Lecture 2

Question 1

Systole

Answer 1

Atrial contraction
Isovolumetric contraction
Rapid ejection
Reduced ejection 
Isovolumetric relaxation 
Rapid filling 
Reduced filling

Question 2

How long does a contraction last

Answer 2

200- 300ms

Question 3

Effects of increased HR

Answer 3

Decreased diastole

Same systole

Question 4

Diacritic notch

Answer 4

Aortic pressure increased transiently due to transient back flow that closes valve

Question 5

A wave

Answer 5

Atrial systole

Question 6

C wave

Answer 6

Mitral valve closes causing an increase in pressure

Question 7

Xd

Answer 7

X descent

The atrial pressure transiently decreases as the base of atrial is pulled down when the ventricles contract

Question 8

V wave

Answer 8

Atrial pressure gradually increases due to venous return

Question 9

Yd

Answer 9

Y descent

Atrial pressure decreases as mitral valve opens

Question 10

EDV

Answer 10

End diastolic volume

Max filling of ventricles

Question 11

IVC

Answer 11

Isovolumetric contraction
No change in ventricular volume
All valves closed

Question 12

ESV

Answer 12

End systolic volume
Lowest ventricular volume
After rapid ejection (systole)

Question 13

After ESV

Answer 13

Rapid filling as mitral valve opens
Diastasis
Last 10% of filling due to atrial contraction

Question 14

IVR

Answer 14

Isovolumetric relaxation
Decline in pressure
Volume stays the same
All valves are closed

Question 15

Diastasis

Answer 15

Rate of filling decreases as ventricles reach inherent relaxed volume
90% full

Question 16

S1

Answer 16

All valves closed
Lub
Before Q wave

Question 17

S2

Answer 17

All valves closed
Dub
After T wave

Question 18

S3

Answer 18

Normally silent
Ventricular filling
Normal in children
Pathological in adults

Question 19

Stenosis

Answer 19

Valve doesn’t open enough - narrowed

Obstruction to blood flow

Question 20

Regurgitation

Answer 20

Valve doesn’t close properly

Back flow

Question 21

Causes of aortic stenosis

Answer 21

Degenerative - senile calcification and fibrosis
Congenital - bicuspid
Chronic rheumatic fever - inflammation and commissary fusion of leaflets

Question 22

Effects of aortic stenosis

Answer 22

LV hypertrophy 
Left sided heart failure 
Syncope - fainting 
Angina 
Microangiopathic haemolytic anaemia 

Crescendo-decrescendo heart murmur

Question 23

Aortic valve regurgitation

Answer 23

Aortic root dilation - leaflets pulled apart 
Endocarditis 
Rheumatic fever (valvular damage)

Question 24

Effects of aortic regurgitation

Answer 24

Increase in SV - increased systolic pressure
Left ventricle hypertrophy
Bounding pulse (head bobbing and Quinke’s sign)

Early decrescendo diastolic murmur

Question 25

Mitral valve stenosis

Answer 25

Rheumatic fever

Question 26

Mitral stenosis effects

Answer 26

Increased left atrium pressure Pulmonary oedema Dysopnea - difficult breathing Pulmonary hypertension RV hypertrophy Left atrial dilution - atrial fibrillation, thrombus formation - oesophagus compression, dysphagia Diastolic rumble

Question 27

Mitral valve regurgitation causes

Answer 27

Myxomatous degeneration - weakened tissue that prolapses Damaged papillary muscles post MI Left sided heart failure - LV dilation stretches valves Rheumatic fever Pansystolic (holosystolic)

Question 28

Effects of mitral regurgitation

Answer 28

Increased preload LV hypertrophy Holosytolic murmur