Freshmen Week 2 - AL

Right heart?

Low pressure, low resistance

Left heart?

High pressure, high resistance

AV valves are open during?

Diastole

SL Valve are open during?

Systole

One complete cycle, or heartbeat broken down into 4 phases is?

The cardiac cycle

What are the 4 different phases of the cardiac cycle?

Isovolumic relaxation time(IVRT), diastole, Isovolumic contraction time(IVCT), and systole.

The 2 smaller phases in the complete cardiac cycle are?

Isovolumic relaxation time (IVRT) and Isovolumic contraction time (IVCT)

Means equalized volume?

Isovolumic

What valves are open during Isovolumic periods?

None, all 4 valves are closed

Why are all valves closed during Isovolumic periods?

Because the pressures are changing to begin to relax or begin to contract.

Immediately precedes diastole?

IVRT

Ventricular Volumes remain constant however atrial volumes change?

IVRT and IVCT

Ventricular pressures drop in preparation of ventricular diastole while atrial pressures rise.

IVRT

What is the first phases in the cardiac cycle?

IVRT

Atria increasing in pressure, while filling, volume of the ventricle is staying the same however the pressure is decreasing is an example of what?

IVRT

Period of time where the ventricles fill with blood.

Diastole

The 2nd part of the cardiac cycle?

Diastole

What are the 3 phases of diastole in order?

Rapid early filling, diastasis, and atrial kick

Creates a sucking motion to suck down the blood?

The ventricles

Accounts for 75% of ventricular filling?

Rapid early filling

Can create a 3rd heart sound?

Rapid early filling

Is a 3rd heart sound normal in adults?

No it's abnormal in adults

Is a 3rd heart sound considered a normal variant in children?

Yes

The atrial and ventricular pressures reach equilibrium causing the flow to slow down.

Diastasis

During end diastole what occurs?

Atrial kick/systole occurs

Accounts for 15-30% of ventricular filling?

Atrial kick

Can create a 4th heart sound?

Atrial kick

Is the 4th heart sound normal variant in adults or children?

Children, abnormal in adults

When the ventricles are at their largest capacity for blood?

End-diastolic volume (EDV)

When AV valves slam shut it causes what?

The first heart sound, which is normal in everyone

Immediately precedes systole?

IVCT

Ventricular pressures rise in preparation of ventricular systole.

IVCT

3rd part of cardiac cycle?

IVCT

4th phase of cardiac cycle?

Systole

Period of contraction/squeezing when blood is ejected from the heart.

Systole

Once ventricular pressure exceeds the great arteries (AO and MPA) the _____ valves open and blood is ejected out to the great arteries.

Semilunar (AOV and PV)

In systole ejection begins at the ____ and proceeds up to _____.

Apex; base

Once blood is ejected all the way out, systole will be completes, semilunar valves will slam shut which creates?

The second heart sound (normal)

What steps in the cardiac cycle create one single heart beat?

IVRT, diastole, IVCT, and systole

When a normal valve is open there is no _____________.

Pressure gradient

When a normal valve is closed there is a significant ________.

Pressure gradient(PG)

Difference in pressure across 2 chambers?

Pressure Gradient

Occurs when ventricular pressures are at their lowest?

Rapid early filling

Ventricular equilibrium causing flow to slow down.

Diastasis

Last kick to get blood down to ventricles; occurs during end diastole.

Atrial kick

As ventricular pressures increases and the atria complete their contraction the TV and MV are slammed shut creating?

The 1st heart sound normal

When TV and MV are closed during systole it creates?

A significant pressure gradient

Blood will always flow where?

The path of least resistance

The differences in the proximal and the distal chamber between a closed valve?

Pressure Gradient

The pressure gradient, PM's, and CT main job is to what?

Prevent backflow of blood into the atria during systole.

Allows blood from the ventricles to go out to great arteries. Sending blood out to the lungs and the body.

Semilunar Valves

Is there a pressure gradient against open valves?

No

During systole where is the PG?

The AV valves

When PV and AOV it creates?

2nd heart sound

Once blood is out what happens?

Valves close

During diastole there is a pressure gradient against the ventricles and the _____ because the valves are closed.

Great arteries

The heart needs to supply the _____ of the body.

Demand

The hearts main job is to?

Pump blood to the body

How well the heart pumps/ squeezes, how much blood the heart can get out is what?

Systolic Function

How well the heart relaxes and fills?

Diastolic Function

LVEF?

Left Ventricle Ejection fraction

Shows how well the left ventricle is squeezing?

Left Ventricle Ejection fraction (LVEF)

Normal Left Ventricular Ejection Fraction?

53%-73%

Diastolic dysfunction often will preceded what?

Systolic dysfunction

Systolic and diastolic function are dependent on what?

Contractility, chamber size, and ventricular end-diastolic pressure

The wall thickening and the wall motion

contractility

WMA?

wall motion abnormality

Excessive wall motion

Hyperkinesis

Decreased wall motion

Hypokinesis

No movement/thickening of myocardium; may indicate Myocardial Infarction(MI) or hibernation.

Akinesis

Ischemic segment that is akinetic, but not infarcted, that can be reversed with restoration of coronary blood flow.

Hibernation

Echo cannot differentiate between a hibernating wall and a ____.

MI

Movement away from the center of the cavity; may indicate MI.

Dyskinesis

Wall motion terms reflect what?

Systolic function

Lack of Oxygen to Myocardium?

Myocardium Infarction (MI)(Heart Attack)

Normal, viable chambers concentrically _______ in size during systole and concentrically _____ in size during diastole.

Decrease, increase

Corresponds to how much the ventricle is stretching at the end of diastole, so at its largest?

LV end-diastolic pressure(LVEDP) and RV end-diastolic pressure(RVEDP) both AKA preload

The more blood in the chamber the harder it has to _____ to get it out.

Squeeze

BSA?

Body Surface Area

Takes into account someone's height, weight, gender, and age?

BSA

The volume of blood pumped out per minute is?

Cardiac Output (CO)

Cardiac Output normal range at rest?

4-8L/min

CO equation?

CO= SV x HR

Volume of blood ejected per heartbeat?

Stroke Volume(SV)

SV normal range at rest?

70-100ml

SV equation?

SV = EDV-ESV

Heart beats per minute?

Heart rate (HR)

Normal HR?

60-100bpm

Cardiac Output(CO) corrected for body surface area(BSA)?

Cardiac Index(CI)

Cardiac Index(CI) normal range at rest?

3-4L/min^2

Taking into account of patients BSA?

Index

Cardiac Index (CI) equation?

CI= CO/BSA

The driving force of the cardiac output(CO) depends on what?

Preload, afterload, inotropic force, and chronotropic force

Preload is AKA

end diastolic pressure(EDP)

The amount that the ventricles have to stretch or the degree that the fibers have to stretch at end diastole?

Preload

What is dependent on end diastolic volume(EDV)?

Preload

Length tension relationship?

Frank Starling Law

The more blood that enters the ventricles, the greater the force of contraction needs to be.

Frank Starling Law

The longer distance or time (interval) between heart beats the stronger the contraction needs to be.

Interval-strength relationship

The greater the force required to eject blood during systole the slower the velocity of the fiber shortening. (The greater the force the slower the muscle fibers shorten)

Force-Velocity relationship