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echocardiography 1

Two main systems left and right
The left coronary artery (LCA) branches into: • Left Anterior Descending (LAD) -feeds anterior wall of LV, IVS, apex of heart • Left Circumflex (LCx) -feeds lateral and posterior portion of LV
Right system Right Coronary Artery (RCA) -feeds inferior wall of RV
The largest vessels in the body are Arteries and Veins
The exchange of blood occurs at Capillary level
• The spinal cord is posterior to the heart? True
Arteries have small valves inside them to assist in the movement of flow back to the heart? False
Sinoatrial (SA) Node - located at the right atrial wall; inferior to opening of SVC, - Has the highest degree of “automaticity” - Native “pacemaker” of the heart
Internodal Pathways -Three: Anterior, Middle, Posterior - Feeds RA - Bachmann’s Bundle – Feeds LA
AV Node and Bundle of His - Connections of atria to ventricles; - impulse slows for about .05 seconds to allow for ventricular filling
Bundle Branches - Right and Left bundle branches; Right feeds RV, Left feeds LV
Purkinje fibers - Penetrates into the ventricular muscle, - rapidly conducts action potential to ventricles
Normal Intracardiac Pressures RA – mean of 5 mmHg RV – 25/5 mmHg PA – 25/10 mmHg LA – mean of 10 mmHg LV – 120/10 mmHg AO – 120/80 mmHg
P wave represents atrial depolarization (discharge), followed immediately by atrial systole (contraction)
QRS Complex represents ventricular depolarization (discharge), followed immediately by ventricular systole (contraction)
T wave represents ventricular repolarization (recharge)
Isoelectric line represents no conduction or contraction
R to R interval represents 1 complete cardiac cycle
1 cardiac cycle includes two phase… Systole and diastole
R – R represents 1 complete cardiac cycle
Ventricular contraction Ventricular Systole
Ventricular Systole ECG timing: Closure of the AV valves to closure of the SV valves Defined from the R wave to the end of the T wave
Ventricular Systole Includes 3 phases Isovolumic contraction phase (time) Rapid ejection Reduced ejection
Isovolumic Contraction Period/Time (IVCT) Period begins at atrioventricular (AV) valve closure (enddiastole) and continues until semilunar (SL) valve opening
Iso volumic equal volume
Isovolumic Contraction Period/Time Heart volume is at its largest No volume change because all valves are closed during this period Duration: Valves are closed for a split second Pressure rises rapidly in preparation for SL valve opening
Rapid Ventricular Ejection Occupies the approx. first half of systole SL Valves open Rapid ejection of blood Ventricular volume rapid decreases
Reduced Ventricular Ejection Ventricular pressure begins to decline Repolarization (recharging) occurs (on the T wave)
Ventricular Diastole Ventricular filling Closure of the SL valves to closure of the AV valves.
Ventricular Diastole ECG rhythm timing: Defined from the end of the T wave to the R wave
Ventricular Diastole Includes 4 phases Isovolumic relaxation phase (time) Early rapid filling Diastasis Late filling
Isovolumic Relaxation Time/Period (IVRT) Period begins at semilunar (SL) valve closure (endsystole) and continues until atrioventricular (AV) valve opening
Isovolumic Relaxation Time/Period IVRT Heart volume is at its smallest No volume change because all valves are closed during this period Duration: Valves are closed for a split second Pressure decreases rapidly in preparation for AV valve opening
Stroke Volume (SV) Volume of blood pumped out of the ventricles during systole (per heart beat
SV timing SL valve opening-toclosure ( upstroke of S wave to end of T wave)
SV measurements Measured in milliliters (mL’s) or cubic centimeters (cc’s
SV normal range 70 – 100 mL/ heart beat
Frank-Starling Law The greater the volume of blood in the heart during diastole (filling), the more forceful the contraction, the more blood the ventricle will pump
Frank-Starling Law normal volume/pres relationship Stroke volume ~ 75 mL/beat (changes with heart rate) LVEDP ~ 8 mmHg
Frank-Starling Law Increase venous return = increased LVEDP = increased preload = increased SV and vise versa
SV Calculations End diastolic volume (EDV) – End systolic volume (ESV)
Four Determinants of Left Ventricular Function Heart Rate Preload Afterload Contractility
Heart Rate (chronotropic)
Heart Rate expressed as beats per minute (BPM)
Created by: eduarda146