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CVS > CVS 2 The Heart As A Pump > Flashcards

CVS 2 The Heart As A Pump Flashcards

(68 cards)

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1
Q

Name the valves on the left side of the heart

A

Mitral
Aortic

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2
Q

Name the valves on the right side of the heart

A

Tricuspid
Pulmonary

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3
Q

How to valves prevent back flow?

A

Valve cusps are pushed open (due to differential pressure) to allow blood flow and close to seal

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4
Q

What prevent inversion of tricuspid and mitral valves?

A

Papillary muscles via chordae tendineae

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5
Q

What valve has two leaflets?

A

Mitral

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6
Q

Stroke volume definition

A

Amount of blood pumped out per beat

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7
Q

Systole meaning

A

Contraction and ejection of blood from ventricles

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8
Q

Disastole meaning

A

Relaxation and filling of ventricles

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9
Q

What type of pressure is systemic circulation under?

A

High

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10
Q

What type of circulation is under high pressure?

A

Systemic

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11
Q

What type of pressure is pulmonary circulation under?

A

Low

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12
Q

What type of circulation is under low pressure?

A

Pulmonary

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13
Q

What do the papillary muscles and chordae tendineae do?

A

Attach to the mitral and tricuspid valve to prevent inversion in systole

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14
Q

Explain the process of conduction

A

1- pacemaker cells in the SAN generate action potential
2- atrial systole
3- AP reaches AVN along the bundle of His
4- AP delayed (~120 ms) to ensure atria have finished contracting
5- AP spreads down septum
6- spreads through ventricular myocardium from inner (endocardial) surface to outer (epicardial) surface
7- purkinje fibres causes ventricles to contract from apex up - ventricular systole

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15
Q

What are the 7 stages in the cardiac cycle?

A

1- atrial contraction
2- isovolumetric contraction
3- rapid ejection
4- reduced ejection
5- isovolumetric relaxation
6- rapid filling
7- reduced filling

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16
Q

What letters are used for ECG wave?

A

PQRST

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17
Q

What causes the P wave?

A

Atrial depolarisation

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18
Q

What causes the QRS wave?

A

Ventricular depolarisation

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19
Q

What causes the T wave?

A

Ventricular repolarization

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20
Q

What causes the first heart sound?

A

Closure of mitral and tricuspid valve

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21
Q

What causes the second heart sound?

A

Closure of aortic and pulmonary valves

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22
Q

What is ventricular filling making a sound a sign of?

A

Pathology in adults
Normal in children

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23
Q

Types of abnormal valve function

A

Stenosis
Regurgitation

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24
Q

What is valve stenosis?

A

Valve doesn’t open enough
Causes obstruction of blood when valves open

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25
Causes of stenosis
**Degenerative** - calcification or fibrosis **Congenital** - bicuspid form of valve **Chronic rheumatic fever** > inflammation
26
Degenerative meaning
Progressive loss of function
27
Congenital meaning
From birth
28
Effects of aortic valve stenosis
**Less blood can get through valve** - Increased LV pressure > **LV hypertrophy** - Left sided heart failure > **angina and syncope** - Shear stress > **microangiopathic haemolytic anaemia**
29
Syncope meaning
Fainting
30
What is the main cause of mitral valve stenosis?
Rheumatic fever
31
Effects of mitral valve stenosis
- **increased LA pressure** - pulmonary oedema, dyspnea and pulmonary hypertension leading to **RV hypertrophy** - LA dilation > atrial fibrillation > **thrombus formation** - LA dilation > oesophagus compression > **dysphagia**
32
Dyspnea meaning
Laboured breathing
33
Dysphagia meaning
Difficulty swallowing
34
What is a pulmonary oedema?
Fluid accumulation in the air spaces and parenchyma (tissue) of the lungs
35
What is valve regurgitation?
Valve doesn’t close all the way Causes back leakage
36
Causes of aortic valve regurgitation
- **aortic root dilation** - leaflets pulled apart - **valvular damage**
37
Effects of aortic valve regurgitation
- blood flows back into LV in systole - increased stroke volume - increased systolic pressure - decreased diastolic pressure - bounding pulse > Quinke’s sign - LV hypertrophy
38
What is Quinke’s sign?
Capillary pulsations upon light compression to tip of fingernail
39
Causes of mitral valve regurgitation
- **myxomatous degeneration** > weakens tissue > prolapses of mitral valve - **damaged papillary muscles** due to heart attack - **left heart failure** > LV dilation > stretched valve - **rheumatic fever** > leaflet fibrosis > disrupts seal formation
40
Myoxmatous degeneration meaning
Deterioration of connective tissue
41
Effects of mitral valve regurgitation
Blood leaks back > increased pre load > **LV hypertrophy**
42
Describe the pathway blood takes from the vena cava to the aorta
1- deoxygenated blood enters right atrium through superior and inferior vena cava 2- tricuspid valve opens 3- blood fills right ventricle 4- pulmonary valve opens 5- blood leaves via pulmonary artery to lungs 6- oxygenated blood enters left atrium through pulmonary vein 7- mitral valve opens 8- blood fills right ventricle 9- aortic valve opens 10- oxygenated blood leaves through aorta to the body
43
What causes the dicrotic notch?
Aortic valve closes Short period of increased pressure
44
What is the approximate stroke volume?
70 ml blood per beat
45
Valve positions of atrial contraction
MT open AP closed
46
Valve positions of isovolumetric contraction
MT closed AP closed
47
Valve positions of rapid ejection
MT closed AP open
48
Valve positions of reduced ejection
MT closed AP open
49
Valve positions of isovolumetric relaxation
MT closed AP closed
50
Valve position of rapid filling
MT open AP closed
51
Valve positions of reduced filling
MT open AP closed
52
How long does systole occur for?
~0.35 s
53
How long does diastole occur for?
~ 0.55 s
54
What is the dicrotic notch a marker of?
End of systole Start of diastole In arteries
55
Main cause of mitral valve stenosis
Rheumatic fever
56
How is electrical activity in the heart initiated?
Spontaneous depolarisation
57
What is heard with an aortic valve stenosis?
Crescendo descrescendo murmur
58
What is heard in aortic valve regurgitation?
Early decrescendo diastolic murmur
59
What is heard in mitral valve regurgitation?
Holosystolic murmur
60
What is heard in mitral valve stenosis?
Snap as valve opens Diastolic rumble
61
What chamber of the heart can cause dysphagia and how?
**Left atrium** Can compress the oesophagus can dilated
62
Auscultations of the heart valves
Apt. M #2245 - **Aortic** - right side 2nd intercostal space on sternal edge - **Pulmonary** - left side 2nd intercostal space on sternal edge - **Tricupsid** - left side 4th intercostal space on lower sternal border - **Mitral** - left side 5th intercostal space in midcalvicular line
63
What sided heart murmurs are louder in inspiration?
**RILE** **R**ight - **I**nspiration
64
What sided heart murmurs are louder in expiration?
**RILE** **L**eft - **E**xpiration
65
Where can the aortic valve be auscultated?
**Apt. M #2245** Right side 2nd intercostal space on sternal edge
66
Where can the pulmonary valve be auscultated?
**Apt. M #2245** Left side 2nd intercostal space on sternal edge
67
Where can the tricupsid valve be auscultated?
**Apt. M #2245** Left side 4th intercostal space On lower left sternal border
68
Where can the mitral valve be auscultated?
**Apt. M #2245** Left side 5th intercostal space In midclavicular line

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