Physiology

diastolic blood pressue

minimum value of BP during ventricular diastole depends on arterial wall elasticity, shows the constant load against heart to work 70 - 90 mmhg

Pulse rate

the number of pulses per minutes, can be used to determine heart rate

systolic blood pressure

maximum value of BP during ventricular systole depends on cardiac output 120 - 140 mmhg

pulse deficit

the difference between apical and radial pulse rates

Apexcardiogram

A wave = atrial systole, 4th heart sound C point = beginning of isovolumetric contraction CE period = isovolumetic contraction, closure of mitral valve, 1st heart sound E peak = systolic peak, opening of aortic valve H point = closure of aortic valve. 2nd heart sound EH period = ejection of LV O point = diastolic peak, opening of mitral valve HO period= isvolumetric relaxation OF period = rapid filling, 3rd heart sound FA period = Slow filling OC period = total ventricular filling

1st heart sound - "lubb"

Auscultation area: Heard all over the cardia area Maximum intensity - 5th left intercostal space, medial clavicular line for the bicuspid valve - the base of the xiphoid process for the tricuspid valve Characteristics Long,brave and strong Low pitched; loud sound Cause: vibrations associated with closure of AV valves Clinical identification: coincide with apex and carotid pulse Onset of ventricular systole - systolic sounds 3 components: muscular, valvular and vascular Duration: 0.08 - 0.15 seconds Frequency: 35 - 100 Hz On ECG: 0.02 - 0.04 second after Q or R

2nd heart sound

Heard all over cardiac area Max intensity in 2nd intercostal space 2cm of sternum border Right side for aortic valve Left side for pulmonary valve Short,sharp and high pitched Vibrations associated with closure of ventricular diastole Occurs after carotid pulse Diastolic sound 3 components determined by vibrations of blood of low amplitude, high amplitude by semilunar valves closing and AV valve opening duration; 0.07 - 0.1 seconds frequency of vibrations; 100 - 150 Hz On ECG; last part of T wave

jugulogram

a wave = venous distension due to atrial contraction systole, before 1st sound z point = depending on the PR interval, the decent of venous pulse may continuw until a plateau it raeached just prior to right ventricular systole c wave = is due to bulging of tricuspid valve into the right atrium during right ventricular isovolumetric systole as the right ventricular pressure rises X descent = due to a combination of atrial relaxation, downward displacement of tricuspid valve during right ventricular systole, and ejection of blood from both ventricles v wave = due to passive rise in pressure in right atrium as a result of increased blood volume in the vena cava and the right atrium during ventricular sysole and isovolumetric ventricular relaxation y descent = is due to the fall in t right atrial pressure as the tricuspid valve opens and rapid ventricular filling occurs

anacrotic limb

an ascending limb which corresponds to systolic rise of blood pressure during rapid ejection phase of ventricular systole

dicrotic wave

appears due to a rebound of blood column from the closed aortic valve because of elaastic recoil of arterial wall

mean arterial pressure

average of pressure during cardiac cycle but its not a simple arithmithic average as ventricular systole is shorter than diastole we measure MAP = SBP - DBP /3 plus DBP 90 - 100 mmhg

dicrotic notch

closure of aortic valve and corresponds to end of ventricular ejection

catacrotic limb

descending limb which represents the decrease of blood pressure during slow ejection and ventricular relaxation

4th heart sound

diastolic or presystolic sound occurs during ventricular filling produced by ventricular wall during atrial systole cannot be heard woth stethoscope On ECG; after the P wave

3rd heart sound

diastolic sound produced by ventricular wall vibrations during rapid filling of ventricles physiological conditions; young people and children pathologicsl conditions; left ventricular failure duration; 0.04 - 0.06 seconds frequency; 25 - 100 Hz On ECG; between T and P wave

pulse pressue

difference between systolic and diastolic pressure detemines the pulse volume 40 mmhg

Rhythm

interval between 2 consecutive pulsations, can e regular or irregular