1. Order of circulation
    • Systemic
    • Right atrium
    • Tricuspid valve
    • Right ventricle
    • Pulmonic valve
    • Pulmonary circulation
    • Left atrium
    • Mitral valve
    • Left ventricle
    • Aortic Valve
    • Aorta
  2. Define isovolumetric contraction
    Period of ventricular contraction before pressure exceeds that in arteries
  3. Define isovolumetric relaxation
    Period of ventricular relaxation before atrioventricular valves open
  4. Define diastasis
    Period of low ventricular filling in late diastole prior to atrial kick
  5. What is the dicrotic notch
    Period of backward flow and sudden stop as aortic and pulmonary valves close
  6. "A" wave
    • Atrial pressure wave caused by atrial contraction
    • Follows ECG P wave
  7. "C" wave
    • Atrial pressure wave caused by backbulging of AV valves (during ventricular contraction)
    • Follows ECG QRS complex
  8. "X" descent
    • Atrial pressure fall from ventricular emptying (thoracic pressure, volume fall)
    • After "c" wave
  9. "V" wave
    Atrial pressure increase from venous return into atria with closed AV valves
  10. "Y" descent
    Atrial pressure drop when AV vavles open
  11. Which atrial waves are seen in venous pressure?
    • A wave
    • C wave
    • V wave
  12. First heart sound (S1)
    AV valves close
  13. Second heart sound (S2)
    Semilunar (aortic and pulmonary) vavles close
  14. Third heart sound (S3)
    Vibration of blood entering the ventricle during diastole
  15. Fourth heart sound (S4)
    Flow from atrial kick at end of diastole
  16. Structures associated with AV valves
    • papillary muscles - contract during systole to prevent AV valve bulging
    • Chordae tendinae - attach valves to papillary muscles
  17. What is the splitting of S2?

    Is a split S1 theoretically possible?
    Aortic valve closes before pulmonary valve

    Yes, mitral valve closes just before tricuspid valve
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