Class 7

Question 1

What is defined as the property of the contractile myocytes that account for the strength of contraction?

Answer 1

Contractility

Question 2

Contractibility is also known as

Answer 2

Inotropic state, strong or weak

Question 3

What is contractility related to?

Answer 3

Intrinsic cellular mechanisms that regulate the interaction between actin and myosin

Question 4

Is contractility independent of the preload and afterload?

Answer 4

Yes

Question 5

What haemodynamic parameters can be employed to evaluate the cardiac performance? (5)

Answer 5

1. Ventricular end diastolic pressure
2. Cardiac index
3. Stroke volume
4. Ejection fracture
5. Peak rate of ventricular pressure development during isovolumetric contraction
6. End systolic pressure volume relationship
7. Maximum velocity of muscle shortening

Question 6

Any condition resulting in inadequate systolic emptying will lead to what happening to the ESV?

Answer 6

Increase in ESV

Question 7

Regardless of its compliance an increase in EDV will give rise to what happening to EDP?

Answer 7

Increase

Question 8

How to give a cardiac output the heart with a greater contractility will result in a higher or lower EDP?

Answer 8

Lower

Question 9

In a failing heart, any increase in preload will do what two stroke volume?

Answer 9

Has very little effect on stroke volume

Question 10

Concentric hyper trophy is what to wall thickness?

Answer 10

Increasing well fitness

Question 11

An increase in contracutility will do what to stroke volume at a given preload and thus generate a higher or lower cardiac index?

Answer 11

Increase, higher

Question 12

What indirectly reflects the extent of ventricular fibre shortening 

Answer 12

Stroke volume

Question 13

What is defined as a fraction of end-diastolic volume ejected from the ventricle during each systolic contraction?

Answer 13

Ejection fraction

Question 14

How do you calculate ejection fraction?

Answer 14

EF = SV/EDV

Question 15

EF depends on the variation of what?

Answer 15

Afterload

Question 16

What is the value corresponding to the rate of pressure rises in the ventricular chamber during isovolumetric contraction?

Answer 16

Peak rate of ventricular pressure development

Question 17

Stronger the force of contraction, is the slope steeper or less steep for rate of ventricular pressure development?

Answer 17

Steeper

Question 18

When is the highest DP/DT?

Answer 18

Just before the opening of semi lunar valves

Question 19

Series of successfully stronger contraction can be observed when the muscle fibre receives closely spaced stimuli describes what phenomenon?

Answer 19

Treppe or Bowditch effect

Question 20

What ion is immediately toxic to the heart?

Answer 20

Calcium

Question 21

Any increase in entropy will do what to the ESPVR?

Answer 21

Shift it upward to the left

Question 22

What is the true indicator of contractility at a given inotropic state?

Answer 22

Maximum velocity of muscle shortening or Vmax

Question 23

Can you measure Vmax?

Answer 23

No

Question 24

When contractility of the ventricle is increased, what happens to the force velocity curve?

Answer 24

It shift up and to the right

Question 25

Increase in Vmax means an increase in contractility, what does it do to ejection velocity, stroke volume, ESV, and ESP?

Answer 25

- increase ejection velocity - Increase stroke volume - Reduce ESV - Reduce ESP

Question 26

With an increase in contractility, what does it do to ESV, EDV and stroke volume?

Answer 26

- large decrease in ESV - moderate decrease in EDV - Overall increase in stroke volume

Question 27

Narrow opening of aortic valve with resistance to flow describes what?

Answer 27

Aortic stenosis

Question 28

Ian aortic stenosis can the valve close completely open completely?

Answer 28

Close completely, cannot be fully opened

Question 29

When will you hear a systolic murmur?

Answer 29

During aortic stenosis, between S1 and S2, During the ejection phase or when the aortic valve is supposed to open

Question 30

Aortic stenosis does what to velocity of the blood?

Answer 30

Increases

Question 31

Aortic stenosis causes an increase or decrease in LVP do to increase and after load?

Answer 31

Increase

Question 32

Increase in afterload causes a huge increase or decrease in ESV?

Answer 32

Increase

Question 33

Aortic stenosis result in a decrease or increase in stroke volume?

Answer 33

Decrease

Question 34

Chronic left ventricular volume and pressure overload from aortic stenosis will lead to onset of what?

Answer 34

Pulmonary hypertension

Question 35

Pulmonary hypertension results in what?

Answer 35

Right ventricular disfunction and eventually congested heart failure

Question 36

Increase resistance to flow across the mitral valve during ventricular filling and giving rise to the elevation of the left atrial pressure describes what?

Answer 36

Mitral stenosis

Question 37

Mitral stenosis could lead to a huge reduction in what?

Answer 37

LVEDV

Question 38

Huge reduction in LVEDD from mitral stenosis does what two stroke volume in cardiac output?

Answer 38

Decreases both

Question 39

With mitral stenosis when do you hear a diastolic murmur?

Answer 39

Between S2 and S one due to higher velocity of blood flow through stenotic mitral valve into left ventricle

Question 40

What is aortic insufficiency?

Answer 40

Incomplete closure of aortic valve, no problem opening

Question 41

What does incomplete closure of aortic valve give rise to?

Answer 41

Regurgitation of blood back to the left ventricle

Question 42

Regurgitation does what to pre-load?

Answer 42

Increase it

Question 43

When is there no true ventricular isovolumetric relaxation or contraction phase?

Answer 43

In an aortic regurgitated heart/aortic insufficiency

Question 44

When do you hear a diastolic murmur in aortic insufficiency?

Answer 44

Between us two and S one, during ventricular diastolic due to backflow of blood from aorta back to left ventricle

Question 45

What is the incomplete closure of the mitral valve?

Answer 45

Mitral insufficiency

Question 46

What does mitral insufficiency do?

Answer 46

Incomplete closure of mitral valve, Bloodflows back to left atrium during ventricular contraction

Question 47

When blood flows back to left atrium during ventricular contraction what does this due to left atrial pressure?

Answer 47

Causes sharp rise in pressure during ventricular system

Question 48

When can you hear the systolic murmur for mitral insufficiency?

Answer 48

Between S1 and S2, the backflow of blood to left atrium during ventricular systole

Question 49

Is there a true isovolumetric relaxation and contraction phase is in my phone regurgitated heart?

Answer 49

No

Question 50

In mitral regurgitated heart what happens to afterload?

Answer 50

Left ventricle afterload is reduced because total outflow resistance is reduced

Question 51

My troll insufficiency leads to what happening to LVEDV and LVESV?

Answer 51

Sharp Increase, huge decrease