RTP 233 Final Exam 2024/2025 fully solved
& updated
Causes of heart sounds - ANSWER-1: sudden closure of mitral and tricuspid
valve
2: closing of aortic and pulmonic valve leaflets
3: rapid ventricular filling immediately after systole
4: results from increased stiffness of left ventricle
Distribution of blood flow and venous return - ANSWER-Tricuspid Valve - blood
from right atrium enters right ventricle
Pulmonic Valve - blood ejects from right ventricle to lungs
Mitral Valve - blood from left atrium enters left ventricle
Aortic Valve - blood ejects from left ventricle to body
Stroke volume: Preload - ANSWER-Preload: Degree that myocardial fiber is
stretched prior to contraction More stretch = stronger contractions
Reflected in ventricular end-diastolic pressure (VEDP) and ventricular end-
diastolic volume (VEDV)
Increased VEDP = Increased VEDV
Decreased VEDP = Decreased VEDV
Afterload - ANSWER-Afterload: Amount of resistance the heart must pump
against to circulate blood
Determined by volume and viscosity of blood ejected and systemic vascular
resistance
Calculate by SVR equation = (MAP - CVP) / CO multiplied by 80.
More stretch = stronger contractions
Reflected in ventricular end-diastolic pressure (VEDP) and ventricular end-
diastolic volume (VEDV)
, Increased VEDP = Increased VEDV
Decreased VEDP = Decreased VEDV
Contractility - ANSWER-Force of contraction
Positive inotrope increases contractility
Negative inotrope decreases contractility
Contractility increases = CO increases
Contractility decreases = CO decreases
MAP = SBP + 2(DBP) / 3
Frank Starling Law - ANSWER-Stroke volume increases in response to an
increase in the volume of blood in the ventricles due to increased stretch causing
more forceful contraction
Factors affecting Cardiac index - ANSWER-High: more blood being pumped than
necessary
• Increase in CO, SV, or HR
Low: not enough blood and oxygen to tissues
• Decrease in CO, SV, or HR
Stroke index reflects - ANSWER-Contractility of the heart
Overall blood volume status
Amount of venous return
Causes of inadequate and increased oxygen delivery - ANSWER-Decreased:
trauma, sepsis, heart damage, negative inotropes
Increased: anemia, HTN, positive inotropes
Oxygen consumption- definition and factors that may increase or decrease -
ANSWER-Amount of oxygen extracted by peripheral tissues for 1 minute
Increase: fever and inflammatory states, metabolic rate, and muscular activity
Decrease: hypothermia and skeletal muscle relaxation
Steps to hemodynamic monitoring accuracy - ANSWER-Leveling, zeroing, and
square wave test
CVP - ANSWER-Pressure of the blood in the right atrium or vena cava, where the
blood is returned to the heart from the venous system
& updated
Causes of heart sounds - ANSWER-1: sudden closure of mitral and tricuspid
valve
2: closing of aortic and pulmonic valve leaflets
3: rapid ventricular filling immediately after systole
4: results from increased stiffness of left ventricle
Distribution of blood flow and venous return - ANSWER-Tricuspid Valve - blood
from right atrium enters right ventricle
Pulmonic Valve - blood ejects from right ventricle to lungs
Mitral Valve - blood from left atrium enters left ventricle
Aortic Valve - blood ejects from left ventricle to body
Stroke volume: Preload - ANSWER-Preload: Degree that myocardial fiber is
stretched prior to contraction More stretch = stronger contractions
Reflected in ventricular end-diastolic pressure (VEDP) and ventricular end-
diastolic volume (VEDV)
Increased VEDP = Increased VEDV
Decreased VEDP = Decreased VEDV
Afterload - ANSWER-Afterload: Amount of resistance the heart must pump
against to circulate blood
Determined by volume and viscosity of blood ejected and systemic vascular
resistance
Calculate by SVR equation = (MAP - CVP) / CO multiplied by 80.
More stretch = stronger contractions
Reflected in ventricular end-diastolic pressure (VEDP) and ventricular end-
diastolic volume (VEDV)
, Increased VEDP = Increased VEDV
Decreased VEDP = Decreased VEDV
Contractility - ANSWER-Force of contraction
Positive inotrope increases contractility
Negative inotrope decreases contractility
Contractility increases = CO increases
Contractility decreases = CO decreases
MAP = SBP + 2(DBP) / 3
Frank Starling Law - ANSWER-Stroke volume increases in response to an
increase in the volume of blood in the ventricles due to increased stretch causing
more forceful contraction
Factors affecting Cardiac index - ANSWER-High: more blood being pumped than
necessary
• Increase in CO, SV, or HR
Low: not enough blood and oxygen to tissues
• Decrease in CO, SV, or HR
Stroke index reflects - ANSWER-Contractility of the heart
Overall blood volume status
Amount of venous return
Causes of inadequate and increased oxygen delivery - ANSWER-Decreased:
trauma, sepsis, heart damage, negative inotropes
Increased: anemia, HTN, positive inotropes
Oxygen consumption- definition and factors that may increase or decrease -
ANSWER-Amount of oxygen extracted by peripheral tissues for 1 minute
Increase: fever and inflammatory states, metabolic rate, and muscular activity
Decrease: hypothermia and skeletal muscle relaxation
Steps to hemodynamic monitoring accuracy - ANSWER-Leveling, zeroing, and
square wave test
CVP - ANSWER-Pressure of the blood in the right atrium or vena cava, where the
blood is returned to the heart from the venous system
