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Echocardiography > Hemodynamics & Auscultation > Flashcards

Hemodynamics & Auscultation Flashcards

(73 cards)

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1
Q

event responsible for the first heart sound

A

closure of the AV valves

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2
Q

event responsible for 75% of ventricular filling

A

rapid early filling in diastole

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3
Q

event responsible for 10-30% of ventricular filling

A

end-diastole atrial contraction/atrial kick/late filling

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4
Q

percentage of filling provided by early filling

A

75%

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5
Q

percentage of filling provided by atrial contraction

A

10-30%

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6
Q

event responsible for the second heart sound

A

closure of the semilunar valves

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7
Q

cardiac phase that lengthens and shortens with heart rate

A

diastasis

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8
Q

hibernation

A

reversible ischemia of a segment of heart wall

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9
Q

normal amount of concentric thickening and contraction expected during systole

A

30%

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10
Q

normal BP

A

120/80 mmHg

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11
Q

high BP threshold

A

140/90 mmHg, taken on two occasions

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12
Q

borderline high BP

A

130/85 mmHg

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13
Q

low BP threshold

A

90/60 mmHg

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14
Q

phase responsible for 2/3 of cardiac cycle

A

diastole

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15
Q

phase responsible for 1/3 of cardiac cycle

A

systole

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16
Q

fraction of cardiac cycle occupied by diastole

A

2/3

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17
Q

fraction of cardiac cycle occupied by systole

A

1/3

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18
Q

describe pulse pressure

A

difference in arterial blood pressure between systole and diastole

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19
Q

formula for pulse pressure

A

BPsystole - BPdiastole

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20
Q

describe mean arterial pressure

A

average arterial blood pressure over one full cardiac cycle

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21
Q

formula for MAP

A

diastolic method: BPdiastole + (pulse pressure)/3
=BPdiastole + 1/3(BPsystole-BPdiastole)
systolic method: BPsystole + 2/3(BPdiastole)

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22
Q

MAP

A

mean arterial pressure

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23
Q

simplified Bernoulli’s equation

A

4v^2

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24
Q

describe pressure gradient

A

difference in pressures btwn two adjacent locations in the heart, within the same cardiac phase

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25
formula for change in pressure along a flow path
simplified Bernoulli's = 4v^2
26
normal LV blood pressures, systole/diastole
100-140 / 3-12 mmHg
27
normal RV blood pressures, systole/diastole
15-30 / 2-8 mmHg
28
normal LA blood pressures
mean 2-12 mmHg
29
normal RA blood pressures
mean 2-8 mmHg
30
describe stroke volume
blood volume leaving ventricle per contraction
31
formula for stroke volume using volumes
EDV-ESV
32
describe cardiac output
blood volume leaving ventricle per minute
33
formula for cardiac output
SV x HR
34
describe cardiac index
blood volume leaving the ventricle per minute, relative to body size
35
formula for cardiac index
CO/BSA
36
BSA
body surface area
37
normal stroke volume
70-100 mL
38
normal cardiac output
4-8 L/min
39
normal cardiac index
3-4 L/min^2
40
formula for BSA
root of [weight(kg) x height(cm)]/60
41
formula for stroke volume using LVOT measurements
CSA x VTI = πr^2 x VTI
42
preload
end-diastolic volume and how it affects the length-tension relationship
43
Frank-Starling Law
relates ability to stretch to contractility more preload = larger ventricle = increased longitudinal stretching of the myocardial fibres = increased tension -> greater contractile force required for ejection
44
What relationship is demonstrated by the Frank-Starling Law?
Length-Tension relationship of the ventricle
45
formula for cross sectional area
πr^2
46
Length-Tension relationship of the ventricle
relates ability to stretch to contractility more preload = larger ventricle = increased longitudinal stretching of the myocardial fibres = increased tension -> greater contractile force required for ejection
47
afterload
systemic resistance that the ventricles must pump against
48
Interval-Strength relationship of the ventricle
relates time for ventricle to fill vs strength contraction required (interval-strength) affects HR: longer interval btwn heartbeats = increased preload, results in stronger contraction required for ejection
49
describe inotropic force
relates contractile force to contractile speed (force-velocity): force required for ejection affects the velocity of ventricle muscle fibre contraction
50
describe chronotropic force
relates time for ventricle to fill vs strength contraction required (interval-strength) affects HR: longer interval btwn heartbeats = increased preload, results in stronger contraction required for ejection
51
Which maneuver can be used to decrease venous return, stroke volume, and cardiac output?
Valsalva maneuver
52
Which maneuver can be used to increase venous return, stroke volume, and cardiac output?
amyl nitrate inhalation
53
Force-Velocity relationship of the ventricle
relates contractile force to contractile speed (force-velocity): force required for ejection affects the velocity of ventricle muscle fibre contraction
54
factors that affect afterload
``` viscosity arterial resistance (systemic BP, HTN) vascular geometry (stenosis, structural anomalies) valvular geometry (stenosis, structural anomalies) ```
55
factors that affect contractility/inotropic force
increased inotropic force: medications | decreased inotropic force: disease, hypertrophic or fibrosed heart muscle, hypoxia
56
factors that affect chronotropic force
increased chronotropic force: adrenaline (sympathetic nervous system) decreased chronotropic force: medications, relaxation, high fitness level
57
phases of systole
isovolumic contraction time, ventricular systole
58
phases of diastole
isovolumic relaxation time, early filling, diastasis, late filling
59
normal IVCT
30-50 ms
60
normal systolic ejection time
300 ms
61
In which direction does the muscle contraction progress through the ventricle during systole?
apex to base
62
normal aortic blood pressure, systole/diastole
100-140 / 60-90 mmHg (systole matches LV pressures)
63
What marks the transition between IVCT and systole, causing the aortic valve to open?
The LV to aorta pressure gradient must be exceeded. | The rising IVCT pressures in the LV exceed the diastolic aortic pressure (Ao dia 60-90 mmHg, usually around 80)
64
What marks the transition between systole and IVRT, causing the aortic valve to close?
The LV to aorta pressure gradient must fall. | The risen systolic pressures in the Ao exceed the emptied LV pressure (Ao sys 100-140 mmHg)
65
normal IVRT
50-100 ms
66
What marks the transition between IVRT and diastole, causing the mitral valve to open?
The LA to LV pressure gradient must be exceeded. | The rising filling pressures in the LA exceed the LV pressure (LA mean 2-12)
67
What marks the transition between diastole and IVCT, causing the mitral valve to close?
The LA to LV pressure gradient must fall. | The risen IVCT pressures in the LV exceed the emptied LA pressures.
68
normal early filling time
150-250 ms
69
What occurs during diastasis?
atrioventricular pressure gradient equalizes very briefly, dependant on heart rate
70
normal diastasis time
variable, dependant on heart rate
71
normal late filling time
???
72
normal pulmonary artery pressure, systole/diastole
15-30 / 4-12 mmHg
73
normal RVSP
under 35 mmHg

Echocardiography (11 decks)

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