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The heart as a pump.

Part I
Chapter 21 Lecture 5 April Strader

The 4 Phases of the Cardiac Cycle

Identical volumes

Phase I Diastole Ventricular Filling


INFLOW PHASE Vena cava aorta Pulmonary artery -Rapid ventricular filling -Slow ventricular filling (diastasis) - P wave occurs in mid diastole -Atrial contraction (atrial kick) - 10% rest 40% exercise (SV) (right first, left second) -Atrio-ventricular valves open (Tricuspid and Mitral) -Semilunar valves closed (Aortic and pulmonary) . Vena cava -Volume of blood in ventricles after Phase 1 is called End Diastolic Volume (EDV) ~ 120 ml

Pulmonary veins Mitral valve Tricuspid valve

Phase 2 Systole Isovolumetric contraction


Termination of Phase I AV valves close Vena cava aorta Pulmonary artery First heart sound S1 Lub (M1 and T1 split) All heart valves closed

Tricuspid valve

Pulmonary Occurs after QRS complex veins Mitral Ventricles contract valve HUGE pressure increase in ventricles (all valves closed) Semilunar valve opening terminates Phase 2.

Vena cava

Ventricular contraction

Fig. 21-7A

Right ventricle bellows like contraction 3 motions - long. Axis shortens - free wall moves to septum - septum convex movement Low pressure ejection

Left ventricle 2 motions - circular muscle contraction (toothpaste tube like motion) - Spiral muscles pulls mitral ring toward apex (shortening) Conical shape High pressure ejection

Phase 3 Systole Outflow phase


Vena cava aorta Pulmonary artery Pulmonary veins Mitral valve Tricuspid valve Rapid ventricular ejection Slow ventricular ejection About 70 ml of blood is ejected (Stroke Volume) into aorta, leaving 50 ml behind (End SystolicVolume). SV = EDV - ESV Cardiac Output = SV x HR

Vena cava

No sounds during ejection. If so, these are typically murmurs.


Termination of Phase 3 Semilunar valves close (Second heart sound S2 dub)

Phase 4 Diastole Isovolumetric relaxation


Vena cava aorta Pulmonary artery Pulmonary veins Mitral valve Tricuspid valve Relaxation of the ventricles Ventricular pressure drop

Vena cava Termination of Phase 4 - Atrioventricular valves open

Pressure Volume Charts of Cardiac Cycle

Pressure (mmHg)

Volume (ml)

PHASE

Identical volumes

Cardiac Dynamics
Atria contract asynchronously
Right side first Left side second
Why?

Volumes are EQUAL on both sides. Ventricles contract asynchronously - Left side first - right side second Right side (pulmonary valve) opens first Left side (aortic valve) opens second

Why?