Heart Structure and Function

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Questions and Answers

What are the two upper chambers of the heart called?

  • Superior and inferior chambers
  • Left ventricle and right ventricle
  • Aortic and pulmonary chambers
  • Left atrium and right atrium (correct)

Which valve is responsible for blood flow from the right atrium to the right ventricle?

  • Mitral valve
  • Pulmonary valve
  • Aortic valve
  • Tricuspid valve (correct)

Which chamber of the heart receives non-oxygenated blood from the superior and inferior vena cava?

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

What is the function of the right ventricle?

<p>To pump non-oxygenated blood to the lungs (C)</p> Signup and view all the answers

How many valves are present in the human heart?

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

What type of heart character is associated with a pressure overload condition?

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

Which type of thrill is typically associated with mitral stenosis (MS)?

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

What is the first step to take when a patient is not feeling well during examination?

<p>Turn the patient to the left lateral position (D)</p> Signup and view all the answers

What sign is observed in right ventricular enlargement?

<p>Apex shifted outward in the same intercostal space (C)</p> Signup and view all the answers

Which statement best describes palpitation?

<p>An abnormal awareness of heartbeats, either regular or irregular (C)</p> Signup and view all the answers

What occurs during atrial systole?

<p>Atria contract and force blood into the ventricles. (C)</p> Signup and view all the answers

Which wave on an ECG represents ventricular repolarization?

<p>T-Wave (B)</p> Signup and view all the answers

What happens in the first phase of ventricular systole?

<p>AV valves close due to ventricular contraction. (A)</p> Signup and view all the answers

During which phase do the semilunar valves close?

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

What is indicated by the QRS complex on an ECG?

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

What is the origin of the first heart sound 'S1'?

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

In which condition is the second heart sound 'S2' most likely to be increased?

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

When is the third heart sound 'S3' typically heard?

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

Which of the following describes a thrilling murmur?

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

What is a characteristic of left-sided murmurs during respiration?

<p>Increase with expiration (C)</p> Signup and view all the answers

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

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

Which of the following vessels is NOT involved in fetal circulation?

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

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

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

Which of the following best describes the role of the Foramen ovale in fetal circulation?

<p>Allows blood to bypass the lungs (D)</p> Signup and view all the answers

Which component is NOT part of an electrocardiogram (ECG)?

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

What is the typical location of the apex of the heart in adults?

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

In which condition would the apex shift outward and downward?

<p>Left ventricular hypertrophy (LVH) (A)</p> Signup and view all the answers

What is the nature of the apex formed by in a normally functioning heart?

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

When auscultating the tricuspid valve, which anatomical location is primarily examined?

<p>Right 4th intercostal space along the sternum (D)</p> Signup and view all the answers

In right ventricular hypertrophy (RVH), how is the extent of the apex typically described?

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

What is the primary function of the mitral valve?

<p>Facilitate the flow of oxygenated blood from the left atrium to the left ventricle (C)</p> Signup and view all the answers

Which structure receives oxygenated blood from the lungs?

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

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

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

What is the role of atrio-ventricular valves?

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

How many cusps does the pulmonary semilunar valve have?

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

Which type of congenital heart disease accounts for 80% of cases?

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

What is the main etiology of congenital heart diseases?

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

Which of the following is a cyanotic congenital heart disease with decreased pulmonary flow?

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

Which maternal factor is associated with the development of congenital heart disease when affected during pregnancy?

<p>Systemic lupus erythematosus (SLE) (D)</p> Signup and view all the answers

Which condition is commonly associated with Down syndrome related to congenital heart disease?

<p>Endocardial cushion defect (CAVC) (C)</p> Signup and view all the answers

What type of blood flows from the body to the heart through the umbilical cord in fetal circulation?

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

Which condition results in oxygenated blood from the aorta mixing with deoxygenated blood from the pulmonary artery?

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

Which of the following defects is characterized by symptoms of cyanosis?

<p>Tetralogy of Fallot (A)</p> Signup and view all the answers

Which symptom is common to both Patent Ductus Arteriosus and Atrial Septal Defect?

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

Which of the following conditions is associated with an increased risk of endocarditis?

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

What is one of the primary characteristics of Fallot Tetralogy?

<p>Infundibular pulmonary stenosis (C)</p> Signup and view all the answers

How does blood flow in the right ventricle during Fallot Tetralogy?

<p>Divides into two pathways (B)</p> Signup and view all the answers

What symptom is commonly associated with Fallot Tetralogy due to reduced oxygen in the blood?

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

Which statement about the large ventricular septal defect (VSD) in Fallot Tetralogy is accurate?

<p>It causes pressure to equalize between ventricles (C)</p> Signup and view all the answers

What can happen to infants with a severe degree of pulmonary stenosis at birth?

<p>Immediate central cyanosis can occur (D)</p> Signup and view all the answers

Flashcards

What does the left atrium do?

The left atrium receives oxygen-rich blood from the lungs and pumps it into the left ventricle through the mitral valve.

What is the role of the left ventricle?

The left ventricle pumps oxygen-rich blood to the aorta, which distributes it to the rest of the body.

Describe the mitral valve.

The mitral valve, also known as the bicuspid valve, is located between the left atrium and the left ventricle. It has two cusps: anterior and posterior.

What is the tricuspid valve and where is it located?

The tricuspid valve is positioned between the right atrium and the right ventricle. It has three cusps: anterior, septal, and posterior.

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What is the function of semilunar valves?

The semilunar valves prevent backflow from the great vessels (aorta and pulmonary trunk) into the ventricles.

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Heaving heart beat

A forceful, outward movement of the heart's apex, often due to increased pressure within the heart chambers.

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Palpitation

A feeling of fluttering, pounding, or racing heartbeats, either regular or irregular.

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Hyperdynamic heart

An abnormal awareness of the heart's beat, caused by an increased volume of blood in the heart chambers.

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Pulmonary hypertension

An increased pressure in the pulmonary arteries, causing a rhythmic forceful pulsing in the chest.

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Thrill

A palpable, vibrating sensation felt over a blood vessel, usually caused by turbulent blood flow within the heart.

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Right Atrium

The upper chamber of the heart that receives deoxygenated blood from the body through 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

A valve located between the right atrium and right ventricle, controlling blood flow.

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Pulmonary Valve

A valve located between the right ventricle and pulmonary artery, allowing blood to flow to the lungs.

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Inferior Vena Cava (IVC)

The largest vein in the body that carries deoxygenated blood from the lower body to the right atrium.

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What is the apex of the heart?

The lowest and outermost point of the heart's pulsation, typically formed by the left ventricle.

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Where is the apex of the heart located?

Located in the 5th intercostal space, along the midclavicular line (nipple line) on the chest. This is where you can feel the heart beat.

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What happens to the apex in Right Ventricular Hypertrophy (RVH)?

A condition where the right ventricle is enlarged, causing the apex to shift outwards and become less forceful.

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What happens to the apex in Left Ventricular Hypertrophy (LVH)?

A condition where the left ventricle is enlarged, causing the apex to shift outwards and downwards, and becoming more forceful.

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What does it mean when the apex is localized?

A condition where the apex is felt only in one intercostal space, typically associated with Left Ventricular Hypertrophy.

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What causes the first heart sound (S1)?

The first heart sound, 'S1', is produced by the closure of the mitral and tricuspid valves.

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What causes the second heart sound (S2)?

The second heart sound, 'S2', is produced by the closure of the aortic and pulmonary valves, marking the end of ventricular systole.

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What is a thrill in cardiology?

A palpable murmur, known as a thrill, is a vibration felt when the heart sounds are very loud.

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How does lying on the left side affect a mitral murmur?

Mitral murmurs often become louder when a patient lies on their left side, as this increases blood flow across the mitral valve.

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How are heart murmurs graded?

The intensity of a murmur is graded on a scale from 1 to 6. Grades 1-3 are audible only with a stethoscope, while grades 4-6 are accompanied by a palpable thrill.

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Left to right shunt

A type of congenital heart defect where blood flow is directed from the left side of the heart to the right side, often causing an overload of the right ventricle and pulmonary circulation.

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Patent ductus arteriosus (PDA)

A condition where the ductus arteriosus, a blood vessel connecting the aorta and pulmonary artery, remains open after birth, allowing blood to bypass the lungs.

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Ventricular septal defect (VSD)

A group of congenital heart defects characterized by a hole in the ventricular septum, the wall separating the two ventricles of the heart.

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Transposition of great arteries (TGA)

A condition where the great arteries, the aorta and pulmonary artery, are switched, resulting in oxygen-poor blood circulating to the body.

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Aortic stenosis (AS)

A congenital heart defect where the aortic valve is narrowed, restricting blood flow from the left ventricle to the aorta.

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

Echocardiography with Doppler is a primary diagnostic tool used to investigate congenital heart disease, providing detailed images of the heart's structure and function.

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Explain fetal circulation.

Fetal circulation is a unique circulatory system in the developing fetus, utilizing specialized structures like the foramen ovale and ductus arteriosus to bypass the lungs.

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What does an ECG show?

An electrocardiogram (ECG) is a non-invasive test that records the electrical activity of the heart, providing insights into heart rhythm and function.

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What does the fetal circulation diagram depict?

The fetal circulation diagram illustrates the path of blood flow in the fetus, highlighting key structures like the umbilical vein, ductus arteriosus, and foramen ovale.

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What is the function of the inferior vena cava?

The inferior vena cava carries deoxygenated blood from the lower body to the right atrium of the heart.

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Fallot Tetralogy

A congenital heart defect characterized by four specific anomalies: pulmonary stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy. It results in shunting of blood from the right ventricle to the aorta, bypassing the lungs, leading to oxygen-deficient blood circulation.

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Pulmonary Stenosis (PS)

Narrowing of the pulmonary valve or the outflow tract of the right ventricle, obstructing blood flow to the lungs.

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Overriding Aorta

The aorta, the main artery carrying blood from the heart to the body, sitting directly over the VSD, receiving blood from both ventricles.

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Right Ventricular Hypertrophy (RVH)

A thickening of the right ventricle wall due to the increased workload caused by pulmonary stenosis and the VSD.

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Describe fetal blood circulation.

Deoxygenated blood from the body travels to the heart via the umbilical cord, while oxygenated blood from the placenta flows back to the fetus through the umbilical cord into the heart. This results in mixed blood flowing from the heart to the body.

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What is Patent Ductus Arteriosus (PDA)?

The ductus arteriosus remains open after birth, allowing oxygenated blood from the aorta to mix with deoxygenated blood from the pulmonary artery. This results in a mixture of oxygenated and deoxygenated blood.

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Describe Cyanogenic Heart Defects.

These defects cause blue skin discoloration (cyanosis). Some common examples include Tetralogy of Fallot, resulting in symptoms like squatting, cyanosis, clubbing, and syncope.

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Describe Acyanotic Heart Defects.

These defects do not usually cause cyanosis. Examples include Patent Ductus Arteriosus (PDA), Atrial Septal Defect (ASD), and Ventricular Septal Defect (VSD). These defects usually lead to fatigue, murmurs, and an increased risk of complications.

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Explain what Tetralogy of Fallot is and its symptoms.

Tetralogy of Fallot is a complex heart defect that causes a mixture of oxygenated and deoxygenated blood to flow into the body. This leads to cyanosis and other symptoms like squatting, clubbing, and syncope.

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What is Atrial Systole?

Atrial contraction forces blood into the ventricles, marking the start of the cardiac cycle.

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What happens during Ventricular Systole?

The ventricles contract, closing the AV valves, and pushing blood into the aorta and pulmonary artery.

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What happens during Early Ventricular Diastole?

The semilunar valves close, preventing blood from flowing back into the ventricles, while blood returns to the atria.

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What is the state of the heart during Late Ventricular Diastole?

The heart chambers completely relax, allowing passive filling of the ventricles with blood.

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What does the QRS complex indicate?

Depolarization of the ventricles, causing them to contract, and is represented by an ECG wave.

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Study Notes

Heart Structure and Function

  • The heart is composed of four chambers
  • Two upper chambers are the left atrium and right atrium
  • Two lower chambers are the left and right ventricles
  • The heart also has four valves
  • Tricuspid valve
  • Pulmonary valve
  • Mitral valve
  • Aortic valve

Right Atrium

  • Receives deoxygenated blood from the body's largest veins (superior vena cava and inferior vena cava)
  • Pumps the blood through the tricuspid valve to the right ventricle

Right Ventricle

  • Pumps the blood through the pulmonary valve to the lungs for oxygenation

Left Atrium

  • Receives oxygenated blood from the lungs
  • Pumps it through the mitral valve to the left ventricle

Left Ventricle

  • Pumps oxygen-rich blood to the aorta and the rest of the body (Cardiac output)

Atrioventricular Valves

  • Function: Prevents backflow from the ventricles to the atria
  • Tricuspid valve:
    • Located between the right atrium and right ventricle
    • Has three cusps/leaflets (Anterior/anterosuperior, Septal, and Posterior/inferior)
  • Mitral valve (Bicuspid valve):
    • Located between the left atrium and left ventricle
    • Has two cusps/leaflets (Anterior/aortic and Posterior/mural)

Semilunar Valves

  • Function: Prevents backflow from the great vessels to the ventricles
  • Pulmonary semilunar valve:
    • Located between the right ventricle and the pulmonary trunk
    • Has three semilunar cusps/leaflets (Anterior/non-adjacent, Left/left adjacent, and Right/right adjacent)
  • Aortic semilunar valve:
    • Located between the left ventricle and the opening of the aorta
    • Has three semilunar cusps/leaflets (Left/left coronary valve, Right/right coronary valve, and Posterior/non-adjacent)

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