1. The cardiac cycle describes the pressure, volume, and flow changes that occur in the ventricles from one heartbeat to the next.
2. It begins with atrial systole, where the atria contract and contribute approximately 10-15% of ventricular filling.
3. Isovolumic contraction follows, where the ventricles contract but their volume remains unchanged as the AV valves close and pressure builds.
4. Ejection then occurs as ventricular pressure exceeds aortic/pulmonary pressure, opening the semilunar valves and allowing blood to be pumped out of the ventricles.
Def: The cardiac events that occur from
beginning of one heart beat to the beginning of
the next.
■ first assembled by Lewis in 1920 but first
conceived by Wiggers in 1915 Atria act as PRIMER PUMPS for
ventricles & ventricles provide major
source of power for moving the blood
through the vascular system.
■ Initiated by spontaneous generation of
AP in SA node (located in the superior lateral wall of
the right atrium near the opening of the superior vena cava)
The document summarizes key aspects of cardiac physiology including the cardiac cycle, myocardial action potential, coronary circulation, and jugular venous pulse (JVP). It describes the electrical and mechanical events of the heart during one cardiac cycle as represented by an electrocardiogram (ECG) and pressures. It also discusses the anatomy and regulation of coronary blood flow to meet metabolic demand of the myocardium.
The document summarizes the cardiac cycle, including:
(1) It describes the four main events - atrial systole, ventricular systole, ventricular diastole, and atrial diastole.
(2) It outlines the pressure and blood flow changes that occur in the heart chambers and valves during each phase of the cycle.
(3) It examines the corresponding electrocardiogram changes and heart sounds that occur with each phase of the cardiac cycle.
The cardiac cycle consists of five main mechanical events: late diastole, atrial systole, isovolumetric ventricular contraction, ventricular ejection, and isovolumetric ventricular relaxation. During late diastole, the atrioventricular valves are open and the ventricles fill passively with blood from the atria. Atrial systole then provides a small, additional filling of the ventricles before they contract. Isovolumetric contraction occurs as the ventricles contract without a change in volume prior to the opening of the semilunar valves. Ventricular ejection follows as the ventricles pump blood into the arteries. Isovolumetric relaxation happens as the ventricles relax without a
CARDIAC CYCLE-The cardiac cycle is the performance of the human heart from th...zaaprotta
The cardiac cycle refers to all of the events that occur from the beginning of one heartbeat to the beginning of the next and can be divided into two parts: a period of relaxation known as diastole and a period of contraction known as systole.
The document summarizes the cardiac cycle, including the electrical and mechanical events of the heart. It describes the conduction system that controls heart rhythm, including the sinoatrial node as the pacemaker. The main phases of the cardiac cycle are described in detail: atrial systole, isovolumetric contraction, ejection, isovolumetric relaxation, and ventricular filling. Pressure values for the different chambers are also provided. The coordination of these electrical and mechanical events ensures effective pumping of blood throughout the cardiovascular system.
The cardiac cycle consists of electrical, mechanical, and hemodynamic changes that occur from one heartbeat to the next. It begins with an electrical impulse originating in the sinus node that travels through the heart, causing atrial and ventricular contraction. This leads to three main phases: 1) Isovolumic contraction as ventricular pressure rises, 2) Ejection as blood is pumped out of the ventricles into the arteries, and 3) Isovolumic relaxation as pressure falls before ventricles refill. The cycle is completed by rapid and slow ventricular filling before the next impulse begins the cycle again. The precise timing and coordination of these electrical and mechanical events allow the heart to efficiently pump blood to the body.
The electrocardiogram (EKG) below the diagram shows the corresponding waves with each phase of the cardiac cycle. The bottom line represents the first and second heart sounds. The cardiac cycle represents the hemodynamic and electric changes that occur in systole and diastole. It has many phases.
Def: The cardiac events that occur from
beginning of one heart beat to the beginning of
the next.
■ first assembled by Lewis in 1920 but first
conceived by Wiggers in 1915 Atria act as PRIMER PUMPS for
ventricles & ventricles provide major
source of power for moving the blood
through the vascular system.
■ Initiated by spontaneous generation of
AP in SA node (located in the superior lateral wall of
the right atrium near the opening of the superior vena cava)
The document summarizes key aspects of cardiac physiology including the cardiac cycle, myocardial action potential, coronary circulation, and jugular venous pulse (JVP). It describes the electrical and mechanical events of the heart during one cardiac cycle as represented by an electrocardiogram (ECG) and pressures. It also discusses the anatomy and regulation of coronary blood flow to meet metabolic demand of the myocardium.
The document summarizes the cardiac cycle, including:
(1) It describes the four main events - atrial systole, ventricular systole, ventricular diastole, and atrial diastole.
(2) It outlines the pressure and blood flow changes that occur in the heart chambers and valves during each phase of the cycle.
(3) It examines the corresponding electrocardiogram changes and heart sounds that occur with each phase of the cardiac cycle.
The cardiac cycle consists of five main mechanical events: late diastole, atrial systole, isovolumetric ventricular contraction, ventricular ejection, and isovolumetric ventricular relaxation. During late diastole, the atrioventricular valves are open and the ventricles fill passively with blood from the atria. Atrial systole then provides a small, additional filling of the ventricles before they contract. Isovolumetric contraction occurs as the ventricles contract without a change in volume prior to the opening of the semilunar valves. Ventricular ejection follows as the ventricles pump blood into the arteries. Isovolumetric relaxation happens as the ventricles relax without a
CARDIAC CYCLE-The cardiac cycle is the performance of the human heart from th...zaaprotta
The cardiac cycle refers to all of the events that occur from the beginning of one heartbeat to the beginning of the next and can be divided into two parts: a period of relaxation known as diastole and a period of contraction known as systole.
The document summarizes the cardiac cycle, including the electrical and mechanical events of the heart. It describes the conduction system that controls heart rhythm, including the sinoatrial node as the pacemaker. The main phases of the cardiac cycle are described in detail: atrial systole, isovolumetric contraction, ejection, isovolumetric relaxation, and ventricular filling. Pressure values for the different chambers are also provided. The coordination of these electrical and mechanical events ensures effective pumping of blood throughout the cardiovascular system.
The cardiac cycle consists of electrical, mechanical, and hemodynamic changes that occur from one heartbeat to the next. It begins with an electrical impulse originating in the sinus node that travels through the heart, causing atrial and ventricular contraction. This leads to three main phases: 1) Isovolumic contraction as ventricular pressure rises, 2) Ejection as blood is pumped out of the ventricles into the arteries, and 3) Isovolumic relaxation as pressure falls before ventricles refill. The cycle is completed by rapid and slow ventricular filling before the next impulse begins the cycle again. The precise timing and coordination of these electrical and mechanical events allow the heart to efficiently pump blood to the body.
The electrocardiogram (EKG) below the diagram shows the corresponding waves with each phase of the cardiac cycle. The bottom line represents the first and second heart sounds. The cardiac cycle represents the hemodynamic and electric changes that occur in systole and diastole. It has many phases.
The cardiac cycle describes the sequence of events in one heartbeat. It involves contraction of the myocardium which generates pressure changes, causing blood to flow from areas of high pressure to low pressure through the heart's valves. The cycle includes atrial systole where the atria contract and push blood into the ventricles, followed by isovolumetric contraction where the ventricles contract but their volume does not change as the valves close. Then rapid ejection occurs as the ventricle pressure rises above the arteries and the valves open, pushing blood out of the heart. Reduced ejection follows as blood flows more slowly out of the ventricles until the valves close, ending ventricular systole.
The cardiac cycle describes the sequence of events in one heartbeat. It involves contraction of the myocardium which generates pressure changes, causing blood to flow from areas of high pressure to low pressure through the heart's valves. The cycle includes atrial systole where the atria contract and push blood into the ventricles, followed by isovolumetric contraction where the ventricles contract but their volume does not change as pressure builds, then rapid ejection when pressure rises enough for the valves to open and blood is ejected from the ventricles into the arteries. This is followed by reduced ejection as blood flow slows before the valves close, ending ventricular systole.
The cardiac cycle describes the repeating pattern of heart contraction and relaxation during one heartbeat. It consists of two phases: systole, when the heart contracts, and diastole, when the heart relaxes and fills with blood. The cardiac cycle involves precise coordination between electrical signals, pressure changes within the heart chambers, opening and closing of valves, and the sounds produced. Key events include atrial systole, ventricular systole with isovolumetric contraction and ejection phases, isovolumetric relaxation, and ventricular filling. The cycle repeats with each heartbeat to pump blood through the body.
1. The cardiac cycle describes the sequence of events in the heart from the beginning of one heart contraction to the next. It has two main phases: ventricular systole and ventricular diastole.
2. During ventricular systole, which lasts 0.3 seconds, the ventricles contract and eject blood. This phase has three periods: isovolumic contraction, rapid ejection, and reduced ejection.
3. Ventricular diastole lasts 0.5 seconds and allows the ventricles to relax and fill with blood. It includes isovolumic relaxation, rapid filling, slow filling, and atrial systole.
4. The cardiac cycle is highly coordinated with electrical and
Describe events in cardiac cycle.
Describe atrial, ventricular and aortic pressure changes during cardiac cycle.
Describe the changes in ventricular volume & stroke volume during cardiac cycle.
Relate ECG changes to the phases of cardiac cycle.
Describe the functions of cardiac valves and relate their state to the production of heart sounds during cardiac cycle.
med_students0
The lecture objectives are to describe various cardiac arrhythmias including their pathophysiological causes, mechanisms of cardiac block, origins of ectopic foci, common arrhythmias and related ECG changes. The document then discusses the normal cardiac conduction system and provides detailed explanations of sinus rhythm, heart rate calculation, abnormal rhythms involving conduction blocks, premature contractions from different locations, ventricular fibrillation, ventricular tachycardia, atrial fibrillation, atrial flutter and multifocal atrial tachycardia. Potential causes and treatments of different arrhythmias are also outlined.
The cardiac cycle describes the sequence of events that occur with each heartbeat. It begins with spontaneous depolarization of the sinoatrial node which generates an electrical impulse that causes the atria to contract. There is a brief delay before the impulse reaches the ventricles allowing the atria to empty blood into the ventricles. The ventricles then contract ejecting blood from the heart.
The jugular venous pulse reflects right atrial pressure changes during the cardiac cycle. It normally displays 3 positive waves and 2 negative troughs that can be related to timing of heart sounds on auscultation. Abnormal jugular venous waveforms provide clues about underlying cardiac abnormalities such as increased right heart pressures or valvular
This document discusses the cardiac cycle and its various phases. It begins with a brief history of understanding of the cardiac cycle. It then defines the cardiac cycle as representing the electrical and mechanical events from the beginning of one heartbeat to the next.
The cardiac cycle is described in detail through different sections. It discusses the atrial cycle, ventricular cycle, phases of the ventricular cycle through a Wiggers diagram, heart sounds, physiological vs cardiological systole and diastole, and concludes with explaining the ventricular pressure-volume loop. Various phases of the atrial and ventricular cycles are explained in detail through pressure curves and timing.
The document describes the cardiac cycle, which consists of atrial systole, isovolumetric contraction, rapid ejection, reduced ejection, isovolumetric relaxation, rapid ventricular filling, and reduced ventricular filling. During atrial systole, the atria contract and push a small amount of additional blood into the ventricles. Isovolumetric contraction occurs as the ventricles contract but their volume does not change. Rapid ejection follows as the semilunar valves open and blood is rapidly pumped out. During reduced ejection, blood ejects more slowly until pressure in the ventricles falls below arterial pressure. Isovolumetric relaxation happens as the ventricles relax but their volume does not change. Then
The document discusses the history and development of electrocardiography (ECG/EKG) and summarizes the key aspects of ECG interpretation. Some of the main points covered include:
- The key individuals who contributed to the development of ECG, from its initial discovery in the 1800s to modern applications.
- The components of a standard 12-lead ECG, including the waves, intervals, leads, and their normal values and appearances.
- Common ECG abnormalities such as arrhythmias, conduction blocks, hypertrophy, ischemia, and injury patterns.
- Guidelines for proper ECG acquisition and systematic interpretation.
The document provides information on ECG basics and heart physiology. It discusses the structure of cardiac muscle and how the heart maintains pumping. Key points include the syncytial nature of cardiac muscle, differences in resting membrane potential and action potential compared to skeletal muscle, and the heart's ability for auto-rhythmicity. Factors affecting the cardiac action potential include potassium, calcium, and sodium concentrations as well as temperature. Excitation-contraction coupling and the duration of atrial and ventricular contraction are also covered. The document then discusses the cardiac cycle, heart sounds, regulation of pumping via the Frank-Starling mechanism and autonomic innervation, and the effects of autonomic stimulation. Special topics include the conductive system
Interpretation of normal 12 leads electrocardiogram & someHarihar Adhikari
This document provides an overview of interpreting normal 12-lead electrocardiograms and some abnormal findings. It discusses the electrical conduction system of the heart and how depolarization spreads. Key aspects of a normal ECG are described, including intervals, waves, and what each lead measures. Common abnormalities are explained like arrhythmias, conduction defects, myocardial infarction, and hypertrophy. The diagnostic value of ECGs for conditions like coronary artery disease and various cardiac arrhythmias is also covered.
The cardiac cycle consists of systole and diastole. During systole, the heart contracts and pumps blood, while during diastole the heart relaxes and fills with blood. The cycle takes approximately 0.8 seconds and is initiated by the sinoatrial node firing an electrical impulse. Key events in the cycle include atrial systole, isovolumic contraction, rapid ejection, slow ejection, isovolumic relaxation, and rapid and slow ventricular filling. Diseases associated with abnormalities in the cardiac cycle include angina, congestive heart failure, myocardial infarction, and valve disorders like mitral stenosis.
This presentation describes the normal cardiac cycle referred to pressure-time curves for aorta, the left ventricle and left atrium, the electrocardiogram and the phonocardiogram.
This document provides a 10 step process for interpreting ECGs:
1. Identify patient information and ensure proper calibration
2. Analyze rhythm, rate, axis
3. Examine PR interval and segments
4. Assess QRS morphology, duration, and amplitude
5. Evaluate ST segments and T waves
6. Measure QT interval
7. Interpret signs of ischemia, injury, or infarction
8. Consider additional conditions like electrolyte imbalances or cardiac abnormalities
9. Review dysrhythmia examples
10. Note any miscellaneous findings like pericarditis or right bundle branch block
The document discusses cardiac muscle and the cardiac cycle. It provides details on:
- Cardiac muscle histology and action potential, including ion channels involved
- The cardiac cycle and components such as atrial systole, ventricular ejection, and filling phases
- How the cardiac cycle is coordinated by the conduction system and regulated by the autonomic nervous system
- Key concepts like the Frank-Starling law of the heart and factors affecting cardiac performance
Valves in the heart allow blood to flow in only one direction. The atrioventricular valves between the upper and lower chambers prevent backflow. The semilunar valves at the exits of the ventricles are more robust to withstand back pressure. Damage to one ventricle can cause imbalance if the other cannot keep up with the flow rate.
This document discusses cardiac rhythms and electrocardiogram (ECG) interpretation. It provides normal and abnormal heart rate ranges for the sinoatrial node, atrioventricular node, and bundle branches. It also describes ECG patterns such as sinus rhythm, arrhythmias, conduction abnormalities, myocardial infarction, and other cardiac conditions. Measurement techniques for rate, intervals, and waveform analysis on ECG strips are outlined.
The document summarizes the cardiac cycle and related events. It describes:
1) Atrial pressure changes including a, c, and v waves that occur during atrial systole and ventricular contraction and filling.
2) The relationship between the ECG and cardiac cycle, with the P wave occurring during atrial depolarization, the QRS complex starting ventricular contraction, and the T wave coinciding with ventricular relaxation.
3) The timing of events in the right and left sides of the heart, with right atrial contraction preceding left atrial contraction and right ventricular ejection beginning before left ventricular ejection.
4) Key metrics like end diastolic volume, stroke volume, end systolic volume
The cardiac cycle describes the sequence of events in one heartbeat. It involves contraction of the myocardium which generates pressure changes, causing blood to flow from areas of high pressure to low pressure through the heart's valves. The cycle includes atrial systole where the atria contract and push blood into the ventricles, followed by isovolumetric contraction where the ventricles contract but their volume does not change as the valves close. Then rapid ejection occurs as the ventricle pressure rises above the arteries and the valves open, pushing blood out of the heart. Reduced ejection follows as blood flows more slowly out of the ventricles until the valves close, ending ventricular systole.
The cardiac cycle describes the sequence of events in one heartbeat. It involves contraction of the myocardium which generates pressure changes, causing blood to flow from areas of high pressure to low pressure through the heart's valves. The cycle includes atrial systole where the atria contract and push blood into the ventricles, followed by isovolumetric contraction where the ventricles contract but their volume does not change as pressure builds, then rapid ejection when pressure rises enough for the valves to open and blood is ejected from the ventricles into the arteries. This is followed by reduced ejection as blood flow slows before the valves close, ending ventricular systole.
The cardiac cycle describes the repeating pattern of heart contraction and relaxation during one heartbeat. It consists of two phases: systole, when the heart contracts, and diastole, when the heart relaxes and fills with blood. The cardiac cycle involves precise coordination between electrical signals, pressure changes within the heart chambers, opening and closing of valves, and the sounds produced. Key events include atrial systole, ventricular systole with isovolumetric contraction and ejection phases, isovolumetric relaxation, and ventricular filling. The cycle repeats with each heartbeat to pump blood through the body.
1. The cardiac cycle describes the sequence of events in the heart from the beginning of one heart contraction to the next. It has two main phases: ventricular systole and ventricular diastole.
2. During ventricular systole, which lasts 0.3 seconds, the ventricles contract and eject blood. This phase has three periods: isovolumic contraction, rapid ejection, and reduced ejection.
3. Ventricular diastole lasts 0.5 seconds and allows the ventricles to relax and fill with blood. It includes isovolumic relaxation, rapid filling, slow filling, and atrial systole.
4. The cardiac cycle is highly coordinated with electrical and
Describe events in cardiac cycle.
Describe atrial, ventricular and aortic pressure changes during cardiac cycle.
Describe the changes in ventricular volume & stroke volume during cardiac cycle.
Relate ECG changes to the phases of cardiac cycle.
Describe the functions of cardiac valves and relate their state to the production of heart sounds during cardiac cycle.
med_students0
The lecture objectives are to describe various cardiac arrhythmias including their pathophysiological causes, mechanisms of cardiac block, origins of ectopic foci, common arrhythmias and related ECG changes. The document then discusses the normal cardiac conduction system and provides detailed explanations of sinus rhythm, heart rate calculation, abnormal rhythms involving conduction blocks, premature contractions from different locations, ventricular fibrillation, ventricular tachycardia, atrial fibrillation, atrial flutter and multifocal atrial tachycardia. Potential causes and treatments of different arrhythmias are also outlined.
The cardiac cycle describes the sequence of events that occur with each heartbeat. It begins with spontaneous depolarization of the sinoatrial node which generates an electrical impulse that causes the atria to contract. There is a brief delay before the impulse reaches the ventricles allowing the atria to empty blood into the ventricles. The ventricles then contract ejecting blood from the heart.
The jugular venous pulse reflects right atrial pressure changes during the cardiac cycle. It normally displays 3 positive waves and 2 negative troughs that can be related to timing of heart sounds on auscultation. Abnormal jugular venous waveforms provide clues about underlying cardiac abnormalities such as increased right heart pressures or valvular
This document discusses the cardiac cycle and its various phases. It begins with a brief history of understanding of the cardiac cycle. It then defines the cardiac cycle as representing the electrical and mechanical events from the beginning of one heartbeat to the next.
The cardiac cycle is described in detail through different sections. It discusses the atrial cycle, ventricular cycle, phases of the ventricular cycle through a Wiggers diagram, heart sounds, physiological vs cardiological systole and diastole, and concludes with explaining the ventricular pressure-volume loop. Various phases of the atrial and ventricular cycles are explained in detail through pressure curves and timing.
The document describes the cardiac cycle, which consists of atrial systole, isovolumetric contraction, rapid ejection, reduced ejection, isovolumetric relaxation, rapid ventricular filling, and reduced ventricular filling. During atrial systole, the atria contract and push a small amount of additional blood into the ventricles. Isovolumetric contraction occurs as the ventricles contract but their volume does not change. Rapid ejection follows as the semilunar valves open and blood is rapidly pumped out. During reduced ejection, blood ejects more slowly until pressure in the ventricles falls below arterial pressure. Isovolumetric relaxation happens as the ventricles relax but their volume does not change. Then
The document discusses the history and development of electrocardiography (ECG/EKG) and summarizes the key aspects of ECG interpretation. Some of the main points covered include:
- The key individuals who contributed to the development of ECG, from its initial discovery in the 1800s to modern applications.
- The components of a standard 12-lead ECG, including the waves, intervals, leads, and their normal values and appearances.
- Common ECG abnormalities such as arrhythmias, conduction blocks, hypertrophy, ischemia, and injury patterns.
- Guidelines for proper ECG acquisition and systematic interpretation.
The document provides information on ECG basics and heart physiology. It discusses the structure of cardiac muscle and how the heart maintains pumping. Key points include the syncytial nature of cardiac muscle, differences in resting membrane potential and action potential compared to skeletal muscle, and the heart's ability for auto-rhythmicity. Factors affecting the cardiac action potential include potassium, calcium, and sodium concentrations as well as temperature. Excitation-contraction coupling and the duration of atrial and ventricular contraction are also covered. The document then discusses the cardiac cycle, heart sounds, regulation of pumping via the Frank-Starling mechanism and autonomic innervation, and the effects of autonomic stimulation. Special topics include the conductive system
Interpretation of normal 12 leads electrocardiogram & someHarihar Adhikari
This document provides an overview of interpreting normal 12-lead electrocardiograms and some abnormal findings. It discusses the electrical conduction system of the heart and how depolarization spreads. Key aspects of a normal ECG are described, including intervals, waves, and what each lead measures. Common abnormalities are explained like arrhythmias, conduction defects, myocardial infarction, and hypertrophy. The diagnostic value of ECGs for conditions like coronary artery disease and various cardiac arrhythmias is also covered.
The cardiac cycle consists of systole and diastole. During systole, the heart contracts and pumps blood, while during diastole the heart relaxes and fills with blood. The cycle takes approximately 0.8 seconds and is initiated by the sinoatrial node firing an electrical impulse. Key events in the cycle include atrial systole, isovolumic contraction, rapid ejection, slow ejection, isovolumic relaxation, and rapid and slow ventricular filling. Diseases associated with abnormalities in the cardiac cycle include angina, congestive heart failure, myocardial infarction, and valve disorders like mitral stenosis.
This presentation describes the normal cardiac cycle referred to pressure-time curves for aorta, the left ventricle and left atrium, the electrocardiogram and the phonocardiogram.
This document provides a 10 step process for interpreting ECGs:
1. Identify patient information and ensure proper calibration
2. Analyze rhythm, rate, axis
3. Examine PR interval and segments
4. Assess QRS morphology, duration, and amplitude
5. Evaluate ST segments and T waves
6. Measure QT interval
7. Interpret signs of ischemia, injury, or infarction
8. Consider additional conditions like electrolyte imbalances or cardiac abnormalities
9. Review dysrhythmia examples
10. Note any miscellaneous findings like pericarditis or right bundle branch block
The document discusses cardiac muscle and the cardiac cycle. It provides details on:
- Cardiac muscle histology and action potential, including ion channels involved
- The cardiac cycle and components such as atrial systole, ventricular ejection, and filling phases
- How the cardiac cycle is coordinated by the conduction system and regulated by the autonomic nervous system
- Key concepts like the Frank-Starling law of the heart and factors affecting cardiac performance
Valves in the heart allow blood to flow in only one direction. The atrioventricular valves between the upper and lower chambers prevent backflow. The semilunar valves at the exits of the ventricles are more robust to withstand back pressure. Damage to one ventricle can cause imbalance if the other cannot keep up with the flow rate.
This document discusses cardiac rhythms and electrocardiogram (ECG) interpretation. It provides normal and abnormal heart rate ranges for the sinoatrial node, atrioventricular node, and bundle branches. It also describes ECG patterns such as sinus rhythm, arrhythmias, conduction abnormalities, myocardial infarction, and other cardiac conditions. Measurement techniques for rate, intervals, and waveform analysis on ECG strips are outlined.
The document summarizes the cardiac cycle and related events. It describes:
1) Atrial pressure changes including a, c, and v waves that occur during atrial systole and ventricular contraction and filling.
2) The relationship between the ECG and cardiac cycle, with the P wave occurring during atrial depolarization, the QRS complex starting ventricular contraction, and the T wave coinciding with ventricular relaxation.
3) The timing of events in the right and left sides of the heart, with right atrial contraction preceding left atrial contraction and right ventricular ejection beginning before left ventricular ejection.
4) Key metrics like end diastolic volume, stroke volume, end systolic volume
Similar to Cardiac_cycle_presentation (1).ppt (20)
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Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
2. Cardiac Cycle
Def: The cardiac events that occur from
beginning of one heart beat to the beginning
of the next.
first assembled by Lewis in 1920 but first
conceived by Wiggers in 1915
3. Atria act as PRIMER PUMPS for ventricles &
ventricles provide major source of power for
moving the blood through the vascular
system.
Initiated by spontaneous generation of AP in
SA node (located in the superior lateral wall of the right atrium
near the opening of the superior vena cava)
5. 1. AV nodal delay of 0.09 sec before the impulse
enters the penetrating portion of the A-V bundle
2. A final delay of another 0.04 sec occurs mainly in
this penetrating A-V bundle
total delay in the A-V nodal and A-V bundle
system is about 0.13 sec
A total delay of 0.16 sec occurs before the excitatory
signal finally reaches the contracting muscle of the
ventricles from its origin in sinus node.
6. Delay in AV node (0.13sec)
Why delay?
Diminished numbers of gap junctions Between successive
cells in the conducting pathways.
Significance?
Delay allows time for the atria to empty their blood into the
ventricles before ventricular contraction begins
7. Rapid Transmission in the Purkinje System
(1.5 to 4.0 m/sec)
i.e.
• About 6x that in ventricular muscle
• About 150x that in A-V nodal fibers
allowing almost instantaneous transmission
of the cardiac impulse throughout the
ventricular muscle
(B/c of very high level of permeability of the gap junctions)
10. Cardiac cycle – basically describes…
1. Pressure
2. Volume, and
3. Flow phenomenon
in ventricles as a function of time
11. Basics
1 Beat = 0.8 sec (800 msec)
Systole = 0.3 sec
Diastole = 0.5 sec
In tachycardia, Diastolic phase decreases more than
systolic phase
12. Phases of cardiac cycle
LV Contraction
Isovolumic contraction (b)
Maximal ejection (c)
LV Relaxation
Start of relaxation and reduced ejection (d)
Isovolumic relaxation (e)
LV Filling
Rapid phase (f)
Slow filling (diastasis) (g)
Atrial systole or booster (a)
13. Time Intervals
Total ventricular systole 0.3 sec
Isovolumic contraction (b) 0.05 sec (0.015sec for RV)
Maximal ejection (c) 0.1 sec
Reduced ejection (d) 0.15 sec
Total ventricular diastole 0.5 sec
Isovolumic relaxation (e) 0.1 sec
Rapid filling phase (f) 0.1 sec
Slow filling (diastasis) (g) 0.2 sec
Atrial systole or booster (a) 0.1 sec
GRAND TOTAL (Syst+Diast) = 0.8 sec
14. Physiologic Versus Cardiologic Systole and
Diastole
PHYSIOLOGIC
SYSTOLE
CARDIOLOGIC
SYSTOLE
Isovolumic
contraction
Maximal
ejection
From M1 to A2,
including:
Major part of
isovolumic contraction
Maximal ejection
Reduced ejection
PHYSIOLOGIC
DIASTOLE
CARDIOLOGIC
DIASTOLE
Reduced
ejection
Isovolumic
relaxation
Filling phases
A2-M1 interval
(filling phases included)
20msec
Physiological systole
15. cardiologic systole, demarcated by heart
sounds rather than by physiologic events, starts
fractionally later than physiologic systole and
ends significantly later.
Cardiologic systole> physiologic systole
17. Atrial Systole
A-V Valves Open; Semilunar Valves Closed
Blood normally flows
continually from great
veins into atria
80% flows directly thr
atria into ventricle
before the atria
contracts.
20% of filling of
ventricles – atrial
contraction
Atrial contraction is
completed before the
ventricle begins to
contract.
18. Atrial contraction normally accounts for about
10%-15% of LV filling at rest, however, At
higher heart rates, atrial contraction may
account for up to 40% of LV filling referred to
as the "atrial kick”
The atrial contribution to ventricular filling
varies inversely with duration of ventricular
diastole and directly with atrial contractility
19. Atrial Systole
Pressures & Volumes
‘ a ‘ wave – atrial contraction,
when atrial pressure rises.
Atrial pressure drops when
the atria stop contracting.
20. After atrial contraction is complete
LVEDV typically about 120 ml (preload)
End-diastolic pressures of
LV = 8-12 mmHg and
RV = 3-6 mmHg
AV valves floats upward (pre-position)
21. Abnormalities of “a” wave
Elevated a wave
Tricuspid stenosis
Decreased ventricular compliance (ventricular failure, pulmonic valve
stenosis, or pulmonary hypertension)
Cannon a wave
Atrial-ventricular asynchrony (atria contract against a closed tricuspid valve)
complete heart block, following premature ventricular contraction,
during ventricular tachycardia, with ventricular pacemaker
Absent a wave
Atrial fibrillation or atrial standstill
Atrial flutter
22. Why blood does not flow back in to SVC/PV
while atria contracting, even though no valve
in between?
Wave of contraction through the atria moves
toward the AV valve thereby having a
"milking effect."
Inertial effects of the venous return.
23. Atrial Systole
ECG
p wave – atrial depolarization
impulse from SA node results in depolarization &
contraction of atria ( Rt before Lt )
PR segment – isoelectric line as depolarization
proceeds to AV node.
This brief pause before contraction allows the
ventricles to fill completely with blood.
24. Atrial Systole
Heart Sounds
S4 (atrial or presystolic gallop) - atrial emptying after forcible
atrial contraction.
appears at 0.04 s after the P wave (late diastolic)
lasts 0.04-0.10 s
Caused by vibration of ventricular wall during rapid
atrium emptying into non compliant ventricle
25. Causes of S4
Physiological;
>60yrs (Recordable, not audible)
Pathological;
All causes of concentric LV/RV hypertrophy
Coronary artery disease
Acute regurgitant lesions
An easily audible S4 at any age is generally abnormal.
26. Clinical Facts about S4
In contrast to S3, which may mean ventricular
failure, the presence of S4 does not indicates heart
failure. It only signify “hardworking ventricle”.
The presence of S4 correlate with a gradient of at
least 50mmHg across LVOT in suspected LVOT
obstruction.
(This correlation is not applicable in HCM)
27. In setting of MI, an audible S4 indicates that at least
10% of myocardium is at jeopardy.
In presence of Shock, S4 indicates that hypovolemia
is unlikely as PCWP will be >18mmHg.
S4 can be heard when RVEDP >12mmHg on Rt or
LVEDP > 15mmHg on Lt side. If EDP is very high i.e.
>25 mmHg, S4 may be absent b/c of insufficient
atrial functions.
28. JVP: x descent
Prominent x descent
1 Cardiac tamponade
2 Constrictive pericarditis
3 Right ventricular ischemia with preservation of atrial
contractility
Blunted x descent
1 Atrial fibrillation
2 Right atrial ischemia
30. Isovolumetric Contraction
Pressure & Volume Changes
The AV valves close when the
pressure in the ventricles (red)
exceeds the pressure in the
atria (yellow).
As the ventricles contract
isovolumetrically -- their volume
does not change (white) -- the
pressure inside increases,
approaching the pressure in the
aorta and pulmonary arteries
(green).
JVP: c wave- d/t Right
ventricular contraction pushes
the tricuspid valve into the
atrium and increases atrial
pressure, creating a small wave
into the jugular vein. It is
normally simultaneous with the
carotid pulse.
31. Ventricular chamber geometry changes considerably as the
heart becomes more spheroid in shape; circumference
increases and atrial base-to-apex length decreases.
Early in this phase, the rate of pressure development becomes
maximal. This is referred to as maximal dP/dt.
Ventricular pressure increases rapidly
LV ~10mmHg to ~ 80mmHg (~Aortic pressure)
RV ~4 mmHg to ~15mmHg (~Pulmonary A pressure)
At this point, semilunar (aortic and pulmonary) valves open against the
pressures in the aorta and pulmonary artery
32. LV Torsion
Figure: Schematic Drawing of LV Torsion
The image on the left shows the myofiber directions. Solid lines epicardial region; dashed
lines endocardial region. The image on the right shows untwisting.
ED end-diastole; ES end-systole; LV left ventricle.
(J Am Coll Cardiol Img 2009;2:648–55)
left-handed helix in subepicardium right-handed helix in subendocardium
34. Isovolumetric Contraction
Heart Sounds
S1 is d/t closure and after
vibrations of AV Valves. (M1
occurs with a definite albeit 20
msec delay after the LV-LA
pressure crossover.)
S1 is normally split (~0.04 sec)
because mitral valve closure
precedes tricuspid closure.
(Heard in only 40% of normal individuals)
35. S1 heart sound
low pitch and relatively long-lasting
lasts ~ 0.12-0.15 sec
frequency ~ 30-100 Hz
appears 0.02 – 0.04 sec after the
beginning of the QRS complex
36. Some Clinical facts about S1
S1 is a relatively prolonged, low frequency
sound, best heard at apex.
Normally split of S1 (~40%)is heard only at
tricuspid area.(As tricuspid component is
heard only here.)
If S1 is equal to or higher in intensity than S2
at base, S1 is considered accentuated.
37. Variable intensity of S1 and jugular venous pulse are
highly specific and sensitive in the diagnosis of
ventriculoatrial dissociation during VT, and is helpful
in distinguishing it from supraventricular tachycardia
with aberration.
Value of physical signs in the diagnosis of ventricular tachycardia. C J Garratt, M J
Griffith, G Young, N Curzen, S Brecker, A F Rickards and A J Camm, Circulation.
1994;90:3103-3107
38. Causes of
Loud S1 Soft S1
1. Exercise
2. Emotinal excitibility
3. Mitral stenosis
4. Hyperkinetic circulation
5. Atrial septal defect
6. Sinus tachycardia
7. Short P-R interval
1. Sinus tachycardia
2. Mitral regurgitation
3. Severe AR
4. Ventricular aneurysm
5. Acute MI
6. Myocarditis
7. Cardiomyopathy
8. Prolonged P-R interval
9. Calcific MS
39. Ejection
Aortic and Pulmonic Valves Open; AV Valves Remain Closed
The Semilunar valves ( aortic ,
pulmonary ) open at the beginning of
this phase.
Two Phases
• Rapid ejection - 70% of the blood
ejected during the first 1/3 of ejection
• Slow ejection - remaining 30% of
the blood emptying occurs during
the latter 2/3 of ejection
40. Rapid Ejection
Pressure & Volume Changes
When ventricles continue
to contract , pressure in
ventricles exceed that of
in aorta & pul arteries &
then semilunar valves
open, blood is pumped
out of ventricles &
Ventricular vol decreases
rapidly.
42. Rapid Ejection
ECG & Heart Sounds
In rapid ejection part of the
ejection phase there no
specific ECG changes / heart
sounds heard.
43. Slow Ejection
Aortic and Pulmonic Valves Open; AV Valves
Remain Closed
Blood flow from the left
ventricle to the aorta
rapidly diminishes but
is maintained by aortic
recoil, the “Windkessel
effect “
At the end of ejection,
the semilunar valves
close. This marks the
end of ventricular
systole mechanically.
44. Slow Ejection
ECG & Heart Sounds
T wave – slightly
before the end of
ventricular
contraction
it is d/t ventricular
repolarization
heart sounds : none
45. Beginning of Diastole
Isovolumetric relaxation
All Valves Closed
At the end of systole, ventricular relaxation
begins, allowing intraventricular pressures to
decrease rapidly (LV from 100mmHg to
20mmHg & RV from 15mmHg to 0mmHg),
aortic and pulmonic valves abruptly close (aortic
precedes pulmonic) causing the second heart
sound (S2)
Valve closure is associated with a small backflow
of blood into the ventricles and a characteristic
notch (incisura or dicrotic notch) in the aortic
and pulmonary artery pressure tracings
After valve closure, the aortic and pulmonary
artery pressures rise slightly (dicrotic wave)
following by a slow decline in pressure
46. Isovolumetric relaxation
Volumes remain constant because all valves
are closed
volume of blood that remains in a ventricle is
called the end-systolic volume (LV ~50ml).
pressure & volume of ventricle are low in this
phase .
47. Isovolumetric relaxation
Throughout this and the
previous two phases, the
atrium in diastole has been
filling with blood on top of
the closed AV valve,
causing atrial pressure to
rise gradually
JVP - "v" wave occurs
toward end of ventricular
contraction – results from
slow flow of blood into atria
from veins while AV valves
are closed .
48. Isovolumetric relaxation
ECG & Heart Sounds
ECG : no deflections
Heart Sounds : S2 is
heard when the
semilunar vlaves
close.
A2 is heard prior to
P2 as Aortic valve
closes prior to
pulmonary valve.
49. Why A2 occurs prior to P2 ?
“Hangout interval” is longer for pulmonary side
(~80msec),compared to aortic side (~30msec).
Hangout interval is the time interval from crossover of
pressures (ventricle with their respective vessel) to the
actual occurrence of sound.
Due to lower pressure and higher distensibility,
pulmonary artery having longer hangout interval
causing delayed PV closure and P2.
50. S2 heart sound
Appears in the terminal period of the T
wave
lasts 0.08 – 0.12s
51. Some clinical facts about S2
Normal split: Two components heard during
inspiration and is single sound during expiration.
(A2-P2 ~20- 50 msec in inspiration)
Clinically split is defined as wide, if it is heard well in
standing position, in expiration (normally not heard as the
split is 15 msec, which can not be heard by human ears)
Single S2: absence of audible split in either phase of
respiration.
52. Fixed split: two components fails to move
with respiration.
Reverse split: Inaudible split during
inspiration and audible split during expiration.
(recognized by wider split in expiration)
53. Common causes of wide split S2
RBBB
Sev PAH
ASD
Idiopathic dilatation of pul artery
Sev right heart failure
Moderate to severe PS
Severe MR
Normal variant
54. Common causes of wide fixed split S2
ASD
All causes of wide split with associated
severe right ventricular failure.
55. Common causes of single S2
Truncus arteriosus
Pulmonary atresia
Aortic atresia
TGA
AS, PS
Single loud P2 in extreme PAH
56. Causes of reverse split S2
LBBB
RV pacing
RV ectopy
Severe AS
Acute MI
WPW type B
Severe TR
Aneurysm of ascending aorta
Severe systemic hypertension
57. JVP: V wave
Elevated v wave
1 Tricuspid regurgitation
2 Right ventricular heart failure
3 Reduced atrial compliance (restrictive myopathy)
a wave equal to v wave
1 Tamponade
2 Constrictive pericardial disease
3 Hypervolemia
58. Rapid Inflow ( Rapid Ven. Filling)
A-V Valves Open
Once AV valves are open the
blood that has accumulated
in atria flows into the
ventricle.
59. Rapid Inflow
Volume changes
Despite the inflow of blood from
the atria, intraventricular
pressure continues to briefly fall
because the ventricles are still
undergoing relaxation
JVP: Seen as y-descent.
60. Rapid Inflow ( Rapid Ven. Filling)
ECG & Heart Sounds
ECG : no deflections
Heart sounds : S3 is heard,
lasts 0.02-0.04 sec
(represent tensing of chordae
tendineae and AV ring during
ventricular relaxation and filling)
Whatever the mechanism, a
sudden inherent limitation in
the long axis filling movement
of the LV is consistently
observed.
61. Clinical facts about S3
In presence of HF, S3 correlates well with
ventricular end diastolic pressure and is
usually >25mmHg on left side.
Right sided S3 correlate well with rapid y
descend in neck veins.
Normal A2-S3 interval is between 120-160
msec.
62. Correlates of S3
Anatomical Dilated ventricle
Functional Systolic dysfunction
(EF<40%)
Hemodynamics
LVEDP
Cardiac index
Symptoms
Doppler flow across AV
valve
>25 mmHg
<2 L/min/m2
Dyspnea, PND, Orthopnea
Tall E wave compare to A wave
63. Gallop rhythm
A gallop rhythm is a grouping of three heart sounds that
together sound like hoofs of a galloping horse.
Protodiastolic gallop or ventricular gallop or S3 gallop
addition of an S3 to the physiological S1 and S2 creates a
three-sound sequence, S1-S2-S3.
Presystolic gallop rhythm or atrial gallop
addition of an S4 to the physiological S1 and S2 creates a
three-sound sequence, S4-S1-S2.
(during tachycardia S4-S1 can fuse, producing a summation gallop )
64. Causes of S3
Physiological: Childrens & young adults <40 yrs (nearly 25%)
(Not heard in normal infants & adult >40 yrs.)
Pathological:
Ventricular failure
Hyperkinetic state (anemia, thyrotoxicosis, beri-beri)
MR, TR
AR, PR
Systemic AV fistula
65. JVP: y descent
Prominent y descent
1 Constrictive pericarditis
2 Restrictive myopathies
3 Tricuspid regurgitation
Blunted y descent
1 Tamponade
2 Right ventricular ischemia
3 Tricuspid stenosis
69. The Lewis or wiggers cycle, Guyton & Hall. Textbook of Medical Physiology, 11th Edition
70. Volumes
End diastolic vol : During diastole, filling of
ventricle increases vol of each ventricle to
~ 110 -120 ml
Stroke Vol : amount of blood pumped out of
ventricle during systole. ~ 70 ml
End systolic vol : the remaining amount of
blood in ventricle after the systole. ~40 -50
ml
72. RV v/s LV
Rt Ventricular
• Pressure wave 1/5th
• dp/dt is less
• Isovolumic contraction &
relaxation phases are
short.
73. Timing of Cardiac EVENTS
1. RA start contracting before LA
2. LV start contracting before RV
3. TV open before MV,
so RV filling start before LV.
4. RV peak pressure 1/5th of LV.
5. RV outflow velocity smooth
rise & fall, while Lt side initial
peak followed by quick fall.
74. The First cardiac catheterization
Cardiac catheterization was first attempted by Dr Werner
Forssmann in 1929, at the age of 25 yrs only, when he was a
resident in a hospital at Eberswalde, near Berlin. He was his own
subject. A fellow resident who agreed to pass the catheter, got
scared and abandoned the effort by the time the catheter reached
the axilla. Forssmann completed the task himself with radiographer
holding the mirror infront of screen. Forssmann catheterize his heart
safely nine times till he had no more peripheral veins left to try. But
this was not enough to convince the medical world about the safety
of the procedure. After being banished from academics, frustrated
Forssmann settled for medical practice in a small town.
It was extensive studies with catheterization by Dr Andre
Cournand & Dr Dickinson Richard Jr. and eventually the novel prize
for physiology & medicine was awarded jointly to Forssmann, Cournand
& Richard in 1956.
The history of cardiac catheterization illustrates what
reckless idealism of youth can achieve and the long time (here 27 yrs)
might take the world to realize the value of even something of great
significance.
75. References
1. Guyton and Hall Textbook of Medical Physiology, 11th Ed.
Arthur C. Guyton, John E. Hall.
2. Cardiovascular Physiology Concepts Second Edition, Lippincott
Williams & Wilkins, 2011
3. Clinical Methods in Cardiology By Soma Raju, Second Edition,
orient longman
4. Braunwald's Heart Disease: A Textbook of Cardiovascular
Medicine, ninth edition
5. Harrison's Principles of Internal Medicine, 19th edition,
McGraw-Hill Book Co
6. Understanding Medical Physiology: A Textbook for Medical
Students: By R.L. Bijlani, M.D., RL Bijlani MD SM DSc (Hon
Causa) FAMS, S. Manjunatha,4th edition
76. 7. Medical Physiology E-Book: By Walter F. Boron, Emile
L.Boulpaep, Second Edition
8. Value of physical signs in the diagnosis of ventricular
tachycardia. C J Garratt, M J Griffith, G Young, N Curzen, S
Brecker, A F Rickards and A J Camm, Circulation.
1994;90:3103-3107
9. Color Atlas of Physiology. Stefan Silbernagel, Agamemnon
Despopoulos. 6th Edition.
10. Jacc: cardiovascular imaging, Vol.2 No. 5, 2009. May 2009:
648-55.
77. QUIZ
1. Which letter indicates the point in the
cardiac cycle that the mitral valve
opens?
A. A
B. B
C. C
D. D
78. 2. In a normal cardiac cycle , true is
A. RA ejection precedes LA ejection
B. RV contraction starts before LV contraction
C. LV ejection starts before RV ejection
D. Pulmonary valve closes before aortic valve
79. 3. Which letter in the image represents the
isovolumic contraction of the left ventricle
in the heart?
A. F
B. B
C. H
D. D
2.
80. 4. Which of the following pairs is INCORRECT?
A. P wave: atrial depolarization
B. QRS complex: ventricular depolarization
C. T wave: ventricular repolarization
D. QT interval: Measure of duration of atrial action
potential
81. 5. Isovolumic contraction phase correspond to
A. AV opening to AV Closure
B. MV closure to MV opening
C. MV closure to AV opening
D. AV opening to MV opening
82. 6. Left ventricular end-diastolic volume is:
A. 30-50 mls
B. 50-70 mls
C. 70-120 mls
D. 120-150 mls
83. 7. Prominent y descent in JVP seen in all except
A. Constrictive pericarditis
B. Restrictive cardiomyopathies
C. Tricuspid regurgitation
D. Cardiac temponade
84. 8. All are true about S3 except
A. Right sided S3 correlate well with rapid y descend
in neck veins.
B. S3 normally heard in normal infants
C. S3 usually indicates systolic dysfunction
D. S3 correlates well with ventricular end diastolic
pressure usually >25mmHg on left side
85. 9. Cardiac apex is palpable during which phase of
cardiac cycle
A. Isovolumic contraction phase
B. Isovolumic relaxation phase
C. Rapid ejection phase
D. Atrial systole phase
86. 10. Sensitive & specific sign of ventricularterial
dissociation in VT are
A. Variable intensity of S1
B. Variable jugular venous pulse
C. Both A & B
D. None of the above
87. Answers
1. Which letter indicates the point in the
cardiac cycle that the mitral valve
opens?
A. A
B. B
C. C
D. D
88. 2. In a normal cardiac cycle , true is
A. RA ejection precedes LA ejection
B. RV contraction starts before LV contraction
C. LV ejection starts before RV ejection
D. Pulmonary valve closes before aortic valve
89. 3. Which letter in the image represents the
isovolumic contraction of the left ventricle
in the heart?
A. F
B. B
C. H
D. D
2.
90. 4. Which of the following pairs is INCORRECT?
A. P wave: atrial depolarization
B. QRS complex: ventricular depolarization
C. T wave: ventricular repolarization
D. QT interval: Measure of duration of atrial action
potential
91. 5. Isovolumic contraction phase correspond to
A. AV opening to AV Closure
B. MV closure to MV opening
C. MV closure to AV opening
D. AV opening to MV opening
92. 6. Left ventricular end-diastolic volume is:
A. 30-50 mls
B. 50-70 mls
C. 70-120 mls
D. 120-150 mls
93. 7. Prominent y descent in JVP seen in all except
A. Constrictive pericarditis
B. Restrictive cardiomyopathies
C. Tricuspid regurgitation
D. Cardiac temponade
94. 8. All are true about S3 except
A. Right sided S3 correlate well with rapid y descend
in neck veins.
B. S3 normally heard in normal infants
C. S3 usually indicates systolic dysfunction
D. S3 correlates well with ventricular end diastolic
pressure usually >25mmHg on left side
95. 9. Cardiac apex is palpable during which phase of
cardiac cycle
A. Isovolumic contraction phase
B. Isovolumic relaxation phase
C. Rapid ejection phase
D. Atrial systole phase
96. 10. Sensitive & specific sign of ventricularterial
dissociation in VT are
A. Variable intensity of S1
B. Variable jugular venous pulse
C. Both A & B
D. None of the above