Heart Valves and Heart Sounds; Valvular and Congenital Heart Defects Flashcards
(146 cards)
1
Q
lub is
A
first heart sound
2
Q
dub is
A
second heart sound
3
Q
the sound itself we are hearing is not valve closing, it is
A
the tissue vibrations that result from the valve closing
4
Q
first heart sound associated with what closing
A
AV valves closing
5
Q
AV valves close start
A
systole
6
Q
second heart sound associated with what closing
A
Semilunar valves
7
Q
semilunar valves close start
A
diastole
8
Q
sometimes pulmonary valve closes later than
A
tricuspid valve- this is normal
9
Q
right bundle branch block, which ventricle contract first
A
left
10
Q
right bundle branch block can cause splitting of
A
S2 sound
11
Q
4th heart sound indicates
A
stiff ventricle
12
Q
3rd heart sound is associated with
A
heart failure
13
Q
draw out areas of auscultation
A
pg 3
14
Q
murmur in aotic area you would still hear
A
in other areas - it is just loudest over area you are listening to
15
Q
most common causes of valvular defects is:
A
rheumatic valve injury
16
Q
rhematic valve injury can be caused by
A
rheumatic fever, strep throat
17
Q
rheumatic fever usually occurs about 2-4 weeks after
A
strep throat
18
Q
rheumatic fever is autimmune disease in which
A
autoimmune against self, including heart valves, heart valves can be damaged
19
Q
scarring of valves can be caused due to
A
rheumatic fever
20
Q
which valves are particulary at danger to scarring from for example rheumatic fever
A
mitral valve & aortic valve
21
Q
why are mitral valve & aortic valve morelikely to be damaged by rheumatic fever
A
they are under higher pressure
22
Q
stenosis:
A
valve is narrowed b/c of the scarring
23
Q
what can happen from scarring
A
narrowing of valve
valve doesn’t close all the way
24
Q
when valve doesn’t close all the way what can happen
A
regurgitation
25
stenosis:
Murmur occurs when valve is open due to high velocity blood flow causing turbulence
26
what is murmur
rumbling (like when water goes over rocks)
27
any time blood flow in body is turbulent, you'll hear
murmur
28
stenosis valves cause murmur b/c
have same amount of blood going through normal vavle vs. narrowed valve, the high velocity of blood flow in narrow valve causes turbulence
29
anytime a stenosed valve is open you will hear a
murmur
30
a reguritant valve:
doesn't close properly and blood goes backwards
31
anytime blood goes backwards you will hear a
murmur
32
regurgitation occurs when valve is
clsoed
33
insufficiency or regurgitation:
Murmur occurs when valve is closed because of backward moving blood causing turbulence
34
what kind of murmurs are there
systolic or diastolic
35
aortic valve, during systole blood is
ejected out of aortic valve
36
if aortic valve is stenosed, what murmur?
systolic
37
if aortic vavle doesn't closed properly, what murmur?
diastolic, b/c it doesn't close properly
38
mitral vs. tricuspid murmus, which more common?
mitral
39
mitral valve open during
diastole (ventricles filling)
40
if mitral valve stenosed when open during ____ hear murmur
diastole
41
mitral valve diastole murmur will be very
faint, hard to hear
42
if mitral valve is regurgitatnt, during
systole
43
heart contracting, mitral regurgitation, what kind of murmur
systolic murmur
44
mitral regurigtation will cause what kind of murmur
systolic
45
aortic regurgitation
heart contracts, blood comes back in when heart relaxes
46
what kind of murmur with aortic regurgitation
diastolic
47
what are some causes of aortic regurgitation
congenital (two instead of three valve cusps)
syphilis infection, marfan syndeom
valvular deterioration due to infective endocarditis
48
infective endocarditis, can cause aortic regurgitation, describe
especially bacterial
all blood vessels are coverd with endothelial cells, bacterial infections can cause infection of inner lining of heart and vavles, can cause growth on valves which can make the valves regurgitate
49
what happens to ventricular filing with aortic regurgitation
more blood in ventricle, b/c blood going backward and forwards, will stretch the heart
50
what happens to preload in aortic regurgitation
increase
51
what happens to left atrial pressure in aortic regurgitation
increases - increase amount of blood so right heart is pumping fine, blood builds up in left, pressure just gets higher and higher
52
what happens to stroke volume in aortic regurgitation
increase
53
what happens to systolic aortic pressure in aortic regurgitation
increase a lot
54
what happens to diastolic aortic pressure in aortic regurgitation
decreases
55
what happens to pulse pressure in aortic regurgitation
very strong
56
diastolic murmur and normal pulse, what might it be
pulmonary regurgitation
57
what happens to right atrial pressure in aortic regurgitation
normal
58
what can cause aortic stenosis
congenital
acquired like rheumatic heart disease
calcification of valves - idiopathic
59
in aortic stenosis each time heart contracts blood is being ejected out of
smaller than normal hole
60
during systole what happens in aortic stenosis
very turbulent
61
during diastole in aortic stenosis what happens
everything is fine
62
during aortic stenosis what kind of murmur
systolic
63
what happens to afterload in aortic stenosis
increases a lot
64
what happens to left ventricular pressure in aortic stenosis
increase, it has to pump much higher to pump same amount of blood
65
what happens to aortic pressure in aortic stenosis
normal or even less than normal, b/c less blood is being pumped out of the valve
66
in aortic stenosis does heart empty completely
no, a lot of blood left in it
67
what happens to ventricular filling in aortic stenosis
increased, heart will be stretched b/c lo tof blood left over
68
what happens to preload in aortic stenosis
increase
69
what happens to left atrial pressure in aortic stenosis
increase
70
what happens to stroke volume in aortic stenosis
decrease
71
what happens to pulse pressure in aortic stenosis
weaker than normal, b/c stroke volume is much less
72
put probe into left ventricle what happens in aortic stenosis
pressures go to 200 from 0, that's a lot
73
put probe in left atria what happens in aortic stenosis
pressures go to 70 or 80
74
what happens to systolic aortic pressure in aortic stenosis
decrease
75
what happens to diastolic aortic pressure in aortic stenosis
decrease
76
during systole in mitral regurgitation what happens
blood goes out at aorta, significant percentage goes backwards back into atria
77
any time there is enlarged ventricle, what does it do to valves
can cause valves to stretch
78
heart muscle grows, what doesn't
valves, if they stretch they will be pulled apart
79
if there is problem with papillary muscle, what can happen
when heart contracts the valve bulges up into atria and get regurgitation
80
mitral regurgitation is what kind of murmur
systolic
81
aortic regurgitation what will you hear during diastole
blowing - don't hear individual heart sounds
82
what happens to atrial pressure in mitral regurgitation
increase
83
if left side pumps 5 L /min and right side pumps 5.5 L /min what happens
pressure and filling will increase on left side until it can put enough blood in the ventricle to match what the right side is pumping
84
what happens to ventricular filling in mitral regurgitation
increase
85
hat happens to preload in mitral regurgitation
increase
86
what happens to stroke volume in mitral regurgitation
usually doesn't change dramatically
87
what happens to systolic aortic pressure in mitral regurgitation
small decrease
88
why doesn't stroke volume change much in mitral regurgitation
put a lot more blood in so even though some is going backwards, enough will go forwards
89
what happens to diastolic aortic pressure in mitral regurgitation
small decrease
90
mitral stenosis almost always results from
rheumatic fever
91
what happens to left atria pressure in mitral stenosis
increase
92
left side failure causes what kind of problems
pulmonary
93
right side failure causes what kind of problems
peripheral problems
94
review mitral stenosis
pg 17
95
pressure overloads on heart lead to
concentric hypertrophy
96
what does concentric hypertrophy mean
heart muscle gets bigger
97
voume overload of heart cause
eccentric hypertrophy
98
what does eccentric hypertrophy mean
chamber size is bigger so more volume can fit
99
heart tissue doesn't
proliferate
100
how does heart tissue grow
can put more sarcomeres in, it can't proliferate
101
heart disease causes increase in blood volume in heart due to
renal retentino of fluid
102
when muscle hypertrophy, blood supply to them doesn't usually
match up with the increase in tissue
103
failure of the left ventricle causes the development of
pulmonary edema
104
one of the main causes of atrial fibrillation is
enlarged atria
105
what are the dyamics of mitral stenosis and mitral regurgitation
Pulmonary Edema in Mitral Valvular Disease
Enlarged Left Atrium and Atrial Fibrillation
Compensation in Early Mitral Valvular Disease
106
what is the compensation in early mitral valvular disease
increase in blood volume
| increase in pulmonary artery pressure leading to right side failure
107
patent ductus arteriosus is a ____ to _____ shunt
left to right
108
tetralogy of fallot is a ____ to _____ shunt
right to left
109
patent ductus arteriosus is a ____ defect
congenital
110
tetralogy of fallot is a ______ defect
congenital
111
besides shunts, what is the other major type of congenital anamoly
stenosis of channel
112
left to right shunt means blood flows from
left side of heart or aorta to the right side of th eheart failing to flow through systemic circulation
113
left to right shunt, basically what is the main issue
goes back to lungs and not back to the body
114
what has superoxygenated blood
left to right shunt
115
right to left shunt, blood flows from
right side of heart into left side of heart, failing to flow through the lungs
116
what doesn't have oxygenated blood
right to left shunt
117
right to left shunt, what is the main issue
blood isn't getting oxygenated
118
what happens during fetal life in regards to lungs
lungs collapse - baby gets oxygen from mother
119
resistance to blood flow in lungs is very
high
120
ductus arteriosus
allows baby to get oxygenated blood to body from mom, oxygenated through placenta
121
when baby is born, what is supposed to ductus arteriosus
lungs open up, right heart contracts and blood goes through pulmonary arteries to lungs, the ductus arteriosus is supposed to close
122
how long does it take for ductus arteriosus to close
hours to days
123
patent ductus arteriosus, what happens
pressure in aorta is high, pressure in pulmonary arteries is much lower, when heart contracts and blood ejected out aorta, it wants to go through the ductus arteriosus b/c of the low pressure (low resistance) to go through lungs
124
why is patent ductus arteriosus a problem
can get 4x as much blood going through lungs as going to periphery, so blood to periphery decreased
diminished cardiac and respiratory reserve
125
what kind of murmur in ductus arteriosus
never stops making sound, but louder in systole than diastole (machinery murmur)
126
as children age, if patent ductus arteriosus doesn't close what happens to it
it is going to get bigger and bigger and bigger
127
diminished cardiac and respiratory reserve in patent ductus arteriosus, describe
putting 3-4x the blood throuugh lungs, right atrial pressure and preload
128
what happens to left atrial pressure and preload on heart with patent ductus arteriosus
a lot more blood (up to 4x as much) going back to the right side, causes the left atria and ventricles to enlarge
129
Stroke volume in left side during patent ductus arteriosus
higher
130
diastolic pressure in left side in patent ductus arteriosus
much lower
131
what does PDA stand for
patent ductus arteriosus
132
pulse in child with PDA, strong or weak
stronger
133
why is pulse strong in child with PDA?
systolic pressure is stronger, diastolic pressure is weaker
134
how does person with PDA die?
ventricle will just keep enlarge, there is a limit to how big it can get.
atria pressure keep increasing on left side. this will cause problem in lungs
fluid in lungs, pulmonary congestion, pulmonary edema
135
most common cause of blue babies
Tetralogy of Fallot
136
ventricular septal defect is found in
Tetralogy of Fallot
137
the aortic blood in Tetralogy of Fallot is mainly
unoxygenated venous blood
138
in Tetralogy of Fallot aorta receives blood from
both ventricles
139
what happens to pulmonary artery in Tetralogy of Fallot
stenosis
140
stenosis of pulmonary artery in Tetralogy of Fallot means that
much lower than normal amounts of lbood pass from right ventricle into lungs
141
septal defect in Tetralogy of Fallot means
LV blood flows into RV or directly into aorta
142
what happens to right ventricle in Tetralogy of Fallot
enlarged
143
why is right ventricle enlarged in Tetralogy of Fallot
afterload is increased on right side b/c stenosed valve & right heart blood is giong out the aorta which is high pressure system
144
blue skin another word for it
cyanotic
145
what can cause Tetralogy of Fallot
german measles
genetics: identical twins
if parents had it
146
what 4 things always happen in Tetralogy of Fallot
Aorta received blood from both ventricles
Stenosis of pulmonary artery
Septal defect
Enlarged right ventricle
