What is systole?Period of contraction when the blood is ejected from the heartWhat does closure of the SL valves create?2nd heart soundWhat immediately precedes diastole?IVRTWhen are all four valves closed, ventricular volumes constant while atrial volumes change, and ventricular pressure dropping?IVRTWhat is the period of relaxation when the ventricles fill with blood?DiastoleDuring early diastole, ventricles are at their lowest pressure and experience what?Early rapid fillingEarly rapid filling accounts for how much of ventricular filling in a normal heart?75%What creates a third heart sound in some abnormal hearts?REFWhat is diastasis?As the ventricular walls become stretched, the left atrial and ventricular pressures reach equilibrium causing the flow to slow downAtrial contraction or kick accounts for how much ventricular fulling?10-30%What are the four heart sounds?1. AV closing - at the end of disatole
2. SL closing
3. Rapid Early Filling - abnormal in adults
4. Atrial kick - abnormal in adultsWhat are the three phases of diastole?1. Rapid early filling
2. Diastasis
3. Atrial kick/atrial contractionWhat is the largest volume in the heart during the cardiac cycle?End-diastolic volume aka EDVWhy does ventricular pressure increase?The amount of bloodWhere does contraction begin?ApexTwo golden rules of Doppler1. When a normal valve is open, the pressure on either side is equal: no PG, pressures are equal
2. When a normal valve is closed, there is a PGWhen does REF occur?When ventricular pressures are at their lowestWhen does atrial contraction occur?End-diastoleThe heart's ability to successfully pump a sufficient amount of oxygenated blood to the body under all circumstances is known asCardiac functionWhat is overall cardiac function determined by?Systolic and diastolic functionVentricles ability to eject the blood out of the heart into the systemic and pulmonary circulatory systemsSystolic functionVentricles ability to relax and fillDiastolic functionDecrease in systolic function can indicate heart disease such ashypertension, ischemia, congestive heart failure, and cardiomyopathyWhat is decreased diastolic function better known as?Diastolic dysfunctionWhat is diastolic dysfunction?A failure of the ventricle to relax and allow normal fillingSystolic and diastolic function are dependent upon several components including:Wall thickening, wall motion, chamber size, and ventricular end diastolic pressureWhat are wall thickening and wall motion aka and what do they indicate?Contractility and indicate adequate coronary blood flow and oxygenWhat is hyperkinetic?excessive wall motionWhat is hypokinetic?decreased wall motionWhat is akinetic?No movement or thickening of the myocardium; may indication MI or hibernationWhat is hibernation?Ischemic segment that is akinetic but not infarctedWhat is dyskinetic?Movement away from the center of the cavity; may indicate MINormal left ventricular walls thicken and contract how much?30% toward center of the chamber during systoleFinding that cardiac walls do not thicken/contract properly and may be an indication of ischemic heart diseaseWall motion abnormalityWhat do normal, viable chambers do during systole?Concentrically decrease in sizeWhat do normal, viable chambers do during diastole?Concentrically increase in sizeWhat is defined as the number of heart beats per minute?Heart rate; 60-100bpmWhat is defined as the volume of blood ejected with each heartbeat?Stroke volumeWhat is the SV normal range?70-100mlWhat is the equation for SV?SV = EDV - ESVWhat is defined as the volume of blood the left ventricle pumps out each minute?Cardiac OutputWhat is the CO equation?CO = SV x HRWhat is CO normal range?4-8 l/minWhat is defined as the total surface area of the body?Body surface areaHow do you calculate BSA?Mosteller formulaWhat is defined as cardiac output corrected for the BSA?Cardiac indexWhat is the equation for CI?CI = CO/BSAWhat is CI normal range?3-4 l/min^2The heart's ability to increase CO is dependent upon several factors related to the overall cardiac function:Preload, after load, inotropic force, chronotropic forceWhat is the volume or load in the heart at end-diastole?PreloadWhat is the degree of fiber stretch related to the quantity of blood in the chamber prior to contraction?Left Ventricular End Diastolic PressureWhat is defined as the more blood that enters the ventricle during diastole, the greater the force of the contraction required to eject the blood?Frank-Starling LawWhat is defined as the longer the interval between heartbeats, the stronger the contraction required to eject the blood?Interval-strength relationshipWhat is defined as the greater the force required to eject the blood during systole, the slower the velocity of the muscle fiber shortening?Force-Velocity RelationshipAbnormal, backward flow through a closed, defective valveRegurgitation or insufficiencyDefect in the IVS that creates abnormal flow between the ventriclesVentricular Septal DefectDefect in the IAS that creates a shunt between the atriaAtrial Septal DefectWhen the ductus arteriosus remains open after birth, a shunt remains between the aorta and pulmonary arteryPatent Ductus ArteriosusWhat is defined as the resistance that they heart must pump against?AfterloadVentricular outflow obstructionsAortic and Pulmonic StenosisElevated arterial pressure within the systemic circulatory systemSystemic Hypertension (HTN)Elevated systolic pulmonary artery pressurePulmonary hypertensionForce of the contractionInotropic forceRate of the contractionChronotropic forceWhat increases the HR as part of the fight or flight response?Sympathetic nervous systemWhat decreases the HR via the vagus nerve?Parasympathetic nervous systemMost common maneuver utilized during echoValsalva maneuverWhat are the two main phases of the Valsalva maneuver?Strain and ReleaseWhich phase of the Valsalva maneuver decreases most murmurs?StrainWhich phase of the Valsalva maneuver increases most murmurs?ReleaseWhat maneuvers alter cardiac physiology?1. Valsalva
2. Amyl nitrite
3. Inspiration, Expiration, Squatting, StandingWhich maneuvers decrease venous return, SV, and CO?Expiration, standing, and Strain phase of ValsalvaWhich maneuvers increase venous return, SV, and CO?Release phase of Valsalva, amyl nitrite, inspiration, squatting
