Cardiac Cycle Overview and Phases

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Questions and Answers

What happens to the atrial pressure during the reduced ejection phase?

  • It remains constant.
  • It decreases rapidly.
  • It increases slowly and progressively. (correct)
  • It fluctuates dramatically.

By what percentage does the ventricular volume decrease during the reduced ejection phase?

  • Approximately 20%
  • Approximately 10%
  • Approximately 40%
  • Approximately 30% (correct)

What is the end systolic volume (ESV) at the end of the reduced ejection phase?

  • 30 ml
  • 70 ml
  • 50 ml (correct)
  • 90 ml

What happens to the semilunar and A-V valves during the reduced ejection phase?

<p>A-V valves are closed and semilunar valves are still open. (A)</p> Signup and view all the answers

What is observed on the ECG during the reduced ejection phase?

<p>The first half and top of the T wave are present. (A)</p> Signup and view all the answers

What is the primary function of diastole in the cardiac cycle?

<p>Filling each ventricle from the atrium (D)</p> Signup and view all the answers

At a heart rate of 75 bpm, what is the duration of the cardiac cycle?

<p>0.8 sec (D)</p> Signup and view all the answers

Which phase occupies a greater proportion of the cardiac cycle duration?

<p>Diastole (A)</p> Signup and view all the answers

What happens to the duration of the cardiac cycle at higher heart rates?

<p>It decreases (D)</p> Signup and view all the answers

What is the ejection phase of the cardiac cycle associated with?

<p>Emptying of blood from the ventricles (B)</p> Signup and view all the answers

What proportion of the cardiac cycle does diastole occupy at a heart rate of 200 bpm?

<p>1/2 (A)</p> Signup and view all the answers

Which part of the heart acts as a pressure pump during the cardiac cycle?

<p>Ventricles (B)</p> Signup and view all the answers

How does the atrial systole contribute to filling the ventricles?

<p>It aids in filling the ventricles during their diastole (A)</p> Signup and view all the answers

What percentage of ventricular filling is attributed to atrial systole?

<p>20-30% (C)</p> Signup and view all the answers

Which phase of the cardiac cycle occurs immediately after atrial systole?

<p>Isovolumetric contraction (B)</p> Signup and view all the answers

During atrial systole, what happens to the ventricular volume?

<p>It reaches its maximum (C)</p> Signup and view all the answers

What does atrial systole primarily cause in the atrial pressure curve?

<p>Increase resulting in the 'a' wave (C)</p> Signup and view all the answers

What occurs to the aortic pressure during atrial systole?

<p>It decreases due to closed semilunar valves (C)</p> Signup and view all the answers

Which heart sound is primarily associated with atrial systole?

<p>Fourth heart sound (A)</p> Signup and view all the answers

What role does atrial systole play when the heart rate increases?

<p>It plays a crucial role in ventricular filling (C)</p> Signup and view all the answers

What is the duration of the atrial systole phase?

<p>0.1 sec (D)</p> Signup and view all the answers

What characterizes the isovolumetric contraction phase during ventricular systole?

<p>Ventricular wall tension is maximally increased. (A)</p> Signup and view all the answers

During the isovolumetric contraction phase, which of the following is true about ventricular volume?

<p>It remains unchanged. (C)</p> Signup and view all the answers

What happens to ventricular pressure during isovolumetric contraction?

<p>It increases at a very high rate. (A)</p> Signup and view all the answers

Which event occurs immediately after the closure of the A-V valves?

<p>Isovolumetric contraction begins. (C)</p> Signup and view all the answers

What effect does the isovolumetric contraction phase have on atrial pressure?

<p>It slightly increases due to the bulging of A-V valves. (D)</p> Signup and view all the answers

What distinguishes the end of the isovolumetric contraction phase?

<p>Opening of the semilunar valves. (B)</p> Signup and view all the answers

During isovolumetric contraction, what happens to aortic pressure?

<p>It decreases continuously. (C)</p> Signup and view all the answers

What is the primary characteristic of the ventricles during isovolumetric contraction?

<p>They are contracting as closed cavities. (A)</p> Signup and view all the answers

What is the cardiac cycle primarily defined as?

<p>The sequence of mechanical responses during one heartbeat. (D)</p> Signup and view all the answers

What occurs during systole in the cardiac cycle?

<p>The heart muscle contracts and blood is ejected. (B)</p> Signup and view all the answers

Which event change is typical during diastole?

<p>Blood filling the atria and ventricles. (B)</p> Signup and view all the answers

What effect does tachycardia have on the cardiac cycle?

<p>Decreases the duration of systole. (C)</p> Signup and view all the answers

How is the blood flow affected during the cardiac cycle?

<p>Blood flow changes in response to valve positions and chamber pressure. (B)</p> Signup and view all the answers

What is the primary role of the heart valves during the cardiac cycle?

<p>To regulate blood flow direction and prevent backflow. (D)</p> Signup and view all the answers

Which chambers of the heart undergo simultaneous changes during the cardiac cycle?

<p>Both right and left sides of the heart. (C)</p> Signup and view all the answers

What significant changes occur in the heart during each phase of the cardiac cycle?

<p>Both volume and pressure changes occur in various chambers. (D)</p> Signup and view all the answers

What initiates the first heart sound (S1)?

<p>Closure of A-V valves and ventricular muscle contraction (C)</p> Signup and view all the answers

During which phase is the ventricular volume markedly decreased?

<p>Rapid Ejection Phase (D)</p> Signup and view all the answers

What is the highest systolic blood pressure (SBP) in the left ventricle during the Rapid Ejection Phase?

<p>120 mmHg (B)</p> Signup and view all the answers

Which valves are closed during the Rapid Ejection Phase?

<p>A-V valves only (C)</p> Signup and view all the answers

What significant wave begins just before the Rapid Ejection Phase?

<p>Q wave (D)</p> Signup and view all the answers

What happens to the aortic pressure during the Rapid Ejection Phase?

<p>It gradually increases in parallel to left ventricular pressure (B)</p> Signup and view all the answers

Which heart sound is still heard during the Rapid Ejection Phase?

<p>First heart sound (S1) (C)</p> Signup and view all the answers

Flashcards

Cardiac cycle

The complete sequence of events that occur in the heart during one heartbeat, encompassing contraction and relaxation phases.

Systole

The phase when the heart muscle contracts and pumps blood out of the chambers.

Diastole

The phase when the heart muscle relaxes and the chambers refill with blood.

Tachycardia

A rapid heart rate.

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Mechanical changes of the cardiac cycle

The changes in volume and pressure within the heart chambers, arteries, and veins during each cardiac cycle.

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Valve changes during the cardiac cycle

The opening and closing of the heart valves, allowing blood to flow in one direction.

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Electrical activation of the heart

The electrical activation of the heart that triggers the mechanical events of the cardiac cycle.

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Conduction system of the heart

The way in which the electrical signals of the heart are conducted and spread throughout the heart.

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Atrial Systole

The atria function as volume pumps, adding a little extra blood to the ventricles during diastole.

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Cardiac Cycle Duration

The length of time it takes for one complete cardiac cycle (systole and diastole).

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Normal Cardiac Cycle Duration

The normal cardiac cycle duration at a heart rate of 75 beats per minute is approximately 0.8 seconds.

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Diastole and Systole Duration

Diastole takes up about two-thirds of the cardiac cycle, while systole takes up about one-third.

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Cardiac Cycle Duration and Heart Rate

As heart rate increases, the total cardiac cycle duration shortens, with a greater decrease in diastole duration compared to systole.

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Cardiac Cycle Duration at High Heart Rate

At a heart rate of 200 beats per minute, the cardiac cycle duration is 0.3 seconds, with both systole and diastole lasting 0.15 seconds each.

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Isovolumetric Contraction

The period when the ventricles contract but no blood is ejected yet. The heart chambers are closed, and pressure builds up inside the ventricles.

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Rapid Ejection

The period during which blood is rapidly ejected from the ventricles into the aorta, driven by the strong ventricular contraction.

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Reduced Ejection

The phase when the rate of blood ejection from the ventricles slows down, with the ventricular pressure still above aortic pressure.

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Protodiastole

The very brief period between the end of ventricular ejection and the opening of the AV valves for the next inflow of blood.

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Isovolumetric Relaxation

The period when the ventricles relax and the heart chambers are closed, allowing the pressure in the ventricles to decrease below the pressure in the aorta.

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Rapid Filling

The period when the AV valves open and blood starts flowing from the atria into the ventricles, rapidly filling the ventricles.

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Reduced Filling

The final phase of ventricular filling, where the inflow of blood slows down as the ventricles approach their maximum volume.

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What defines the Isovolumetric Contraction phase?

The interval of time during which the AV valves close and the semilunar valves remain closed. This phase marks the beginning of ventricular contraction.

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What happens during Isovolumetric Contraction?

A brief period of ventricular contraction where the pressure increases rapidly due to a closed system. It's the phase where the heart muscle actively contracts.

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Within the Isovolumetric Contraction phase, what happens to ventricular pressure?

The pressure inside the ventricles begins to rise rapidly during Isovolumetric Contraction. This is because the heart muscle is contracting, putting pressure on the blood within the ventricles.

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What happens to atrial pressure during Isovolumetric Contraction?

During Isovolumetric Contraction, the A-V valves bulge into the atria due to the rising ventricular pressure, creating a small bump known as the "c" wave in the atrial pressure curve.

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What happens to ventricular volume during Isovolumetric Contraction?

During Isovolumetric Contraction, the volume of blood within the ventricles remains constant. This means no blood is entering or leaving the ventricles.

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What happens to aortic pressure (and pulmonary) during Isovolumetric Contraction?

The semilunar valves remain closed during Isovolumetric Contraction, and so the blood ejected during the previous heartbeat continues to flow to the periphery. Because the semilunar valves are closed, no new blood enters the aorta or pulmonary artery.

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What is the state of the valves during Isovolumetric Contraction?

The AV valves and the semilunar valves are both closed during Isovolumetric Contraction, preventing blood from entering or exiting the ventricles.

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Rapid Ejection Phase

The rapid ejection phase is part of systole (heart contraction), where most blood is ejected from the ventricle into the aorta and pulmonary artery.

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What starts the rapid ejection phase?

The rapid ejection phase starts with the opening of the semilunar valves.

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What happens to atrial pressure during rapid ejection?

During the rapid ejection phase, atrial pressure decreases due to the pull of the ventricles on the A-V fibrous skeleton, leading to a negative wave in the atrial pressure and JVP.

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What happens to ventricular volume during rapid ejection?

During the rapid ejection phase, the ventricular volume decreases significantly as the majority of blood is ejected.

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What happens to ventricular pressure during rapid ejection?

Ventricular pressure reaches its maximum value during rapid ejection, which is equal to the highest pressure in the aorta and pulmonary arteries.

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What happens to aortic pressure during rapid ejection?

Aortic pressure increases rapidly during rapid ejection, reaching its maximum value (systolic blood pressure) as blood flows into the aorta.

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What's the relationship between blood flow out of the ventricle and out of the aorta during rapid ejection?

During rapid ejection, more blood leaves the ventricle than escapes from the aorta to the periphery.

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What is the valve status during rapid ejection?

During rapid ejection, the A-V valves are closed, and the semilunar valves are open.

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Reduced Ejection Phase

The period following the rapid ejection phase of the heart's contraction, where blood continues to flow out of the ventricle, but at a slower rate.

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Ventricular pressure during Reduced Ejection Phase

During the Reduced Ejection Phase, the pressure inside the ventricle slowly decreases, paralleling the decrease in aortic pressure.

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Aortic pressure during Reduced Ejection Phase

The aortic pressure also decreases during the Reduced Ejection Phase, primarily because the blood flowing outward to the body exceeds the amount ejected by the ventricle.

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Atrial pressure during Reduced Ejection Phase

Atrial pressure gradually increases during the Reduced Ejection Phase as venous blood continuously returns to the atria, while the atrioventricular valves remain closed.

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Ventricular volume during Reduced Ejection Phase

The ventricular volume considerably decreases during the Reduced Ejection Phase due to blood ejection. The volume reaches its minimum at the end of this phase, known as the end systolic volume (ESV).

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Study Notes

Cardiac Cycle Overview

  • The cardiac cycle is the mechanical response of the heart in one beat.
  • It's a sequence of events resulting from electrical activation.
  • The cycle involves volume and pressure changes in heart chambers and connected arteries/veins.
  • The heart's valves change position (open/closed) in a coordinated manner.
  • Systole is the contraction phase, and diastole is the relaxation phase.
  • Systole's function is ejection; emptying the ventricles into arteries.
  • Diastole's function is filling; filling the ventricles from atria and veins.

Cardiac Cycle Phases

  • The cardiac cycle has 8 phases.
  • Atrial systole: The atria contract, aiding ventricle filling.
  • Isovolumetric contraction: All valves closed, ventricular pressure rises.
  • Rapid ejection: Semilunar valves open, blood exits ventricles.
  • Reduced ejection: Ventricular pressure decreases, less blood leaves.
  • Protodiastole: Initial relaxation phase.
  • Isovolumetric relaxation: All valves are closed, ventricular pressure decreases.
  • Rapid filling: Ventricles fill rapidly.
  • Reduced filling: Very slow ventricular filling.

Effects of Tachycardia

  • Increased heart rate shortens cardiac cycle duration, mostly affecting diastole.

Changes in Each Phase

  • Atrial pressure: Increases during atrial systole.
  • Ventricular volume: Increases during diastole, decreases during systole.
  • Ventricular pressure: Increases during systole.
  • Aortic pressure: Increases during systole.
  • Heart valves: Open and close in a specific sequence.
  • Heart sounds (S1 and S2): Correspond to valve closures.
  • ECG (Electrocardiogram): Specific waveforms correspond to heart activity.

1-Atrial Systole

  • Occurs in the first phase of a new cycle.
  • While ventricles still in the last diastole phase.
  • Completed before the ventricles start contraction.
  • Important for about 20-30% of ventricular filling.
  • Increasing role with higher heart rates.
  • Represents assistance in ventricular filling.

Ventricular Systole

  • Has 3 phases:
  • Isovolumetric contraction: All valves closed, ventricular pressure rise.
  • Rapid ejection: Semilunar valves open, forceful blood ejection.
  • Reduced ejection: Decreasing ventricular pressure and blood ejection.

Isovolumetric Contraction

  • Ventricles contract as closed chambers (isometric).
  • Maximizes ventricular wall tension, causing pressure rise.
  • Switches ventricular pressure from low to high-pressure system.

Isometric Contraction Phase Events

  • Atrial pressure increases slightly due to valve bulging.
  • Ventricular volume stays the same.
  • Ventricular pressure increases rapidly towards aortic and pulmonary pressures.
  • Aortic pressure decreases while semilunar valves still closed.
  • All valves remain closed during this phase.
  • The first heart sound (S1) occurs as all valves close.
  • ECG shows the Q wave before and QRS complex during this phase.

2- Rapid Ejection Phase

  • Ejection is the proper function of systole.
  • Both semilunar valves open in this phase.
  • Most blood ejection (~70%) into aorta and pulmonary artery.

3- Reduced Ejection Phase

  • Continuation of the rapid ejection phase.
  • Blood continues to leave the ventricle, going into the aorta and pulmonary arteries.

Events during Reduced Ejection Phase

  • Atrial pressure gradually increases due to venous return.
  • Ventricle volume decreases with slower blood ejection.
  • Ventricular pressure decreases until it is below aortic pressure.
  • Aortic pressure starts decreasing due to outflow to the periphery.
  • All valves (AV and semilunar) still in same position (AV closed, semilunar open).
  • ECG first half and top of T wave.

Duration of the Cardiac Cycle

  • 0.8 seconds at a heart rate of 75 bpm.
  • Diastole lasts about 2/3 of the cycle (0.53 sec).
  • Systole lasts about 1/3 of the cycle (0.27 sec).
  • Cardiac cycle duration decreases with increased heart rate.

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