Cardiac cycle Flashcards Preview

Year 2 Cardiovascular > Cardiac cycle > Flashcards

Flashcards in Cardiac cycle Deck (36):
1

what is the first event in the cardiac cycle?

atrial contraction

2

is there isovolumic contraction during AV valve opening?

no

3

will there be isovolumic contraction with aortic regurgitation?

no

4

how is central venous pressure assessed?

right atrial pressure

5

what are three common causes of increased CVP?

heart failure
tricuspid valve disorders
pulmonary arterial HTN

6

what two waves are most prominent on a jugular venous wave form? what do they correspond to?

X - fall in RA pressure after a wave peak

X' - descent of cardiac base, atrial relaxation

7

what is the dominant motion of the normal JVP?

X - X' descent

8

what do normal jugular venous pulsations provide information about?

right heart pressure
congestion
abnormal RA pressure
hydration status

9

what is the cause of a very high A wave in jugular venous pulsations?

RA contracting against a closed RV

complete heart block
TV disorders (stenosis)

10

what is the cause of a CV wave in jugular venous pulsations?

ventricularization of RA pressure

TV regurgitation (CHV)

11

S1 corresponds to what?

closure of mitral and tricuspid valves

12

S2 corresponds to what?

aortic (A2) and pulmonic (P2) closure

varies with respiratory cycle

13

what is the cause of physiological splitting of S2?

inspiration
increased venous return to RV
increased RVEDV
increased time to expel blood from RV
pulmonic valve stays open longer

14

when is widened splitting of S2 heard? why?

expiration

1. RBBB - delay in RV contraction - delay in pulmonic closure
2. pulmonic stenosis - more time to open - delay in closure

15

when does fixed splitting of S2 occur? why?

atrial septal defect

high capacitance, low resistance of pulmonary vasculature
delayed back pressure responsible for pulmonic valve closure
P2 is delayed

16

what are the causes of paradoxical splitting of S2? when does it occur, and why?

LBBB
advanced aortic stenosis

expiration - abnormal delay in closure of aortic valve (A2 follows P2)

17

does timing of opening snap in mitral stenosis change with respiration?

no

18

what is the third heart sound S3?

1. early diastole following opening of AV valves during rapid ventricular filling
2. produced by tension of chordae tendinae during rapid filling

19

what is the fourth heart sound S4? when in the cardiac cycle is it heard?

produced when trying to fill a stiff ventricle - coincides with atrial contraction

presystolic (late diastole)

20

in which situations is S4 heard?

low compliance / hypertrophy / acute MI

21

where is an early diastolic murmur heard?

left sternal border

22

what type of murmur is heard at the left sternal border?

early diastolic murmur

23

where is a pansystolic murmur heard?

tricuspid area
mitral area

24

what types of murmurs are heard at the tricuspid area?

pansystolic
mid to late diastolic

25

what type of murmur is heard at the mitral area?

pansystolic

26

ejection type murmurs are due to what causes?

aortic stenosis
pulmonic stenosis

27

pansystolic type murmurs are due to what causes?

mitral regurg
tricsupid regurg
VSD

28

late systolic type murmurs are due to what cause?

mitral valve prolapse

29

aortic and pulmonic stenoses cause what type of murmur?

ejection type

30

mitral and tricuspid regurg, and VSD cause what type of murmur?

pansystolic

31

mitral valve prolapse cause what type of murmur?

late systolic

32

aortic stenosis is heard best at what area? what does it sound like?

2nd ICS pt leaning forward

harsh quality between S1 and S2

33

mitral regurg is common in patients with what condition?

heart failure

34

mitral regurg is heard best at what area? what does it sound like?

apex, radiates to axilla

holo-systolic of constant intensity, plateau shaped extending from S1 to S2

35

aortic regurg is heard best at what area? what does it sound like?

3rd or 4th ICS

high pitched and blowing in quality

36

what can increase aortic regurg heart sounds?

tightening of fists