pbl1

How did mitral valve stenosis lead to pan-systolic murmur?

Enlargement of chamber → valve not closing properly (sometimes called mid-systolic murmur) → regurgitation

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What has caused the enlargement of the heart in rheumatic heart disease??

Autoimmune response destroys the valves → valve incompetence → regergetation → stroke volume drops → cardiac out drops → decrease BP → baroreceptor drop → vasoconstriction → increase afterload → enlargement

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physiology of normal heart sounds

Sounds reflect the turbulence created when the heart valves close shut. The first heart sound is due to the shutting of the atrioventricular valves and the second heart sounds is due to shutting of the semilunar valves.

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First hear sound

Caused by the sudden block of reverse blood flow due to closure of the atrioventricular valves at beginning of ventricular contraction. When the ventricles begin to contact the cusps are pulled shut by the papillary muscles of the ventricles.

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Second heart sound

Caused by the sudden block of reversing blood flow due to closure of the semilunar valves. At the end of ventricular systole and the beginning of ventricular diastole.

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Third hear sound

irregular --> not due to shutting of valve but hitting of blood against hypertrophic ventricular wall. occurs during passive filling (more serve than 4th)

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Fourth heart sound

irregular --> not due to shutting of valve but hitting of blood against hypertrophic ventricular wall. occurs during active filling (heard before 3rd)

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Valvular regurgitation

The valve does not close completely, causing the blood to flow backward instead of forward through the valve.

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Valvular stenosis

The valve opening becomes narrowed or does not form properly, inhibiting the flow of blood out of the ventricle or atria. The heart is forced to pump blood with increased force in order to move blood through the stiff (stenotic) valve

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Heart murmurs

generated by turbulent flow of blood.Abnormal murmurs --> stenosis restricting opening of heart valve, resulting in turbulence as blood flows through it or valvular insufficiency (regurgitation), back flow of blood when valve closes only partially

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Pan Systolic murmurs

occur through systole due to atrioventricular regurgitation (mitral)

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3 layers of heart wall

Epicardium (epithelial and connective tissue)--> Myocardium (cardiac muscle) --> Endocardium (squamous epithelium, connective tissue)

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right boarder of the heart

Formed by right atrium and in line with superior and inferior vena cava

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inferior boarder of the heart

Formed mainly by the right ventricle and slightly by the left ventricle near the apex

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left boarder of the heart

Formed by the left ventricle and slightly by the left atrium

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superior boarder of the heart

Formed by both atria

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Other cards in this set

Card 2

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Card 4

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Card 5

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