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FS Exam 4 > Cardiac Cycle > Flashcards

Cardiac Cycle Flashcards

(81 cards)

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1
Q

Systole

A

Contraction

Blood is ejecting

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2
Q

Diastole

A

Relaxation

Filling

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3
Q

How much does systole do and in what time?

A

ejects 2/3 of blood

total time = 1/3

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4
Q

How much does diastole do and in what time?

A

Coronary blood flow filling

total time = 2/3

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5
Q

As you increase heart rate, what is compromised?

A

Filling - diastole

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6
Q

Movement of blood depends on

A

Pressure Gradient

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7
Q

What generates the pressure

A

The heart - by contracting

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8
Q

Purpose of isovolumetric contraction

A

btw r and s - beginning of systole
causes increase in ventricular pressure
we need to exceed aortic pressure so blood can go from LV to body

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9
Q

End Systolic Volume

A

What is left in the heart after contracting

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10
Q

End Diastolic Volume

A

What we filled the heart/ventricle with

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11
Q

EDV - ESV

A

120-50 = 70

70mL is now in the aorta - this is stroke volume - how much we ejected from the heart

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12
Q

Isovolumetric relaxation purpose

A

drop pressure
we want to refill heart again so need gradient
need to lower ventricular pressure so its lower than atrial

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13
Q

As filling heart, which will be higher ventricular or atrial

A

atrial will always be higher during filling

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14
Q

When ventricular is higher than atrial, where will flow go? if valve open

A

back into atrium

Need to close valve so close AV valves

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15
Q

S1

A

Closure of mitral and tricuspid valves

lub

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16
Q

S2

A

closure of aortic and pulmonary valves

dub

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17
Q

S3

A

rapid ventricular filling
not typically audible in adults
Might indicate congestive heart in adults

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18
Q

S4

A

active ventricular filling

not typically audible in adults

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19
Q

Stroke volume

A

How much work the heart is doing

About 70mL

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20
Q

Cardiac Output

A

Flow out of the heart

HR * SV

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21
Q

Ejection Fraction

A

SV/EDV
of what you filled the heart with, how much are you actually ejected
Normally about 55%, 30% in heart failure

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22
Q

EF is an index for what

A

How hard the heart is working

or its contractility

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23
Q

Heart Rate - how regulated

A

Para and Sym
Can also be intrinsic on its own 100 bpm
Heart rate impacts CO - inc heart rate, compensating so can inc CO

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24
Q

Stroke Volume - how regulated

A

Sympathetic Nerves
Contractile Strength
EDV - fill heart more

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25
Regulation of Heart Rate - nerves
None needed!
26
Regulation of Heart Rate with nerves - Symp
F/F - Increases HR via cardiac accelerator nerves (innervate SA node) and then NE binds to B1 adrenergic receptors and inc HR
27
Regulation of HR with nerves - Para
Dec HR via vagus nerve, Ach binds to muscarinic cholinergic receptors in SA node
28
Inspiration does what to HR
Increases HR
29
Exhalation does what to HR
Decreases HR
30
Atropine
Muscarinic Antagonist - Parasympathetic tone
31
Propanolol
Beta Blocker - Sympathetic | Preventing inc in HR
32
At rest, we rely more on sym or para
more on sympathetic then parasympathetic
33
End Diastolic Volume - Regulation of SV
Preload Length tension relation and amount of filling Changing the length by how much you are filling it with
34
Aortic Pressure/Mean Arterial Pressure - Regulation of SV
Afterload Pressure the heart pumps against to eject blood Aortic pressure that heart is fighting against to get flow out
35
Inc in afterload will... (SV)
SV will decrease
36
Inc in preload will... (SV)
SV will increase
37
Strength of Ventricular contraction - Regulation of SV
Contractility | How forcefully the heart contracts
38
What is the major factor controlling Q
The amount of blood returning to the heart | The heart can do no more than pump out what it receives
39
Inc contractility does what to SV
Increase SV
40
Frank Starling Mechanism
EDV - Preload Greater preload results in stretch of ventricles Inc in stretch optimizes # of CB formation And this leads to more force and more CO and more SV
41
As you stretch the heart you will...
Fill it and optimize CB formation
42
Ca affinity for TnC is greater with
sarcomere length
43
The skeletal muscle pump
Milking action of muscle Rhythmic muscle contractions force blood toward the heart Decreased venous pressure sucking more blood through muscle
44
Generally what does skeletal muscle pump do
Increase venous return back to the heart | Increase blood flow to muscle
45
What prevents backflow of blood
One way valves
46
EVD is also affected by
Venoconstriction | Respiratory pump - breathe in you are dec pressure and this facilitates bringing flow into the heart
47
Mean Arterial Pressure
Afterload Force opposing the ejection of blood from ventricles Increasing the afterload increases the force required by the heart to eject blood into aorta You are dec pressure gradient - making heart work harder
48
Ventricular Contractility
Intrinsic ability of cardiac muscle to generate force at given fiber length Independet of pre and after load Usually associated with change in intracellular Ca
49
Ventricular Contractility is induced by
Circulating EPI and NE | Direct sympathetic stimulation of heart
50
B1 effects on tissues
Inc heart rate and glycogenolysis and lipolysis and contractility
51
B2 effects on tissues
Inc bronchodilation and vasoconstriction
52
A1 effects on tissue
Inc vasoconstriction
53
A2 effects on tissue
Opposes B1 and B2 receptors
54
CO =
HR x SV HR - intrinsic and syp and para SV - preload (EDV), afterload (MAP), contractility
55
SV =
EDV - ESV
56
Ways to evaluate contractility
Ejection Fraction End Systolic Pressure Volume Relation Change in pressure over change in time
57
Ejection Fraction
SV/EDV Used as index for evaluating heart failure less than 30%
58
End Systolic Pressure Volume Relation
Slope of a line connecting aortic valve closing to max isovolumetric pressure (max pressure achieved during systole)
59
Change in Pressure over Change in Time
Contractility alters rate of pressure developed
60
Increased Contractility does what to SV
Increases it | ESV Decreased
61
Increased Preload (filling) does what with SV
Increases it | EDV increased
62
Increased afterload (aortic pressure) does what to SV
Decreases it | ESV increased
63
Greater SV = what for the heart
greater work for the heart, makes it more efficient - is a good thing
64
What does efficiency of the heart mean
Work over expenditure | Expenditure = energy cost, or what you have to invest in it
65
Wall tension and energy expenditure
Wall tension is where most of the energy from the heart is going - this puts more stress (bad) on the heart
66
What are smaller fractions that are associated with energy expenditure
Kinetic energy and external work
67
Stress on heart is determined by what
1. Afterload (greater wall tension required) 2. HR (more time in systole) 3. Rate Pressure Product
68
Rate Pressure Product
SBP x HR | How much investment you are making; the stress load (decreases with exercise)
69
Ideal stress on heart
Low wall tension and less time in systole
70
Heart Rate is affected by
Symp and Para NS (ANS)
71
Contractility is affected by
Symp NS MI - dec contractility Heart Failure - dec contractility
72
Preload is affected by
``` Venous return and EDV Blood volume Postural change Skeletal muscle contraction Respiration ```
73
Afterload is affected by
Hypertension Arterial stiffness Inc in TPR
74
At a given velocity of shortening, muscle exerts....
more tension if we stretch it with more preload
75
At a given afterload, shortening ____ if we stretch the muscle with more preload
Increases
76
Input into RA =
Output from LV
77
As you dec Rigth Atrial Pressure you will do what to venous return (flow)
Increase it
78
Y intercept of Vascular Function Curve
RAP of zero - no more venous return
79
X intercept of Vascular FUnction Curve
Pressure when CO is 0 | Mean circulatory pressure
80
Slope of Vascular Function Curve depends on
Venous Compliance
81
If you dec RAP...
``` you inc gradient for filling inc venous return increase preload Inc SV inc CO ```

FS Exam 4 (6 decks)

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