Structural Heart Disease

Question 1

order of heart chambers for blood from body back out to body?

Answer 1

inferior/superior vena cava → right atrium → right ventricle → pulmonary arteries → pulmonary veins → left atrium → left ventricle → aorta

Question 2

which valve separates the right atrium and right ventricle?

Answer 2

Tricuspid

Question 3

which valve separates the left atrium and left ventricle?

Answer 3

Mitral valve (bicuspid)

Question 4

which valves control entry into the aorta and pulmonary arteries respectively?

Answer 4

aortic valve and pulmonary valve (both semilunar)

Question 5

heart wall layers from innermost to outermost?

Answer 5

endocardium → myocardium → epicardium
Endocardium lines cavities of heart and regulates contractions
Myocardium important for contraction
Epicardium protects heart

Question 6

where are the pectinate muscles and what is one of their functions?

Answer 6

found in the right atrium and auricle, help to increase surface area

Question 7

what do the chordae tendinae connect and what is their function?

Answer 7

connect papillary muscles to the mitral and tricuspid valves, stop the valves from prolapsing during ventricular systole

Question 8

what are papillary muscles? what do they do?

Answer 8

small muscles attaching via chordae tendinae to atrioventricular valves and preventing prolapse or inversion during systole

Question 9

what are trabeculae carnae and what do they do?

Answer 9

muscle columns projecting from ventricles. provide support to atrioventricular valves, maintain cardiac output and stroke volume

Question 10

what is the intraventricular septum?

Answer 10

muscle wall separating left and right ventricle

Question 11

difference between systole and diastole?

Answer 11

systole = contraction/ejection, diastole = relaxation/filling

Question 12

phases of systole? (ventricular)

Answer 12

isovolumetric contraction, rapid ejection, reduced ejection

Question 13

what is sound S1?

Answer 13

closure of atrioventricular valves

Question 14

what does QRS complex indicate?

Answer 14

Depolarization

Question 15

What does the T wave indicate

Answer 15

Repolarization

Question 16

what is sound S2?

Answer 16

Closure of aortic and pulmonary valves

Question 17

phases of diastole? (ventricular)

Answer 17

isovolumetric relaxation, rapid filling, reduced filling

Question 18

what is the LV volume before systole known as?

Answer 18

LVEDV → left ventricular end diastolic volume

Question 19

what is the LV volume after systole known as?

Answer 19

LVESV → left ventricular end systolic volume

Question 20

how do you calculate cardiac output?

Answer 20

stroke volume * heart rate

Question 21

how do you calculate mean arterial pressure MAP?

Answer 21

diastolic pressure + 1/3 * difference between systolic and diastolic pressure
Cardiac output times systemic vascular resistance then add central venous pressure

Question 22

what is stroke volume?

Answer 22

difference between end diastolic volume and end systolic volume

Question 23

how to calculate ejection fraction?

Answer 23

stroke volume / end diastolic volume (how much of the blood in the heart is being ejected)

Question 24

what is heart sound S3?

Answer 24

low frequency sound in early diastole produced by rapid filling of ventricles

Question 25

most common cause of pathological S3?

Answer 25

congestive heart failure (heart too weak or stiff to pump properly)

Question 26

what is heart sound S4?

Answer 26

low frequency sound in late diastole from atria forcing blood into stiff ventricles. always pathological e.g. aortic stenosis, systemic hypertension ischaemic or hypertrophic cardiomyopathy

Question 27

three types of heart murmur?

Answer 27

systolic, diastolic, continuous

Question 28

aortic stenosis heart murmur + explanation

Answer 28

Valve is tight so when blood rushes through tight opening makes sound EJECTION SYSTOLIC MURMUR

Question 29

aortic regurgitation heart murmur + explanation

Answer 29

diastolic bc valve doesn’t close properly after systole so there is audible backflow when valve should be closed i.e. during diastole (blood flows back from aorta into ventricle) DIASTOLIC MURMUR

Question 30

patent ductus arteriosus heart murmur + explanation

Answer 30

continuous → hole causing free flow of blood between lungs, aorta, pulmonary artery CONTINOUS MURMUR

Question 31

mitral stenosis heart murmur + explanation

Answer 31

mid-diastolic rumble bc mitral valve (atrioventricular) is tight → difficult for blood to flow properly during diastole from atrium to ventricle MID DIASTOLIC MURMUR

Question 32

mitral regurgitation heart murmur + explanation

Answer 32

systolic bc floppy valve can’t close properly so leakage when valve is supposed to be closed i.e. during systole Holosystolic murmur

Question 33

Ventricular septal defect

Answer 33

Hole in between two ventricles Causes mixing of oxygenated and deoxygenated blood Lungs become overfilled with both types of blood

Question 34

Atrial septal defect

Answer 34

Hole in atria Mixing of blood Pooling of blood in lungs

Question 35

Tetralogy of fallot

Answer 35

1)ventricular defect 2)overarching of aorta(receives mixed blood) 3)pulmonary artery narrowing 4)right ventricular hypertrophy

Question 36

Coarctation of aorta

Answer 36

Less blood flows to lower parts of body