questions 6

Cardiac Cycle

Topic updated on 01/31/17 11:22am

Overview
  • Phases of left ventricle   
    • isovolumetric contraction 
      • period between mitral valve closure and aortic valve opening
      • period of highest O2 consumption
    • systolic ejection 
      • period between aortic valve opening and closing
    • isovolumetric relaxation
      • period between aortic valve closing and mitral valve opening
    • rapid filling
      • period just after mitral valve opening
    • reduced filling
      • period just before mitral valve closure
  • Sounds   
    • S1
      • mitral and tricuspid valve closure
      • loudest at mitral area
    • S2 
      • aortic and pulmonary valve closure
      • loudest at left sternal border
    • S3  (in early diastole during rapid ventricular filling phase)
      • associated with ↑ filling pressures
      • more common with dilated ventricles
      • normal in children and pregnant women
    • S4 ("atrial kick")
      • in late diastole
      • high atrial pressure 
      • associated with ventricular hypertrophy 
      • left atrium must push against stiff LV wall
  • Jugular venous pulse (JVP)    
    • a wave 
      • atrial contraction
    • c wave
      • RV contraction 
      • tricuspid valve bulging into atrium
    • v wave
      • ↑ atrial pressure due to filling against closed tricuspid valve       

 



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Qbank (3 Questions)

TAG
(M1.CV.42) Figure A shows a pressure-volume loop for the left ventricle. Which of the following changes on the pressure-volume loop best corresponds to stroke volume? Topic Review Topic
FIGURES: A          

1. 4 => 1
2. 1 => 2
3. 3 => 4
4. 2 => 3
5. Stroke volume can not be calculated from this diagram

PREFERRED RESPONSE ▶
TAG
(M1.CV.75) A 69-year-old male with a history of well-controlled hypertension, diabetes, and depression presents to his primary care physician for a routine visit. He has no present complaints at this time and states that he has been compliant on all his medications. On exam, the physician appreciates a IV/VI crescendo-decrescendo systolic ejection murmur that is immediately preceded by a click and radiates into the carotids. Which of the following pressure-volume loops corresponds to this patient's condition? Topic Review Topic
FIGURES: A   B   C   D   E  

1. Figure A
2. Figure B
3. Figure C
4. Figure D
5. Figure E

PREFERRED RESPONSE ▶
TAG
(M1.CV.75) A 72-year-old female with a history of diabetes, asthma, and uncontrolled hypertension presents to her primary care physician for a routine appointment. She reports that she feels well although she does admit that she has been poorly compliant with the diet and exercise changes her physician prescribed on her prior visit. On exam, the physician hears an extra heart sound in late diastole that immediately precedes S1. This heart sound is most associated with which of the following? Topic Review Topic

1. Mitral stenosis
2. Ventricular dilation
3. Mitral regurgitation
4. Increased filling pressures
5. High atrial pressure

PREFERRED RESPONSE ▶
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