Cardiac Cycle II

Question 1

what happens at the beginning of isometric relaxation

Answer 1

aortic/pulmonic valve closure

Question 2

why does the Q wave dip downward

Answer 2

because the left side of the heart is depolarized first

Question 3

when would you hear an accentuated S1

Answer 3

exercise, sympathetic stimulation, mild mitral stenosis

Question 4

when would you hear a diminished S1

Answer 4

AV, high diastolic filling pressure (stiff ventricle), severe AV stenosis

Question 5

during what action does physiological splitting of S2 occur

Answer 5

inspiration (pulmonic valve stays open longer)

Question 6

what do you suspect if there is an audible separation during expiration that disappears during inspiration

Answer 6

(delay in aortic closure) left bundle branch block (LBB), advanced aortic stenosis

Question 7

what is the name of the sound cause from the opening of the MV valve

Answer 7

opening snap

Question 8

what is the name of the sound that may be heard during rapid filling of the ventricle

Answer 8

S3

Question 9

what is the sound that may be heard from aortic stenosis or aortic dilation (just before S1)

Answer 9

ejection click

Question 10

an incompetent valve is also known as

Answer 10

regurgitation

Question 11

what events happen between S1 and S2? what murmurs?

Answer 11

1. AV valves close (regurgitation)
2. semilunar valves open (stenosis)
3. blood may be shunted (ventricular septal defect)

Question 12

what kind of shunt is a ventricular septal defect

Answer 12

left to right

Question 13

aortic and pulmonic stenosis are what type of murmur

Answer 13

ejection ype

Question 14

mitral/tricuspid regurgitation, ventricular septal defect is what type of murmur

Answer 14

pansystolic

Question 15

a mitral valve prolapse is what kind of murmur

Answer 15

late systolic

Question 16

what happens between S2 and S1? murmur?

Answer 16

1. semilunar valves close (regurgitation)
2. AV valves open (opening snap)
3. blood moves across AV valve for diastolic filling (stenosis)
4. ventricles fill with blood (S3)
5. Atrial kick (S4)

Question 17

aortic/pulmonic regurgitation is an example of what kind of murmur

Answer 17

early decrescendo

Question 18

mild mitral or tricuspid stenosis an an example of what kind of murmur

Answer 18

mid-to-late

Question 19

severe mitral or tricuspid stenosis is an example of what kind of murmur

Answer 19

prolonged mid-to-late

Question 20

sound due to early diastolic fillling, may or may not be pathologic

Answer 20

S3

Question 21

sound due to late diastolic filling, always pathologic

Answer 21

S4

Question 22

what does a large gap in the systolic vs diastolic pressure indicate in aorta

Answer 22

aortic incompetence

Question 23

taking a long time to reach high systolic pressure in aorta is indicative of

Answer 23

aortic stenosis

Question 24

FOR JVP, what is the a wave

Answer 24

contraction of atria

Question 25

For JVP, what is c wave

Answer 25

contraction of ventricle

Question 26

In JVP, an elevated a wave, and slow y descent indicates

Answer 26

tricuspid stenosis

Question 27

In JVP, an absent a wave is

Answer 27

atrial fibrillation

Question 28

In JVP, a cannon A wave is indicative of

Answer 28

AV block

Question 29

In JVP, a giant V and absent x is indicative of

Answer 29

tricupsid incompetence

Question 30

Give an example of a chronotropic agent and explain what it does

Answer 30

NE-> B1 receptors. Increases Na entry to the cell and inccreases the phase 4 slope

Question 31

Give an example of a negative chronotropic agent

Answer 31

Arch-> muscarinic receptors, increase potassium permeability. Phase 4 becomes less steep

Question 32

What happens if you change the RMP

Answer 32

The 0 upstroke becomes less steep

Question 33

The ______ _______ is always faster than the muscle

Answer 33

Intrinsic system

Question 34

Atrial and ventricular myocardium has a _____ conduction velocity

Answer 34

Medium

Question 35

Junctional tissue has a ______ conduction velocity

Answer 35

Slow

Question 36

Purkinje fibers have a _______ conduction system

Answer 36

Fast