Components Of The Cardiac Cycle & Corresponding Heart Sounds

Front 1

Cardiac Cycle

Back 1

rhythmic movement of blood through the heart

Front 2

The 2 phases of cardiac cycle

Back 2

1. Diastole

2. Systole

Front 3

Diastole

Back 3

2/3 of the cardiac cycle

ventricles relax and fill with blood
AV valves open

Front 4

Early or Protodiastolic Filling

Back 4

the first passive filling phase in diastole

pressure in atria is higher than ventricles --> blood pours rapidly into ventricles

*S3

Front 5

Presystole or Atrial Systole

Back 5

"atrial kick"

ACTIVE FILLING PHASE

toward end of diastole

atria contract and push last amount of blood into ventricles

Front 6

Systole

Back 6

blood is pumped from ventricles and fills pulmonary and systemic arteries

1/3 of cardiac cycle

mitral and tricuspid valves close

Front 7

The closure of AV valves contributes to ______________ and signals the _______ of systole.

Back 7

-1st Heart Sound (S1)

-beginning of systole

Front 8

The closure of the semilunar valves causes the _____________ and signals the _______ of systole.

Back 8

-2nd Heart Sound (S2)

-end of systole

Front 9

Heart sound that is loudest at base of heart

Back 9

S2

Front 10

Heart sound that is loudest at apex of heart

Back 10

S1

Front 11

This side of the heart is louder than the other during INSPIRATION

Back 11

RIGHT SIDE

Front 12

Split S2

Back 12

when the aortic valve closes significantly earlier than the pulmonic valve and two components can be heard separately

Front 13

Third Heart Sound (S3)

Back 13

in SOME CONDITIONS during diastole- ventricular filling creates vibrations that can be heard over the chest

occurs when ventricles are resistant to filling during protodiastole

occurs immediately after S2

Front 14

Fourth Heart Sound (S4)

Back 14

occurs at end of diastole- at PRESYSTOLE- when ventricle is resistant to filling

occurs just before S1

vibrations occurring when ATRIA PUSH BLOOD INTO NONCOMPLIANT VENTRICLE

Front 15

Depolarization of the atria

Back 15

P wave

Front 16

PR Interval

Back 16

the time necessary for atrial depolarization plus time for the impulse to travel through the AV node to the ventricles

Front 17

Depolarization of the ventricles

Back 17

QRS complex

Front 18

Repolarization of the ventricles

Back 18

T wave

Front 19

Electrical events happen slightly __________ the mechanical events

Back 19

electrical events happen slightly BEFORE

Front 20

Cardiac Output

Back 20

equals the volume of blood in each systole

Front 21

Preload

Back 21

the venous return that builds during diastole

the length to which the ventricular muscle is stretched at the end of DIASTOLE just before contraction

Front 22

Afterload

Back 22

the opposing pressure the ventricle must generate to open the aortic valve against the higher aortic pressure

the resistance against which the ventricle must pump its blood

Front 23

Frank-Starling Law

Back 23

the greater the stretch of the muscle bundles, the stronger is the heart's contraction

Front 24

The 3 Histologic changes responsible for age-related changes in ECG conduction system

Back 24

1. First degree AV block: Prolonged P-R interval, Q-T interval --(QRS unchanged)

2. Left axis deviation from age-related mild LV hypertrophy and fibrosis in L bundle branch

3. Increased incidence of bundle branch

Front 25

aortic valve area

Back 25

2nd Right interspace

Front 26

pulmonic valve area

Back 26

2nd Left interspace

Front 27

tricuspid valve area

Back 27

left lower sternal border

Front 28

mitral valve area

Back 28

fifth interspace at around left midclavicular line

Front 29

Pulse Deficit

Back 29

ABNORMAL

signals a weak contraction of the ventricles; it occurs with atrial fibrillation, premature beats, and heart failure

Front 30

Fixed Split

Back 30

ABNORMAL

unaffected by respiration; the split is always there

Front 31

Paradoxal Split

Back 31

ABNORMAL

the sounds fuse on inspiration
split on expiration

Front 32

Pathologic S3

Back 32

ABNORMAL

ventricular gallop
occurs with heart failure and volume overload

Front 33

Pathologic S4

Back 33

ABNORMAL

atrial gallop
occurs with CAD

Front 34

Systolic Murmur

Back 34

may occur with a normal heart or with heart disease

Front 35

Diastolic Murmur

Back 35

ALWAYS INDICATES HEART DISEASE

Front 36

Murmur of MITRAL stenosis

Back 36

ABNORMAL

rumbling

Front 37

Murmur of AORTIC stenosis

Back 37

ABNORMAL

harsh

Front 38

Oxygen desaturation of congenital heart disease is signaled just after birth by-

Back 38

Cyanosis

Front 39

Most important signs of heart failure in an infant (3)

Back 39

1. persistent tachycardia
2. tachypnea
3. liver enlargement

Front 40

Failure to thrive occurs with-

Back 40

cardiac disease

Front 41

Respiratory crackles are important signs of heart failure in __________

Back 41

Adults only

Front 42

Persistent tachycardia in newborns

Back 42

>200/min

Front 43

Persistent tachycardia in infants

Back 43

>150/min

Front 44

Bradycardia in newborns

Back 44

<90/min

Front 45

Bradycardia in infants

Back 45

<60/min

Front 46

A fixed split S2 indicates _________

Back 46

atrial septal defect

Front 47

Cardiac enlargement is signaled by

Back 47

a precordial bulge to the left of the sternum with a hyperdynamic precordium

Front 48

A substernal heave occurs with-

Back 48

right ventricular enlargement

Front 49

An apical heave occurs with-

Back 49

left ventricular hypertrophy

Front 50

An apical impulse moving laterally indicates-

Back 50

cardiac enlargement

Front 51

Pregnancy-induced Hypertension

Back 51

sustained rise of 30 mm Hg systolic

or

15 mm Hg diastolic under basal conditions

Front 52

T/F: Murmurs of aortic valve disease cannot be obilterated

Back 52

TRUE

Front 53

S3 in those over age 35 is associated with-

Back 53

heart failure