The heart pump Nov1 M1

Question 1

Wiggers diagram represents what (what variables in there)

Answer 1

aortic pressure, LEFT ventricular P, LEFT atrial P, LEFT ventricular volume, electrocardiogram, phonocardiogram

Question 2

2 phases of systole

Answer 2

isovolumetric contraction, ejection

Question 3

aortic pressure when isovol contraction starts and when it ends

Answer 3

almost at its minimum and then at its minimum (80 is aorta EDP, end diastolic volume)

Question 4

ventr. P at end of diastole and how varies during isovol contraction + value at the end of isovol contract

Answer 4

0. it goes up very quickly. 80 at end of isovol contract bc reaches aortic P

Question 5

atrial P at end of diastole and how varies during isovol contraction

Answer 5

almost 0. goes up a little (by 10)

Question 6

ventricular V at end of diastole and how it varies during isovol contraction

Answer 6

140 mL. stays constant

Question 7

isovol contraction beginning middle and end ECG correspondence

Answer 7

starts at top R wave. ends right after S wave.

Question 8

phonocardiogram during isovol contraction

Answer 8

S1 made by sum of AV valve closing at beginning of isovol contraction

Question 9

ejection phase how ventr. P changes

Answer 9

from 80, goes up more until 120 and goes back down to 80

Question 10

ejection phase how aortic P changes

Answer 10

goes up from 80 reaches 120 and goes back down to 95

Question 11

ejection phase how atrial P changes

Answer 11

from 10, goes down almost to 0 quickly and then increases slowly

Question 12

ejection phase how ventr. volume changes

Answer 12

from 130 ml, drops down 1 over x shape until 50 ml.

Question 13

ECG correspondence to ejection phase

Answer 13

T wave starts in middle of ejection

Question 14

phonocardiogram in ejection phase

Answer 14

nothing

Question 15

3 phases of diastole

Answer 15

• isovol relaxation
• rapid inflow+diastasis
• atrial systole

Question 16

ventr P during isovol relaxation

Answer 16

goes down from 80 (to 20)

Question 17

aortic P during isovol relaxation

Answer 17

goes back up a little from 95 to 100

Question 18

atrial P during isovol relaxation

Answer 18

is still slowly increasing, reaches 10 (its maximum)

Question 19

left vent volume during isol relaxation

Answer 19

stays at 50 mL

Question 20

ECG during isovol. relaxation

Answer 20

end of T wave

Question 21

phonocardiogram during isovol relax

Answer 21

aortic valve closes at beginning + mitral valve opens at end = S2 sound

Question 22

vent P during rapid inflow-diastasis

Answer 22

goes down (from 20) to 0 in very beginning and stays at 0

Question 23

aortic P during during rapid inflow-diastasis

Answer 23

goes down from 95 to around 80

Question 24

atrial P during during rapid inflow-diastasis

Answer 24

goes back down to 0

Question 25

during during rapid inflow-diastasis, which P is higher between left atrium and ventricle P

Answer 25

atrial P a bit higher (so that flow to ventricle occurs)

Question 26

ventr. volume during during rapid inflow-diastasis

Answer 26

ventricle fills a lot (from 50 to almost 110)

Question 27

ECG during during rapid inflow-diastasis

Answer 27

P wave middle at end of diastasis

Question 28

phonocardiogram during rapid inflow-diastasis

Answer 28

if S3 present, would hear it right between rapid inflow and diastasis

Question 29

vent P during atrial systole

Answer 29

goes up slightly up and back down but above 0

Question 30

aortic P during atrial systole

Answer 30

still decreasing, reaches its minimum of 80 at the end of atrial systole

Question 31

atrial P during atrial systole

Answer 31

goes up a little and goes back down above 0. always greater than vent P

Question 32

vent volume during atrial systole

Answer 32

goes up from 110 to 130 mL

Question 33

ECG during atrial systole

Answer 33

second half of P wave then Q wave and start of R wave

Question 34

left vent P variation during cardiac cycle

Answer 34

1. 0 at end diastole, goes up to 120 during ejection, back to 0 at end of isovol relax 2. stays at 0 during rapid inflow-diastasis 3. increases a bit and goes back down during atrial systole

Question 35

aortic P variation during cardiac cycle

Answer 35

1. 80 at end of isovol contraction (lowest) 2. goes from 80 to 120 to 95 during ejection 3. 95 to 100 during isovol relax 4. drops back slowly to 80 during diastole

Question 36

atrial P variation during cardiac cycle

Answer 36

1. near 0 at end diastole 2. increases a bit during end isovol contraction 3. drops low at start of ejection and goes back up slowly until 7-8 value at end of isovol relax 4. goes down slowly during rapid inflow-diastasis 5. goes up and back down during atrial systole

Question 37

vent volume during cardiac cycle

Answer 37

1. at 50 at end of isovol relax 2. up to 110 during rapid inflow-diastasis 3. 110 to 130 ml during atrial systole 4. from 130 at end diastole to 50 at end isovol relax

Question 38

ECG during cardiac cycle

Answer 38

- P between diastasis atrial systole - Q and R during and at end of atrial systole - S at end of isovol contraction - T at end ejection + small portion in isovol relax

Question 39

QRS complex present where and represents what

Answer 39

AP passing through AV node and sweeping over ventricular muscle. At start of systole

Question 40

name of max pressure reached by LV and aorta during ejection phase

Answer 40

peak systolic BP

Question 41

what is called the slight increase in aortic P from 95 to 100 during isovol relaxation

Answer 41

incisura or dicrotic notch

Question 42

when does the left ventricle reach its minimum volume + name of that

Answer 42

ESV. when aortic valve closes. when isovol relax starts

Question 43

3 things the proper filling of ventricles depends on

Answer 43

1. filling P of blood returning to heart 2. ability of AV valves to open fully 3. Low resistance to stretch

Question 44

what causes atrial systole (contraction) and when is it especially important

Answer 44

P wave. atrial systole important during exercise when low passive filling time

Question 45

When is LV at its fullest and at its emptiest

Answer 45

at fullest right before isovol contraction | at emptiest right before isovol relaxation

Question 46

SV def

Answer 46

EDV - ESV

Question 47

Ejection fraction def

Answer 47

SV divided by EDV

Question 48

normal ejection fraction

Answer 48

55-70%

Question 49

systolic BP def

Answer 49

highest arterial BP (at peak vent contraction): 120

Question 50

diastolic BP def

Answer 50

lowest recorded BP (at end of diastole)

Question 51

normal BP

Answer 51

120 over 80

Question 52

Pulse pressure def and normal value

Answer 52

systolic BP - diast BP. normal 40

Question 53

diastole to systole time ratio

Answer 53

2:1. diastole takes two thirds of cardiac cycle

Question 54

Mean arterial pressure (MAP) formula

Answer 54

diastolic BP + third of pulse pressure

Question 55

how aorta acts when distended and why this is useful

Answer 55

elastic membranes. It recoils. helps maintain arterial pressure

Question 56

why similar mechanical events occur at the same time in both sides of the heart

Answer 56

bc entire heart is served by single electrical excitation

Question 57

how SV differs from one side of the heart to the other and why

Answer 57

is the same. (they're in series)

Question 58

how pressure varies in the right atrium

Answer 58

- goes up and back down at atrial contraction (7) - goes a little bit up and back down more at isovol contraction and ejection (4,5,2) - goes back up until isovol relax ends (5) - back to 2 immediately and then goes up slowly until reach 7 at atrial contraction

Question 59

how P varies in right ventricle

Answer 59

same as atrial P but after drop from 7 to 4 (atrial systole, isovol contr.), goes up to 25 at isovol contract and ejection and back down to 5 on atrial P graph at end

Question 60

how pulm artery pressure varies

Answer 60

1. increases at ejection until 24 and back down to 20 at end ejection 2. back up to 22 at isovol relax 3. from isovol relax to next ejection, drops down from 22 to 8

Question 61

normal pulm artery pressure (syst and diast)

Answer 61

24 over 8

Question 62

what is the jugular venous pulse

Answer 62

puslation in the large veins transmitted by the right atrium

Question 63

why jugular vein is an important diagnostic tool

Answer 63

if have right heart failure or valve problem, can manifest there

Question 64

a wave on right cardiac cycle

Answer 64

atrial and vent P rise to 7 during atrial contraction

Question 65

c wave on right cardiac cycle

Answer 65

bump in atrial P to 5 bc of tricuspid valve leaflets bulging in RA

Question 66

X descent on right cardiac cycle

Answer 66

``` atrial relaxation (ventricle is ejecting) tricuspid valve displaced downwards during systole ```

Question 67

v wave on right cardiac cycle

Answer 67

bump back up of the atrial P to 5. (filling from the SVC and IVC)

Question 68

Y descent on right cardiac cycle

Answer 68

opening of tricuspid valve and emptying of the atrium