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Physiology #7&8 Last
Physiology #7&8 Last
Faisal Mohammaed
atrioventricular
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different from one person to another.
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During the 0.8 (sec) these events happen:
1. Systole of ventricles
2. Diastole of ventricles
3. Systole of atria 00
4. Diastole of atria Before ventricular systole we have to record QRS
which is (ventricular depolarization) Always the electrical
T precedes the mecanicl.
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Systole of the atria has to be produced
by P-wave, so the P-wave will be
recorded before the atrial systole. Atrial systole = 0.1 sec
Atrial diastole = 0.7
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1. Rapped filling
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o 2. Slow filling
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2
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1 1
2 1. Rapped ejection of blood
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2. Slow ejection of blood
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- Ventricular diastole= 0.5 seconds
systole 7
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- Ventricular systole= 0.3 second
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- Isovolumic relaxation 0.02 seconds
- Rapid filling & Slow filling (Diastasis) 1 2 0
- Isovolumic contraction 0.01 seconds
e - Rapid ejection period & Slow ejection period
- Atrial contraction 0
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volume
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Pressure
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7 4 11 Dicrotic notch: brief rise in aortic pressure
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caused by backflow of blood rebounding off
semilunar valves
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Tidd diastole z
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Atrial pressure:
V-wave A-wave =atrial systole
C-wave= ventricular
C-wave contraction (AV closure)
A-wave V-wave= ventricular
diastole (Av opening).
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- The volume of right and left ventricles are the same, the difference is in their
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pressure.
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- We considered that the volume of left ventricle before the atrial systole = 100,
but it dosen’t mean anything, it is just for teaching purposes (in the exam it can to
be different)
(غير مطالبين بحفظ أرقام الحجوم ألنها افتراضية فقط
- When the atria contracts it pushes certain amount of the blood into the
ventricles very fast, so its volume will become ~ 125 mm that means the atria
systole doesn’t contribute more than 25% it’s not more than that because
during the atrial systole the AV valve was open if AV valve is open, the blood
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comes to the ventricles so the maximum contribution of atrial systole is 25%
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1- Systole of ventricles: pressure increase too much, reach more than 80
(which is the pressure in aorta during diastole) or more than 8 (which is the
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- When systole ends, the ventricles won’t completely empty, because it’s a hollow
organ, no matter how much you compressed it, small volume will remain in it.
systole.
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End-systolic volume (ESV): the volume that stays in the ventricles at the end of
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2- Diastole of ventricles: After the ventricles have constricted, the blood will flow
into the aorta (in the left ventricle), and the pulmonary (in the right ventricle),
now the ventricles will relax and the pressure in them will decrease gradually till
a point where its less than the pressure in the aorta and pulmonary.
- As we know the blood a
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flows from a high-pressure area to a low pressure one,
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but we don’t want the blood to go back to the ventricles, so the semilunar valves
will close to prevent the blood from going_to
back to the ventricles.
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- The blood remain in the aorta and pulmonary for short period called isovolumic
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relaxation (0.02sec) which all valves are closed the pressure decrease (less
than 0) in ventricles AV valves open the blood come from atrial to the
ventricles blood collects rapidly in ventricles Rapid filling phase will happen
then the Slow filling phase will happen.
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3- Pressure changes in left ventricle: considered the pressure = 0 (it’s -1 because
it’s pressure less than atrial pressure, but we considered it = 0)
during the atrial systole, the atria contracts pushes certain amount of blood
to the ventricles very fast the pressure in left ventricle increases the systole
of ventricle starts as the pressure increase more than 0 AV valves closes
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which is the beginning of isovolumic contraction pressure increased very fast.
- When the pressure reach more than 80 in left ventricle the aortic valve open,
why? because the pressure in the aorta = 80 so when the ventricle exceeds 80
gradient in pressure make the blood moves from high to low pressure, so even if
the blood moves out from the ventricles, the P still increases
tearer
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Why? because the contraction force is more than output blood volume, so there
is increasing in blood pressure of ventricles.
- The max pressure in left ventricle is around 120mmHg (it should be more than
the aortic pressure as it moves from the ventricle to the aorta)
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4- Isovolumic relaxation: (the V in right = the V in left)
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the pressure change from 80 to less than 0 AV valve opens.
✓ the Pressure of left ventricles varies between 0-120 o o
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✓ the Pressure of right ventricles varies between 0-25
✓ the Pressure of aorta varies between 80-120
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✓ the pulmonary artery pressure varies between 8-25
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✓ Diastolic pressure in pulmonary artery = 8
to
___
✓ Diastolic pressure in aorta = 80
✓ the pulmonary artery systolic pressure = 25
(all of them in mmHg)
( اذا بدنا رسمة80-120) الي بيتراوح بينleft ventricle اللي فوق فيه رسمة الdiagram ( ال
)left وبتطلع نفس رسمة ال120 -> 25 و8 80 بنبدلright ventricle ال
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- Atrial depolarized atrial systole P increase make A wave AV valve
close blood tries to go away from Atria.
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- P in ventricles too high pushes the AV valve toward the Atria make C-wave
AV valve opens at the end of isovolumic relaxation P decrease and make
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V-wave.
Eg amateur
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▪ End diastolic volume (EDV) – End systolic volume (ESV) = Stroke volume (SV)
SV: Volume of blood ejected from ether the right ang left ventricles ml/beat.
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MR 70
CO: Volume of blood ejected from ether the right ang left ventricles ml/minute.
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……………………………………………………………………………………………………………………………
Changes in heart sounds
- Heart sounds (lub-dup) are associated with closing of heart valves
- Auscultation – listening to heart sound via stethoscope
S1: “lubb” caused by the closing of the AV valves Bicuspid
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- turbulence of blood around AV valve. NOTE:
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We will take each period separately and look at it from all angles, let’s start with
Atrial systole:
- When the atrial is depolarized it makes a P-wave, at this moment the atrial
systole. Faction
- It systole = contraction so the pressure in it will increase (notice that the atrial
pressure curve__ has risen slightly in this period)
- When the atrial systole it will pump the blood to the ventricles so the
ventricular volume will increase (notice that the ventricular volume curve has
risen slightly)
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Isovolumetric contraction (very short period 0.01 sec - QRS): the volume in
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each ventricle stays the same the amount of the blood in them remains
the same (look at the ventricular volume curve in this short period it’s a
straight line) that’s because when the ventricles start contracting it closes all
the valves (There is no difference in ventricular volume, but the difference in
their pressure), this period ends with the semilunar valve opening.
50
^ when are all valves open at the same time?
3
- It’s impossible for that to happen
Ventricular systole:
- Before ventricular systole we have to record QRS which is a ventricular
depolarization ventricular contraction ventricular pressure will increase
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dramatically results in closing of AV valves
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- T-wave shows ventricular repolarization
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rebounding off semilunar valves.
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● Cardiac reserve is the difference between resting and maximal CO.
70 to
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For example, 15 L/min – 5 L/min = 10 L/min
CO = HR × SV
For example:
SV = EDV – ESV
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End Diastolic Volume (EDV) is the amount of blood collected in a
ventricle during diastole (at the end of diastole)
End Systolic Volume (ESV) is the amount of blood remaining in a
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ventricle after contraction (at the end of the systole) t
Factors affecting stroke volume Estes
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● Preload (EDV): is the amount ventricles stretched by contained
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blood, in other word we can say it is the amount of tension before
contraction that’s why we call it Preload.
high
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Increase EDV Increases preload Increases CO
to 0 as
● Contractility: cardiac cell contractile force due to factors other than
EDV. With fixed EDV there is an increase in SV.
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If afterload increases SV decreases unless you develop more
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- Hypertension means increasing in the blood pressure, if it’s
happened we will need more energy to deliver blood to aorta from
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left ventricle. Blood pressure should be lowered in order to prevent
ischemia or infarction from occurring.
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……………………………………………………………………………
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● Slow heart beat and exercise increase venous return to the haert,
increasing SV.
IMPORTANT NOTE:
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- When the HR is slow there will be more time for filling which increases SV.
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- When the HR is fast there will be less time for filling which decreases SV.
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The preload The ventricles are dilated and full with
blood.
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NOTE:
Increased HR is not always lead to increase the CO; in certain condition it may lead to
decrease it. For example, in exercise the HR shouldn’t be higher than certain limit, if it
does be higher the SV will decrease which lead to decrease the CO.
EDV.
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● Contractility is the increase in contractile strength, independent of stretch and