Week 2 Cardiac
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Questions and Answers

What is the relationship between systolic pressure and stroke volume?

  • Lower systolic pressure has no effect on stroke volume
  • Higher systolic pressure leads to decreased stroke volume (correct)
  • Higher systolic pressure leads to increased stroke volume
  • Lower systolic pressure leads to decreased stroke volume

Which factor influences preload by contributing to ventricular wall tension at the end of diastole?

  • Atrial kick (correct)
  • Valvular regurgitation
  • Venous tone
  • Body position

What does the Frank-Starling mechanism state about the relationship between ventricular end-diastolic volume (preload) and stroke volume?

  • The heart will eject a greater stroke volume if it is filled to a smaller volume at the end of diastole
  • The heart's stroke volume is not affected by the end-diastolic volume
  • The heart will eject a greater stroke volume if it is filled to a greater volume at the end of diastole (correct)
  • The heart will have a lower stroke volume if it is filled to a smaller volume at the end of diastole

What is afterload in the context of ventricular function?

<p>The force that the ventricle must overcome to eject its stroke volume (B)</p> Signup and view all the answers

How do increases in afterload affect the Frank-Starling curve and stroke volume?

<p>Increases in afterload shift the curve down and to the right, decreasing stroke volume (A)</p> Signup and view all the answers

What is contractility defined as in the context of cardiac physiology?

<p>The intrinsic strength of the heart muscle (C)</p> Signup and view all the answers

Which event takes place during diastole in the cardiac cycle?

<p>Relaxation and passive filling of the ventricles with blood from atria (C)</p> Signup and view all the answers

What does Wigger's diagram depict?

<p>Pressure waveform due to atrial systole, ventricular contraction, and pressure buildup from venous return before AV valve opens again (A)</p> Signup and view all the answers

Which type of hypertrophy is expected in response to mitral regurgitation?

<p>Eccentric hypertrophy (C)</p> Signup and view all the answers

What is the normal mitral valve area?

<p>$4-6$ cm2 (C)</p> Signup and view all the answers

Which condition is a cause of mitral stenosis?

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

What is the goal for heart rate in the anesthetic management of mitral stenosis?

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

What is the pathophysiological effect of chronic mitral regurgitation on the left ventricle?

<p>Dilating and increasing end-diastolic volume (D)</p> Signup and view all the answers

Which condition is a cause of aortic regurgitation?

<p>Rheumatic heart disease (D)</p> Signup and view all the answers

What is the expected effect of aortic regurgitation on the left ventricle?

<p>Dilation and eccentric hypertrophy (C)</p> Signup and view all the answers

"Fast and forward" is a goal in the anesthetic management of which condition?

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

What is the expected effect of aortic stenosis on ventricular thickness?

<p>Thickening with decreased compliance (D)</p> Signup and view all the answers

What does the acronym 'SAD' represent in the context of aortic stenosis?

<p>Syncope, angina, dyspnea (C)</p> Signup and view all the answers

What is the primary role of Bachmann's bundle in the heart's conduction system?

<p>Preferential path for electrical activation of the left atrium (B)</p> Signup and view all the answers

What is the role of Purkinje fibers in the heart's conduction system?

<p>Rapidly conduct the action potential to myocytes throughout the ventricles (B)</p> Signup and view all the answers

What is the main function of the SA node in the heart's conduction system?

<p>Generates the action potential leading to depolarization of all other cardiac muscle cells (B)</p> Signup and view all the answers

Which part of the heart serves as the link between atrial and ventricular depolarization?

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

What occurs as a result of dysfunction in the left bundle branch of the heart's conduction system?

<p>Excess widths of QRS &gt; 0.12 (C)</p> Signup and view all the answers

Which part of the heart plays a role in atrial fibrillation and interatrial block?

<p>Bachmann's bundle (A)</p> Signup and view all the answers

What is the major function of the bundle of His (AV bundle) in the heart's conduction system?

<p>Conducts action potential to right and left bundle branches (A)</p> Signup and view all the answers

What is the significance of gap junctions in the heart's conduction system?

<p>Allows spread of action potentials between myocardial cells (C)</p> Signup and view all the answers

What occurs during systole in the cardiac cycle?

<p>Contraction and tension development (A)</p> Signup and view all the answers

What is the primary function of isovolumetric relaxation in the cardiac cycle?

<p>Relaxation of the ventricular myocardium (B)</p> Signup and view all the answers

What does the pressure-volume loop provide an assessment of?

<p>Integrity of cardiac valves (A)</p> Signup and view all the answers

What happens when LV pressure exceeds LA pressure but is less than aortic pressure in the cardiac cycle?

<p>Mitral valve closes (D)</p> Signup and view all the answers

Which phase of the cardiac cycle is characterized by a period of rapid ejection of blood from the ventricle?

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

What happens when LV pressure falls below aortic pressure in the cardiac cycle?

<p>Aortic valve closes (D)</p> Signup and view all the answers

What is the primary factor responsible for LV dysfunction when EF < 40%?

<p>Low ejection fraction (EF) (B)</p> Signup and view all the answers

What is the primary indicator used to calculate stroke volume in the pressure-volume loop?

<p>$EDV - ESV$ (C)</p> Signup and view all the answers

What is the primary determinant of resting membrane potential (RMP) in cells?

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

What happens to the RMP when serum potassium (K+) decreases?

<p>RMP becomes more negative (B)</p> Signup and view all the answers

What initiates the depolarization of the cell membrane?

<p>Voltage-gated sodium channel opening (A)</p> Signup and view all the answers

What is the main function of the Sodium-Potassium ATPase (pump) in cardiac cells?

<p>Restores ionic balance towards RMP (A)</p> Signup and view all the answers

What is the characteristic feature of the SA node's resting membrane potential (RMP)?

<p>-55 to -60 mV RMP (A)</p> Signup and view all the answers

What is responsible for the slow depolarization known as 'pacemaker potential' in the SA node?

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

What is the rate of inherent conduction for atrial pacemakers (SA node)?

<p>60-100 bpm (B)</p> Signup and view all the answers

What are the typical rates of conduction for Purkinje fibers?

<p>&lt;20 bpm (B)</p> Signup and view all the answers

What is the hallmark of right bundle branch block (RBBB) on an ECG?

<p>Widened and upwardly deflected QRS complex in lead V1 (B)</p> Signup and view all the answers

Which phase of the ventricular muscle action potential is characterized by the opening of voltage-gated L-type Ca++ channels?

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

What is the resting membrane potential (RMP) of the ventricular muscle cell?

<p>-90 mV (D)</p> Signup and view all the answers

During which phase of the action potential is the cell easier to depolarize?

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

What is the absolute refractory period in the context of action potentials?

<p>Time during which an action potential may not be evoked, even if elicited by a stimulus (B)</p> Signup and view all the answers

What ion is the myocyte permeable to, but not to other electrolytes or proteins?

<p>Potassium (K+) (A)</p> Signup and view all the answers

What differentiates the action potentials of different types of heart cells?

<p>Shape of the action potential (B)</p> Signup and view all the answers

What phenomenon refers to the internal voltage at which the cell depolarizes and exhibits an all or none response?

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

What does the plateau phase of the cardiac action potential allow for?

<p>Prolonged depolarization to allow time for contraction (C)</p> Signup and view all the answers

During which period may a second action potential be fired with a greater than normal stimulus?

<p>Relative refractory period (B)</p> Signup and view all the answers

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