Cardiac Cycle Flashcards

(55 cards)

1
Q

What does the cardiac cycle consist of?

A
  • contraction = systole
    *relaxation = diastole
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2
Q

What stages occur in the mid to late diastole?

A

*ventricular filling
*atrial contraction

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3
Q

What stages occur in the ventricular systole?

A

*isovolumetric contraction point
*ventricular ejection phase

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4
Q

What phase happens in early diastole?

A

*isovolumetric relaxation

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5
Q

What happens during ventricular (atrial) filling?

A

*atrial diastole
*ventricular diastole
Relaxation Phase: Both the atria and ventricles are in a relaxed state, allowing them
to fill with blood.
*Blood Inflow: The atria receive blood from the body and lungs, while the ventricles
passively fill with blood from the atria.
*Atrioventricular Valves: The tricuspid and mitral valves remain open to facilitate the
flow of blood into the ventricles.

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6
Q

What happens in atrial diastole?

A

*relaxes + fills with blood
* Right Atrium: Receives deoxygenated blood from the body via the
superior and inferior vena cava.
* Left Atrium: Receives oxygenated blood from the lungs via the pulmonary
veins.

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7
Q

What happens in ventricular diastole?

A
  • Passive Filling: Blood flows passively from the atria into the ventricles
    through the open atrioventricular (AV) valves (tricuspid valve on the right
    side and mitral valve on the left side).
  • Rapid Filling Phase: Initially, blood flows quickly due to the pressure
    difference between the atria and ventricles
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8
Q

What happens in ventricular systole of the isovolumetric contraction?

A
  • Contraction: The ventricles begin to contract, increasing the pressure
    within the chambers.
  • Valve Status: Both the atrioventricular (tricuspid and mitral) valves and
    the semilunar (aortic and pulmonary) valves are closed.
  • Pressure Buildup: As the ventricles contract, the pressure rises rapidly.
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9
Q

what happens in the transition to ejection phase?

A
  • Transition to Ejection Phase:
  • Pressure Surpasses: When the pressure in the ventricles exceeds the
    pressure in the aorta and pulmonary artery, the semilunar valves open.
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10
Q

What happens during ventricular ejection?

A
  • Semilunar Valves Open: With the increased pressure, the aortic and
    pulmonary valves open.
  • Blood Ejection: Blood is expelled from the ventricles into the aorta and
    pulmonary artery.
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11
Q

What happens during isovolumetric relaxation?

A
  • Ventricular Diastole:
  • Relaxation: The ventricles begin to relax after the ejection of blood.
  • Valve Status: Both the aortic and pulmonary valves close to prevent
    backflow of blood into the ventricles.
  • Pressure Changes:
  • Pressure Drop: As the ventricles relax, the pressure within them drops
    rapidly.
  • Closed Valves: The atrioventricular valves (tricuspid and mitral) remain
    closed during this phase, ensuring that the blood does not flow back into
    the atria.
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12
Q

What are the two AV valves?

A

*tricuspid valve
*mitral valves

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13
Q

What do the AV valves do during the ventricular filling and atrial contraction?

A
  • The AV valves are open, allowing blood to flow from the
    atria into the ventricles.
  • During atrial contraction, the atria push the remaining blood into the ventricles, ensuring they are fully filled.
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14
Q

What do the AV valves do during isovolumetric contraction?

A

The AV valves close as the ventricles begin to contract,
preventing backflow of blood into the atria

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15
Q

What do the AV valves do during isovolumetric relaxation?

A

The AV valves remain closed until the pressure in the
ventricles drops below the pressure in the atria, at which
point they open to allow ventricular filling

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16
Q

What makes up the semi-lunar valves?

A

*pulmonary + aortic valves

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17
Q

What do the semi-lunar valves do during isovolumetric contraction?

A

The semilunar valves remain closed as the pressure builds
in the ventricles

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18
Q

What do the SL valves do during ventricular ejection?

A

When the pressure in the ventricles exceeds the pressure in
the pulmonary artery and aorta, the semilunar valves open,
allowing blood to be ejected into these arteries

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19
Q

What do the SL valves do during isovolumetric relaxation?

A

The semilunar valves close as the ventricles relax,
preventing the backflow of blood from the arteries back
into the ventricles

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20
Q

How does atrial pressure differ in the cardiac cycle?

A
  • Increases during atrial systole.
  • Decreases during ventricular systole and remains low during ventricular
    filling
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21
Q

How does ventricular pressure differ during the cardiac cycle?

A
  • Low during diastole (filling phase).
  • Rapidly increases during isovolumetric contraction.
  • Peaks during ventricular ejection.
  • Rapidly decreases during isovolumetric relaxation
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22
Q

How does aortic pressure differ during the cardiac cycle?

A
  • High and stable during ventricular diastole.
  • Increases and peaks during ventricular ejection.
  • Briefly rises (dicrotic notch) during isovolumetric relaxation due to the
    closure of the aortic valve.
  • Gradually decreases during the rest of the diastole
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23
Q

Describe all the characteristics to dow with the S1 heartbeat sound

A

*Cause: Closure of the mitral and tricuspid valves.
*Timing: Occurs at the beginning of isovolumetric ventricular contraction.
*Characteristics:
* Splitting: Normally slightly split (~0.04 seconds) because the mitral valve
closes slightly before the tricuspid valve. This split is usually too short to
be heard with a stethoscope, so S1 is perceived as a single sound.

24
Q

Describe all the characteristics to do with the S2 heartbeat sound

A

*Cause: Closure of the aortic and pulmonic valves.
*Timing: Occurs at the beginning of isovolumetric ventricular relaxation.
*Characteristics:
* Splitting: Physiologically split because the aortic valve closes slightly
before the pulmonic valve.
* Variability: The duration of S2 splitting changes depending on respiration,
body posture, and certain pathological conditions. For instance, the split
widens during inspiration and narrows during expiration

25
What are the characteristics of the sinoatrial node?
* Intrinsic Electrical Activity: The SA node is electrically unstable and capable of spontaneous depolarisation. * Rate of Depolarisation: It spontaneously depolarises at a rate of 90-100 times per minute. * Impulse Generation: The SA node generates electrical impulses that spread throughout the atria, initiating atrial contraction
26
What are the characteristics of the Atrial ventricular node?
* Intrinsic Electrical Activity: The AV node is also electrically unstable and capable of spontaneous depolarisation, but at a slower rate than the SA node. * Rate of Depolarisation: It spontaneously depolarises at a rate of 40-60 times per minute. * Impulse Generation: The AV node generates and conducts electrical impulses to the ventricles, ensuring coordinated ventricular contraction.
27
What is the function of the inter-nodal tracks?
Carry electrical impulses from the SA node to the AV node, ensuring coordinated atrial depolarisation and contraction.
28
What is the function of the fibrous midline?
Serves as an electrical insulator, preventing direct conduction between atria and ventricles, ensuring the impulse passes through the AV node.
29
What is the function and role in conduction of the bundle of his?
*Function: Collects electrical impulses from the AV node and carries them to the higher and lower parts of the ventricles, including the apex *Role in Conduction: Ensures coordinated contraction of the ventricles for effective blood ejection
30
What is the function and role of conduction of the purkinjae fibres
*Function: Conduct electrical impulses rapidly to the ventricular contractile myocytes. *Role: Ensure coordinated and efficient ventricular contraction by synchronising the depolarisation of ventricular muscle cells.
31
What is the sympathetic stimulation effect on the SA node?
* Increases Rate of Depolarisation: Sympathetic nerves release norepinephrine (noradrenaline), which binds to beta-1 adrenergic receptors in the SA node. * Mechanism: This increases the permeability of the SA node cells to calcium and sodium ions, accelerating the rate of spontaneous depolarisation. * Result: Increased heart rate (positive chronotropic effect)
32
What is the effect on the SA node of parasympathetic stimulation?
Decreases Rate of Depolarisation: Parasympathetic nerves release acetylcholine, which binds to muscarinic receptors in the SA node. * Mechanism: This increases the permeability of the SA node cells to potassium ions while decreasing their permeability to calcium and sodium ions, slowing the rate of spontaneous depolarisation. * Result: Decreased heart rate (negative chronotropic effect).
33
What is the effect of sympathetic stimulation on the AV node?
* Increases Rate of Conduction: Sympathetic nerves release norepinephrine (noradrenaline), which binds to beta-1 adrenergic receptors in the AV node. * Mechanism: This increases the permeability of the AV node cells to calcium ions, enhancing the rate of conduction. * Result: Faster transmission of electrical impulses from the atria to the ventricles, leading to a decrease in the AV nodal delay and a quicker coordination of atrial and ventricular contractions.
34
What is the effect of parasympathetic stimulus on AV node?
* Decreases Rate of Conduction: Parasympathetic nerves release acetylcholine, which binds to muscarinic receptors in the AV node. * Mechanism: This increases the permeability of the AV node cells to potassium ions while decreasing their permeability to calcium ions, slowing the rate of conduction. * Result: Slower transmission of electrical impulses through the AV node, leading to an increase in the AV nodal delay and more regulated timing of atrial and ventricular contractions
35
What are the two types of cardiac muscle cells?
* Contractile Cells (99%): Responsible for the actual contraction and pumping action of the heart. * Autorhythmic Cells (1%): Specialised cells that generate and conduct electrical impulses, initiating and regulating the heartbeat
36
What is the structure of cardiac muscle?
*striated muscle fibres *nucleaus *mitochondria *T-TUBULES *intercalated disks *gap junctions *desosomes
37
What are the key properties of cardiac muscle?
*Autorhythmicity *excitability *conductivity *contractility
38
What is step 1/2 of the contraction mechanism?
*AP from adjacent cells excites myocytes and triggers membrane depolarisation in T-tubules *Depolarisation causes voltage-gated calcium channels to open, allowing calcium ions (Ca2+) to enter the cells from the extracellular space
39
What is step 3 of the contraction mechanism?
The influx of calcium ions binds to ryanodine receptors (RYR) on the sarcoplasmic reticulum (SR), inducing the release of additional calcium from the SR into the cytoplasm
40
What is step 4 of the contraction mechanism?
Calcium binds to troponin and triggers acting-myosin complex and contraction
41
What is step 5 of the contraction mechanism?
Calcium unbound from troponin and pumped back into SR
42
What is step 6 of the contraction mechanism?
Calcium unbinding causes relaxation and excess Ca2+ exchanged with Na+
43
What is step 7 of the contraction mechanism?
Na+ gradient is maintained by sodium-potassium- ATPase pump
44
*The P wave on an electrocardiogram (ECG) represents atrial depolarisation initiated by the SA node. *In sinus rhythm, P waves are consistent in shape and occur before each QRS complex.
45
*The PR interval is the time from the onset of the P wave to the start of the QRS complex, representing the time taken for the electrical impulse to travel from the atria to the ventricles. *A normal PR interval ranges from 0.12 to 0.20 seconds.
46
*The QRS complex represents ventricular depolarisation. *In sinus rhythm, the QRS complexes are narrow (less than 0.12 seconds) and follow each P wave.
47
AS = 0.1 seconds VS = 0.3 seconds Diastole = 0.4 seconds
48
At a normal resting heart rate of about 70 BPM, one cardiac cycle takes approximately 0.86 seconds
49
What are the three sinus rhythm conditions?
*Sinus Bradycardia (<60BPM but PQRST regular and right order) *Sinus Tachycardia (>100 BPM but PQRST regular and right order) *Sinus Arrhythmia (Irregular BPM, PQRST rhythm and order)
50
What is sinus bradycardia?
* Sinus bradycardia is a slower-than-normal sinus rhythm with a heart rate of less than 60 beats per minute. * It can occur in well-trained athletes, during sleep, or as a result of medications or certain medical conditions.
51
What is sinus tachycardia?
*Sinus tachycardia is a faster-than-normal sinus rhythm with a heart rate greater than 100 beats per minute. * It can occur due to exercise, stress, fever, or other conditions that increase the body's demand for oxygen
52
What is sinus arrhythima?
* Sinus arrhythmia is a normal variation in the sinus rhythm where the heart rate varies with the respiratory cycle. * It is most commonly seen in children and young adults and is considered a normal finding.
53
How can sinus bradycardia be managed?
* Beta-blockers or calcium channel blockers may be used if necessary
54
What is the occurrence of sinus tachycardia?
* Normal during exercise or stress. * Patients are usually asymptomatic. * May be associated with hypovolaemia or underlying medical problems.
55
What are some associated diseases to sinus arrhythmia?
*Heart Block/Disease: Sinus arrhythmia can be associated with various forms of heart block or underlying heart disease. *Respiratory Disease: It can also be associated with respiratory conditions, often influenced by changes in intrathoracic pressure during breathing