CVS Revision Part 4 - JVP, Heart sounds, Pulse

cardiovascular system Revision Part 4 - JVP, Heart sounds, Pulse

Jugular venous pressure

The changes in atrial preesure are transmitted to the great veins producing three peaks and two decend

Name	Timing	Reason
a wave	Atrial systole	Regurgitation of blood through narrowed orifice
c wave	Isovolumetric ventricular contraction	Bulging of the tricuspid valve into the right atrium
v wave	Diastole	Rise in atrial pressure Before the tricuspid valve opens
x decent	Occurs when atrial contraction finish	Due to atrial relaxation and downward displacement of tricuspid valve
y decend	Following the opening of the tricuspid valve	Due to emptying of the atrium into the ventricle

Heart sounds

Name	Character	Reason	Timing	Specialties
S1	Low pitched Slightly prolonged	Closure of AV valves	At the start of ventricular systole Duration - 0.15 s	Loud in tachycardia
S2	High pitched Shorter	Sudden closure of semilunar valves	End of ventricular systole Duration - 0.12 s	Loud when diastolic pressure is elevated in the aorta
S3	Low – pitched sound	Due to rapid ventricular	Diastole
S4		Due to ventricular filling	Immediately before the S1

Murmurs

Abnormal sounds are heard in various parts of the vascular system ( mainly over the heart )

They mainly occur due to diseased heart valves . There can be two such disorders

Stenosis – when the orifice of a valve is narrowed
2Regurgitation – valve is incompetent . So blood flows back through the valves

Valve	Abnormality	Timing heard
Aortic / pulmonary	Stenosis	Systole
Aortic / pulmonary	Regurgitation	Diastole
Mitral / Tricuspid	Stenosis	Diastole
Mitral / Tricuspid	Regurgitation	Systole

Pulse

Characteristics of pulse

· Rate

· Rhythm

· Character

· Volume

Arterial pulse

Blood forced into the aorta during systole sets up a pressure wave that travels around the arteries . This pressure wave expands arterial wall . Which is palpable as the pulse

Labels: CVS, CVS Revision

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