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Questions and Answers
Which of the following factors would increase preload?
Which of the following factors would increase preload?
Which of the following accurately describes the relationship between blood vessel radius and resistance according to Poiseuille's Equation?
Which of the following accurately describes the relationship between blood vessel radius and resistance according to Poiseuille's Equation?
Which of the following conditions would decrease afterload?
Which of the following conditions would decrease afterload?
A patient with a condition requiring a permanent pacemaker is likely experiencing:
A patient with a condition requiring a permanent pacemaker is likely experiencing:
Which of the following arteries exhibit the Windkessel Effect?
Which of the following arteries exhibit the Windkessel Effect?
If blood vessel B has a radius twice that of blood vessel A, and both vessels have the same length, what is the ratio of blood flow in vessel B to vessel A?
If blood vessel B has a radius twice that of blood vessel A, and both vessels have the same length, what is the ratio of blood flow in vessel B to vessel A?
Which of the following is a characteristic of the aorta?
Which of the following is a characteristic of the aorta?
Which of the following is NOT a direct consequence of coarctation of the aorta?
Which of the following is NOT a direct consequence of coarctation of the aorta?
What is the ECG pattern suggestive of atrial fibrillation?
What is the ECG pattern suggestive of atrial fibrillation?
Which of the following is a key characteristic of the Bezold-Jarisch reflex?
Which of the following is a key characteristic of the Bezold-Jarisch reflex?
What is the ECG pattern associated with hyperkalemia?
What is the ECG pattern associated with hyperkalemia?
Which condition is characterized by an increase in jugular venous pressure during inspiration?
Which condition is characterized by an increase in jugular venous pressure during inspiration?
Which of the following is a characteristic pattern seen in the ECG of a patient with Wolf-Parkinson-White Syndrome?
Which of the following is a characteristic pattern seen in the ECG of a patient with Wolf-Parkinson-White Syndrome?
Which of the following statements about the Frank-Starling law is TRUE?
Which of the following statements about the Frank-Starling law is TRUE?
Which of the following is a common cause of First Degree Heart Block?
Which of the following is a common cause of First Degree Heart Block?
What is the most dangerous type of second-degree heart block?
What is the most dangerous type of second-degree heart block?
What is the ECG pattern typically seen in patients with stable Ventricular Tachycardia?
What is the ECG pattern typically seen in patients with stable Ventricular Tachycardia?
Which of the following is TRUE regarding Torsades de Pointes?
Which of the following is TRUE regarding Torsades de Pointes?
Which drug class is known to cause Torsades de Pointes by blocking potassium channels?
Which drug class is known to cause Torsades de Pointes by blocking potassium channels?
Which of the following is NOT a characteristic feature of cardiac tamponade?
Which of the following is NOT a characteristic feature of cardiac tamponade?
Which of the following conditions is most likely to be associated with Osborn waves (J waves) on an ECG?
Which of the following conditions is most likely to be associated with Osborn waves (J waves) on an ECG?
What is the mechanism by which dopamine helps treat oliguria?
What is the mechanism by which dopamine helps treat oliguria?
Which of the following is TRUE regarding the Bainbridge reflex?
Which of the following is TRUE regarding the Bainbridge reflex?
Which area of the chest is best for auscultation of the aortic valve?
Which area of the chest is best for auscultation of the aortic valve?
What is the resting membrane potential of cardiac myocytes?
What is the resting membrane potential of cardiac myocytes?
During which phase of the action potential does potassium efflux begin?
During which phase of the action potential does potassium efflux begin?
What causes the first heart sound (S1)?
What causes the first heart sound (S1)?
Which heart sound is typically not heard in normal adults?
Which heart sound is typically not heard in normal adults?
What type of murmur is associated with mitral regurgitation?
What type of murmur is associated with mitral regurgitation?
Which heart sound occurs during atrial contraction?
Which heart sound occurs during atrial contraction?
What phase of the cardiac action potential is characterized by balanced calcium influx and potassium efflux?
What phase of the cardiac action potential is characterized by balanced calcium influx and potassium efflux?
Which of the following is a characteristic of Crescendo-Decrescendo murmurs?
Which of the following is a characteristic of Crescendo-Decrescendo murmurs?
Which of the following conditions is characterized by a diastolic rumble with an opening snap?
Which of the following conditions is characterized by a diastolic rumble with an opening snap?
What is the primary wave associated with atrial contraction in Jugular Venous Pressure (JVP) measurements?
What is the primary wave associated with atrial contraction in Jugular Venous Pressure (JVP) measurements?
Which phase of the cardiac cycle begins with mitral valve closure and is characterized by pressure rising without a change in volume?
Which phase of the cardiac cycle begins with mitral valve closure and is characterized by pressure rising without a change in volume?
Which abnormal JVP pattern is characterized by prominent X descent and is commonly seen in cardiac tamponade?
Which abnormal JVP pattern is characterized by prominent X descent and is commonly seen in cardiac tamponade?
Which of the following is NOT typically associated with aortic regurgitation?
Which of the following is NOT typically associated with aortic regurgitation?
Marfan Syndrome is associated with which of the following cardiac complications?
Marfan Syndrome is associated with which of the following cardiac complications?
The dichroic notch occurs during which phase of the cardiac cycle?
The dichroic notch occurs during which phase of the cardiac cycle?
Which reflex is known to increase heart rate in response to increased venous return?
Which reflex is known to increase heart rate in response to increased venous return?
Mitral regurgitation is best characterized by which change in the left ventricular pressure volume loop?
Mitral regurgitation is best characterized by which change in the left ventricular pressure volume loop?
What does the baroreceptor reflex primarily respond to?
What does the baroreceptor reflex primarily respond to?
Which abnormal JVP pattern is associated with atrioventricular dissociation?
Which abnormal JVP pattern is associated with atrioventricular dissociation?
Which of the following is a characteristic finding of mitral stenosis?
Which of the following is a characteristic finding of mitral stenosis?
What is likely to occur during the isovolumetric relaxation phase of the cardiac cycle?
What is likely to occur during the isovolumetric relaxation phase of the cardiac cycle?
Which condition may present with large A waves in JVP measurements?
Which condition may present with large A waves in JVP measurements?
Flashcards
What is preload?
What is preload?
What is afterload?
What is afterload?
Describe coarctation of the aorta
Describe coarctation of the aorta
What is Poiseuille's Law?
What is Poiseuille's Law?
Explain the Windkessel effect
Explain the Windkessel effect
Why does the aorta have the highest blood pressure?
Why does the aorta have the highest blood pressure?
How do venous dilation and constriction affect preload?
How do venous dilation and constriction affect preload?
How do arterial dilation and constriction affect afterload?
How do arterial dilation and constriction affect afterload?
Cardiac Myocyte Resting Membrane Potential
Cardiac Myocyte Resting Membrane Potential
Depolarization (Phase 0)
Depolarization (Phase 0)
Early Repolarization (Phase 1)
Early Repolarization (Phase 1)
Plateau Phase (Phase 2)
Plateau Phase (Phase 2)
Repolarization (Phase 3)
Repolarization (Phase 3)
Essential Calcium
Essential Calcium
First Heart Sound (S1)
First Heart Sound (S1)
Second Heart Sound (S2)
Second Heart Sound (S2)
Valsalva Maneuver
Valsalva Maneuver
Baroreceptor Reflex
Baroreceptor Reflex
Carotid Sinus Reflex
Carotid Sinus Reflex
Frank-Starling Law
Frank-Starling Law
EDV and SV Relationship
EDV and SV Relationship
Sawtooth Waves on ECG
Sawtooth Waves on ECG
Absent P Waves on ECG
Absent P Waves on ECG
Dopamine
Dopamine
Bezold-Jarisch Reflex
Bezold-Jarisch Reflex
Bainbridge Reflex
Bainbridge Reflex
Irregularly Irregular Rhythm
Irregularly Irregular Rhythm
PSVT ECG Pattern
PSVT ECG Pattern
Ventricular Tachycardia ECG Pattern
Ventricular Tachycardia ECG Pattern
Torsades de Pointes
Torsades de Pointes
Delta Waves
Delta Waves
What is Marfan Syndrome?
What is Marfan Syndrome?
What is Mitral Valve Prolapse?
What is Mitral Valve Prolapse?
What is Mitral Stenosis?
What is Mitral Stenosis?
What is Aortic Regurgitation?
What is Aortic Regurgitation?
What is the Isovolumetric Contraction phase in the left ventricular pressure-volume loop?
What is the Isovolumetric Contraction phase in the left ventricular pressure-volume loop?
What is the Rapid Ejection Phase in the left ventricular pressure-volume loop?
What is the Rapid Ejection Phase in the left ventricular pressure-volume loop?
What is the Slow Ejection Phase in the left ventricular pressure-volume loop?
What is the Slow Ejection Phase in the left ventricular pressure-volume loop?
What is the Isovolumetric Relaxation Phase in the left ventricular pressure-volume loop?
What is the Isovolumetric Relaxation Phase in the left ventricular pressure-volume loop?
What is the Ventricular Filling Phase in the left ventricular pressure-volume loop?
What is the Ventricular Filling Phase in the left ventricular pressure-volume loop?
What is Jugular Venous Pressure (JVP)?
What is Jugular Venous Pressure (JVP)?
What is the A wave in JVP?
What is the A wave in JVP?
What is the X descent in JVP?
What is the X descent in JVP?
What is the C wave in JVP?
What is the C wave in JVP?
What is the V wave in JVP?
What is the V wave in JVP?
What is the Y descent in JVP?
What is the Y descent in JVP?
What is the Dichroic Notch?
What is the Dichroic Notch?
Study Notes
Cardiac Physiology
- Cardiac myocyte resting membrane potential = -90 mV, equal to potassium equilibrium potential.
- Neuron resting membrane potential = -70 mV, equal to chloride equilibrium potential.
- Action Potential Phases:
- Depolarization (Phase 0): Sodium influx.
- Early Repolarization (Phase 1): Potassium efflux begins.
- Plateau Phase (Phase 2): Calcium influx and potassium efflux are balanced.
- Repolarization (Phase 3): Potassium efflux predominates.
- Essential Calcium:
- Calcium entering during the plateau phase is "essential calcium."
- Triggers calcium release from the sarcoplasmic reticulum (SR) via ryanodine receptors (RYR).
- Leads to muscle contraction.
Heart Sounds
- First Heart Sound (S1):
- Occurs during isovolumetric contraction.
- Caused by closure of mitral and tricuspid valves, preventing backflow.
- Second Heart Sound (S2):
- Occurs during protodiastole or isovolumetric relaxation.
- Caused by closure of aortic and pulmonic valves.
- Third Heart Sound (S3):
- Heard during rapid ventricular filling.
- Typically not heard in normal adults.
- Can be physiological in children and pregnant individuals.
- May be associated with hyperdynamic states.
- Fourth Heart Sound (S4):
- Heard during atrial contraction.
- A low-pitched sound.
- Occurs as ventricles fill with ~30% of blood volume.
- Low-Pitched Heart Sounds:
- S3, S4, and Tumor Plop are low-pitched heart sounds.
- Tumor Plop Sound:
- Associated with atrial myxoma (a tumor in the left atrium).
- Created by the tumor hitting the mitral valve wall during contractions.
Murmurs
- Pan Systolic (Holosystolic) Murmurs:
- Occur throughout systole.
- Associated with mitral regurgitation, tricuspid regurgitation, and ventricular septal defect (VSD).
- Cresendo-Decresendo Murmurs:
- Intensity increases then decreases during systole.
- Also called diamond-shaped murmurs.
- Associated with pulmonic stenosis, subaortic stenosis, and hypertrophic obstructive cardiomyopathy (HOCM).
- Continuous Murmurs:
- Heard during systole and diastole.
- Associated with patent ductus arteriosus (PDA), continuous blood shunting from aorta to pulmonary trunk.
Other Important Concepts
- Mitral Valve Prolapse:
- Associated with midsystolic clicks.
- Can be an isolated finding or associated with Marfan syndrome.
- Marfan Syndrome:
- Connective tissue disorder affecting the fibrillin-1 gene.
- Can lead to aortic dissection, a serious medical emergency.
- Mitral Stenosis:
- Characterized by diastolic rumble and opening snap.
- Often associated with rheumatic heart disease.
- Initially presents as mitral regurgitation, progressing to stenosis in chronic cases.
- Aortic Regurgitation:
- Associated with blowing diastolic murmur, bounding pulse, head bobbing, and widened pulse pressure.
Left Ventricular Pressure-Volume Loop
- Shows pressure and volume changes during a cardiac cycle.
- End Systolic Volume (ESV): ~50 mL.
- End Diastolic Volume (EDV): ~120 mL.
- Isovolumetric Contraction: Mitral valve closes, pressure rises (5 mmHg to 80 mmHg) but volume remains constant.
- Rapid Ejection Phase: Aortic valve opens, pressure rises further (to 120 mmHg), rapid blood ejection.
- Slow Ejection Phase: Ventricular pressure decreases; slower ejection.
- Isovolumetric Relaxation: Aortic valve closes when ventricular pressure falls below aortic pressure. Mitral valve opens. Pressure drops quickly, volume remains constant.
- Ventricular Filling: Mitral valve open, blood flows from atrium to ventricle. Pressure drops, reflecting ventricular relaxation.
- Changes in the loop:
- Narrow and tall: Aortic stenosis.
- Extending to the right side: Aortic regurgitation.
- Short: Mitral stenosis.
- Extending to both sides: Mitral regurgitation.
Jugular Venous Pressure (JVP)
- Measures right atrial pressure, observed in the internal jugular vein.
- A wave: Positive wave due to atrial contraction.
- X descent: Negative wave due to atrial relaxation; blood moving to right atrium.
- C wave: Positive wave from tricuspid valve bulging into atrium during right ventricular contraction.
- V wave: Positive wave due to atrial filling.
- Y descent: Negative wave from atrial emptying into the right ventricle.
- Abnormal JVP: Refer to notes for various scenarios.
Other Relevant Cardiac Concepts (updated)
-
Dichroic Notch: Formed during rapid ejection phase due to aortic valve closure; prominent during slow ejection phase.
-
Cardiac Reflexes: All reflexes decrease heart rate except the Bainbridge reflex.
- Cushing reflex: Increased intracranial pressure, bradycardia, Cushing ulcers.
- Bainbridge reflex: Tachycardia induced by increased venous return, right atrial distention, or increased blood volume (e.g., normal saline).
- Bezold-Jarisch reflex: Bradycardia, hypotension, and prolonged apnea triggered by chemicals like serotonin, capsaicin, veratridine.
- Baroreceptor reflex: Negative feedback mechanism; triggered by increased blood pressure, leading to decreased heart rate and blood pressure. Activated by the aortic arch and carotid sinus. Mary's Law: Increased BP results in decreased heart rate. Manuevers and clamping above/below the carotid sinus activate baroreceptors.
-
Frank-Starling Law: Increased end-diastolic volume (preload) leads to increased stroke volume.
-
ECG Points:
- Atrial Flutter: Sawtooth waves.
- Atrial Fibrillation: Absent P waves.
-
Dopamine: Positive inotropic drug, increases myocardial contractility; used for shock and oliguria.
-
Important ECG Points (Auscultation Area): Refer to existing notes.
-
Additional Notes (updated):
- ... (Refer back to existing notes for other key concepts)
...(Rest of the existing notes remain as is.)
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