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[link] illustrates the relationship between the cardiac cycle and the ECG.

Relationship between the cardiac cycle and ecg

This image shows the correlation between the cardiac cycle and the different stages in a electrocardiogram.
Initially, both the atria and ventricles are relaxed (diastole). The P wave represents depolarization of the atria and is followed by atrial contraction (systole). Atrial systole extends until the QRS complex, at which point, the atria relax. The QRS complex represents depolarization of the ventricles and is followed by ventricular contraction. The T wave represents the repolarization of the ventricles and marks the beginning of ventricular relaxation.

Heart sounds

One of the simplest, yet effective, diagnostic techniques applied to assess the state of a patient’s heart is auscultation using a stethoscope.

In a normal, healthy heart, there are only two audible heart sounds    : S 1 and S 2 . S 1 is the sound created by the closing of the atrioventricular valves during ventricular contraction and is normally described as a “lub,” or first heart sound. The second heart sound, S 2 , is the sound of the closing of the semilunar valves during ventricular diastole and is described as a “dub” ( [link] ). In both cases, as the valves close, the openings within the atrioventricular septum guarded by the valves will become reduced, and blood flow through the opening will become more turbulent until the valves are fully closed. There is a third heart sound, S 3 , but it is rarely heard in healthy individuals. It may be the sound of blood flowing into the atria, or blood sloshing back and forth in the ventricle, or even tensing of the chordae tendineae. S 3 may be heard in youth, some athletes, and pregnant women. If the sound is heard later in life, it may indicate congestive heart failure, warranting further tests. Some cardiologists refer to the collective S 1 , S 2 , and S 3 sounds as the “Kentucky gallop,” because they mimic those produced by a galloping horse. The fourth heart sound, S 4 , results from the contraction of the atria pushing blood into a stiff or hypertrophic ventricle, indicating failure of the left ventricle. S 4 occurs prior to S 1 and the collective sounds S 4 , S 1 , and S 2 are referred to by some cardiologists as the “Tennessee gallop,” because of their similarity to the sound produced by a galloping horse with a different gait. A few individuals may have both S 3 and S 4 , and this combined sound is referred to as S 7 .

Heart sounds and the cardiac cycle

This image shows a graph of the blood pressure with the different stages labeled. Under the graph, a line shows the different sounds made by the beating heart.
In this illustration, the x-axis reflects time with a recording of the heart sounds. The y-axis represents pressure.

The term murmur    is used to describe an unusual sound coming from the heart that is caused by the turbulent flow of blood. Murmurs are graded on a scale of 1 to 6, with 1 being the most common, the most difficult sound to detect, and the least serious. The most severe is a 6. Phonocardiograms or auscultograms can be used to record both normal and abnormal sounds using specialized electronic stethoscopes.

During auscultation, it is common practice for the clinician to ask the patient to breathe deeply. This procedure not only allows for listening to airflow, but it may also amplify heart murmurs. Inhalation increases blood flow into the right side of the heart and may increase the amplitude of right-sided heart murmurs. Expiration partially restricts blood flow into the left side of the heart and may amplify left-sided heart murmurs. [link] indicates proper placement of the bell of the stethoscope to facilitate auscultation.

Stethoscope placement for auscultation

This image shows the points on the human chest where the stethoscope can be placed to hear the heart beat.
Proper placement of the bell of the stethoscope facilitates auscultation. At each of the four locations on the chest, a different valve can be heard.

Chapter review

The cardiac cycle comprises a complete relaxation and contraction of both the atria and ventricles, and lasts approximately 0.8 seconds. Beginning with all chambers in diastole, blood flows passively from the veins into the atria and past the atrioventricular valves into the ventricles. The atria begin to contract (atrial systole), following depolarization of the atria, and pump blood into the ventricles. The ventricles begin to contract (ventricular systole), raising pressure within the ventricles. When ventricular pressure rises above the pressure in the atria, blood flows toward the atria, producing the first heart sound, S 1 or lub. As pressure in the ventricles rises above two major arteries, blood pushes open the two semilunar valves and moves into the pulmonary trunk and aorta in the ventricular ejection phase. Following ventricular repolarization, the ventricles begin to relax (ventricular diastole), and pressure within the ventricles drops. As ventricular pressure drops, there is a tendency for blood to flow back into the atria from the major arteries, producing the dicrotic notch in the ECG and closing the two semilunar valves. The second heart sound, S 2 or dub, occurs when the semilunar valves close. When the pressure falls below that of the atria, blood moves from the atria into the ventricles, opening the atrioventricular valves and marking one complete heart cycle. The valves prevent backflow of blood. Failure of the valves to operate properly produces turbulent blood flow within the heart; the resulting heart murmur can often be heard with a stethoscope.

Questions & Answers

why does the material not allow in mri
Simran Reply
what do you mean 'mri'
Nimco
short for magnetic resonance imaging. "the researchers used MRI to record the brain activity" a medical examination performed using magnetic resonance imaging. "he's having an MRI to determine the extent of the injury" an image obtained by magnetic resonance imaging. "after looking at the MRI, the d
Riyaz
what is the meaning of sutures
Ibrahim Reply
i do not know
Nimo
immovable joints btn two bones.eg the skull bones
Japhar
Really,it's true
Nimco
Sutures are immovable junction between two bones e.g those of the skull
Surphy
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Sandra Reply
study harder
Japhar
Between the heart and the Brain which one is more important to human being... discuss
Faith Reply
well the brain is important for motor skills, the heart is important for involuntary muscle movement supporting body functions. the body can survive without brain involvement, but the body cannot last without the heart
john
granted the heart is important, but the brain gives the body purpose
john
the brain is more important
Kevin
why?
john
brain
tracey
Even though the brain helps the human being to behave normally and purposefully, I think the heart is much more important cos human being cannot live without the heart
Dzifa
why?
john
change the question
Bind
hello guys
Kevin
heart
Kevin
it is difficult to select which organ is more important, now you can replace the heart with a mechanical device and the body could still function, and with technology today brain activity can also be replicated. But life would not be the same
john
there's coordination btn the two..so without any of them no life
Japhar
the heart
The brain is important to humans.
Zozo
what is homeostasis
Rebecca Reply
It is the condition when body feel comfortable
Jazil
Wo feels hungry, thirty due to homeostasis
Jazil
Is the maintenance of the internal environment of all the body cells for normal growth
Komolika
what is the composition of saliva
Vijay Reply
ഫസ്റ്റ് ചാപ്റ്റർ ഇംപോർട്ടൻസ് പോസ്റ്റ്
Reshma Reply
Yes....
Loving
nhi samjh aya
Anshika
Nhi wt is this
Loving
I don't know
Anshika
Okk wre frm u r
Loving
what is mean of? reshma
Asad
I don't know but would like to
Rebecca
D bone in d ankle joint re what ?
Ifunanya Reply
patellar
Ibrahim
can one define a cell as a basic unit of a living organism
Michael Reply
cell is the structural and functional unit of living organisms
Fidel
Which of the following hormones are responsible for the adolescent growth spurt? estrogen and testosterone, even in women?
Kepa Reply
estrogen
Farhana
Estrogen!
Jazil
estrogen hormone
Michael
yes estrogen hormone
Anshika
yes
Sale
testrogen
Rebecca
What is sling give d characteristics of sling uses of sling
adamu Reply
a sling a rope used in hunting ie throwing of rocks
Michael
I went to learn anatomy of joints
Arman Reply
me 2
adamu
joint have 3 cartilaginous joint fibrous joint synovial joint U can reserch in Google can explain U well
sopheaktra
define sling
adamu
To throw with a circular or arcing motion
real
pls hux I was given an assignment,, Between the heart and Brain which one is more important to human being... discuss
Faith
what is respiration
Osele Reply
what is respiration
Paul
Respiration is the process by which oxygen is taken in and carbon dioxide is given out.
Md
Respiration is the combination of inhalation and exhalation.
Khim
inhalation is the taking in air from environment to lung and exhalation is taking out sir from the lung to environment ..
Khim
is the process by wich gases(oxygen and carbon(IV)oxide go through the nose, trachea and the lungs to the blood stream
Michael
what is holistic
Kibrom Reply
Holistic means encompassing the whole of a thing, and not just the part. Holistic medicine looks at the whole person for answers, not just at physical symptoms. You might have heard of holistic medicine, which tries to treat someone as mind and body, instead of treating only the part of the patient
I want to learn one by one system like skeleton system... muscular system
Mary Reply
i want to learn this
Kibrom
what is the difference between regional anatomy and system anatomy
David
system anatomy is when we study the system like digestive, circulatory, reproductive, but regional anatomy is studying the anatomy by regions of body like anatomy of neck, thorax, head etc. Regional anatomy may include system anatomy...
Biplav
yes
Anshika

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Source:  OpenStax, Anatomy & Physiology. OpenStax CNX. Feb 04, 2016 Download for free at http://legacy.cnx.org/content/col11496/1.8
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