The heart as a Pump Flashcards

1
Q

Systole

A

Chamber contracts and ejects blood

~0.3s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Diastole

A

Relaxation Phase

~0.5s
*when HR increases, diastole is most affected.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Specific sequence of events

A
Atrial Systole
Isovolumic contraction
Rapid Ejection
Reduced Ejection
Isovolumic relaxation
Rapid Filling
Reduced filling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Atrial Systole

A

Soon after the start of the “P” wave; Atrial Depolarization

  • top-up ventricles by contracting, completes filling
  • Responsible for small increase in A/V pressure and venous volume.
  • ‘a’ wave
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When is atrial contraction really necessary?

A

-Contraction not usually necessary as much filling is passive. But at high HR, extra boost is important

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Isovolumic Contraction

A
  • Phase between the start of ventricular systole and the opening of the Semilunar valves
  • Onset coincides with R-wave peak
  • Volume constant but Pressure steeply rises
  • c-wave
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Rapid Ejection

A

Semilunar (aortic and pulmonary) valves open

  • Rapid increase in aortic flow
  • Rapid drop in LV volume
  • Atrial pressure drops; base moves towards apex and stretches atria
  • Sharp increase in LV and Aortic pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Reduced Ejection

A

-Runoff from aorta to periphery exceeds LV output> aortic P drops > aortic flow drops

  • Aortic pressure just > LV pressure
  • Forward momentum continues ejection
  • Atrial pressure rising (filling from veins)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How much blood is ejected from LV

A

55%-75%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ESV?

A

~60mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Isovolumic Relaxation

A
  • Aortic valve closes due to Pressure-Gradient Reversal. Semilunar also closed
  • Incisura
  • 2nd heart sound
  • Rapid fall in LV pressure, no change volume
  • Aortic Pressure remains high
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Incisura/dicrotic notch

A

Small notch of aortic pressure during isovolumic relaxation
-coincides with SL valve closure, as the blood reversal occurs and blood tries to flow back into the LV, there is a increase in Aortic presure due to the elastic recoil of the artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Rapid FIlling

A

Major part of V filling
LV rapid increase in LV volume, as blood flows from the atria > ventricles
V pressure is still dropping

3rd Heart sound sometimes heard

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Slow filling

A

Diastasis

  • Equalised pressures, slow rise in A and V and venous pressures, and ventricular volume
  • Blood returns from peripheral veins > RV and blood from lungs > LV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are heart sounds?

A

Due to turbulence cause by valves closing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

1st heart sound

A

Due to AV valves closing. During begining ofisovolumic contraction, rapid P development, opening of semilunar valves and outflow

17
Q

2nd Heart sound

A

Due to semilunar valves closing/tensing > resulting vibrations. During Isovolumic relaxation.

18
Q

Heart Vibrations

A

Very low frequencies, amplitudes and durations
30-250Hz

Heard via auscultation

19
Q

Venous pulse/pressure Waves: “a” wave”

A

Retrograde pressure pulse in jugular when atria contract

20
Q

Venous pulse/pressure Waves: “c” wave”

A

during early phase of ventricular systole

21
Q

Venous pulse/pressure Waves: “v” wave”

A

gradual pressure increase during reduced ejection and isovolumic relaxation

22
Q

How to the RV and LV pressures differ

A

RV pressures are similar to LV, just slightly lower, same with atrial pressures. Also a slight difference in timing.

Same venous pulses

This is due to pulmonary circulation having a lower resistance

23
Q

Abnormal Heart Sounds:

A

Regurgitation: Blood leaks back through valve in the wrong direction

Mitral Valve prolapse: mitral valve has “floppy” flaps and doesn’t close tightly. Sometimes causes regurgitation

Stenosis: Valves doesn’t open enough restricting blood flow

24
Q

Cardiac catherterization

A

Long thin flexible tube is put in blood vessel in arm, groin or neck and threaded to your heart. Saline filled. Far less invasive

25
Swan Ganz catheter
Way to measure Left atrial P through SVC> RA> RV>pulmonary artery, which is between R heart and left atrial pressure. Balloon at tip, can be inflated, pressure sensore at the tip Balloon inflated: pressure after (left arterial P) can be measured! "a, c and v" waves
26
Thermodilation: measure CO
Cold saline released in right atria, tip (at pulmonary artery) measure temp change and pressure change is measured. Better then diodilution as less toxic/invasive
27
TPR looks at whereas PVR looks at
total resistance of systemic circulation to flow total resistance of pulmonary circulation to flow