Lecture 11 Cardiac Cycle Flashcards

1
Q

Starting from isometric/isovolumic contraction, what is the sequence of closing and opening of valves in the cardiac cycle?

A

VENTRICULAR PRESSURE CURVE:

From beginning of isovolumic contraction (when ventricles are pumping - remember both ventricles pump at the same time!):
Mitral Valve Closes
Aortic Valve Opens
Aortic Valve Closes
Mitral Valve Opens
Mitral Valve Closes

By stages: REMEMBER DURING IC AND IR = all 4 valves are closed.

  • Isovolumic contraction: Mitral valve closing to Aortic Valve opening
  • Systole: Aortic valve opening to Aortic valve closing
  • Isometric Relaxation: Aortic valve closing to Mitral valve opening
  • Diastole: Mitral valve opening to Mitral valve closing
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2
Q

Why is it important for the cardiac conduction system to pause at the AV node?

A

Depolarization pauses at the AV node to allow for VENTRICULAR FILLING!

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3
Q

What is the hangout interval (when the pressure gradient is reversed = starts to fall) also known as?

A

protodiastole

*the heart has started to rapidly eject blood so it takes a few miliseconds for the aortic valve to close

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4
Q

What is the pressure in the heart (LVED) at the end of diastole?

A

4-12 mm Hg

*Because the heart has been filling the pressure has gone up a bit

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5
Q

Is diastole almost twice as long as systole and why?

A

Yes! To allow for filling the heart with blood

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6
Q

What is the dichrotic notch in aortic pressure and what causes it?

A

a high frequency oscillation in the aortic pressure

caused by the reverberation of the aortic valve closing

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7
Q

The Wigger’s Diagram (Cardiac Cycle Diagram) shows what pressures, volumes and sounds?

A
aortic pressure
ventricular pressure
atrial pressure
ventricular volume
heart sounds (phonocardiogram)
EKG
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8
Q

What happens to the aortic pressure curve i.e. mean pressure and pulse as blood goes from the Aorta to arteries, arterioles, capillaries and veins?

A

Mean Pressure goes down (bec/ of reflected waves), lose high frequency components and you get higher highs and lower lows and
Pulse widens for 2-3 generations

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9
Q

What factors influence arterial pressures?

A

changes in:

  • stroke volume
  • heart rate
  • aortic distensibility
  • peripheral resistance
  • ejection velocity
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10
Q

If you have a low HR but the same CO, how does your Stroke Volume and Pulse Pressure compare to HR?

A

SV is high

PP is high

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11
Q

What is pulse pressure?

A

Systolic Pressure - Diastolic Pressure

If its harder to eject blood/takes a longer time to eject blood, then your pulse pressure will be lowered!

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12
Q

What is peak systolic pressure for systemic circulation and peak systolic pressure for the pulmonary artery?

A

Systolic Pressure = can reach up to 120 mmHg

Pulmonary Artery systolic pressure = can reach up to 25 mmHg

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13
Q

What is protodiastole aka “hangout interval”?

A

the interval between Aortic valve closing and crossing of Aortic pressure and Left ventricle pressure curves

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14
Q

What is the c wave of atrial pressure?

A

first upward deflection of the atrial pressure during isometric contraction which is caused by bulging of AV valves

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15
Q

What is the v wave of atrial pressure?

A

LA pressure falls SLOWLY

*remember when LVP falls below atrial pressure, mitral valve opens

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16
Q

What is the a wave?

A

atria contraction caused by atria depolarizing (P wave of EKG)

17
Q

What is the ejection fraction?

A

ratio of SV to EDV

In normal heart should be at least 1/2

18
Q

What is residual volume?

A

volume of blood remaining in the heart after systole

19
Q

What is systolic reserve capacity?

A

volume of blood remaining the heart after systole that could be pumped during a maximal contraction

20
Q

What type of filling does atrial contraction produce?

A

active ventricular filling = 20% of all filling in the resting state (so not much represents active filling) but can be greater with rapid heart rates

21
Q

When the mitral valve opens at the beginning of diastole, what type of filling is occurring?

A

Rapid passive ventricular filling

22
Q

What is the diastolic filling pattern?

A

RAPID passive ventricular filling –> SLOW passive ventricular filling (= DIASTASIS) –> atrial contraction produces ACTIVE filling