Cardiac Physiology and Heart Failure Quiz
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Questions and Answers

Which of the following formulas is used to calculate stroke volume (SV)?

  • SV = EDV - ESV (correct)
  • SV = EDV + ESV
  • SV = EDV x ESV
  • SV = ESV / EDV

    • Which of the following is a measure of ventricular contractility?

  • Cardiac output (CO)
  • Pulse pressure (PP)
  • Mean arterial pressure (MAP)
  • Ejection fraction (EF) (correct)

    • In which type of heart failure is ejection fraction (EF) usually normal?

  • Congestive heart failure
  • Diastolic heart failure (correct)
  • Hypertensive heart disease
  • Systolic heart failure

    • What is the Fick principle used to calculate?

    <p>Cardiac output (CO) (A)</p> Signup and view all the answers

    During early stages of exercise, cardiac output (CO) is primarily maintained by:

    <p>Increasing stroke volume (SV) (B)</p> Signup and view all the answers

    In which stage of exercise does cardiac output (CO) become primarily dependent on an increased heart rate (HR)?

    <p>Later stages (D)</p> Signup and view all the answers

    What happens to diastolic filling time, stroke volume (SV), and cardiac output (CO) when heart rate (HR) increases significantly?

    <p>Diastolic filling time decreases, SV decreases, CO decreases (B)</p> Signup and view all the answers

    Pulse pressure (PP) is directly proportional to which of the following?

    <p>Stroke volume (SV) (A)</p> Signup and view all the answers

    Conditions that can increase pulse pressure (PP) include all of the following except:

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

    Which equation represents the mean arterial pressure (MAP) calculation?

    <p>MAP = 2/3 DBP + 1/3 SBP (D)</p> Signup and view all the answers

    What does the Starling curve describe in relation to the heart?

    <p>The relationship between preload (ventricular end-diastolic volume) and stroke volume (CO) (C)</p> Signup and view all the answers

    Which factor is NOT associated with increasing myocardial contractility?

    <p>Myocardial infarction (MI) (B)</p> Signup and view all the answers

    What is the formula for calculating mean arterial pressure (MAP)?

    <p>MAP = 2/3 DBP + 1/3 SBP (C)</p> Signup and view all the answers

    What does the Starling curve describe?

    <p>The relationship between preload (ventricular end-diastolic volume) and stroke volume (CO) (D)</p> Signup and view all the answers

    Which factor is NOT associated with increasing myocardial contractility?

    <p>Myocardial infarction (MI) (B)</p> Signup and view all the answers

    What is the formula for calculating mean arterial pressure (MAP)?

    <p>MAP = 2/3 DBP + 1/3 SBP (B)</p> Signup and view all the answers

    What does the Starling curve describe?

    <p>The relationship between preload (ventricular end-diastolic volume) and stroke volume (CO) (D)</p> Signup and view all the answers

    Which factor is NOT associated with increasing myocardial contractility?

    <p>Myocardial infarction (MI) (D)</p> Signup and view all the answers

    During which phase of the left ventricle's cycle does the highest oxygen consumption occur?

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

    What is the primary cause of the S3 heart sound, which is heard during early diastole?

    <p>Increased atrial pressure (C)</p> Signup and view all the answers

    Which heart sound is associated with the 'atrial kick' during late diastole?

    <p>S4 (A)</p> Signup and view all the answers

    In which position is the S3 heart sound best heard?

    <p>Left lateral decubitus (D)</p> Signup and view all the answers

    What is the typical location where the S1 heart sound is loudest?

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

    What phase of the left ventricle's cycle occurs just before the mitral valve closes?

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

    The a wave in the jugular venous pulse corresponds to:

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

    Which condition may result in a 'cannon a wave' in the jugular venous pulse?

    <p>Right heart failure (D)</p> Signup and view all the answers

    In which condition might you expect the x descent in the jugular venous pulse to be reduced or absent?

    <p>Tricuspid regurgitation (C)</p> Signup and view all the answers

    The y descent in the jugular venous pulse is absent in which cardiac condition?

    <p>Cardiac tamponade (C)</p> Signup and view all the answers

    Flashcards

    What is stroke volume?

    The volume of blood ejected from the left ventricle with each heartbeat. It's calculated by subtracting the end-systolic volume (ESV) from the end-diastolic volume (EDV).

    What is ejection fraction?

    The fraction of blood ejected from the left ventricle during each heartbeat. It's a measure of the heart's pumping efficiency.

    What is heart failure with preserved ejection fraction?

    A condition where the heart has difficulty pumping blood effectively, even though the ejection fraction is normal.

    What is the Fick principle?

    A method to calculate cardiac output (CO) by measuring oxygen consumption and the difference in oxygen content between arterial and venous blood.

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    What is cardiac output?

    The amount of blood pumped by the heart per minute. It's calculated by multiplying stroke volume (SV) by heart rate (HR).

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    How does cardiac output initially increase during exercise?

    In the early stages of exercise, the heart compensates for increased demand by increasing the amount of blood pumped with each beat. This occurs before heart rate increases significantly.

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    What happens to stroke volume and heart rate during sustained exercise?

    As exercise intensity increases, the heart's ability to increase stroke volume plateaus. To maintain cardiac output, the heart relies more on increased heart rate.

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    What is pulse pressure?

    The difference between systolic and diastolic blood pressure. It reflects the force of blood ejection from the heart.

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    What is mean arterial pressure (MAP)?

    The average pressure in the arteries throughout the cardiac cycle. It's calculated using the formula: MAP = (CO x TPR) + CVP.

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    What is the Starling curve?

    A graphical representation of the relationship between preload (ventricular filling pressure) and stroke volume. It describes the relationship between the amount of blood returning to the heart and the force of contraction.

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    What are positive inotropic agents?

    Factors that increase the force of contraction of the heart muscle. They improve the heart's pumping efficiency.

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    What are negative inotropic agents?

    Factors that decrease the force of contraction of the heart muscle. They weaken the heart's pumping ability.

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    What is end diastolic volume (EDV)?

    The volume of blood in the ventricle at the end of diastole (relaxation). It's also known as preload.

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    What is end systolic volume (ESV)?

    The volume of blood remaining in the ventricle after contraction. It's related to contraction strength and afterload.

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    What is afterload?

    The resistance the heart has to pump against. It's related to the pressure in the arteries.

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    What is ventricular pressure?

    The amount of pressure the heart has to generate to overcome afterload and eject blood.

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    When does the left ventricle experience its highest oxygen consumption?

    The highest oxygen consumption of the left ventricle occurs during this phase of the cardiac cycle, when ventricular pressures are at their peak.

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    What is the S3 heart sound?

    A heart sound that reflects the rapid inflow of blood into the ventricle during early diastole. It's often associated with increased ventricular filling pressure.

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    What is the S4 heart sound?

    A heart sound that occurs during late diastole and is caused by the contraction of the atria. It's associated with reduced ventricular compliance or increased left ventricular pressure.

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    What does the 'a wave' in the jugular venous pulse represent?

    The 'a wave,' a component of the jugular venous pulse, represents right atrial contraction.

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    What is a 'cannon a wave' pattern?

    A wave pattern in the jugular venous pulse that is abnormally prominent, often seen in conditions like junctional rhythm or complete heart block.

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    What is the 'x descent' in the jugular venous pulse?

    The 'x descent' in the jugular venous pulse, which reflects atrial relaxation and ventricular filling, may be reduced in conditions like tricuspid regurgitation.

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    What is the 'y descent' in the jugular venous pulse?

    The 'y descent' in the jugular venous pulse, which occurs due to the filling of the right ventricle, is absent in conditions like cardiac tamponade.

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    What is cardiac tamponade?

    A condition where fluid builds up in the sac around the heart, restricting its ability to fill and pump blood effectively.

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    What is the S1 heart sound?

    The heart sound that occurs during closure of the mitral and tricuspid valves, marking the beginning of systole. It's typically loudest at the apex of the heart.

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    Study Notes

    Stroke Volume and Contractility

    • Stroke volume (SV) can be calculated using the formula: SV = End Diastolic Volume (EDV) - End Systolic Volume (ESV).
    • Ventricular contractility is commonly assessed through measures such as Ejection Fraction (EF).
    • In heart failure with preserved ejection fraction, EF is typically normal.

    Fick Principle and Cardiac Output

    • The Fick principle calculates cardiac output (CO) based on oxygen consumption and the arteriovenous oxygen difference.
    • During early exercise stages, cardiac output is primarily maintained by increased stroke volume (SV).
    • As exercise intensity progresses, cardiac output becomes increasingly reliant on elevated heart rate (HR).

    Heart Rate Effects

    • An increase in heart rate significantly reduces diastolic filling time, but stroke volume (SV) and cardiac output (CO) may initially increase before plateauing or declining at extremely high rates.

    Pulse Pressure

    • Pulse pressure (PP) is directly proportional to stroke volume (SV) and inversely related to compliance of the arterial system.
    • Conditions that can increase pulse pressure include hypertension and aortic regurgitation, but not myocardial ischemia.

    Mean Arterial Pressure

    • The mean arterial pressure (MAP) is calculated using the equation: MAP = (CO × Total Peripheral Resistance) + Central Venous Pressure (CVP).
    • The Starling curve illustrates the relationship between preload and stroke volume, indicating that greater venous return increases contractility and stroke volume.

    Myocardial Contractility

    • Factors not associated with increased myocardial contractility include decreased preload and negative inotropic agents.
    • The highest oxygen consumption of the left ventricle occurs during isovolumetric contraction when ventricular pressures peak.

    Heart Sounds

    • The S3 heart sound, indicative of rapid ventricular filling, is primary caused by the sudden inflow of blood during early diastole.
    • The "atrial kick," contributing to the S4 heart sound, occurs during late diastole.
    • The best position to auscultate the S3 heart sound is typically in the left lateral decubitus position.
    • The S1 heart sound, produced by closure of the mitral and tricuspid valves, is loudest at the apex of the heart.

    Jugular Venous Pulse

    • The "a wave" in the jugular venous pulse corresponds to right atrial contraction.
    • Conditions that may lead to a "cannon a wave" pattern include junctional rhythm or complete heart block.
    • The "x descent" can be reduced or absent in conditions like tricuspid regurgitation.
    • The "y descent" in the jugular venous pulse is absent in cardiac tamponade.

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    Description

    This quiz will test your knowledge on cardiac physiology and heart failure. Learn about the formula for calculating stroke volume, measures of ventricular contractility, and the relationship between ejection fraction and heart failure.

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