SECTION 1 Basic Sciences Flashcards
Describe the murmurs heard for Mitral stenosis ?
Opening snap that occurs early in diastole and a RUMBLING diastolic murmur
What is the stethoscope location for mitral stenosis murmur where they are best heard?
Best heard with the chest piece placed over the APEX
Describe the murmurs heard for Mitral Regurgitation?
The cardinal feature of mitral regurgitation is a blowing holosystolic murmur HEARD THROUGHOUT SYSTOLE
Where does mitral regurgitation murmur radiates to?
AXILLA
Murmur heard throughout systole
Mitral regurgitation murmur
2 murmur heard over the CARDIAC APEX
Mitral stenosis and mitra regurgitation
Describe the murmurs f the patient has aortic
Stenosis
Systolic murmur,
Best stethoscope location for AORTIC Stenosis
second right intercostal space (over the aortic arch)
Murmur that radiates to the neck?
AORTIC Stenosis
Murmur description for aortic regurgitation
Diastolic murmur
Best murmur heard over the Left sternal border?
Aortic Regurgitation
When the ventricle fills more during diastole, more blood is ejected during systole. Whose law is this?
Starling’s (or Frank-Starling’s) law of the heart.
Starling’s law of the heart relates ventricular filling during diastole to the
amount of blood ejected during systole.
Starling Law, the greater the ventricular filling during diastole , meaning the greater the _______, the
Preload; The greater the quantity of blood pumped into the aorta during systole.
What causes a change in blood pressure when changing the patient’s position?
Altered preload (altered venous return) is most responsible for a change in blood pressure when the patient is re-positioned.
What nerves carry the afferent and efferent signals of the Bainbridge reflex?
stretch receptors send Afferent signals to the medulla via the vagus nerve. The medulla then transmits Efferent signals via the sympathetic nerves to increase heart rate (by as much as 75%) and myocardial contractility.
What does the Bainbridge reflex help prevent?
The Bainbridge reflex helps prevent damming up of blood in veins, the atria, and the pulmonary circulation.
When does the Bainbridge reflex get activated?
When the great veins and right atrium are stretched by increased vascular volume
Describe the venous drainage of the lung. BAHIB
The venous drainage of the bronchi occurs through the bronchial, azygous, hemiazygos, and intercostal veins, which then drain into brachiocephalic veins of the neck and ultimately the superior vena cava.
The pulmonary circulation returns to the heart via
the pulmonary veins, which empty into the left atrium.
Describe the Valsalva maneuver.
Forced expiration with the glottis closed.
Valsava maneuver increase what kind of pressure?
All intrathoracic pressures including intrapleural and intrapulmonary pressures.
With valsava maneuver, intrapleural pressures changes from _______. What happens to CO and BP?
Negative to positive, so venous return to the RV decreases and CO and BP decrease
With valsava maneuver what causes an increase in HR?
The decrease in BP results in a reflex increase in HR.