CVPP Week 10: Cardiac Cycle, Heart Sounds & Murmurs

Whats it called when calcium activates the ryanodine receptor on the sarcoplasmic reticulum which releases Ca into the sarcoplasmic reticulum

Ca induced calicum release

What does calcium bind to to initiate contraction

Binds to troponin

Preload

Initial stretching of cardiac myocytes prior to contraction

Preload = to

Venous return

Afterload

Force against which the heart has to contract to eject blood

As afterload increases...

SV decreases

Left AV valve AKA's (2)

Bicuspid or mitral valve

Right AV valve AKA

Tricuspid valve

Atrial systole begins how

SA node fires

Isovolumetric contraction also known as

First phase of ventricular systole

Isotonic contraction also known as

Second phase of ventricular systole

Isovolumetric contraction occurs

When the ventricles contract while all valves are closed

-this causes pressure to rise without changing volume

Isovolumetric contraction makes what heart sound

S1 (LUB)

Isotonic contraction is

Constant muscle tension with a change in muscle length due to contraction

-semilunar valves open and blood ejected

S2 (DUB) comes from what

Closure of semilunar valves when ventricular pressure goes down

-from backwash of arteries

First heart sound is marker for...

Systole (QRS)

Second heart sound is marker for...

Diastole (T-wave)

Mitral valve and aortic valve closes _____ in regards to tricuspid and pulmonary valve

Close first

First heart sound pitch in regards to second heart sound

S1 is lower pitch than S2

S3 is ____ but S4 is always ____

S3 is sometimes normal but S4 is always pathological

S3 AKA

Ventricular gallop

S3 is normal with... (2)

-kids with thin chest wall

-exercising adults

S3 is pathological when... (2)

-excessive filling or septal defect —> can indicate heart disease

-abnormal after 40 years old

S3 is ____ filling sound

Passive

S4 is ____ filling sound

Active

S4 heart sound comes from _____ and give examples (3)

Atrium contracts into non-compliant ventricle (waves crashing into rocks)

-concentric hypertrophy

-fibrotic issue

-high blood pressure

Normally, L valve closes _____ R valve

Before

Physiological splitting occurs due to...

Breathing, making it inconsistent

Inhalation favors ______ while exhalation favors _____

Inhalation favors venous return to right atrium while exhalation favors venous return to left atrium

Inhalation does what to gut veins

Compresses —> more venous return

Fixed splitting is ____

Constant

Fixed splitting caused by

Bundle branch block

-infarction has occured: R or L bundle branch dead and not conducting

Paradoxical split S2

Left bundle branch is affected and aortic valve closes after pulmonary valve

APETMONKEY

Aortic

Pulmonary

Erb's point

Tricuspid

Mitrial (S3 and S4 heard best here)

Murmur def

Due to turbulent flow through heart valves

Stenosis def

Failure of valve to open completely

-due to hardness/narrowing

Reguritation def

Failure of valve to close completely

-allows backflow of blood

ARMS and PRTS in diastole

-AORTIC REGURGITATION, MITRAL STENOSIS

-PULMONIC REGURGITATION, TRICUSPID STENOSIS

Mitral valve prolapse creates a classic pathogmonic murmur

Mid systolic click

Mitral valve prolapse is associated with...

Marfan's syndrome

Normal mitral valve prolapse:

Doesn't cause any health problems or require treatment

Importance of knowing if you have mitral valve prolapse (3)

1. Vulnerable to colonization by germs

2. Infective endocarditis

3. Dentists will have this in their intake form