The document summarizes key hemodynamic indicators of the heart including systolic blood volume (SBV) and minute volume of blood (MBV). It describes that SBV is the amount of blood ejected per heart beat, while MBV is the total amount ejected per minute. Other metrics like cardiac index and systolic index relate these values to body surface area. The document also outlines the process of auscultation to listen to heart sounds and characteristics of a phonocardiogram used to record heart sounds and murmurs during the cardiac cycle. It details the timing and components of ventricular systole and diastole.

1. HEMODYNAMIC
ORGANIZATION

3. Video
Video

4. MAIN HEMODYNAMIC INDICATORS OF
THE HEART
systolic blood volume (SBV)
minute volume of blood (MBV).
The cardiac parameters are:

5. SBV
SBV MBV
MBV
the amount of blood that is
ejected into the main
vessels by the ventricles of
the heart in one systole
(normally 60-80 ml)
is the amount of blood that is
ejected by the ventricles of the
heart into the main vessels in
one minute:
MBV= SBV x HR(normally 4-5
l/min)
HR- heart rate

6. To level anthropometric data one can use the cardiac index (CI
- the ratio of the MBV to the body surface - S) and the
SYSTOLIC index (Syst.I - the ratio of the SBV to S):
CI=MBV/S
Syst.I=SBV/S

7. Auscultation and
Auscultation and
phonocardiography
phonocardiography

8. Heart sounds
Heart sounds
Sound vibrations (heart sounds) that occur during one cardiac cycle
can be heard this is called auscultation or recorded - a
phonocardiogram (PCG)
During auscultation only two tones can be heard:
1 (appearing during systole -systolic tone)
II (occurring during diastole - diastolic tone).

9. Video
Video

10. auscultation
auscultation
The best place to listen to the
first tone is the 5th intercostal
space to the left 1.5-2 cm
medially from the midclavicular
line (closing of the bicuspid
valve) and at the base of the
xiphoid process (closing of the
tricuspid valve).

11. auscultation
auscultation
The best place to listen to the
second sound is the second
intercostal space on the right at
the edge of the sternum (closing
of the valves of the aorta) and
in the second intercostal space
on the left at the edge of the
sternum (closing of the valves
of the pulmonary artery).

12. auscultation
auscultation
In addition sound vibrations associated with the closure of
the aortic semilunar valves can be heard on the left side of
the sternum at the site of attachment III

13. what is it?
what is it?

14. A phonocardiogram (or PCG) is a plot of
high-fidelity recording of the sounds and
murmurs made by the heart with the help
of the machine called the
phonocardiograph; thus,
phonocardiography is the recording of all
the sounds made by the heart during a
cardiac cycle.

15. On PCG it is possible to note 4 tones: one
systolic (I tone) and three diastolic (II III and
IV tones).

16. I tone
I tone
consists of the following components:
1)the tension of the muscles of the ventricles and
the tension of the tendon filaments of the leaflets;
2) closing of the valvular valves;
3) opening of the semilunar valves;
4) the dynamic effect of blood pumped from the
ventricles and the vibration of the walls of the
main vessels;

17. II and III tone
II and III tone
II tone occurs as a result closing of the semilunar
valves;
III tone occurs as a result of vibration of the walls
of the ventricles in the phase of their rapid filling
when the valvular valves are opened;

18. IV tone
IV tone
IV tone is associated with fluctuations in the walls
of the ventricles in the phase of additional (active)
filling due to atrial systole

20. Ventricular systole lasts 0.33 s. and consists of
two phases and four periods.
I. Tension phase- in this phase preparation of the
ventricles for the performance of useful basic work
pumping of blood from the ventricles of the heart
into the main vessels occurs (0.07 - 0.08 s.)
VENTRICULAR SYSTOLE

21. 1)the period of asynchronous contraction (0,04-0.05 s) - the
entire ventricular myocardium is covered by excitation.
During this period the valvular valves are open and the
semilunar valves are closed;

22. 2) the period of isometric contraction (0.02-0.03 s) - starts
from the moment that valvular valves become close. The
contraction occurs in closed cavities during the period of
isometric contraction .When the cavities of the ventricles are
closed the tension of the myocardium increases, an increase
in pressure occurs and when in the left ventricle it becomes
equal to 70-80 mm Hg, and in the right - 12-15
mmHg. the semilunar valves of the aorta and pulmonary
artery become open. From this moment begins the second
phase of cardiac sycle

23. 1) the period of rapid ejection (0.12 s). At this
time the pressure in the ventricles continues to
increase - in the left ventricle up to 110-120 mm
Hg and in the right - up to 25-30 mm Hg.
II. PHASE OF BLOOD EJECTION

24. 2) the period of slow ejection (0.13-0.17 s). This
period of ejection continues until the pressure
in the cavities of the ventricles and in the main
vessels become equal.
II. PHASE OF BLOOD EJECTION

25. begins from the moment of cessation of ejection
(pressure in the ventricles corresponds to the
pressure in the main vessels). At the same time the
semilunar valves had not yet closed but the
ejection had ceased.
VENTRICULAR DIASTOLE

26. DIASTOLE CONSISTS
OF:
Proto-diastolic period
Isometric relaxation
Phase of ventricular
filling

27. 1. Proto-diastolic period (0.015-0.02c) - time from the end of blood
ejection till the semilunar valves closing.
2. Isometric relaxation (0.08s) - the time from the closing of the
semilunar valves to the opening of the valvular valves. At the same
time relaxation of the ventricular myocardium occurs within
closed cavities (valvular and semilunar valves are both closed).

28. 3. Phase of ventricular filling (0,35s) - the time from the opening of
the valvular valves to the beginning of ventricular systole. This
phase consists of three periods:
a) period of rapid passive filling (0.08 s);
b) the period of slow passive filling (0.17 s).
c) the period of active filling of the ventricles carried out by atrial
systole (0.1 s)

29. THANK YOU