Lecture 3: Study Guide For Quiz

Question 1

The cardiac cycle has how many phases?

Answer 1

7 phases

Question 2

Phase 1 =

Answer 2

Atrial systole

Question 3

Phase 2 =

Answer 3

Isovolumic contraction

Question 4

Phase 3 =

Answer 4

Rapid ejection

Question 5

Phase 4 =

Answer 5

Reduced ejection

Question 6

Phase 5 =

Answer 6

Isovolumic relaxation

Question 7

Phase 6 =

Answer 7

Rapid filling

Question 8

Phase 7 =

Answer 8

Diastasis

Question 9

What phases are part of ventricular systole?

Answer 9

Phase 2: isovolumic contraction
Phase 3: rapid ejection
Phase 4: reduced ejection

Question 10

What phases are part of ventricular diastole?

Answer 10

Phase 5: isovolumic relaxation
Phase 6: rapid filling
Phase 7: diastasis
Phase 1: atrial systole

Question 11

During what phase does most of ventricular filling occur?

Answer 11

Phase 6–rapid ventricular filling

Question 12

Does opening or closing of healthy heart valves create heart sounds?

Answer 12

Closing

Question 13

The incisura or dicrotic notch of the aortic pressure tracing marks the beginning of what?

Answer 13

The beginning of ventricular systole

Question 14

What valve closes at the dicrotic notch?

Answer 14

Aortic valve

Question 15

During what phases of the cardiac cycle are the mitral and aortic valves both closed?

Answer 15

Phase 2: isovolumic contraction (ventricular systole)

Phase 5: isovolumic relaxation (ventricular diastole)

Question 16

Name the various waves of the CVP.

Answer 16

• A wave
• C wave
• V wave
• X descent
• Y descent

Question 17

CVP—A wave

Answer 17

• End diastole

- Atrial contraction

Question 18

CVP—C wave

Answer 18

• Early systole

- Ventricular filling

Question 19

CVP—V wave

Answer 19

• Late systole

- Atrial filling from ventricular systole

Question 20

CVP—X descent

Answer 20

• Mid systole

- Atrial relaxation

Question 21

CVP—Y descent

Answer 21

• Early diastole

- Ventricular filling

Question 22

The first heart sound signifies closure of which heart valves?

Answer 22

Closure of mitral/tricuspid (AV) valves during isovolumic contraction (phase 2)

Question 23

The second heart sound signifies closure of which heart valves?

Answer 23

Closure of aortic/pulmonic valves during isovolumic relaxation (phase 5)

Question 24

During which phase of the cardiac cycle is the majority of blood ejected from the left ventricle?

Answer 24

Phase 3–rapid ejection

Question 25

During which phase of the cardiac cycle does most of the filling of the left ventricle occur?

Answer 25

Phase 6–rapid ventricular filling

Question 26

What is the “atrial kick”?

Answer 26

Occurs near the end of diastole as the atria begin contracting and pump blood into the ventricles—this pressurized delivery during ventricular relaxation (ventricular diastole) is called the atrial systole or atrial kick

Question 27

How much does the atrial “kick” contribute to ventricular filling? Does it vary with different rhythms?

Answer 27

At normal heart rates, 10% At higher heart rates (i.e.: during exercise), can contribute up to 40% of ventricular filling. There can be a loss of atrial kick in patients with atrial fibrillation.

Question 28

What are the 4 major determinants of cardiac output?

Answer 28

- Preload - Afterload - Contractility - Heart rate

Question 29

Under normal circumstances, stroke volume can be INCREASED by increasing or decreasing end-diastolic volume (no change in ESV)?

Answer 29

Increasing EDV

Question 30

Under normal circumstances, stroke volume can be INCREASED by increasing or decreasing end-systolic volume (no change in EDV)?

Answer 30

Decreasing ESV

Question 31

What is the Bowditch Effect/Treppe Effect/Staircase Phenomenon?

Answer 31

The idea that an increase in heart rate will also cause positive inotropy

Question 32

What are other names for the Bowditch Effect?

Answer 32

- Treppe Effect | - Staircase Phenomenon

Question 33

What causes the Bowditch Effect?

Answer 33

- It occurs due to an increase in intracellular Ca++ with higher heart rates - More Ca++ = more depolarizations per minute - Na+/K+-ATPase pump cannot keep up with the influx of Na+, thus the Na+-Ca++ exchange pump doesn’t function as well

Question 34

Why do extremely high heart rates result in a decrease in cardiac output?

Answer 34

The heart at a faster rate does not stay relaxed long enough to allow for complete ventricular filling

Question 35

As preload increases (within normal limits), cardiac output increases. What is the name for this phenomenon?

Answer 35

Frank-Starling Mechanism

Question 36

As preload decreases, cardiac output decreases. What is the name for this phenomenon?

Answer 36

Frank-Starling Mechanism

Question 37

What physiologic relationship keeps cardiac output of the ventricle matched with venous return?

Answer 37

Frank-Starling Mechanism

Question 38

What physiologic relationship keeps the cardiac output of the right and left ventricles matched?

Answer 38

Frank-Starling Mechanism

Question 39

What are some of the things that affect ventricular preload? (6 things)

Answer 39

- Venous blood pressure (affected by venomotor tone/venous volume) - Filling time - Ventricular compliance - Atrial contraction - Inflow or outflow resistance - Ventricular systolic failure

Question 40

What affects venous volume? (5 things)

Answer 40

- Venous return - Total blood volume - Respiration - Exercise/muscle contraction - Gravity

Question 41

What is the Frank-Starling Relationship?

Answer 41

When venous return to the heart is increased, ventricular filling increases, as does preload. This stretching of the myocytes causes an increase in force generation, which enables the heart to eject the additional venous return and thereby increase stroke volume. AKA—the heart pumps the blood that returns to it

Question 42

The Frank-Starling Relationship allows the heart to readily adapt to changes in ___

Answer 42

Venous return

Question 43

The Frank-Starling Relationship plays an important role in balancing...

Answer 43

The output of the 2 ventricles

Question 44

(According to the Frank-Starling Relationship) Increasing ___ and ___ leads to an increase in ___

Answer 44

Venous return and ventricular preload, stroke volume

Question 45

What parameter is representing on the “y” axis (vertical axis) of the Frank-Starling Curve?

Answer 45

Stroke volume

Question 46

What parameter is represented on the “x” axis (horizontal axis) of the Starling Curve?

Answer 46

Left ventricular end diastolic pressure (LVEDP)

Question 47

What factors can cause an increased afterload? (4 things)

Answer 47

- Increased aortic pressure - Increased systemic vascular resistance - Aortic valve stenosis - Ventricular dilation

Question 48

Increases in afterload cause cardiac output to increase or decrease?

Answer 48

Decrease

Question 49

Wall stress can be used to help understand what determinant of cardiac output?

Answer 49

Afterload

Question 50

Define contractility.

Answer 50

The inherent capacity of the myocardium to contract independently of changes in afterload or preload

Question 51

What is another name for contractility?

Answer 51

Inotropy