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1.2.1. Cardiovascular System > The Heart as a Pump > Flashcards

The Heart as a Pump Flashcards

1
Q

What is systole?

A

ventricular contraction = pressure within them exceeds atrial = tricuspid and mitral values shut. Exceeds pressure in pulmonary artery and aorta = pushing open pulmonic and aortic valves = ejection of blood

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2
Q

What is diastole?

A

ventricular relaxation/filling = from the atria across open tricuspid + mitral valves causes gradual increase in ventricular diastolic pressures

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3
Q

What happens in late diastole?

A

atrial contraction propels final bolus of blood into each ventricle = further rise in atrial and ventricle pressures = a wave

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4
Q

When is the first heart sound heard, S1?

A

shutting of the tricuspid and mitral values during systolic ventricular contraction

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5
Q

When is the second heart sound heard, S2?

A

shutting of the pulmonic and aortic valves

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6
Q

Systole and diastole can be approximated as the period between what?

A

S = S1 – S2. D = S2 – S1

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7
Q

What is the apical impulse?

A

Vibration resulting from heart rotating, moving forward and stricking against the chest wall during diastole

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8
Q

What is mitral valve regurgitation?

A

When the mitral valve doesn’t close all the way and there is back flow of blood.

Common cause = mitral valve prolapse = weakened connective tissue.

Increases pre-load

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9
Q

What is mitral valve stenosis?

A

The mitral valves doesn’t open all the way = hard for blood to get through.

Common cause = rheumatic fever that’s causes the leaflets to fuse = commissural fusion

Commissural fusion = accumulation of blood in atria = increased pres = irritation of pacemaker cells = higher risk of atrial fibrillation, therefore thrombus formation.

Also accum of blood = compression of oesophagus = dysphagia

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10
Q

What keep the mitral valves from prolapsing?

A

Chordae tendineae + papillary muscles

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11
Q

What is aortic valve stenosis?

A

The aortic valve doesn’t open all the way = hard for blood to get through.

Common cause = fibrosis, calcification, chronic rheumatic fever, bicuspid form.

Left sided heart failure = syncope and angina. Increased LV pressure = LV hypertrophy. Shear stress on RBCs = microangiopathic haemolytic anaemia

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12
Q

What is aortic valve regurgitation?

A

Aortic valve doesn’t close all the way and there is back flow of blood to L ventricle.

Common cause = aortic root dilation = pulls apart leaflets OR Valvular damage = infective endocarditis.

Increased SV and systolic pressure, decreases diastolic pressure

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13
Q

What are resistance vessels and where are they found?

A

arterioles and pre-capillary sphincters: restrict blood flow to drive supply to hard to perfuse areas

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14
Q

Describe capacitance vessels and where they are found?

A

found in the venous circulation: enable system to vary the amount of blood pumped around the body by acting as a storage of blood

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15
Q

Which circulation has the higher pressure: systemic or pulmonary?

A

systemic

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16
Q

Which side of the heart works under a higher pressure?

A

left

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17
Q

How many leaflets do the heart valves each have?

A

mitral = 2, aortic, pulmonary, tricuspid = 3

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18
Q

What can be said about the cardiac output of each side of the heart?

A

output must be equal, if not it = oedema

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19
Q

What is the left atrium pressure (mm Hg)?

A

8-10

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20
Q

What is the left ventricle pressure (mm Hg)?

A

120 systole / 10 diastole

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21
Q

What is the aorta pressure (mm Hg)?

A

120 systole / 80 diastole

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22
Q

What is the right atrium pressure (mm Hg)?

A

0-4

23
Q

What is the right ventricle pressure (mm Hg)?

A

25 systole / 4 diastole

24
Q

What is the pulmonary artery pressure (mm Hg)?

A

25 systole / 10 diastole

25
Q

The atria can be described as what for the ventricles?

A

Priming pump

26
Q

What is the stroke volume for a 70kg individual?

A

70ml

27
Q

Per minute how much blood is pumped around the body with a resting heart rate of 70bpm?

A

~4.9L = nearly the entire blood volume

28
Q

What is the length of a cardiac action potential and why is it this way?

A

~280 milli secs, relatively long as it lasts for the during of a single contraction

29
Q

What differentiates cardiac muscle from smooth and skeletal?

A

Functional Syncytium of cells (not merged cells but very tightly bound), tightly connected by gap junctions = what happens in one cells readily influences others

30
Q

What prevents the inversion of valves on systole?

A

Chordae tendineae + papillary muscles

31
Q

What drives the opening and closing of valves in the heart?

A

Differing pressures across the valve

32
Q

What cells generate an action potential in the heart?

A

Pacemaker cells in the sinoatrial node

33
Q

Describe the AV delay

A

~120 milli sec delay = ensures that the atria have ejected their blood into the ventricles first before the ventricles contract, stops simultaneous contraction of the atria and ventricles and prevents atrial fibrillation from escalating into ventricular fibrillation

34
Q

How does an action potential spread through the myocardium?

A

From the inner endocardial to the outer epicardial surface

35
Q

What are the 7 stages of the cardiac cycle?

A

Atrial contraction, isovolumetric contraction, rapid ejection, reduced ejection, isovolumetric relaxation, rapid filling, reduced filling

36
Q

Which stages of the cardiac cycle are diastole and systolic?

A

2-4 = systolic, 5-1 = diastolic

37
Q

As heart rate increases what happens to systolic and diastolic speed?

A

Systolic = stays the same, diastolic = gets shorter

38
Q

What is the length of the cardiac cycle?

A

Total = 0.9sec, diastole ~0.55s, systole ~0.35s

39
Q

What sound is heard for aortic valve stenosis?

A

Crescendo-decrescendo murmur

40
Q

What sound is heard for aortic valve regurgitation?

A

Early decrescendo diastolic murmur

41
Q

What sound is heard for mitral valve stenosis?

A

Snap as valve opens, diastolic rumble

42
Q

What sound is heard for mitral valve regurgitation?

A

Holosystolic murmur

43
Q

How do the ventricles fill with blood?

A

Passive filling, the final 10% is achieved by atrial contraction

44
Q

What occurs during phase 1 of the cardiac cycle?

A

Atrail contraction

Atrial systole = A wave, atrial depolarisation = P-wave, LV vol increase due to atrial contraction

45
Q

What happens in phase 2 of the cardiac cycle?

A

Isovolumetric contraction

Mitral valve closes = c wave = S1 lub, rapid rise in LV pressure due to ventricle contraction, ventricular depolarisation = QRS complex, isovolumetric = no change in ventricle volume = valves shut

46
Q

What happens during stage 3 of the cardiac cycle?

A

Rapid ejection

Ventricle vol decrease = ejection = ventricle pressure higher than aortic = aortic valve open, x descent = atrial pressure drops as atria are pulled down as ventricles contract

47
Q

Outline stage 4 in the cardiac cycle

A

Reduced ejection

V wave = atria pressure rises due to venous return from lungs, ventricular repolarisation = T-wave, = rate of ventricle ejection begins to fall

48
Q

Describe phase 5 of the cardiac cycle

A

Isovoumetric relaxation

Ventricular pressure lower than aortic = aortic valve shuts = S2 dub = dicrotic notch, isovolumetric relaxation = valves close so vol constant

49
Q

What happens in phase 6 of the cardiac cycle?

A

Rapid filling

Y descent = fall in atrial pressure after mitral valve opens = rapid ventricular filling (normally silent S3 = pathology in adults)

50
Q

Outline stage 7 of the cardiac cycle

A

Reduced filling

Diastasis = rate of filling slows down as ventricle reaches inherent relax vol

51
Q

What stages of the cardiac cycle are all the valves closed?

A

Phase 2, 5

52
Q

In what stage of the cardiac cycle are the mitral and tricuspid valves open?

A

Phase 1, 6, 7

53
Q

In what stages of the cardiac cycle are the aortic and pulmonary valves open?

A

Phase 3, 4

54
Q

What diagram outlines pressure, volume and ECG changes in the left side of the heart?

A

Wiggers diagram

1.2.1. Cardiovascular System (18 decks)

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