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Flashcards in CVS 2 The Heart As A Pump Deck (29):
1

List the general properties of cardiac muscle that allow the heart to act as a pump?

Striations
Branching
Centrally positioned nuclei(1 or 2 per cell)
Intercalated discs
Adherens-type junctions
Gap junctions
T tubules in line with Z bands (not A-I band junction as in skeletal)

2

What is systole and how long does it last?

contraction of heart- 280ms

3

What is diastole?

relaxation of heart between contractions, typically about 700ms

4

How does excitation spread in systole?

SA node fires AP which spreads over atria causing atrial systole.
AP reaches AV node where delayed for about 120ms
From AV spreads down bundle of his in septum
Spreads from inner (endocardial) to outer (epicardial) surface
Ventricle contracts from apex up, forcing blood towards outflow valves

5

How does organisation of muscle in ventricular walls facilitate pumping?

Organised into figure of eight bands that squeeze ventricular chamber forcefully in most effective way for ejection. Apex contracts first and relaxes last to prevent backflow

6

What are the differences between right and left heart?

Left has thicker myocardium as it must generate force to get blood all round body. Right side has pacemaker SA node

7

What is the inflow valve to the left ventricle?

Mitral

8

What is the outflow valve from the left ventricle?

aortic

9

When do outflow valves close?

When ventricles begin to relax and intraventricular pressure falls below arterial pressure and there is brief backflow shutting the valves

10

When do atrioventricular valves open?

When ventricular pressure falls below the atrial pressure in diastole. Atrial pressure had been gradually rising in systole as atria continue to fill with blood

11

What is the 'rapid filling phase'?

Phase in diastole when a/v valves open and ventricles are filling with blood. Lasts about 200-300ms and is where most of ventricle filling occurs

12

What happens after rapid filling phase?

Ventricles continue to fill more slowly until intraventricular pressure matches atrial pressure causing av valves to close, rising as ventricular walls stretch

13

Do the ventricles fill during atrial contraction?

No. A tiny bit of blood enters during atrial systole but this amount is about the same as flows back when the valve shuts. Therefore the heart can pump fine without atrial contraction

14

What is isovolumetric contraction?

Event occurring in early systole where both inflow and outflow valves shut and the ventricles contact without changing in volume, increasing the intraventricular pressure

15

What is the rapid ejection phase?

Phase immediately after outflow valves open when blood ejected rapidly into the arteries

16

What is the first heart sound?

'lup' sound as the AV valves close at onset of ventricular systole

17

What is the second heart sound?

'dup' sound from closure of outflow valves at end of systole

18

What is the interval between the 1st and 2nd heart sounds? Does this change?

~280ms. No doesnt change

19

Does the interval between the 2nd and 1st heart sounds change?

Yes as this represents diastole. This decreases as heart rate increases and is usually around 700ms

20

What causes heart sounds that are like a galloping horse with 4 sounds?

Slight difference in time when valves close between left and right side

21

When may a 3rd sound be heard

Early diastole

22

When may a 4th sound be heard

atrial systole

23

What causes heart murmurs?

Turbulent blood flow e.g from stenosis or incompetence. Murmurs occur when blood flow highest

24

What is stenosis?

Narrowed valve

25

What is incompetence?

When a valve isn't closing properly

26

When does aortic stenosis cause a murmur?

in rapid ejection phase 'lup' whoosh 'dup'

27

How do you work out cardiac output?

stroke volume x heart rate

28

What is the typical cardiac output at rest?

80ml x 60= 5L/min

29

What is a typical stroke volume at rest?

80ml