12.1 A Part 2

Question 1

In words what is arterial diastolic pressure?

Answer 1

the pressure in the aorta and systemic arteries at the time of opening of the aortic valve

Question 2

In words what is end diastolic pressure?

Answer 2

the pressure in the ventricle at the end of diastole

Question 3

Arterial diastolic pressure has a value of roughly what?

Answer 3

80 mm Hg

Question 4

End diastolic pressure usually sits at about how many mm Hg?

Answer 4

0-10 mm Hg

Question 5

What is an S3 heart sound?

Answer 5

the sound of the ventricle wall vibrating from rapid ventricular filling, usually because of ventricular hypertrophy

Question 6

What is an S4 heart sound?

Answer 6

occurs during atrial contraction due to vibration of the mitral or tricuspid valve leaflets as blood flows into the ventricle, usually due to atrial hypertrophy

Question 7

Atrial hypertrophy will commonly result in what additional heart sound?

Answer 7

S4

Question 8

Ventricular hypertrophy will commonly result in what additional heart sound?

Answer 8

S3

Question 9

What is the venous a wave?

Answer 9

an increase in right atrial pressure produced by atrial contraction near the end of diastole

Question 10

What is the venous c wave?

Answer 10

a slight increase in right atrial pressure that results from bulging of the tricuspid valve into the right atrium during ventricular contraction

Question 11

What is the venous v wave?

Answer 11

a gradual rise in right atrial pressure due to atrial filling by venous return during ventricular systole

Question 12

Why is there physiological splitting of S2?

Answer 12

• inspiration increases chest cavity volume, lowering atrial pressure
• this increases venous return to the right heart
• the right ventricle becomes more filled
• right stroke volume increases
• the time for ejection increases
• causes delayed closure of the pulmonic valve

Question 13

Wide splitting of S2 is characterized by what changes?

Answer 13

an increase in the A/P split during expiration and even more so during inspiration

Question 14

Wide splitting of S2 occurs when what occurs?

Answer 14

• prolonged right ventricle ejection

- due to right bundle branch block or pulmonic stenosis

Question 15

How does a right bundle branch block cause wide S2 splitting?

Answer 15

the slower depolarization of the right ventricle prolongs ejection

Question 16

How does pulmonic stenosis lead to wide S2 splitting?

Answer 16

the high resistance of a stiff pulmonic valve prolongs ejection from the right ventricle

Question 17

What is paradoxical splitting of S2?

Answer 17

you can hear an S2 split during expiration in which the pulmonic valve closes before the aortic and no split during inspiration

Question 18

What are two possible causes of paradoxical splitting?

Answer 18

left bundle branch block or aortic stenosis

Question 19

Normal cardiac output has what range?

Answer 19

5 - 6 liters/minute

Question 20

What is cardiac index?

Answer 20

a way to normalize values for cardiac output based on body size

Question 21

What is a normal cardiac index value?

Answer 21

2.6 - 4.2 liters/minute/square meter of body surface area

Question 22

Which has a higher pressure typically, right or left atrium?

Answer 22

left atrium by just a little

Question 23

Left atrial pressure usually has what range?

Answer 23

1 - 10 mm Hg

Question 24

What is the range of left ventricular pressure during diastole?

Answer 24

3-12 mmHg