Heart Structure and Function Quiz

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Questions and Answers

What percentage of congenital heart diseases are classified as cyanotic?

  • 30%
  • 20%
  • 80% (correct)
  • 5%

Which of the following is NOT a possible cause of congenital heart disease?

  • Maternal irradiation
  • Maternal use of antibiotics (correct)
  • Fetal alcohol syndrome
  • Maternal diabetes

Which congenital heart disease is most commonly associated with Down syndrome?

  • Patent ductus arteriosus (PDA)
  • Ventricular septal defect (VSD)
  • Pulmonary stenosis (PS)
  • Endocardial cushion defect (CAVC) (correct)

What is the most common etiology of congenital heart diseases?

<p>Multifactorial or polygenic inheritance (A)</p> Signup and view all the answers

Which of the following is a common presentation of congenital heart disease?

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

What type of heart sound is associated with a slapping quality?

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

Which of the following is NOT a possible cause of an impalpable apex beat?

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

A patient with a shifted apex beat outward and downward in the next intercostal space, localized and strong, is most likely experiencing:

<p>Left ventricular enlargement (B)</p> Signup and view all the answers

Which of the following signs is NOT typically associated with pulmonary hypertension?

<p>Prominent S1 at the apex (C)</p> Signup and view all the answers

What is the most likely cause of physiological palpitation?

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

Which phase of the cardiac cycle corresponds to the QRS complex on an ECG?

<p>Ventricular Systole (first phase) (B)</p> Signup and view all the answers

What is the primary function of the semilunar valves during the second phase of ventricular systole?

<p>Ejecting blood from the ventricles into the arteries (D)</p> Signup and view all the answers

What is the significance of the T-wave on an ECG?

<p>It represents ventricular repolarization (D)</p> Signup and view all the answers

During which phase of the cardiac cycle do the AV valves close?

<p>Ventricular Systole (first phase) (D)</p> Signup and view all the answers

Which valves are responsible for preventing backflow of blood from the arteries into the ventricles?

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

What is the primary diagnostic tool for investigating congenital heart disease?

<p>Echocardiography with Doppler (C)</p> Signup and view all the answers

Which of the following components is NOT present in an electrocardiogram (ECG)?

<p>U wave (C)</p> Signup and view all the answers

Which vessel is part of the fetal circulation diagram?

<p>Superior vena cava (A)</p> Signup and view all the answers

What additional tests should be performed if congenital heart disease is suspected?

<p>Chest X-ray and ECG (B)</p> Signup and view all the answers

What does the diagram of fetal circulation illustrate?

<p>Flow of blood in a fetus (A)</p> Signup and view all the answers

What is the anatomical location for auscultating the aortic valve?

<p>2nd intercostal space right sternal border (A)</p> Signup and view all the answers

At what location does the apex typically form in adults?

<p>5th intercostal space in MCL (A)</p> Signup and view all the answers

In right ventricular hypertrophy (RVH), how is the apex shifted?

<p>Outwards and diffuse (C)</p> Signup and view all the answers

Which statement regarding the apex in left ventricular hypertrophy (LVH) is true?

<p>It is usually localized and forcible. (C)</p> Signup and view all the answers

For children under 4 years, where is the apex hardly located?

<p>5th intercostal space in MCL (A)</p> Signup and view all the answers

What are the two upper chambers of the human heart called?

<p>Left atrium and right atrium (A)</p> Signup and view all the answers

Which valve is involved in pumping blood from the right ventricle to the lungs?

<p>Pulmonary valve (C)</p> Signup and view all the answers

Where does the right atrium receive blood from?

<p>Superior and inferior vena cava (D)</p> Signup and view all the answers

How many chambers does the human heart have?

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

Which of the following valves is NOT part of the heart structure?

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

What is the function of the mitral valve?

<p>Prevent backflow from the left ventricle to the left atrium. (D)</p> Signup and view all the answers

Which structure receives oxygenated blood from the lungs?

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

Which valve is located between the left ventricle and the aorta?

<p>Aortic semilunar valve (B)</p> Signup and view all the answers

What do the atrio-ventricular valves primarily do?

<p>Prevent backflow from the ventricles to the atria. (B)</p> Signup and view all the answers

How many cusps does the tricuspid valve have?

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

What is the primary abnormality associated with pulmonary stenosis in Fallot Tetralogy?

<p>Pulmonary infundibular or valvular narrowing (A)</p> Signup and view all the answers

Which component contributes to the central cyanosis seen in Fallot Tetralogy?

<p>Partial desaturation of blood entering the aorta (C)</p> Signup and view all the answers

What effects the appearance of cyanosis in infants with Fallot Tetralogy?

<p>Degree of pulmonary stenosis (B)</p> Signup and view all the answers

Which feature of Fallot Tetralogy leads to equal pressure in the ventricles?

<p>Large ventricular septal defect (VSD) (D)</p> Signup and view all the answers

What is a characteristic finding in the ventricular structure of patients with Fallot Tetralogy?

<p>Thickened right ventricular wall (D)</p> Signup and view all the answers

What type of blood flows from the body to the heart in normal fetal circulation?

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

What is a common symptom of Tetralogy of Fallot?

<p>Clubbing (B), Cyanosis (C)</p> Signup and view all the answers

What condition results from an open ductus arteriosus after birth?

<p>Patent Ductus Arteriosus (C)</p> Signup and view all the answers

Which of the following is NOT a symptom of Atrial Septal Defect (ASD)?

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

What is the primary cause of cyanosis in cyanogenic heart defects?

<p>Mixing of oxygenated and deoxygenated blood (B)</p> Signup and view all the answers

What is the primary origin of the first heart sound "S1"?

<p>Closure of mitral &amp; tricuspid valves (B)</p> Signup and view all the answers

In which condition is the first heart sound "S1" increased?

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

Where is the second heart sound "S2" best heard?

<p>Over aortic &amp; pulmonary areas (B)</p> Signup and view all the answers

What is the timing of the third heart sound "S3"?

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

How does aortic murmur intensity change with position?

<p>Increases when leaning forward (A)</p> Signup and view all the answers

Flashcards

What does the Left Atrium do?

The Left Atrium receives oxygenated blood from the lungs and pumps it through the mitral valve to the Left ventricle during late diastole.

What does the Left Ventricle do?

The Left Ventricle pumps oxygen-rich blood to the aorta and the rest of the body.

What is the function of the Atrio-Ventricular valves?

The Atrio-Ventricular valves prevent backflow from the ventricles to the atria.

Describe the Tricuspid valve.

The Tricuspid valve is located between the right atrium and right ventricle and has three cusps or leaflets: Anterior/anterosuperior, Septal and Posterior/inferior.

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Describe the Mitral valve.

The Mitral valve, located between the left atrium and left ventricle, resembles a miter in shape and has two cusps: Anterior/aortic and Posterior/mural.

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Right Atrium

The upper chamber of the heart that receives deoxygenated blood from the body via the superior and inferior vena cava.

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Right Ventricle

The lower chamber of the heart that pumps deoxygenated blood to the lungs through the pulmonary valve.

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Tricuspid Valve

One of the four heart valves, located between the right atrium and right ventricle.

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Pulmonary Valve

One of the four heart valves, located between the right ventricle and the pulmonary artery.

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Superior and Inferior Vena Cava

The largest veins in the body that bring deoxygenated blood from the body to the right atrium.

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What is the apex of the heart?

The most outward and lower point of the heart's visible pulsation.

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Which chamber of the heart forms the apex?

The left ventricle is the heart chamber that forms the apex.

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Where is the normal location of the apex?

The 5th intercostal space in the midclavicular line (MCL), which is aligned with the nipple line, is where the normal apex is located.

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What does a shift of the apex outwards and downwards indicate?

A shift of the apex outwards and downwards, usually localized and forceful, can be a sign of left ventricular hypertrophy (LVH).

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What does a shift of the apex outwards and diffusely indicate?

A shift of the apex outwards and diffusely, with weaker pulsations, can be a sign of right ventricular hypertrophy (RVH).

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Hyperdynamic apex beat

A forceful, outward displacement of the apex beat, often associated with increased blood volume in the left ventricle, seen in conditions like aortic regurgitation (AR) or mitral regurgitation (MR).

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Systolic thrill

A palpable vibration felt over the heart, usually indicating turbulent blood flow, occurring during systole (heart contraction) and often associated with mitral regurgitation.

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Downward and outward apex beat shift

An outward shift of the apex beat, felt in a lower intercostal space, usually indicating left ventricular enlargement.

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Palpitations

A feeling of your heartbeat, either regular or irregular, that is noticeable and may feel abnormal. It can be caused by both normal and abnormal heart activity.

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Heaving apex beat

A forceful, outward displacement of the apex beat, often associated with increased pressure in the left ventricle, prevalent in conditions like aortic stenosis (AS) or systemic hypertension.

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What is the first heart sound (S1)?

The closure of the mitral and tricuspid valves, creating a sound best heard over the apex of the heart.

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What is the second heart sound (S2)?

The closure of the aortic and pulmonary valves, creating a sound best heard over the base of the heart.

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What is S3?

A heart sound that occurs during diastole, after the second heart sound (S2), caused by the vibration of the ventricle as it fills with blood.

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What is S4?

A heart sound that occurs during systole, just before the first heart sound (S1), caused by the stiffening of the ventricle during atrial contraction.

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What is a thrill in cardiology?

A palpable murmur, also known as a 'thrill,' is a vibration felt over the heart during a murmur, indicating a stronger or more turbulent blood flow.

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Left-to-Right Shunt Lesion

A type of congenital heart defect where blood flows from the left side of the heart to the right side, usually due to a hole in the septum between the atria or ventricles.

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Ventricular Septal Defect (VSD)

A congenital heart defect where a hole exists in the wall separating the two ventricles, allowing blood to flow between them abnormally.

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Cyanotic Heart Disease

Congenital heart defects characterized by insufficient oxygen in the blood, leading to a blue color in the skin (cyanosis).

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Atrial Septal Defect (ASD)

A congenital heart defect where a hole exists in the wall separating the two atria, allowing blood to flow between them abnormally.

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Obstructive Heart Lesions

A category of congenital heart defects where there is a blockage or narrowing of the major blood vessels near the heart, causing extra pressure.

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Atrial Systole

Atrial contraction, forcing blood into the ventricles.

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Ventricular Systole (First Phase)

Ventricular contraction pushes the atrioventricular (AV) valves closed, preventing blood backflow from ventricles into atria.

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Ventricular Systole (Second Phase)

Semilunar valves open, allowing blood to be ejected from the ventricles to the pulmonary artery (right ventricle) or aorta (left ventricle).

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Early Ventricular Diastole

Semilunar valves close, preventing blood from flowing back into the ventricles, while blood flows passively into the atria.

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Late Ventricular Diastole

Chambers fully relax, and blood passively flows into the ventricles.

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Echocardiography with Doppler

A diagnostic tool used to investigate congenital heart disease that utilizes sound waves to create images of the heart's structure and function.

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ECG (Electrocardiogram)

A visual representation of the electrical activity of the heart, showing the P, Q, R, S, and T waves and intervals.

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Inferior vena cava

The major blood vessel that carries deoxygenated blood from the lower body to the heart in a fetus.

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Foramen ovale

A shunt connecting the right and left atria in a fetal heart, allowing some blood to bypass the lungs.

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Ductus arteriosus

A vessel connecting the pulmonary artery to the aorta in a fetus, allowing blood to bypass the lungs.

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What is Fallot Tetralogy?

A congenital heart defect characterized by four main components: pulmonary stenosis, ventricular septal defect (VSD), overriding aorta, and right ventricular hypertrophy.

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What is Pulmonary Stenosis in Fallot Tetralogy?

Narrowing of the pulmonary valve or the area beneath it, restricting blood flow to the lungs.

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What is the Ventricular Septal Defect in Fallot Tetralogy?

A large hole in the wall separating the right and left ventricles, allowing blood to flow from the right ventricle to the aorta.

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What is the Overriding Aorta in Fallot Tetralogy?

The aorta, the main artery carrying blood from the heart, is situated over the hole in the heart, receiving blood from both ventricles, not just the left one.

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What is Right Ventricular Hypertrophy in Fallot Tetralogy?

The right ventricle becomes thickened due to increased pressure caused by the obstruction in the pulmonary valve.

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Fetal Circulation

Deoxygenated blood from the body travels through the umbilical cord to the fetal heart. Oxygenated blood from the placenta flows back to the heart via the umbilical cord. Finally, a mix of oxygenated and deoxygenated blood is circulated to the fetal body. This unique system ensures the fetus receives the necessary nutrients and oxygen.

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Patent Ductus Arteriosus (PDA)

The ductus arteriosus, a blood vessel connecting the aorta and pulmonary artery, fails to close after birth. This results in a mixture of oxygenated and deoxygenated blood circulating through the body. This can cause complications like cyanosis and heart strain.

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Cyanogenic Heart Defects

These heart defects cause a bluish discoloration of the skin (cyanosis), indicating low oxygen levels in the blood. Examples include Tetralogy of Fallot.

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Acyanotic Heart Defects

These heart defects generally do not cause cyanosis, meaning the blood is adequately oxygenated. Examples include Patent Ductus Arteriosus (PDA), Atrial Septal Defect (ASD), and Ventricular Septal Defect (VSD).

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Study Notes

Heart Structure and Function

  • The heart is a four-chambered organ: two atria (upper chambers) and two ventricles (lower chambers)
  • The heart also has four valves:
    • Tricuspid
    • Pulmonary
    • Mitral
    • Aortic

Heart Valves

  • Atrioventricular (AV) Valves:

    • Function: Prevent blood flowing back into the atria from the ventricles.
    • Tricuspid Valve: Located between the right atrium and right ventricle. It has three cusps (leaflets): Anterior/anterosuperior, septal, and posterior/inferior.
    • Mitral Valve (Bicuspid): Located between the left atrium and left ventricle. It has two cusps (leaflets): anterior/aortic and posterior/mural.
  • Semilunar Valves:

    • Function: Prevent blood flowing back into the ventricles from the great vessels
    • Pulmonary Semilunar Valve: Between the right ventricle and the pulmonary trunk. It has three semilunar cusps/leaflets: Anterior/non-adjacent, left/left adjacent, and right/right adjacent.
    • Aortic Semilunar Valve: Between the left ventricle and the opening of the aorta. It has three semilunar cusps/leaflets: Left/left coronary valve, right/right coronary valve, and posterior/non-adjacent.

Blood Flow Through the Heart

  • The right atrium receives deoxygenated blood from the body's largest veins: superior vena cava (SVC) and inferior vena cava (IVC).
  • The right atrium pumps the blood through the tricuspid valve to the right ventricle.
  • The right ventricle pumps the blood through the pulmonary valve to the lungs for oxygenation.
  • Oxygenated blood returns to the heart via the pulmonary veins and enters the left atrium.
  • The left atrium pumps the blood through the mitral valve to the left ventricle.
  • The left ventricle pumps oxygen-rich blood to the aorta and the rest of the body (Cardiac output).

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