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Y1 - CVS > The Heart As A Pump > Flashcards

The Heart As A Pump Flashcards

1
Q

What are the 4 heart valves from the right hand side to the left hand side?

A

Tricuspid valve (atrioventricular valve)
Pulmonic valve (semilunar valve)
Mitral valve (atrioventricular valve)
Aortic valve (semilunar valve)

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2
Q

What are the 4 chambers of the heart?

A

Right atrium
Right ventricle
Left atrium
Left ventricle

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3
Q

How is the heart a pump?

A

It is made up of 2 pumps acting in series

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4
Q

What pressure is pulmonary circulation?

A

Low pressure

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5
Q

What pressure is systemic circulation?

A

High pressure

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6
Q

What is Systole?

A

Contraction and ejection of blood from the ventricles

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7
Q

What is Diastole?

A

Relaxation and filling of the ventricles

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8
Q

How many leaflets does the tricuspid valve, pulmonic valve and the aortic valve have?

A

3 leaflets

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9
Q

How many leaflets does the mitral valve have?

A

2
Also called the Bicuspid valve

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10
Q

How does the thickness of the left ventricle compare to the right ventricle and why?

A

Left is much thicker
Systemic circulation is at a much higher pressure since it needs to pump blood around the body

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11
Q

What is stroke volume?

A

The volume of blood ejected from each ventricles per heart beat

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12
Q

What is the volume of blood in the average 70kg male?

A

5L

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13
Q

What is the stroke volume for the average 70kg man at rest?

A

70ml per beat

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14
Q

How are cardiac myocytes interconnected electrically?

A

Via intercalated discs (contain gap junctions)

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15
Q

What are the visible features of cardiac muscle?

A

Striated
Intercalated discs
Branched
Single central nuclei

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16
Q

What causes the opening and closing of the heart valves?

A

Changes in pressure between the chambers of the heart

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17
Q

What is the function of the chordae tendineae?

A

Prevents the valves from inverting leading to blood leaking back into chambers in the heart

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18
Q

When the aortic valve is open, is the mitral valve open or closed and why?

A

Mitral/Bicuspid valve closed
If aortic valve is open it means ventricular systole is occurring, mitral is closed to prevent blood flowing back into the left atria

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19
Q

What region of the heart are the pacemaker cells found?

A

Sinoatrial node

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20
Q

What is the role of the specialised cardiomyocytes in the sinoatrial node?

A

Initiate and spread action potentials

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21
Q

What is meant by the cells in the Sinoatrial node have autorhythmisicty?

A

The auto rhythmic cells of the SAN initiate their own action potential and the rest of the auto rhythmic cells of the heart conduct the action potential throughout the heart

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22
Q

Once the action potential has been generated at the SAN what happens next?

A

Action potential/wave of depolarisation spreads through the atria to the Atrioventricular node (AVN)

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23
Q

What is the function of the Atrioventricular Node (AVN)?

A

Initiates a time delay before the action potential is conducted to the ventricles

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24
Q

Why is the time delay initiated by the AVN important?

A

Gives time for the atria to finish contraction before the ventricles contract

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25
Following the AVN, how is the action potential conducted?
Down the Bundle of His, then to the bundle branches (left and right) which run down the septum to the apex of the heart where Purkinje fibres conduct the depolarisation to the ventricles
26
How do the ventricles contract?
From the apex upwards
27
What are the 7 phases of the Cardiac cycle?
Atrial Contraction Isovolumetric Contraction (ventricles) Rapid Ejection (ventricles) Reduced Ejection (ventricles) Isovolumetric Relaxation (ventricles) Rapid Filling (ventricles) Reduced Filling (ventricles)
28
In terms of Diastole and systole, how are they affected when heart rate needs to increase?
SYSTOLE = ALWAYS SAME DIASTOLE = SHORTER
29
What is a Wiggers diagram?
Diagram that illustrates changes in blood pressure and volume in the left side of the heart for each cardiac cycle
30
How many heart beats are there per cardiac cycle?
1 heart beat
31
How would a Wiggers diagram from the right hand side of the heart compare to the left hand side of the heart?
Lower pressures for the RHS
32
In an electrocardiogram, what does the P wave represent?
Contraction of the Atria/atrial depolarisation
33
In an electrocardiogram, what does the QRS complex represent?
Contraction of the ventricles/ventricular depolarisation
34
In an electrocardiogram, what does the T wave represent?
Ventricular repolarisation
35
What is End Diastolic Volume (EDV)?
The volume of blood each ventricle contains before ejection/systole
36
What happens during Phase 1: Atrial Contraction of the cardiac cycle? (In terms of pressures, volumes and valves)
Atria contract Atrial pressure increases Left ventricular volume also increases The mitral and tricuspid valve are open Aortic and pulmonic valve closed
37
How do the ventricles fill?
Mainly during diastole when the are relaxed and recoiling Some Atrial kick (atria contract filling final 10% of ventricles)
38
Why can patients survive atrial fibrillation?
The amount of blood that the contraction of the atria are responsible for filling the ventricles is not that much
39
At the end of Phase 1: Atrial Contraction, what is the Normal End-Diastolic volume?
About 120ml
40
What happens during Phase 2: Isovolumetric Contraction of the cardiac cycle? (In terms of pressures, volumes and valves)
Ventricles contract causing rapid rise in ventricular pressure (QRS complex) Mitral/Tricuspid valves closes (Ventricular pressure > atrial pressure) Aortic/pulmonic valves still closed ISOVOLUMETRIC SINCE NO CHANGE IN BLOOD VOLUME IN VENTRICLES AS VALVES ARE CLOSED
41
What sound is made during Phase 2: Isovolumetric Contraction and why?
S1 = Lub Noise Lub noise made by sound of mitral and tricuspid valve closing
42
What happens during Phase 3: Rapid Ejection of the cardiac cycle? (In terms of pressures, volumes and valves)
Aortic valve and pulmonic valve open when Intra ventricular pressure exceeds aortic/pulmonic pressure Mitral/tricuspid valve still closed RAPID DECLINE in ventricular volume as blood ejected into aorta Atrial X descent Then pressure in atria starts to slowly increase as they fill with blood
43
What happens during Phase 4: Reduced Ejection of the cardiac cycle? (In terms of pressures, volumes and valves)
Ventricles begin to repolarise causing ventricular pressure to begin to decrease T Wave Aortic/pulmonary valve still open Atrial pressure still slowly increasing
44
What happens during Phase 5: Isovolumetric Relaxation of the cardiac cycle? (In terms of pressures, volumes and valves)
Intra ventricular pressure continues to fall, once its lower than aortic pressure the AORTIC VALVE CLOSES Volume of ventricles remains the same despite the rapid decrease in pressure (valves closed) Dicrotic notch
45
What is the Dicrotic notch?
Slight increase in aortic pressure caused by the closure of the aortic valve
46
What is Atrial X descent?
The initial decrease in atrial pressure as the atrial base is pulled down as the ventricles contract
47
What is the sound that is made in Phase 5: Isovolumetric Relaxation and why?
S2 = Dub Dub noise made by aortic and pulmonary valve closing
48
What is End Systolic Volume (ESV)?
The volume of blood left in the ventricles after systole/ejection
49
How can you work at Stroke volume?
End diastolic volume - End Systolic volume EDV - ESV
50
What happens during Phase 6: Rapid Filling of the cardiac cycle? (In terms of pressures, volumes and valves)
Mitral valve and tricuspid valve open as atrial pressure exceeds intraventricular pressure Atrial pressure then decreases as mitral valve opens = Y-descent RAPID VENTRICULAR FILLING once mitral valve has opened Volume of ventricles begins to increase
51
Phase 6: Rapid filling can produce a 3rd sound (S3), when is the normal and abnormal?
Normal in children In adults can indicate pathology Filing of ventricles normally silent
52
What happens during Phase 7: Reduced filling of the cardiac cycle? (In terms of pressures, volumes and valves)
Rate of ventricular filling slows Ventricles full to about 90% Next cardiac cycle, atrial kick will fill final 10%
53
What is Stenosis?
When a valve doesn’t open enough obstructing blood flow
54
What is regurgitation/incompetence of the valve?
Valve doesn’t close all the way allowing back flow of blood
55
Which side of the heart is more prone to abnormal valve function and why?
LHS since it is under a higher pressure
56
What can cause Aortic valve stenosis?
Degeneration (senile calcification/fibrosis) Congenital (can be bicuspid instead of 3 leaflets) Chronic rheumatic fever
57
What is Chronic rheumatic fever caused by?
Streptococcal infection Causes autoimmune response targeting heart
58
What blood condition can Aortic valve stenosis cause?
Microangiopathic haemolytic anaemia
59
What is Microangiopathic haemolytic anaemia?
When shear stress likely from a stenosed valve damages RBCs leading to them being broken down causing anemia
60
What are the affects of Aortic valve stenosis?
Less blood can travel through valve causing: Increased LV pressure Left sided heart failure
61
What is the effect of the increased LV pressure due to a stenosed aortic valve?
LV hypertrophy since ventricles need to work harder to force blood through valve
62
What does left sided heart failure cause?
Angina Syncope
63
What is angina?
When the heart doesn’t receive enough oxygenated blood from he coronary arteries causing heart pain
64
What is syncope?
Fainting
65
What causes Aortic valve regurgitation?
Aortic root dilation (LEAFLETS PULLED APART) Valve damage
66
What are the effects of aortic valves regurgitation?
Blood flows back into LV during diastole when it shouldn’t Increases stroke vol Systolic pressure inc Diastolic pressure inc BOUNDING PULSE LV hypertrophy
67
What indicates a bounding pulse?
Head bobbing Quinke’s sign
68
What is Quinke’s sign?
Nails flush red and white with every systole and diastole Seen in aortic valve regurgitation
69
What is Myxomatous degeneration?
Changes in collagen structure weaken valve structure
70
What can cause Mitral valve regurgitation?
Myxomatous degeneration Damaged papillary muscles (heart attack) Rheumatic fever (leaflet fibrosis) Left sided heart failure leading to LV dilation stretching valve
71
What is the main cause of Mitral valve stenosis?
Rheumatic fever (Commissural fusion of valve leaflets)
72
How does Mitral valve stenosis affect pressure of the left atrium?
Increased LA pressure to force blood through
73
What is the effect of increased LA pressure?
LA dilation/hypertrophy Right ventricle hypertrophy since RHS must work harder to pump more blood from the pulmonary artery (sine both sides of the heart need to pump same volumes) Pulmonary oedema Dyspnea Pulmonary hypertension
74
What are the affects of Left Atrial hypertrophy?
Atrial fibrillation (thrombus formation as blood pools in atria) Oesophagus compression causing Dysphagia
75
What is Dysphagia?
Swallowing difficulties
76
How do the volumes of blood pumped by both sides of the heart compare?
Pump the same volumes
77
How long is the typical cardiac cycle?
0.9s
78
Approximately how long does diastole last?
0.55s
79
Approximately how long does systole last?
0.35s
80
What type of sound would be heard for a mitral valve stenosis?
Mid diastolic murmur
81
What sound can be heard in an aortic stenosis?
Crescendo decrescendo

Y1 - CVS (21 decks)

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