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CVS physio paper 1 > Part 2 cardiac cycle > Flashcards

Part 2 cardiac cycle Flashcards

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1
Q

بسم الله الرحمن الرحيم وبه نستعين

Ventricles act as compression suction pump

A

comrpeesion in systole high pressure system for djection

Suction in diatsole low pressure system for filling

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2
Q

In each phase of the cycle there is changes on ?

A 
Atrial Pressure
Ventruclar voulme
venrticular pressure
Aortic pressure
Heart valves
Heart sounds
ECG
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3
Q

Atrial systole repesents?

A

firsth phase of new cycle

third phase of ventricular filling become more imp in increased HR

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4
Q

ATRIAL PRESSURE UN ATRIAL SYSTSOLKE ?

A

Increased = a Wave in juglar venous pressure cureve

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5
Q

Aortic pressure: is,,,,,,,,,,,,,,,,,,,,,,,, as semilunar valves are
still closed why?

A

decreased

no blood ejection, while there is
continuous escape of blood to the periphery.

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6
Q

Atrial systole responsible for sounds?

A

Yes ,4th heart sound not audibe normally

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7
Q

Atrial systole and pwave

A

p wave before atrial systole by 0,02 seconds the latter last for 0,1 second\

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8
Q

• During ventricular systole there are 3 phases:

A
  1. Isovolumetric contraction
  2. Rapid ejection
  3. Reduced ejection
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9
Q

• During which both types of valves are closed.

A

isovlumetric contraction 0,04 seconds

isovlumertic relaxation

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10
Q

And so isometric contarcvtion is responsible for switching of the ventricular
pressure from the low pressure system to the high pressure
system. how ?

A

contract ismoetrically increasing tension on the walls increasing intraventriculare pressure

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11
Q

Isovoumetric contracio0n and Jugular venous pressure?

A

increaing atrial pressure due to ?
Bulging of cusps into atira casuing
C wave in jugular venous pressure

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12
Q

Heart sound on isovolumetric contraction ?

A

First heart sounds shrae by 2 components?
Vlavlar compnent: closed valve
Musclear: contraction of muscles

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13
Q

Q wave and isovoulmetric contraction ?

A

Q wave begins beofr it 0,02seconds

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14
Q

Rapid ejection phase 0,16 second and jugular venous pressure ?

A

Pulling the AV Fibrous skeletion down increasing caivty decreasing the pressure
causing X descent in jugular venous pressure

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15
Q

Ventricular pressuer in rapid ejection phase?

A

the muscles contiume contracting increasing intraventricular pressure

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16
Q

Heart sounds in the rapid ejection phase ?

A

First one

due to vascular compnent : rush of blood into aorta and pulmonary artery

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17
Q

rapid ejection phase in ECG?

A

ST segment and begining of T wave

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18
Q

reduced ejection phase ?

A

0,1 second

Firsth half of t wave and its Top

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19
Q

Protodiastole

A 
0,02 to 0,04 second
between the systole and diastole 
dut to momentum of blood to aorta
when momentum is overcome 
the aortic valve is closed produng second heart sound
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20
Q

Second heart sound in ?

A

portodiastole

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21
Q

During ventricular diastole there are 4 phases:

A
  1. Isovolumetric relaxation.
  2. Rapid filling .
  3. Reduced filling.
  4. Next Atrial systole
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22
Q

Isovolumetric relaxation and jugular venous pressure

A

increased vr with closed valve inicreasing the pressure casuing V wave
in juglar venous pressure

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23
Q

Ventricular pressure in IVR ?

A

Decreasd in high rate to reach 0 to be filled by the atrial blood

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24
Q

incisura of aorta occur in —- phase

A

IVR

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25
IVR
0,06 SECONDS 2ND HEART SOUND End of T wave and start of TP segment
26
Rapid filling phase and JVP ?
Decreased pressure due to evacuation Y descent in JVP Ventricular pressure: remains very low during this phase (~ 0 mm Hg).
27
Rapid filling phase ?
0,1 Second S3 SOUND TP isolectric line
28
diastasis
Blood passes from big veins through atria to ventricles, without staying in the atria (that is why it is also called? RED F P
29
This phase is the longest phase in the cardiac cycle, and continues for 0.2 sec. or even more, and is prolonged when the heart rate decreases.
Reduced filling Phase
30
In case of tachycardia, the role of atrial systole in ventricular filling becomes more important ?
and may cause, in this case, | filling up to 50 % of blood
31
EDV | ESV
EDV=130 Ml after atrial systole | ESV=50 Ml after reduced ejection phase
32
Stroke volume (SV= EDV- ESV) = ~ 80 ml.
• It is the difference between end diastolic | volume and end systolic volume
33
There is no a wave in ?
Atrial fibrillation
34
In case of tricuspid stenosis there is ?
large a wvae
35
tricupsid insufficienct there is ?
Giant c wave
36
In case of heart block first degree there is prolongation of ?
pr interval | ac interval
37
In complete heart block there is
Canon giant a Wave
38
Pulse is ?
Presure wave not blood voulme wave trasmitted through the vessel due to ejection from LV 4-8 M/SEC IN AORTA AND LARGE ARTERIRES RACH 16M/S IN SMALL ARTERIES
39
Arterial pulsations reach to the capillaries, and end at the ?
post capillary | resistance
40
Anacrotic limb due to ?
rapid ejection phase
41
Catacrotic limb
Reduced ejection | Diastole
42
``` • Dicrotic notch: is a small oscillation on the falling phase of the pulse wave caused by vibrations set up by sudden closure of the aortic valve (In the aorta and in central arteries, the closure of aortic valve causes a larger oscillation known as ..........................). ```
incisura
43
Factors affecting pulse pressure velocity?
elasticity 1-age 2-distance 3-atherosclerosis
44
➢Arterial pulse volume is very high in atherosclerosis and in aortic regurgitation and may be so much increased to be known as
Collapsing pulse = Corrigan =Water Hammer puls
45
Arterial pulse volume is decreased in aortic stenosis and in | hemorrhage and may be very small leading to what is known as
thready pulse.
46
Arterial pulse volume is very high in
atherosclerosis and in aortic | regurgitation
47
Arterial pulse volume is decreased in
aortic stenosis and in | hemorrhage
48
• The four sounds can be recoded in the
phonocardiogram.
49
First Heart sound
0,16 second Isovlmetric contraction: valvular comnent muscluar compnent Rapid ejection phase: Vascular compnent
50
2nd heart sound
0,12 second shorter than s1 Isovolumetric relaxation closure of semilunar valves best heaerd at aortic and pulmonary compnent splitting durin inspiration best heard at pulmonary compnent
51
3rd sound?
due to rush of blood from atria to ventricule during rapid filling phase heard in children ,thin people , Heart failure
52
4th Heart sound
rush of blood from atria to ventricle during atrial systole not heared masked by s1 accentuated in mitral and tricuspid stenosis
53
Murmurs?
Abnormal sounds or noise heard due to turbulent flow due to diseased valves القاعدة: الصمام المفتوح في المرحلة لازم يكون ضيق و الارتجاع في الاخر ازاي؟ systolic murmurs aortic or pulmonary stenosis av valves regrgiutation insufficiency incompetence Diastolic murmurs: av valves stenosis aortic or pulmonary regrgiutation insufficiency incompetence
54
•Systolic Time Intervals (STI) • Simultaneous recording of ,??? allows for measurement of the duration of systolic time intervals (STI).
carotid pulse wave ECG phonocardiogram
55
Total Electromechanical Systole (QS2):
is the period from the onset of the QRS complex to the closure of the aortic valve as determined by the onset of the second heart sound.
56
beginning of the carotid pressure rise to the dicrotic notch.
left ventricular ejection time LVET
57
Pre-Ejection Period (PEP):
is the difference between QS2 and LVET. (PEP = QS2 – LVET). PEP represents the time for the electrical and mechanical events that precede systolic ejection.
58
The ratio PEP/ LVET can be used as a measure of left ventricular function. Normally, this ratio is about 0.35, and is increased without change in QS2 , in case of
left ventricular dysfunction.
59
Posture and cop ?
cop decreses by 20% on standing
60
Exercise and metnalitiy on cop ?
Exercise increase | Mental anxiety and dreaming of stressfyl conditions increasing cop
61
COP FACTORS?
4P TMH Posture physical activity pregnancy pathological condition Temperature Meals Hormones
62
Measutment of COP?
On experimetnal animal : In anasthetazied animals aorta pulmnarry trunk In Hear-lung preparation Bell cardiometer On Man: Echocardiogarphy Ficks methold dye dilution technique
63
CO= ? FICKS
O2 CONSUMPTION ________________ Artterial-Venous difference O2
64
COP =SV X HR SO =
(EDV-ESV)X HR
65
SV affected by?
``` PRELOAD Afterload contractility: 1-blood supply 2-metabolism '3-intact myocardium ```
66
Intrinicsi regulation of cop ?
Homeometric regualtion : Preload and EDV | Heteroetirc regulation : the contractilityt at same ED
67
Heterometric regulation
``` Preload phenomenon VR Tranisnet postural changes ,adjustment right and left cop , denervated transplanted heart Fallling heart depend mainly on it ```
68
Factora affecting EDV?
VR COMPLIANCE OF HEART Atrial contraction
69
VR incrasieis in /
Skeletal pumping increasing ciruclating blood increasing intrathoracic negativity Recumbency increasing the VR
70
Homeometric regulation
Afterload phenomenon at same EDV
71
Extirinsic regulation of COP ?
Physiological acting Exterinsic factors Symp-ParaSymp -Neuro hormone Humorally mediated Extirnsic factors Factors acting on cAMP like glucagon + ino +chrnontropics Digitalis myocardial deprssion direct
72
The most important factor that shifts to left?
is the adreanl stimulation of heart or circulating catecholamines
73
Cardiac Resereve ?
قدرة القلب علي تعزيز المخرج عشان يرضي طلباته المتزايدة | الفرق بين أقصي و أقل مخرج قلبي
74
short lived mechanisms of regulation of COP?
MOMENT TO MOMENT depending on VR within permissive limit 12 litrs/min increasing sinus rhtym to 90bpm increasing sv heterometric then homometric regulation
75
Short term beyond permissive limit ?
Sympathatic adranal and catecholamins +chorno tropic increasing HR 180bpm + Inotrioic increasing SV esv < 30 ml
76
الحمدلله رب العالمين

CVS physio paper 1 (4 decks)

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