S3_L2: The Heart as a Pump

Question 1

Enumerate the 5 phases of the cardiac cycle

Answer 1

1. Atrial Systole
2. Isovolumetric Ventricular Contraction
3. Ventricular Ejection
4. Isovolumetric Ventricular Relaxation
5. Ventricular Filling

Question 2

Determine whether the following factors increase or decrease the end-diastolic volume

1. Increased negative intrathoracic pressure
2. Increased venous tone & total blood volume
3. Standing
4. Increased pumping action of skeletal muscles
5. Increased intrapericardial pressure

A. Increases
B. Decreases

Answer 2

1. A
2. A
3. B
4. A
5. B

Question 3

Oxygen consumption of heart is determined by what 3 factors?

Answer 3

1. Intramyocardial tension
2. Contractile state of the myocardium
3. Heart rate

Question 4

TRUE OR FALSE: Aortic pressure is 7x greater than pulmonary artery pressure

Answer 4

True

Question 5

TRUE OR FALSE: Stroke work of the left ventricle is 7x the right ventricle

Answer 5

True

Question 6

Enumerate the four factors that control cardiac output and state whether each factor is a cardiac or coupling factor.

Answer 6

1. Heart Rate (cardiac factor)
2. Myocardial Contractility (cardiac factor)
3. Preload (coupling factor)
4. Afterload (coupling factor)

Question 7

The amount of blood pumped by the heart per minute

Answer 7

Cardiac output

Question 8

TRUE OR FALSE: During isovolumetric contraction, there is a rise in atrial pressure.

Answer 8

True

Question 9

TRUE OR FALSE: Cardiac outputs of both ventricles are equal

Answer 9

True

Question 10

TRUE OR FALSE: Murmurs are heard due to narrowing of the orifice or regurgitation leading to a rippling effect, turbulent blood flow, and a vibration heard. This happens with valvular disease.

Answer 10

True

Question 11

TRUE OR FALSE: Hearing an S3 is normal.

Answer 11

False

Question 12

TRUE OR FALSE: (R) atrial systole occurs after (L) atrial systole.

Answer 12

False

Question 13

TRUE OR FALSE: Sleep increases cardiac output

Answer 13

False

Question 14

TRUE OR FALSE: The resting pressure in the pulmonary arteries is 10mmHg

Answer 14

True

Question 15

TRUE OR FALSE: Pulse is weak during hemorrhage

Answer 15

True

Question 16

TRUE OR FALSE: Myocardial contractility affects venous return

Answer 16

False

Question 17

TRUE OR FALSE: If the aortic valve is stenosed, you would hear the murmur in systole.

Answer 17

True

Question 18

TRUE OR FALSE: RV ejection begins before LV ejection

Answer 18

True

Because of pressure since RV only needs 10 mmHg as compared to LV’s 80 mmHg

Question 19

TRUE OR FALSE: Aging produces a faster pulse wave

Answer 19

True

Question 20

TRUE OR FALSE: The A wave corresponds to the blood regurgitation into the veins during atrial systole

Answer 20

True

Question 21

TRUE OR FALSE: If the semilunar valves are stenosed, the bruit will be heard during systole

Answer 21

True

Question 22

TRUE OR FALSE: Heart rate and pulse rate should be equal

Answer 22

True

Question 23

TRUE OR FALSE: Blood regurgitates to the great veins during atrial systole.

Answer 23

True

Question 24

TRUE OR FALSE: Blood flows from areas of high pressure to low pressure

Answer 24

True

Question 25

How many phases does the cardiac cycle have?

Answer 25

5

Question 26

What happens during late diastole?

Answer 26

Both AV valves are open (mitral and tricuspid)

Question 27

The amount of blood pumped per beat

Answer 27

Stroke volume (SV)

Question 28

Covers the heart

Answer 28

Pericardium

Question 29

Enumerate the normal heart sounds

Answer 29

S1 and S2

Question 30

Stenosis and regurgitation produce ___

Answer 30

Bruits

Question 31

Exercise ___ the cardiac output

Answer 31

increases

Question 32

70% of blood fills the ventricles passively because of the high pressure in the SVC, IVC, and pulmonary veins. Aortic & pulmonic valves are closed. A. Early diastole B. Late diastole C. Ventricular ejection D. Atrial systole E. Isovolumetric ventricular contraction F. None

Answer 32

B. Late diastole

Question 33

Ventricular pressure is very low. A. Early diastole B. Late diastole C. Ventricular ejection D. Atrial systole E. Isovolumetric ventricular contraction F. None

Answer 33

B. Late diastole

Question 34

Atria and ventricular filling A. Early diastole B. Late diastole C. Ventricular ejection D. Atrial systole E. Isovolumetric ventricular contraction F. None

Answer 34

B. Late diastole

Question 35

Aortic and pulmonic valves open, part of ventricular systole, ejection is rapid then slowly declines as systole progresses. Intraventricular pressure rises to a maximum then declines (Peak of LV: 120 mmHg; peak of RV: 25 mmHg). A. Early diastole B. Late diastole C. Ventricular ejection D. Atrial systole E. Isovolumetric ventricular contraction F. None

Answer 35

C. Ventricular ejection

Question 36

The remaining 30% of blood is pumped by the atria and an additional force is needed to pump the remaining 30% blood into the ventricles. A. Early diastole B. Late diastole C. Ventricular ejection D. Atrial systole E. Isovolumetric ventricular contraction F. None

Answer 36

D. Atrial systole

Question 37

Rapid build up pressure of the ventricles to overcome the pressure in aorta (80 mmHg) and in the pulmonary artery (10 mmHg) A. Early diastole B. Late diastole C. Ventricular ejection D. Atrial systole E. Isovolumetric ventricular contraction F. None

Answer 37

E. Isovolumetric ventricular contraction

Question 38

There is some regurgitation of blood to the great veins A. Early diastole B. Late diastole C. Ventricular ejection D. Atrial systole E. Isovolumetric ventricular contraction F. None

Answer 38

D. Atrial systole

Question 39

The phase where both AV valves and semilunar valves are closed and the ventricular muscle initially shortens a little. A. Early diastole B. Late diastole C. Ventricular ejection D. Atrial systole E. Isovolumetric ventricular contraction F. None

Answer 39

E. Isovolumetric ventricular contraction

Question 40

The phase where both AV valves and semilunar valves are open. A. Early diastole B. Late diastole C. Ventricular ejection D. Atrial systole E. Isovolumetric ventricular contraction F. None

Answer 40

F. None

Question 41

Relaxation of the ventricles, ventricular pressure is higher than atrial pressure but the AV valves are not yet open (Isovolumetric ventricular relaxation). Known as protodiastole and the ventricular pressure decreases in preparation for the opening of mitral and tricuspid valve so that blood will flow back again into the ventricles. A. Early diastole B. Late diastole C. Ventricular ejection D. Atrial systole E. Isovolumetric ventricular contraction F. None

Answer 41

A. Early diastole

Question 42

Enumerate the instances where atrial pressure rises

Answer 42

1. Atrial systole 2. Early diastole 3. Isovolumetric ventricular contraction

Question 43

Why is isovolumetric ventricular contraction essential?

Answer 43

It is to build up pressure for ventricular ejection

Question 44

End diastolic volume (EDV) - End systolic volume (ESV) = __?

Answer 44

Stroke volume (SV)

Question 45

Oxygen consumption of a beating heart at rest

Answer 45

9 ml/100g/min

Question 46

Law that explains the energy of contraction is proportional to the initial length of the cardiac muscle fiber and is proportionate to the end-diastolic volume. Preload, venous return, contractility of the heart will affect myocardial fiber shortening.

Answer 46

Frank-Starling Law

Question 47

The cardiac index is the correlation between resting cardiac output and body surface area. At any point in time, an organ receives ___ of blood

Answer 47

3.2 L

Question 48

Pericardial sac has ___ of clear fluid

Answer 48

5 - 30 ml

Question 49

The end-diastolic ventricular volume is (1)___. The end-systolic ventricular volume is (2)___.

Answer 49

1. 130 ml 2. 50 ml (At the end of systole, not all of the blood are ejected)

Question 50

TRUE OR FALSE: RV contraction starts after LV contraction

Answer 50

True Left before right because left ventricle has more force, thicker muscle, and greater pressure that it needs to overcome hence it must contract first

Question 51

During expiration, the (1)___ valves close simultaneously. Conversely, the (2)___ valve closes slightly before the pulmonic valve during inspiration.

Answer 51

1. pulmonic and aortic valves 2. aortic

Question 52

Determine the corresponding descriptions of the heart sounds 1. Closure of aortic & pulmonic valves; "dup" / "dub" 2. Heard 1/3 of the way in diastole 3. Ventricular hypertrophy; heard when atrial pressure is high or in the stiff ventricles 4. Closure of AV valves; "lub" 5. Rapid ventricular filling A. First sound (S1) B. Second sound (S2) C. Third sound (S3) D. Fourth sound (S4)

Answer 52

1. B 2. C 3. D 4. A 5. C

Question 53

Determine the corresponding timing of murmur during these specific abnormalities 1. Aortic or pulmonic Insufficiency 2. Mitral or Tricuspid Stenosis 3. Aortic or pulmonic Stenosis 4. Mitral or Tricuspid Insufficiency A. Systolic B. Diastolic

Answer 53

1. B 2. B 3. A 4. A

Question 54

Determine the corresponding descriptions of the waves (jugular pressure transmitted in the great veins) 1. Rise in atrial pressure before AV valves open in diastole 2. Due to atrial systole; Blood regurgitation 3. Rise in atrial pressure due to bulging of the AV valves during isovolumetric contraction 4. Venous inflow stops = rise in venous pressure A. A wave B. C wave C. V wave

Answer 54

1. C 2. A 3. B 4. A

Question 55

Abnormal sounds heard in the vascular system due to turbulent blood flow. Heard in valvular diseases, such as stenosis, which is narrowing of the valve and it does not open properly, and regurgitation or insufficiency, which is when the valve does not close properly and backflow occurs.

Answer 55

Murmurs / Bruits