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Block C - Circulation > Physiology Lecture 1 -- The Heart as a Pump > Flashcards

Physiology Lecture 1 -- The Heart as a Pump Flashcards

(72 cards)

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1
Q

When does first heart sound (S1) occur?

A

Mitral valve closes

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2
Q

When does S2 occur?

A

Aortic valve closes

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3
Q

When can S3 occur in terms of Wigger’s diagram?

A

After early rapid/brisk filling via the LA-LV P gradient

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4
Q

What is the most common reason for S3 being abnormal?

A

Congestive heart failure causing increased ventricular pressure (a poor prognostic factor)

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5
Q

Define systole in terms of heart events

A

Mitral valve closes –> aortic valve closes

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6
Q

Define diastole in terms of heart events

A

Aortic valve closes –> mitral valve closes

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7
Q

Explain the purpose of isovolumetric contraction

A

Both valves are closed, so no blood flow occurs as pressure builds in the ventricle to overcome the pressure of the aorta = establish P gradient

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8
Q

Pressure gradient during ejection

A

Left ventricle > Aorta

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9
Q

Explain the purpose of isovolumetric relaxation

A

Both valves are closed, so no blood flow as the left ventricle is given time to relax until its pressure is lower than the atrium

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10
Q

Pressure gradient during diastole (post isovolumetric relaxation)

A

Left atrium > Left ventricle

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11
Q

What physical event causes the mitral valve to close?

A

When P left atrium was higher than P left ventricle and then their P become equal

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12
Q

What physical event causes the aortic valve to close?

A

When P left ventricle was higher than P aorta and then their P become equal

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13
Q

What physical event causes the aortic valve to open?

A

When P aorta was higher than P ventricle and then their P become equal

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14
Q

What physical event causes the mitral valve to open?

A

When P ventricle was higher than P atrium and then their P become equal

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15
Q

When can a fourth heart sound be heard?

A

During the atrial kick

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16
Q

How much of the blood is passively emptied from the left atrium to the left ventricle during diastole?

A

70%

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17
Q

What is the purpose of the atrial kick?

A

Contraction of the atrium to force the remaining 30% of the blood to enter the left ventricle

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18
Q

What wave in the wigger’s diagram indicates the atrial kick?

A

a wave

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19
Q

What event does the x descent of the Wigger’s diagram represent?

A

Atrial relaxation (early systole)

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20
Q

What event does the v wave of the Wigger’s diagram represent?

A

Atrial filling

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21
Q

What event does the y descent of the Wigger’s diagram represent?

A

Atrial emptying (early diastole)

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22
Q

What might cause an opening heart sound?

A

Bicuspid aortic valve (an ejection sound)

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23
Q

Define this event

A

Aortic valve closes

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24
Q

Define this event

A

Aortic valve opens

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25
Define this event and associated wave
A Wave = Atrial Kick
26
Define this time interval
Atrial systole
27
Define this time interval
Diastalsis
28
Define this interval
Diastole
29
Define this interval
Ejection
30
Define this interval
Isovolumetric contraction
31
Define this interval
Isovolumetric relaxation
32
Define this event
Mitral valve close
33
Define this event
Mitral valve open
34
Define this interval
Rapid inflow
35
Define this interval
Systole
36
Define this wave
v wave = atrial filling
37
Define this wave
x descent = atrial relaxation
38
Define this wave
y descent = atrial emptying
39
Define ESV
Ventricular volume at the end of systole (when aortic valve closes
40
Define EDV
Ventricular volume at the end of diastole (mitral valve closes)
41
Defien inotropy
Contractility, reflected by the relationship between ESV and afterload
42
Define preload
The ventricular volume of blood prior to systole (same as EDV)
43
Define afterload
The pressure (of aorta) that the left ventricle must overcome during systole to eject blood
44
Describe the significance of the relatively shallow slope of the ventricular fillling line of the PV loop
Low slope = low P for changes in V = good compliance
45
Define diastology
PV relationship during diastole (V filling property; compliance)
46
An example of a heart with decreased compliance
Hypertension (thickened ventricular wall)
47
An example of a heart with increased compliance
Cardiomyopathy
48
What happens if left ventricular pressure cannot overcome aortic P
No ejection = keep contracting isovolumetrically
49
Define SV
Stroke Volume = EDV - ESV Amount of blood ejected to the aorta
50
Define ejection fraction
EF = SV/EDV Proportion of blood ejected to aorta that was in the ventricle
51
3 factors that affect ventricular performance
Contractility Afterload Preload
52
Effect of increased preload on isovolumetric pressure
Increase
53
Define systology
End systolic pressure volume relationship (contracility)
54
Effect of inotropy with constant afterload and preload
Positive inotropic agent = increase contractility = increase SV (blue) Negative inotropic agent = decrease contractility = decrease SV (red)
55
Predict effect of preload based on Starling's Laws
If V is increased, a NORMAL heart will has more vigorous contractions and produce higher pressures
56
Define premature ventricular contraction
Compensatory pause, which signifies filling of the ventricle = bigger ventricle = very forceful contraction
57
Effect of preload with constant inotropy and afterload
Increased preload = increased SV
58
Normal ejection fraction
60%
59
Effect of afterload (aortic P) with constant preload and inotropy
Increased afterload = decreased SV = lowered EF (since higher ESV)
60
How to treat patients with too much afterload
Decrease afterload with vasodilator (ACE inhibitor), which "unloads" the heart
61
Effect of heart failure on PV loops
Decrease contraciltiy and increased EPV --\> decreased SV
62
Afterload
63
Define this event
Aortic valve opens
64
What does this space represent?
Diastole
65
What does this corner represent?
Mitral valve closes EDV = preload
66
What does this corner represent?
ESV Aortic valve close
67
What does this slope represent?
Inotropy
68
What does this edge represent?
Isovolumetric contraction
69
What does this edge represent?
Isovolumetric relaxation
70
What does this space represent?
Systole
71
What does this corner represent?
Mitral valve opens
72
What does this width represent?
SV

Block C - Circulation (26 decks)

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