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Oct. 16 Lecture
Part 1
40
Nursing
Graduate
10/16/2014

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Term
WHAT DOES THE PASSIVE TENSION CURVE DO WITH A VENTRICLE THAT IS STIFF?
Definition
THE SLOPE OF THE PASSIVE TENSION LINE IS GOING TO BE INCREASED. SO AN INCREASE IN THE SLOPE OF THE PASSIVE TENSION CURVE SHOWS US THAT WHAT WE HAVE IS A DECREASE IN COMPLIANCE.
Term
WHAT WILL THE SLOPE OF THE ACTIVE TENSION CURVE DO IF YOU HAVE AN INCREASE AND DECREASE IN CONTRACTILITY?
Definition
THE CURVE WILL SHIFT UPWARD AND TO THE LEFT IF I HAVE AN INCREASE IN CONTRACTILITY. IF I HAVE A DECREASE IN CONTRACTILITY THE LINE WILL SHIFT DOWN AND TO THE RIGHT.
Term
WHAT DOES PRELOAD DO WITH MITRAL STENOSIS?
Definition
IT DECREASES R/T INCREASE RESISTANCE TO FLOW INTO THE LEFT VENTRICLE.
Term
WHAT GIVES US AN INDEX FOR THE SEVERITY OF MITRAL VALVE STENOSIS?
Definition
THE DROP IN LVEDV (PRELOAD)
Term
WITH MITRAL STENOSIS WHAT IS THE FORCE OF CONTRACTION GOING TO BE AND WHY?
Definition
IT WILL BE DECREASED BECAUSE THE PRELOAD IS REDUCED.
Term
DOES THE PEAK SYSTOLIC PRESSURE STAY THE SAME WITH MITRAL STENOSIS?
Definition
NO IT DECREASES
Term
WHAT IS THE AFTERLOAD WITH MITRAL STENOSIS COMPARED TO A NORMAL HEART AND WHY?
Definition
IT STAYS THE SAME BECAUSE THE AFTERLOAD IS A FUNCTION OF THE AORTIC VALVE OR THE AORTIC PRESSURE.
Term
WHAT DOES THE SV DO WITH MITRAL STENOSIS AND WHY?
Definition
IT DECREASES. BECASUE OF THE REDUCTION IN THE LVEDV, LOWER SYSTOLIC PRESSURE GENERALLY, WHAT WE ARE GOING TO SEE IS A REDUCTION IN THE SV. THERE IS A DECREASE IN BOTH THE EDV AND ESV.
Term
FOR MITRAL STENOSIS WHICH ONE EXCEEDS THE OTHER, ESV OR EDV?
Definition
EDV
Term
WHAT IS THE COMPENSATION PROCESS OF MITRAL STENOSIS?
Definition
LEFT ATRIUM PRESSURE OVERLOAD CONCENTRIC HYPERTROPHY
Term
DESCRIBE CONCENTRIC HYPERTROPHY.
Definition
MYOCYTES DON'T REPLICATE. TO MAKE HEART MUSCLE BIGGER IT CAN HAPPEN 1 OF 2 WAYS. 1 WAY IS TO ADD MORE MYOSIN AND ACTIN TO THE MYOCYTE (WHICH ARE PROTEINS). THIS INCREASES THE DIAMETER, BUT THE LENGTH STAYS THE SAME. IF YOU HAVE MORE CROSS BRIDGES YOU CAN GENERATE MORE FORCE. THE WALL OF THE ATRIUM WILL GET THICKER AND THE LEFT ATRIAL PRESSURE WILL BE HIGHER COMPARED TO NORMAL.
Term
WHAT DO WE EXPECT TO SEE IN THE A WAVE FOR A PATIENT WITH MITRAL STENOSIS?
Definition
AN INCREASED AMPLITUDE OF THE A WAVE (ATRIAL CONTRACTION).
Term
WHAT DO WEEXPECT TO SEE IN THE A WAVE FOR A PATIENT WITH TRICUSPID STENOSIS?
Definition
BLOOD WILL BACK UP IN THE VENA CAVA AND THE JUGULAR VEINS. YOU WILL SEE JVD.
Term
HOW ARE THE MYOFILAMENTS ADDED TO EACH OTHER IN MITRAL STENOSIS FOR THE LEFT ATRIUM?
Definition
THEY ARE ADDED IN PARALLEL WITH EACH OTHER.
Term
DOES MITRAL STENOSIS HAVE A SYSTOLIC OR DIASTOLIC MURMUR?
Definition
DIATOLIC MURMUR. WE ARE HEARING THE TURBULENT FLOW OF THIS DURING DIASTOLE. WHEN SYSTOLE BEGINS IT SHOULD ENS THAT TURBULENT FLOW.WH
Term
WHAT IS THE INCREASE IN AFTERLOAD IN AORTIC STENOSIS RESULTED FROM?
Definition
BECAUSE OF THE STENOSIS OF THE VALVES. THE AORTIC EDP MAY BE NORMAL OR EVEN REDUCED.
Term
WHY IS LEFT EMPTYING IMPAIRED R/T AORTIC STENOSIS?
Definition
THERE IS AN INCREASE RESISTANCE TO OUTFLOW
Term
WHAT IS GOING TO HAPPEN TO THE VELOCITY OF CONTRACTION WITH AORTIC STENOSIS?
Definition
IT WILL DECREASE
Term
HOW DO YOU DETERMINE THE SEVERITY OF AORTIC STENOSIS?
Definition
THE DIFFERENCE BETWEEN PEAK LEFT VENTRICULAR PRESSURE AND PEAK AORTIC PRESSURE DURING SYSTOLE.
Term
WHAT IS THE PEAK SYSTOLIC VENTRICULAR PRESSURE GOING TO BE WITH AORTIC STENOSIS?
Definition
INCREASED
Term
WHAT IS YOUR SV GOING TO DO WITH AORTIC STENOSIS AND WHY?
Definition
IT WILL DECREASE. I HAVE DECREASED MY SHORETNING VELOCITY, I HAVE INCREASED THE RESISITANCE TO OUTFLOW, SO SV IS OBVIOUSLY GOING TO BE REDUCED.
Term
WHAT DOES THE END DIATOLIC VOLUMES DO WITH AORTIC STENOSIS?
Definition
THEY INCREASE. THIS IS BLOOD BEING LEFT BEHIND. THERE IS A SLIGHT INCREASE IN EDV, BUT AT THE SAME TIME THE ESV IS RISING EVEN HIGHER.
Term
WHAT IS GOING TO BE THE COMPENSATION FOR AORTIC STENOSIS?
Definition
LEFT VENTRICULAR CONCENTRIC HYPERTROPHY. A CONCENTRIC PRESSURE OVERLOAD HYPERTROPHY OF THE LEFT VENTRICLE. THERE IS AN INCREASE IN WALL THICKNESS WITHOUT A CONCOMITANT INCREASE IN LUMINAL DIAMETER.
Term
WHAT TYPE OF MURMUR WILL YOU HEAR WITH AORTIC STENOSIS?
Definition
A SYSTOLIC MURMUR. THAT MEANS THAT WE ARE GOING TO HEAR THE TURBULENT FLOW ACROSS THE STENOTIC VALCE DURING SYSTOLE.
Term
WHAT TYPE OF SOUND WILL WE GET WIT AORTIC STENOSIS AND WHY?
Definition
CRESCENDO/DECRESCENDO TYPE MURMUR. IT MEANS IT GETS LOUDER AND IT GETS SOFTER. AS THE HEART BEGINS TO RELAX AND WE BEGIN TO LOSE PRESSURE IN THE LEFT VENTRICLE WE GET A DECRESCENDO.
Term
WHY DOES THE ESV INCREASE WITH AORTIC STENOSIS?
Definition
BECAUSE WE ARE GOING TO HIT OUR ACTIVE TENSION CURVE MUCH SOONER THAN WE DID PREVIOUSLY. DURING THE EJECTION PHASE AS SOON AS I CROSS THAT ACTIVE TENSION LINE THAT IS GOING TO SHUT THE VALVE.
Term
WHAT HAPPENS DURING MITRAL REGURGITATION?
Definition
SYSTOLIC BLOOD IS GOING TO BE RETROGRADED INTO THE LEFT ATRIUM
Term
WHAT IS THE LEFT ATRIUM GOING TO DO DURING MITRAL REGURGITATION?
Definition
THE LEFT ATRIUM VOLUME AND PRESSURES ARE GOING TO INCREASE.
Term
WHAT IS GOING TO HAPPEN TO THE V WAVE WITH MITRAL REGURGITATION?
Definition
IT WILL HAVE A LARGER SLOPE. THE V WAVE UNDER NORMAL CONDITIONS IS CAUSED R/T THE FILLING AGAINST A CLOSED VALVE.
Term
WHAT DOES A REGURGITANT VALVE CAUSE?
Definition
NO ISOVOLUMETRIC CONTRACTION AND RELAXATION PHASES.
Term
HOW CAN YOU DETERMINE HOW SEVERE THE MITRAL REGURGITATION IS?
Definition
THE BIGGER THE RETROGRADE VOLUME IS.
Term
THE DIFFERENCE WE HAVE EJECTED HERE IS GOING TO BE SPLIT BETWEEN GOING INTO THE AORTA AND INTO THE ATRIUM. UNTIL I REACH THE POINT ON MY __ __ __ WHERE MY AORTIC VALVE CLOSES.
Definition
ACTIVE TENSION CURVE
Term
WHAT IS THE VENTRICULAR VOLUME DURING THE ISOVOLUMETRIC RELAXATION PHASE GOING TO DO FOR A PATIENT WITH MITRAL REGURGITATION?
Definition
IT IS GOING TO DECREASE BECAUSE I'M PUSHING MORE BLOOD BACK INTO THE ATRIUM.
Term
WHAT IS THE COMPENSATION CALLED FOR MITRAL REGURG?
Definition
VOLUME OVERLOAD HYPERTROPHY AKA ECCENTRIC HYPERTROPHY
Term
DESCRIBE ECCENTRIC HYPERTROPHY.
Definition
INSTEAD OF ADDING THE MYOFILAMENTS IN PARALLEL WHAT HAPPENS IF I WERE TO ADD THEM IN SERIES? I INCREASE THE LENGTH, I MAINTAINED THE SAME DIAMETER. THE DIAMETER STAYS THE SAME AND THE LENGTH INCREASES. WHAT HAPPENS IS THAT THE LUMEN INCREASES TO A LARGE AMOUNT, BUT THE WALL THICKNESS REMAINS RELATIVELY UNCHANGED.
Term
DO YOU HAVE ISOVOLUMETRIC RELAXATION WITH AORTIC REGURGITATION? WHY?
Definition
NO BECAUSE THERE IS BACKFLOW OF BLOOD INTO THE LEFT VENTRICLE.
Term
WHAT HAPPENS TO MY LEFT VENTRICLE VOLUME DURING MY ISOVOLUMETRIC RELAXATION PHASE IN THE CASE OF AORTIC REGURGITATION?
Definition
IN INCREASES
Term
HOW DO WE MONITOR SEVERITY OF AORTIC REGURGITATION?
Definition
HOW FAR IS MY ESV GOING TO BE INCREASED. THE GREATER THE ANGLE IS EQUAL TO THE GREATHER AMOUNT OF REGURGITATION.
Term
IF I INCREASE MY EDV WITH AORTIC REGURGITATION WHAT IS THAT GOING TO DO TO THE PEAK SYSTOLIC PRESSURE?
Definition
INCREASE IT.
Term
WHAT IS THE COMPENSATION FOR AORTIC REGURGITATION?
Definition
LEFT VENTRICULAR ECCENTRIC HYPERTROPHY-VOLUME OVERLOAD. LEFT VENTRICULAR LUMEN DIAMETER INCREASES AND WALL THICKNESS DOESN'T CHANGE.
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