Cardiac Physiology Quiz
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Questions and Answers

Which of the following is the correct order of blood flow through the right side of the heart?

  • Pulmonary valve -> Right atrium -> Right ventricle -> Pulmonary trunk
  • Right ventricle -> Right atrium -> Pulmonary valve -> Pulmonary trunk
  • Right atrium -> Pulmonary valve -> Right ventricle -> Pulmonary trunk
  • Right atrium -> Right ventricle -> Pulmonary valve -> Pulmonary trunk (correct)

    • What is the function of the pulmonary arteries?

  • Carry oxygenated blood from the lungs to the heart
  • Carry oxygenated blood from the heart to the body
  • Carry deoxygenated blood from the heart to the lungs (correct)
  • Carry deoxygenated blood from the body to the heart

    • Which chamber of the heart receives oxygenated blood from the lungs?

  • Left ventricle
  • Left atrium (correct)
  • Right ventricle
  • Right atrium

    • What is the function of the tricuspid valve?

    <p>Prevents the backflow of blood from the right ventricle to the right atrium (A)</p> Signup and view all the answers

    Which of the following is true about the systemic circulation?

    <p>It carries oxygenated blood from the heart to the body. (C)</p> Signup and view all the answers

    Which of the following statements accurately describes the relationship between ventricular filling and atrial contraction during the cardiac cycle?

    <p>Atrial contraction occurs during the early phase of ventricular filling, contributing to the final filling volume. (D)</p> Signup and view all the answers

    What is the primary driving force for the opening and closing of the heart valves?

    <p>The pressure differential across the valves. (B)</p> Signup and view all the answers

    Which phase of the cardiac cycle is significantly shortened with an increased heart rate (BPM)?

    <p>Ventricular filling (D)</p> Signup and view all the answers

    What is the approximate volume of blood present in the left ventricle at the end of diastole, known as the end-diastolic volume?

    <p>130 ml (B)</p> Signup and view all the answers

    Which of the following is NOT a factor that directly contributes to blood flow?

    <p>The type of blood cells present in the blood. (D)</p> Signup and view all the answers

    During which phase of the cardiac cycle are the atrioventricular valves closed and the aortic and pulmonary valves open?

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

    Which of the following accurately describes the role of the left atrium in the circulatory system?

    <p>It receives oxygen-rich blood from the lungs. (B)</p> Signup and view all the answers

    How does exercise contribute to a healthier heart?

    <p>Exercise causes the heart to work harder, leading to heart enlargement and improved function. (E)</p> Signup and view all the answers

    What occurs during the contraction of the ventricles in terms of the atrioventricular (AV) valves?

    <p>AV valves close to prevent backflow into the atria (B)</p> Signup and view all the answers

    What prevents the AV valve flaps from everting into the atria during ventricular contraction?

    <p>Tightening of the chordae tendineae (C)</p> Signup and view all the answers

    What is the main function of the semilunar (SL) valves?

    <p>To prevent backflow into the ventricles when they relax (A)</p> Signup and view all the answers

    What causes the semilunar valves to open and close?

    <p>Pressure changes in the heart chambers (D)</p> Signup and view all the answers

    During which phase are the AV valves closed?

    <p>When the ventricles are contracting (B)</p> Signup and view all the answers

    What percentage of cardiac reserve can atrial contraction contribute during periods of increased need?

    <p>30% (D)</p> Signup and view all the answers

    During which phase of the cardiac cycle does the left ventricle begin to eject blood into the aorta?

    <p>Period of rapid ejection (C)</p> Signup and view all the answers

    What is the stroke volume (SV) if the end diastolic volume (EDV) is 130 mL and the end systolic volume (ESV) is 70 mL?

    <p>100 mL (A)</p> Signup and view all the answers

    What occurs during the isovolumic contraction phase of the cardiac cycle?

    <p>Pressure rises while the ventricle volume remains constant. (C)</p> Signup and view all the answers

    Which of the following statements is true regarding the phases of systole?

    <p>Left ventricular pressure must exceed aorta pressure for ejection to occur. (A)</p> Signup and view all the answers

    What factors determine cardiac output?

    <p>Heart Rate and Stroke Volume (A)</p> Signup and view all the answers

    Which of the following statements about preload is correct?

    <p>Preload directly affects stroke volume. (A)</p> Signup and view all the answers

    What does the formula CO = SV x HR represent?

    <p>The components of cardiac output. (B)</p> Signup and view all the answers

    If the cardiac output is not appropriate, which condition might occur?

    <p>Circulatory shock (D)</p> Signup and view all the answers

    What is the typical range of normal cardiac output at rest?

    <p>3.5 - 8 L/min (C)</p> Signup and view all the answers

    How is cardiac index defined?

    <p>Cardiac output per body surface area (D)</p> Signup and view all the answers

    What condition results from low cardiac output and inadequate blood flow through the vascular system?

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

    Which factor does NOT influence stroke volume?

    <p>Total blood volume in the body (B)</p> Signup and view all the answers

    What does cardiac index measure?

    <p>The stroke volume adjusted for body surface area (B)</p> Signup and view all the answers

    Which of the following factors affects stroke volume?

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

    According to Frank Starling’s Law, what happens to stroke volume when end-diastolic volume (EDV) increases?

    <p>Stroke volume increases due to enhanced myocardial stretch (A)</p> Signup and view all the answers

    What is the relationship between heart rate and diastolic duration?

    <p>Higher heart rate reduces diastolic duration (B)</p> Signup and view all the answers

    Why is cardiac index considered a better indicator of cardiac function?

    <p>It normalizes cardiac output for body habitus (A)</p> Signup and view all the answers

    What does an increase in venous return do to preload?

    <p>Increases preload (D)</p> Signup and view all the answers

    What does afterload represent in the context of stroke volume?

    <p>The pressure in the arteries that must be overcome for blood ejection (B)</p> Signup and view all the answers

    Which of the following describes the effect of training on an athlete’s cardiac function?

    <p>Low heart rate with high stroke volume (B)</p> Signup and view all the answers

    Flashcards

    Atrium

    Upper chambers of the heart that receive blood.

    Atrioventricular Valve (AV Valve)

    Valves between atria and ventricles that prevent backflow.

    Chordae Tendineae

    Strong fibers that connect AV valves to papillary muscles.

    Papillary Muscles

    Muscles that contract to tighten chordae tendineae.

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    Semilunar Valves

    Valves that prevent backflow into ventricles when relaxed.

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    Pulmonary Capillaries

    Tiny blood vessels where blood loses CO2 and gains O2.

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    Right Atrium

    Chamber of the heart that receives deoxygenated blood from the body.

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    Left Ventricle

    The chamber that pumps oxygenated blood into the aorta for distribution.

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    Systemic Capillaries

    Tiny blood vessels where blood loses O2 and gains CO2.

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    Heart as a Double Pump

    The heart pumps blood through two circuits: pulmonary and systemic simultaneously.

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    Atrial contribution

    Atrial contraction can provide 30% of cardiac reserve during increased demand.

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    Isovolumic contraction

    A phase in early systole where valves are closed, ventricles contract but no blood is ejected.

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    Stroke Volume (SV)

    The amount of blood ejected by the ventricle in one contraction, calculated as EDV - ESV.

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    End Diastolic Volume (EDV)

    The total volume of blood in the ventricles at the end of diastole, typically around 135 ml.

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    Diastolic relaxation

    The period when ventricles relax after contraction, all valves are closed.

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    Atrioventricular Valves

    Valves that open during ventricular filling and close when ventricles contract.

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    Cardiac Cycle

    The sequence of events during one heartbeat, including contraction and relaxation phases.

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    Ventricular Systole

    Phase where ventricles contract to pump blood out of the heart.

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    Ventricular Filling Phase

    Phase when ventricles fill with blood during diastole before contraction.

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    Pressure-Driven Valves

    The opening and closing of heart valves are controlled by changes in pressure.

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    Isovolumetric Contraction Phase

    The phase where ventricles contract but no blood is ejected; volume remains the same.

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    Systemic Circulation

    Pathway where blood is pumped from the left side of the heart to the body and back to the right side.

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    Cardiac Output (CO)

    The amount of blood the heart pumps each minute.

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    Heart Rate (HR)

    The number of times the heart beats each minute.

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    Preload

    The volume of blood filling the heart before contraction.

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    Afterload

    The pressure the heart must generate to eject blood.

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    Cardiac Index

    CO adjusted for body surface area; better cardiac function indicator.

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    Venous Return

    The volume of blood returning to the heart.

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    Consequences of Low CO

    Leads to circulatory shock and ischemia; critical condition.

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    Body Surface Area (BSA)

    Measurement to normalize cardiac function for patients based on size.

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    Cardiac Reserve

    Maximum cardiac output (CO) minus CO at rest; indicates heart's extra capacity.

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    Ejection Fraction (EF)

    The percentage of end-diastolic volume (EDV) ejected during each heartbeat, typically 55-75%.

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    Contractility

    The strength of heart muscle contraction, affecting how much blood is pumped with each beat.

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    Frank-Starling Law

    The relationship where increased preload leads to greater stroke volume due to muscle stretch.

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    Study Notes

    Course Information

    • Lecture quizzes are included in exams
    • Attendance is part of the grade
    • Answer keys are posted after class
    • Exam scantrons are not returned
    • Office hours are for reviewing exams
    • The syllabus is a contract; students should read it thoroughly
    • No makeup exams are available
    • Blackboard contains many guidelines and materials
    • Check folders for additional material
    • Recommended materials: Pencil and good eraser for scantrons, save blank scantrons
    • No grade changes due to insufficient materials

    Advanced AP Pathophysiology

    • Apply anatomical and physiological knowledge to case studies, critical thinking questions, and clinical scenarios
    • Understand and apply knowledge to clinical situations
    • Integrate multiple systems of the human body

    Medical Terminology

    • Cardiovascular System: Deals with the heart and blood vessels
    • Chapter 25: Discusses the structure and function of the cardiovascular system
    • Review of Heart Structures and Function: Focuses on the pumping action necessary for blood circulation
    • Functions of the Circulatory System: Blood's transport function (oxygen, nutrients, waste, electrolytes, hormones, immune) along with regulating body temperature

    Heart Locations

    • The heart is located in the mid-sternum area, with its point of maximal intensity (PMI) near the 2nd rib
    • Anatomical references provide specific locations of heart parts and surrounding structures (lungs, diaphragm, etc)

    Heart Conditions

    • Dextrocardia: Congenital birth defect where the heart is positioned on the right side instead of the left.
    • Hypoplastic Left Heart Syndrome: A rare congenital condition where the left side of the heart is severely underdeveloped.

    Heart Anatomy

    • Pericardium: Fibrous covering around the heart, offering protection and holding it in place
    • Myocardium: Muscular portion of the heart forming the walls of the atria and ventricles
    • Endocardium: Thin, three-layered membrane lining the inside of the heart

    Heart Function

    • Valves: Ensure one-way blood flow; atrioventricular valves (tricuspid and mitral/bicuspid) and semilunar valves (aortic and pulmonary) are crucial for proper heart function
    • Fibrous Skeleton: Structural support and isolating force for electrical impulses in the heart

    Heart Valves Functions

    • AV valves: Prevent backflow into atria/open and close in response to pressure
    • Tricuspid valve(right) and mitral valve (left)
    • Chordae Tendineae: Anchor cusps to papillary muscles (special heart muscles) to prevent everting of flaps during contraction
    • Semilunar valves: Prevent backflow into ventricles during heart relaxation/open and close in response to pressure changes
    • Aortic valve and pulmonary semilunar valve
    • No chordae tendineae

    Heart Cycle Recall

    • When the heart contracts, blood must fill the ventricle first. Thus, AV valves need to open first, followed by atrial contraction to fill the ventricle completely before sytole. The volume of blood filling up the ventricles is about 130ml.

    Cardiac Cycle

    • Describes rhythmic pumping action of heart
    • Systole: Ventricular contraction and emptying
    • Diastole: Ventricular relaxation and filling(with blood)
    • Main atrial pressure waves (a, c & v waves) during cardiac cycle
    • Four phases of cardiac cycle

    Ejection Fraction

    • Portion of end diastolic volume ejected during systole
    • Normal ejection fraction is less than 55% of EDV

    Cardiac Output

    • Amount of blood pumped by the heart each minute
    • Determined by stroke volume (amount pumped per beat) and heart rate (number of beats per minute)

    Factors Affecting Stroke Volume

    • Preload: Stretch of ventricular muscle from blood filling before contraction
    • Contractility: Forcefulness of ventricular muscle contraction
    • Afterload: Pressure in arteries that must be overcome for blood ejection
    • Important: Increase in Afterload = Increased Cardiac workload

    Local Control of Blood Flow

    • Blood flow proportional to tissue metabolic needs
    • Autoregulation: Each tissue controls its own blood flow.

    Collateral Circulation

    • Most organs receive blood from multiple branches
    • Arterial anastomosis: Where arteries supplying the same area connect.
    • Coronary collateral arteries: May prevent myocardial ischemia in healthy subjects and in some patients with coronary artery disease.
    • Exercise often increases collateral blood flow.
    • Important to note: Larger coronary arteries being blocked (occluded) may hinder the smaller coronary arteries from restoring blood flow.

    Factors Affecting Heart Rate

    • Parasympathetic activity (vagus nerve): Slows heart rate, no effect on contractility
    • Sympathetic activity: Speeds heart rate, increases contractility

    Nervous Control of BP

    • Input to cardiovascular centers: Several structures in the brains communicate with the medulla oblongata for control and regulation of heart rate and contractility
    • Output to Effectors: Medulla oblongata sends impulses to cause changes in cardiac rate and contractility and vascular resistance

    Additional Information

    • Digitalis (digoxin): Medication helpful for congestive heart failure and atrial fibrillation
    • Definitions of ischemia, hypoxemia
    • Questions for review:
      • Differences between cardiac and skeletal muscle (histology and physiology)
      • What maintains blood flow in Atria
      • What factors regulate right atrial pressure

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