Lecture 2 Heart Cycle

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Revision as of 14:51, 26 January 2011


  • Prof is worried because he hasn't received an object from students.

Contents

Heart cycle

  • There is lots of stuff to memorize here.

Objectives

Valves

  • AV valves
    • Bands of muscles called papillary muscles with chordae tendena
    • From ventricles
    • When vents contract, the papillary contract just before that too keep valves from popping overs.
    • 1-3 mmHg pops the values opne
  • Semilunar valves
    • From ventricles to vessels
    • Close passively
    • have cusps to keep blood from flowing backward into vent
    • fold out of the way when ejecting blood
    • the cusp is caught by the backflow after contraction
    • Open really easily
      • No energy spent on these or AV valves
  • 50 billion heart cycles in 70 years!
    • The heart is beautifully made.

Seven steps of the heart cycle

  • Start with atrial systole

Listening to the heart

  • Old school: put ear to chest
  • 1700s, France:
    • Didn't want physicians putting faces on bodies of the people.
    • Came up with heart trumpet
    • Evolved into stethoscope
  • 1800s, USA: a few physicians started using stethoscopes

Atrial systole

  • EKG:
    • Sturek talked about this, the p wave
    • During atrial systole, the atrial contracts, the AV node gets turned on, and we start to react the septum and the lining of the ventrical.
    • P = atria contract
    • Q & R = something going on in the ventricle
  • Mechanical event:
    • Atria has been resting and receiving blood from appropriate vessels
      • This is a passive event; the arterial and venous pressure cause the blood to enter the atria.
    • Atria contract to push blood into the ventricles
  • Valve fxn:
    • AV valves are open letting blood flow from atria to ventricles.
    • Semilunar valves are closed.
    • Papillary muscles are just beginning to contract to shut AV valves and resist the force of the soon-to-happen ventricular systole.
  • Heart sounds:
    • 4th heart sound
    • It took a long time to find the 4th sound because equipment wasn't good enough to pick up this sound.
    • So it's the fourth sound found.
    • quite little sound; often not heard in healthy normal poeople.
    • heard in heart disease and athletes with great cardiac fxn.
  • Ventricular volume:
    • Increased about 20% by atrial contraction
    • Pretty closed to size at ventricular contraction
  • End diastolic volume:
    • EDV
    • volume in ventricle at the end of atrial systole
    • Plumped ventricle up as much as it will hold
  • Atrial pressure
    • has been falling since atrial systole because there is no flow from great veins and what was in the chamber is moving into the ventricle.

Isovolumetric contraction of the ventricles

  • Here we move the pressure in the ventricle of a few mmHg to high pressure (that which needs to be generated in the arteries, 80-90 mmHg).
    • Happens in the sound of a clap: soft and flabby to rigid
    • this is pressurization of the ventricles.
  • EKG:
    • From peak of the R to the S of the QRS complex.
    • Also, just a little bit of the ST segment
  • Mechanical event:
    • Isovolumetric contraction of the ventricles
    • Papillary muscles are high tensed
    • Pressure in ventricles ins't high enough to get through pulmonary or aortic valves
    • all valves are closed
  • Valve fxn:
  • Heart sounds:
    • first heart sound
    • Heart vibrates
    • heart doesn't open valves but it tenses them and they bulge
    • Heart moves up in the chest because of such fast contraction
    • Complex noise
  • Ventricular volume:
    • hasn't changed
  • End diastolic volume:
  • Atrial pressure
    • Falling, though not much because this is such a short phase
    • lowest arterial pressure

Rapid ventricular ejection

  • The ventricles powerfully contract and overcome the pressure in the aorta and pulmonary artery.
  • EKG:
    • Continuing depolariation and contraction
    • Just a wee bit of the vent starts to repolarize
    • ST seg and a little T
  • Mechanical event:
    • vigorous pumping
    • Oxytonic contraction: forces change as it contracts
  • Valve fxn:
    • Semilunars are open
  • Heart sounds:
    • More of the first heart sound
    • Explosive ejection of blood into arteries causes sound.
    • We sometimes call this an "opening snap" of the semilunar valves.
    • Pressure is so high, it will move a crossed leg. Drop 5 lbs 3 feet and you get the same force.
  • Ventricular volume:
    • 70% of the volume's ejection volume is thrown out
    • Stroke volume = amount of blood pumped in single cycle
      • 70% of this is ejected
    • We got these names because we new about steam engines in the early 1900s when we were discovering hearts.
    • So the ventricular volume goes down 70%
  • End diastolic volume:
  • Atrial pressure
    • Peaks at the end of this cycle
    • We use peak as the stopping point of contraction


  • stopped here at minute 26:45.


Reduced ventricular contraction

  • EKG:
  • Mechanical event:
  • Valve fxn:
  • Heart sounds:
  • Ventricular volume:
  • End diastolic volume:
  • Atrial pressure

  • EKG:
  • Mechanical event:
  • Valve fxn:
  • Heart sounds:
  • Ventricular volume:
  • End diastolic volume:
  • Atrial pressure

  • EKG:
  • Mechanical event:
  • Valve fxn:
  • Heart sounds:
  • Ventricular volume:
  • End diastolic volume:
  • Atrial pressure

  • EKG:
  • Mechanical event:
  • Valve fxn:
  • Heart sounds:
  • Ventricular volume:
  • End diastolic volume:
  • Atrial pressure

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