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CP Exam 2 > Lecture 11: Cardiac Cycle and Heart Sounds > Flashcards

Lecture 11: Cardiac Cycle and Heart Sounds Flashcards

1
Q

Does a murmur always indicate that there is a problem or an underlying dz?

A

No, not always.

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2
Q

If a patient is diagnosed with a heart murmur, what should you do next?

A

Conduct an electrocardiogram

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3
Q

Systole corresponds with:

Contraction/relaxation

Depolarization/ repolarization

A

Contraction

Depolarization

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4
Q

Diastole corresponds with:

Contraction/relaxation

Depolarization/ repolarization

A

Relaxation

Repolarization

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5
Q

What is the difference between systolic BP and diastolic BP?

A

Systolic BP–> the pressure exerted on the artery when the heart contracts

Diastolic BP–> the pressure on the artery when the heart is at rest

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6
Q

In the cardiac cycle, do the electrical and mechanical activity occur at the same time?

A

Yes

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7
Q

Atrial systole occurs during?

A

P wave

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8
Q

Atrial diastole occurs during?

A

PR interval

—-slow conduction through the AV node—

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9
Q

Ventricular Systole occurs during?

A

QRS complex

(which is also atrial diastole and repolarization)

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10
Q

Late ventricular systole occurs during?

A

ST segment

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11
Q

Ventricular diastole (repolarization) occurs during?

A

T wave

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12
Q

The lub sound or S1 comes from?

A

AV valves closing

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13
Q

The dub sound or S2 comes from?

A

Semilunar valves closing

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14
Q

S3 sounds, which can sounds like Ken-tuckee occurs from?

A

blood filling the relaxed and empty ventricle (ventricular filling)

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15
Q

S4 sounds, which present as Tenness-ee occur from?

A

atrial filling from high pressure in SVC (occurs before S1)

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16
Q

Which side of the heart is a low pressure system; L or R?

A

Right.

Left side of the heart is a high pressure ssystem

17
Q

What is the order of heart sounds?

A

S4–> S1–> S2–> S3–> S4–> S1

18
Q

What are the 2 abnormal valve heart sounds?

A

1. Regurgitation–> turbulent flow sound when blood is moving in the opposite direction than what it should be

2. Stenosis–> Noise when blood moves through a stiff, damaged valve.

19
Q

How do we idenfy abnormal heart sounds?

A

We identify them by when they occur in the cardiac cycle:

  • sytolic murmur will occur in ventricular systole
  • diastolic murmur will occur in ventricular diastole
20
Q

All People Enjoy Time Magazine Stands

for what and what intercostal spaces ?

A

*Aortic : Right 2nd ICS along sternum

*Pulmonic: Left 2nd ICS along sternum

Erbs Point: (S1S2) Left 3rd ICS

*Tricuspid: Lower left sternal border/4th ICS

*Mitral: Left 5th ICS, medial to mid clavicular line

21
Q

How are heart murmurs graded?

A

On a scale of 1-6

1. Soft murmur in quiet room

2. Soft murmur in loud room

3. Prominent heard murmur

4. Loud murmur with a thrill

5. Loud heard with edge of steth tilted against chest

6. Loud murmur heard from 5-10mm from chest + thrill

22
Q

What is considered a pathologic murmur?

A

Any murmur that is great or equal to 3/6

23
Q

What valves are open and closed during ventricular systole?

A

Ventricular systole (ventricular contraction)

  • Semilunar valves= open
  • AV valves= closed
24
Q

What is aortic stenosis?

What is pulmonic stenosis?

A

Aortic stenosis–> restricted flow through the aortic valve

Pulmonic stenosis–> restricted through through the pulmonic valve.

25
Q

What valves are open and closed during atrial systole?

A

Semilunar valves are closed

AV valves are open.

26
Q

What are the general rules for what makes murmurs loud or soft?

A

RINSPIRATION- Inspiration makes RIGHT murmurs in the tricuspid and pulmonic valve louder

LEXPIRATION- expiration makes LEFT murmurs in the mitral and aortic valves louderder

27
Q

Preload is the volume of blood sent to the heart.

What happens to the murmur when preload is increased or decreased?

A

Preload is increased--> louder

When preload is decreased--> softer

28
Q

Why is HOCM (hypertrophic obstructive cardiomyopathy)

one of the two exceptions for the rules of preload?

A

An increase in preload improves an aortic murmur by pushing the septum away from the aortic outflow tract, letting blood eject moreesily.

A decrease in preload worsens the aortic murmur because less blood is pushing the outflow track open, thus, fucking up blood flow.

29
Q

Why is MVP (mitral valve prolapse) the second exception for the rules of preload?

A

IN MVP: mitral valve cusps prolapse into left atria under normal pressure and blood flow.

Increase in preload improves murmur by returning the prolaspsed leaflets to their normal position.

30
Q

Afterload is the pressure the ventricles have to generate to move blood forward into the arterial system (PVR).

What happens to the murmur when afterload is increased or decreased?

A

Increased afterload–> makes the murmur louder

Decreased afterload–> makes the murmur softer

Except with HOCM and MVP, where the opposite occurs.

31
Q

Aortic stenosis

A

Aortic stenosis –> increasing, then decreasing murmur between S1 and S2

1. Old- SAD: Syncopy, Angina, Dyspnea

2. Calcified aortic valve

3. Radiates UP to carotids (cresendo-descendo presentation)

32
Q

Mitral regurgitation

A

A constant, steady murmur heard between S1 and S1

Best heard at apex of heart and radiates to the axilla.

33
Q

Tricuspid regurgitation

A

Want to TRI some drugs?

-Usually due to IV drug abuse

-Constant murmur between S1 and S2.

34
Q

Aortic regurgitation

A

Seen in:

  1. CT disorder
  2. Marfan’s syndrome
  3. Femoral bruits
  4. Head bobbing
  5. Water hammer pulse

AR, there she BLOWS

-early blowing diastolic murmur that occurs during S2 and S1

35
Q

Mitral stenosis

A

D/t Rheumatic fever

The Operating System is MicroSoft

Heard between S2 and S1, when the mitral valve opens, it causes an OS (opening snap

36
Q

HOCM

is associated with sudden cardiac death at a young age.

What is different during preload and after load as discussed earlier?

A

Decreased pre/afterload= louder murmur

Increased pre/afterload = softer murmur

37
Q

Mitral valve prolapse

Characterized by?

A
  • Click in the middle of systole
  • IF YOU SEE MYCOMATOUS VALVULAR DZ–> THINK OF MITRAL VALVE PROLAPSE

CP Exam 2 (27 decks)

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