves are not yet open (Isovolumetric ventricular relaxation). Known as protodiastole and the ventricular pressure decreases in preparation for the opening of mitral and tricuspid valve so that blood will flow back again into the ventricles.
A. Early diastole
B. Late diastole
C. Ventricular ejection
D. Atrial systole
E. Isovolumetric ventricular contraction
F. None
A. Early diastole
Enumerate the instances where atrial pressure rises
- Atrial systole
- Early diastole
- Isovolumetric ventricular contraction
Why is isovolumetric ventricular contraction essential?
It is to build up pressure for ventricular ejection
End diastolic volume (EDV) - End systolic volume (ESV) = __?
Stroke volume (SV)
Oxygen consumption of a beating heart at rest
9 ml/100g/min
Law that explains the energy of contraction is proportional to the initial length of the cardiac muscle fiber and is proportionate to the end-diastolic volume. Preload, venous return, contractility of the heart will affect myocardial fiber shortening.
Frank-Starling Law
The cardiac index is the correlation between resting cardiac output and body surface area. At any point in time, an organ receives ___ of blood
3.2 L
Pericardial sac has ___ of clear fluid
5 - 30 ml
The end-diastolic ventricular volume is (1)___. The end-systolic ventricular volume is (2)___.
- 130 ml
- 50 ml (At the end of systole, not all of the blood are ejected)
TRUE OR FALSE: RV contraction starts after LV contraction
True
Left before right because left ventricle has more
force, thicker muscle, and greater pressure that it needs to overcome hence it must contract first
During expiration, the (1)___ valves close simultaneously. Conversely, the (2)___ valve closes slightly before the pulmonic valve during inspiration.
- pulmonic and aortic valves
- aortic
Determine the corresponding descriptions of the heart sounds
- Closure of aortic & pulmonic valves; “dup” / “dub”
- Heard 1/3 of the way in diastole
- Ventricular hypertrophy; heard when atrial pressure is high or in the stiff ventricles
- Closure of AV valves; “lub”
- Rapid ventricular filling
A. First sound (S1)
B. Second sound (S2)
C. Third sound (S3)
D. Fourth sound (S4)
- B
- C
- D
- A
- C
Determine the corresponding timing of murmur during these specific abnormalities
- Aortic or pulmonic Insufficiency
- Mitral or Tricuspid Stenosis
- Aortic or pulmonic Stenosis
- Mitral or Tricuspid Insufficiency
A. Systolic
B. Diastolic
- B
- B
- A
- A
Determine the corresponding descriptions of the waves (jugular pressure transmitted in the great veins)
- Rise in atrial pressure before AV valves open in diastole
- Due to atrial systole; Blood regurgitation
- Rise in atrial pressure due to bulging of the AV valves during isovolumetric contraction
- Venous inflow stops = rise in venous pressure
A. A wave
B. C wave
C. V wave
- C
- A
- B
- A
Abnormal sounds heard in the vascular system due to turbulent blood flow. Heard in valvular diseases, such as stenosis, which is narrowing of the valve and it does not open properly, and regurgitation or insufficiency, which is when the valve does not close properly and backflow occurs.
Murmurs / Bruits