Slide set 1 Flashcards
Thoracic pressure changes usually associated with
Increased RR
What type of things can change Total blood volume
Bleed, dehydration, blood donations
Increased diastolic pressure equals
Lower compliance
What Does PDA feed
Part of septum
AV valves is closed during what phase
Systole
Is Ejection fraction a direct measurement
NO
What is afterload related to
Peripheral vascular resistance
SA node PsNS stimulation causes
decreased HR
Right ventricle transfers deoxy blood to where via what valve
Pulmonary system - Pulmonic valve
What is ventricle irritability esentially referring to
Arrythmia
What are ostia
Small openings of the L-R coronary arteries
Do we have control over Frank starling mechanism of compensation?
No
What stimulation can cause ventricle irritability
Sympathetic innervation
Purpose of papillary muscles
Keeps orifice closed during systle and keeps them from regurging
What connects AV valves to ventricles
Paillary muscles and chordae tendinae
What is the primary measurement of heart fx
Cardiac Output (ejection fraction)
A dilated heart can and cants
Can accept more volume but cant push out as much
Afterload is
the force which the LV must pump against
Blood supply of heart (4)
RCA, LAD, LCX, PDA
Arterial baroreceptors causes the heart rate to
Decrease
How many papillary chordae are in L-Vent
2 (sheets of fiber)
Ventricular dilation is caused by
Chronic high preload or Chronic increase in Left EDV/EDP
Atrial kick represents
Both atria contracting at the end of diastole
L-atrium transfers O2 blood to L-Ventricle via what valve
Mitral valve
What is normal ejection fraction
55-75%
EF equals
SV divided by EDV
Lower end diastolic pressure equals
More compliance
L-Vent transfers O2 blood out into the body via what valve
Aortic valve
What 3 mechanisms contribute to HR reg
ANS Brainbridge reflex to atrial stretch Thoracic pressures with respiration and venous return
What increases myocardial contractility (3)
Adrenergic nervous system Catecholamines POS inotropic drugs
Chronic stimulation of the SNS results in
Down regulation of adrenergic receptors causing less of an effect
Another name for mitral valve is
Bicuspid valve
S4 occurs just before what heart sound
S1
Ventricular dilation initially does what to CO but then changes
Initally increases CO (per Frank Starling) but then decreases CO eventually
What does the RCA feed
Inferior wall of left ventricle Right atrium - ventricle Part of septum SA (Most patients) and AV node PDA (Right dom flow)
SympatheticNS originates where
Thoracic 1-5 ganglia
Right ventricle ejects deoxy blood into pulmonary system during what phase
Systole
What factors determine afterload
Aortic pressure Volume of the ventricular cavity to include wall thickness
Right atria accepts deoxygenated blood from
SVC, IVC, and Coronary sinus
What does the LAD feed
Part of septum Bundle branches Bulk of left ventricle
AV valves is open during what phase
Diastole
The volume and thickness of ventricular cavity is follows whatprinciple
The law of laplace
A hypertrophy heart can and cants
Can push out better but can’t accept as much volume
How many cusps do Semilunar valves have
3 cusps
Atria PsNS stimulation causes
decreased contractility
After all Coronary artery feed zones established what supplies the rest of the heart?
RCA and LCX (generally)
What is the big player of CO
Left Ventricle
Both atria correlates with what ABNL sound
S4 (atrial gallop)
Brainbridge reflex physiology
Atria stretching causes baroreceptors to increase HR so that blood may be redistributed
What indirect method can we use for preload measurement
Pulmonary capillary wedge pressure with Right heart cath
AV Node PsNS stimulation causes
decreased velocity
What can you often hear durinf an MI
Mitral regurgitation
The Law of Laplace says
Afterload increases : SV and CO decreases
Ejection fraction is not the same thing as what
SV
Left atrium accepts O2 blood from where
Pulmonary system via 4 pulmonary veins
Semilunar valves are open during what phase
Systole
What are the 2 names of semilunar valves
Aortic valve and Pulmonary valve
What decreases myocardial contractility (4)
NEG inotropic drugs Some Anti-arrythmics CCBs and B-BLKs
Preload is
the load that causes ventricular wall tension prior to contraction at the end of diastole
Do we have control over sympathetic stimulation compensatory mechansim?
Yes - some (meds)
Example Positive inotropic drugs
Digoxin Isoproterenol Dopamine Dobutamine Caffeine
Chronic overload of the hear results in
Dilation
Disadvantages of ventricular hypertophy
Increased stiffness and increased myocardial O2 demand
Mitral valve has how many leaflets
2 (Anteromedial and Posterolateral)
MUGA stands for
Multi-gated acquisition
What are the 2 names of Semilunar valves
Aortic valve and Pulmonic valve
When does the coronary arteries fill
During Diastole (Low pressure backwash)
Thoracic pressure physiology
Rib cage expands (Diaphragm moves down) Lowers Thoacic P and Rises ABD P Increased ABD P increases venous return
AV correspond to what heart sound
S1 (Lub)
Semilunar valves are close during what phase
Diastole
Disadvantages of ventricular dilation
Increased wall stress (per LaPlace) Increased myocardial O2 demand
Compliance reflects
Diastolic ventricular pressure
Some anti-arrythmic drugs
Quinidine Procainamide Disopyramide
What valves are in time with carotid pulses
AV valves
Right atria transfers deoxy blood to Right ventricle via what valve
Tricuspid
L-Vent SV is inversely related to what
Afterload
Chronic compensatory mechanisms (2)
Ventricular hypertrophy Ventricular Dilation
What type of receptors are innervated through SNS stimulation
?eta-1 receptors
A tear or ischemia of the papillary muscle can cause
Regurgitation
Standing position causes what to venous return
Decreases it
Aortic pressure is influenced by
Blood volume and peripheral vascular resistance
What is normal thickness of L-Vent muscle
8-15mm (3x the size of RV)
What is the function of the heart
Deliver O2 blood to tissues
Cardiac Output is measured as
Total blood volume per minute
SV equals
EDV - ESV
Frank Starling mechansims suggests
More stretch of myocytes the more capable force to a limit
CO equals
SV x HR
Methods EF is determined (3)
Nuclear ventriculography (MUGA) Echocardiography MRI
Ventricular hypertrophy is caused by
Chronic contraction against high afterload
SV is
Volume of blood ejected with each contraction
What allows for beat to beat compensation of the heart?
Frank Starling compensatory mechanism
What are the 2 names of AV valves
Tricuspid and Mitral
What method can use use for direct measurement of preload
Left heart catherization
Semilunar valves correspond to what heart sound
S2 (Dub)
Where does the cardiac plexus meet
Near Aortic arch
ANS regulates what
Rate, Conductivity speed, Force
What does LCX feed
SA node & PDA (Left dom flow) (Not predom) Lateral and part of posterior wall of LV
Ejection fraction physiologically represents
Fraction of EDV ejected from ventricle each systolic contraction
What are the names of Aortic valve cusps
Right cornary cusp, Left cornary cusp, and Noncoronary cusp
Increase preload you increase what?
Stroke volume (per Frank Starling mech)
Major compnents of preload (4)
Total blood volume Distribution of blood volume Atrial contraction Heart compliance
Increased preload leads to
V-con or increased volume Increased contractility increasing SV
Preload is measured with what values
Ventricular end diastolic volume (VEDV) Ventricular end diastolic pressure (VEDP)
CO and HR are inversely or directly proporational
Directly proportional
SA node SNS stimulation causes
Increased HR
Ventricle SNS stimulation causes
Increased contractility and conduction speed
Acute compensatory mechanisms (2)
Frank Starling mechanism Sympathetic Stimulation
Aortic pressure is also known as
The resistance against which the Ventricles must contract or mean blood pressure
Tricuspid valve corresponds to what chambers
RA and RV
Atria SNS stimulation causes
Increased contractility and conduction speed
Gold standard of determinging EF is
Cardiac cath (invasive)
CO is affected by (4)
Preload, afterload, Myocardial contractility and HR
AV Node SNS stimulation causes
increased conduction speed
Mitral valve corresponds to what chambers
LA and LV
What nerve is used for parasympathetic innervation
Vagus nerve
Acute compensatory SNS innervation results in
Increased HR or contractility
How do semilunar valves close
After ventricles eject into great vessels backward pressure catches the cusps and closes them
Is there ventricle PsNS innervation
NO
