Blood Flow / Heart Sounds / Cardiac Cycle

What is the equation for flow?

F = ∆P/R

What is valvular insufficiency?

Failure of any valve to prevent reflex

What heart valves does rheumatic fever attack?

Mitral and aortic valves (note both on L side)

What are the causes of a diastolic murmur?

Aortic regurgitation
Mitral stenosis
Pulmonic regurgitation
Tricuspid stenosis

What are the causes of systolic murmur?

Mitral/tricuspid regurgitation
Atrial/pulmonic stenosis
Mitral prolapse

What is Erb's point?

One of five classic auscultation points for listening to heart sounds
Best for listening to S2

What heart sound is caused by the closure of the aortic and pulmonary valves?

S2

Which heart sound produces the 'lub' sound and occurs with closure of AV valves?

S1

What heart sound produces the 'dub' sound and occurs with closure of semilunar valves?

S2

Which heart sound is heard in youth, athletes, and pregnant women?

S3

What combination of sounds is called the 'Kentucky gallop'?

S1, S2, and S3

What heart sound is produced from contraction of atria pushing blood into stiff/hypertrophic ventricle (indicates left ventricle failure)?

S4 - Tennessee Gallop

What is stroke volume?

Volume of blood ejected by the ventricles

What is ejection fraction?

% of EDV ejected

What is the stroke volume formula?

EDV - ESV

What is the formula for ejection fraction?

EF = SV/EDV * 100%

What phase of the cardiac cycle is the heart in with ventricular diastole and atrial systole?

Ventricular filling

What is the order of the cardiac cycle phases?

1. Ventricular filling
2. Isovolumetric contraction
3. Ventricular ejection
4. Isovolumetric relaxation

What phase of the cardiac cycle is the heart in with ventricular systole and atrial diastole?

Isovolumetric contraction and ventricular ejection

What phase of the cardiac cycle is the heart in during ventricular and atrial diastole?

Isovolumetric relaxation

What are the three phases of ventricular filling?

Rapid ventricular filling
Diastasis - slower filling (both - passive - 30 mL)
Atrial systole (40 mL - active)

What is the term for blood volume at the end of ventricular filling?

EDV

Describe isovolumetric contraction.

Atria repolarize and are in diastole
Ventricles depolarize, cause QRS complex, and contract
AV valves close
S1 sound occurs
Cardiomyocytes exert force but with all four valves closed
Ventricles contract, but blood isn't ejected yet

Describe ventricular ejection

Ventricular pressure exceeds arterial pressure
Semilunar valves open
Rapid then reduced ejection
T wave begins late in this phase
Stroke volume is about 70 mL

Describe isovolumetric relaxation.

T wave ends
Ventricles begin re-expanding
Semilunar valves close
Atria fill with blood
All 4 valves are closed

What results from failure of either ventricle to eject blood effectively?

Congestive heart failure

What are some causes of congestive heart failure?

MI
Chronic hypertension
Valvular insufficiency
Congenital defects

Failure of what heart chamber results in blood backing up into lungs causing pulmonary edema?

Left ventricle

What are some symptoms of left ventricular failure?

Shortness of breath
Sense of suffocation

Failure of what heart chamber results in blood backing up in the vena cava causing systemic or generalized edema?

Right ventricle

What are the symptoms of right ventricular failure?

Enlargement of liver
Ascites
Distension of jugular veins
Swelling of fingers/ankles/feet