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CV System - Alex's Cards (ESA2) > Session 2 Lectures > Flashcards

Session 2 Lectures Flashcards

1
Q

What are capacitance vessels?

A

Vessels that enable the system to vary the amount of blood pumped around body
Too much blood - blood stored here
Not enough blood - obtain from here

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2
Q

What are resistance vessels?

A

Vessels that restrict blood flow to drive supply to areas of the body that most need it

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3
Q

At rest where does the majority of our blood supply?

A

GI tract

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4
Q

When exercising where does the majority of our blood supply?

A

Muscles

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5
Q

What is systole?

A

The contraction and ejection of blood from ventricles

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6
Q

What is diastole?

A

The relaxation and filling of ventricles

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7
Q

Name the veins, arteries and valves in the right side of the heart

A 
Veins = superior and inferior vena cava 
Arteries = pulmonary trunk supplying left and right pulmonary arteries 
Valves = tricuspid valve and pulmonary valve
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8
Q

Name the veins, arteries

and valves of the left side of the heart

A 
Veins = pulmonary veins 
Arteries = ascending aorta (enters the arch of aorta with the brachiocephalic trunk, the left common carotid artery and the left subclavian vein)
Valves = mitral valve and aortic valve
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9
Q

What is the typical pressure (mmhg) on right side of heart?

A

25 systole / 4 diastole

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10
Q

What is the typical pressure (mmhg) on left side of heart?

A

120 systole / 10 diastole

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11
Q

What is the stroke volume?

A

Amount of blood pumped per heartbeat

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12
Q

What is approximate stroke volume?

A

70ml per heartbeat

Over 1 minute this is roughly 5L blood

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13
Q

How are cardiac myocytes connected?

A

Via gap junctions

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14
Q

How are mitral and tricuspid valves attached to papillary muscles?

A

Via chordae tendineae

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15
Q

What are pacemaker cells and where are they?

A

Specialised myocytes that can conduct an action potential

Located in sinoatrial node

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16
Q

Why is there a delay in action potential spread at atrioventricular node?

A

To allow time for atrium to stop contracting before ventricles do

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17
Q

Where does action potential travel to from the AV node?

A

Down the Bundle of His (left and right bundle branches) to Purkinje fibres

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18
Q

As heart rate increases what changes - systole or diastole?

A

Diastole time decreases

Systole always remains the same

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19
Q

How many stages to the cardiac cycle are there and what stage do we begin at?

A

7 stages

Start at atrial contraction

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20
Q

What is phase 1 of the cardiac cycle?

Describe what you may see on the graph at this stage

A 
Atrial contraction (part of diastole)
The A wave = atrial pressure rises
Small increases in LV volume = blood is being topped up as over 80% full from ventricle filling 
The P wave = in ECG is onset of atrial depolarisation
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21
Q

What is the end diastolic volume?

A

The maximal volume of the ventricles

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22
Q

What is phase 2 of the cardiac cycle?

Describe what you may see on the graph at this stage

A 
Isovolumetric contraction (part of systole)
Mitral valve closes when LV pressure is greater than LA pressure
C wave = in atrial pressure 
Isovolumetric = no change in ventricular volume as mitral valve closed 
QRS complex in ECG = onset of LV depolarisation 
S1 on phonocardiogram = closing of mitral valve
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23
Q

What is phase 3 of the cardiac cycle?

Describe what you may see on the graph at this stage

A

Rapid ejection (part of systole)
Aortic valve opens when LV pressure is greater than LA
X descent (after C wave) on atrial pressure = where pressure decreases as LA is pulled down during LV contraction
Decrease in LV volume as blood ejected

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24
Q

At phase 3 of the cardiac cycle what valves are open and closed?

A

Aortic and pulmonary valves open

Mitral and tricuspid valves closed

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25
Q

What valves are open and closed during phase 1 of cardiac cycle?

A

Mitral and tricuspid open

Aortic and pulmonary closed

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26
Q

What valves are open and closed during phase 2 of cardiac cycle?

A

All valves closed (isovolumetric = no change in volume)

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27
Q

What is phase 4 of the cardiac cycle?

Describe what you may see on the graph at this stage

A 
Reduced ejection (part of systole)
Decline in LV pressure as LV repolarises
V Wave in atrial pressure = atrial pressure gradually rises from venous return 
T wave of ECG = LV repolarisation
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28
Q

What valves are open and closed during Phase 4?

A

Aortic and pulmonary open

Mitral and tricuspid closed

29
Q

What is phase 5 of the cardiac cycle?

Describe what you may see on the graph at this stage

A

Isovolumetric relaxation (part of diastole)
When LV pressure falls below aortic pressure aortic valve closes
S2 on phonocardiogram (sound 2)
Diacrotic notch in aortic pressure = increase as valve closes
Ventricular volume same = all valves closed
LV pressure rapid decline

30
Q

Which valves are open and closed during phase 5 of cardiac cycle?

A

All valves closed (isovolumetric)

31
Q

How do you calculate stroke volume?

A

End diastolic volume - end systolic volume

32
Q

What is phase 6 of the cardiac cycle?

Describe what you may see on the graph at this stage

A

Rapid filling (part of diastole)
Y descent on atrial pressure = fall of pressure as mitral valve opens
When LV pressure falls below LA pressure the mitral valve opens
Increase in LV volume

33
Q

When can S3 sometimes be heard and what does this mean?

A

During stage 6 = rapid filling
Sometimes S3 is heard during ventricular filling
Can often be heard in children but not in adults. In adults = sign of pathology e.g. heart failure

34
Q

What is phase 7 of the cardiac cycle?

Describe what you may see on the graph at this stage

A 
Reduced filling (part of diastole)
Left ventricular volume only slowly rising as ventricle reaches maximum volume (end diastolic volume)
35
Q

What valves and open and closed during phase 6 of cardiac cycle?

A

Mitral and tricuspid = open

Aortic and pulmonary = closed

36
Q

What valves are open and closed during phase 7 of cardiac cycle?

A

Mitral and tricuspid = open

Aortic and pulmonary = closed

37
Q

What side to most valve failures occur on?

A

Left

38
Q

What is valve stenosis?

A

Valve doesn’t open enough = obstruction to blood flow

39
Q

What is valve regurgitation?

A

Valve doesn’t close all the way = back leakage of blood

40
Q

Give 3 possible causes of aortic stenosis

A
  1. Senile calcification/fibrosis (due to old age)
  2. Congenital = bicuspid valve rather than tricuspid
  3. Rheumatic fever
41
Q

What is damage to RBCs called and how might it occur?

A

Shear stress

From aortic valve stenosis

42
Q

What can aortic stenosis lead to?

A 
LV hypertrophy (increased pressure)
Left sided heart failure - can lead to angina (not enough blood to heart)
43
Q

Give 2 causes of aortic valve regurgitation

A
  1. Aortic root dilation (leaflets pulled apart)

2. Rheumatic fever (damages valve)

44
Q

Give 3 possible causes of mitral valve regurgitation

A
  1. Damage to papillary muscle after heart attack
  2. Left sided heart failure can stretch valve
  3. Rheumatic fever
45
Q

What can cause preload to be increased?

A

Mitral valve regurgitation = more blood enters ventricle in next cycle

46
Q

What is the main cause of mitral valve stenosis?

A

Rheumatic fever

47
Q

Describe some of the effects of mitral valve regurgitation

A
  • pulmonary oedema
  • pulmonary hypertension
    (both can lead to RV hypertrophy)
  • stretching of cardiac myocytes in LA can cause atrial fibrillation and oesophagus compression
48
Q

What is the afterload?

What pressure is it equivalent to?

A

The load the heart must eject blood against - roughly equivalent to aortic pressure

49
Q

What is preload?

A

Amount the ventricles are stretched during diastole

50
Q

What is total peripheral resistance?

A

Resistance to blood flow by all systemic vasculature

Majority occurs in arterioles

51
Q

What vessels offer greatest resistance?

What happens to pressure on each side of resistance?

A

Arterioles offer greatest resistance - the pressure drops as it flows through a resistance
Constriction of arterioles increases resistance = pressure increases on arterial side and pressure decreases on venous and capillary side

52
Q

What happens to pressure in arteries and veins when:
TPR decreases
cardiac output the same

A 
Arteries = pressure decreases 
Veins = pressure increases
53
Q

What happens to pressure in arteries and veins when:
TPR increases
cardiac output same

A 
Arteries = pressure increases
Veins = pressure decreases
54
Q

What happens to pressure in arteries and veins when:
CO increases
TPR same

A 
Arteries = pressure increases
Veins = pressure decreases
55
Q

What happens to pressure in arteries and veins when:
CO decreases
TPR stays same

A 
Arteries = pressure decreases 
Veins = pressure increases
56
Q

If the tissues need more blood what happens to arterioles and capillary sphincters?

A

They dilate and TPR falls

This would result in artery pressure dropping - in order to prevent that the heart pumps more to balance the pressure

57
Q

How do you calculate cardiac output?

A

Stoke volume x Heart rate

58
Q

How do you calculate stroke volume?

A

End diastolic volume - end systolic volume

59
Q

The ventricles fill during diastole until the pressure is equal to…?

A

the venous pressure

60
Q

What happens to end diastolic volume when the pressure in the veins increase?

A

When the venous pressure increases the heart fills more during diastole so EDV increases

61
Q

What is the frank starling law of the heart?

A

The more the heart fills (muscles are stretched) the harder it contracts

62
Q

What is the normal left ventricle end diastolic pressure?

A

8 mm/hg

63
Q

What is normal stroke volume?

A

Approx 70ml

64
Q

What is contractility?

A

Force of contraction for a given fibre length

65
Q

What extrinsic factors can increases contractility?

A

Sympathetic stimulation and circulating adrenaline

66
Q

What happens to the left ventricular end diastolic volume when you increase and decrease contractility?

A

Increase contractility = increased stroke volume and decreased LVEDP
Decreased contractility = decreased stroke volume and increased LVEDP

67
Q

What is the aortic impedance?

A

Pressure in the aorta

68
Q

What happens to the TPR when metabolism increases?

How does this affect cardiac output?

A

When metabolism increases the TPR decreases to allow more blood to be supplied
When TPR decreases arterial pressure decreases and venous pressure increases
The heart reacts by pumping more = increases cardiac output so that the arterial pressure rises

CV System - Alex's Cards (ESA2) (9 decks)

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