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Physiology- Cardiophysiology
Cardiac Output (T Pierce)
31
Medical
Post-Graduate
01/26/2009

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Cards

Term
Relation of cardiac output to venous return
Definition
CO = venous return
Term
Relation of CO to metabolic state of tissue
Definition

CO is proportional to tissue mass/metabolic rate

Term

Long term factors that affect CO

Definition
  • ventricular geometry
    • thickness
    • radius
  • ventricular compliance (see pressure, volume loops)
  • electrical coordination of contraction
Term
Short term factors affectin CO
Definition
  • preload
  • afterload
  • contractility
  • heart rate
Term
Relation of HR to CO
Definition
mostly linear, unless it gets so fast the heart does not have enough time to fill with blood (decrease EDV)
Term
Effect of sympathetic system on heart
Definition
  • positive chronotropic effect
    • increases rate of phase four depolarization of SA nodal cells → increase HR
  • positive dromotropic effects
    • AV node- speed conduction and decrease AV node delay
  • positive inotropic effects
    • myocytes- increase atrial and ventricular contractility
Term
Effect of parasympathetic system on heart
Definition
  • negative chronotropic effect
    • SA node- decrease rate of depolarization of phase 4 → slower heart rate
  • negative dromotropic effect
    • AV node- slows conduction, prolong AV delay
  • minor negative inotropic effect
    • some affect on atria
      • decrease calcium entry during AP lead to decrease calcium release from SR → weaken contractility
Term
When you hear an individuals heart beat using a stethascope. At the same time you palpate pulse from wrist. Is the beat detected at the wrist the same beat that is heard thru the stethoschope?
Definition

They are the same. When you feel the pulse, you feel the pressure wave. The pressure wave is different from the actually velocity of blood. Since the arteries have sturdy walls, the presure wave moves faster.

Term

Relation of pulse pressure to flow

Definition
pulse pressure is faster than flow and would occur even if their was no flow
Term
What is pulse pressure dependent on
Definition
  • peripheral pressure
  • stroke volume
  • arterial compliance
Term
Compare blood pressure of medium size arteries to aorta pressure
Definition
  • greater systolic pressure
  • lesser diastolic pressure
  • greater pulse pressure

Incisura disappears and hump disappears.

Term

Compare small arteries blood pressure to aorta pressure

Definition
  • lesser systolic and diastolic pressure
  • lesser pulse pressure
Term
Compare equation of MAP for normal heart rates and rapid heart rates
Definition
  • normal: MAP =2/3DP + 1/3SP
  • rapid HR: MAP =1/2DP + 1/2SP
Term
Pulse pressure is means to evaluate what?
Definition
cardiac contractility (the greater the slope of the graph, the greater the contractility)
Term

Pulse pressure relation with compliance and how this is important as it relates to elastic arteries

Definition
  • pulse pressure increase with decreasing compliance
  • elastic arteries keep pressure from getting too high, thereby causing loss of compliance
Term
Pulse pressure in diseases of aortic regurgitation
Definition
  • increase stroke volume
  • increase systolic pressure
  • decrease diastolic pressure (can't hold pressure long since blood is going backwards)
  • substantial increases in pulse pressure
Term
Relation of left and right heart venous return
Definition
left venous return equal to right venous return
Term
Three extra pumpts aiding in venous return
Definition
  • respiratory pump
  • aortic pump
  • skeletal muscle pump
Term
Mechanism of action of skeletal muscle influencing venous return
Definition
  • contain valves in the veins of the limbs that direct the flow of blood to the heart, preventing edema
  • skeletal muscle compress veins durin skeletal muscle contraction

Both of these events force blood back toward the heart. If muscle relaxes, venous pressure in that segment is low.

Term
Clinical consequences of muscles in limbs are not contracting, to force blood back to heart
Definition
  • blood pools, leading to venous pressure rising
  • after which, capillary absorption is reduced
  • this leads to increased interstital fluid volumes and swelling

Prolonged quite standing leads to dependent edema and eventually fainting if venous pooling occurs and persists.

Term
Define mean systemic filling pressure
Definition
measure of the "fullness" of the CV circuit (where are the fluid is if you stop the heart from pumping)
Term
How can you increase mean systemic filling pressure
Definition
increase the volume of blood (ex: infusion of saline)
Term
Effect of exhalation on heart function
Definition
  • increase intrathoracic pressure
  • increase right atrial pressure
  • decrease pressure difference
  • decrease venous return
Term
Effect of inhalation on heart function
Definition
  • decrease intrathoracic pressure
  • decrease right atrial pressure
  • increases pressure difference
  • increases venous return
Term
Effect of total peripheral resistance on venous return
Definition
increases in total peripheral resistance will decrease venous return (harder for blood to flow thru circuit)
Term
Effect of gravity on venous return (same effect on arteries and veins)
Definition
  • if you stand, your venous blood will drain toward the feet, away from the heart, decreasing venous return
  • leads to pooling of blood to stretchable veins
  • typically, you will see higher pressures on lower limbs that push blood up toward heart
    • you still have the same pressure gradient pushing blood from arteries to heart, but the pressure in the arteries and veins, respectively, increase equally due to gravity
Term
Factors affecting venous return
Definition
  • auxillary pumps
  • total peripheral resistance
  • mean systemic filling pressure
  • compliance of veins
  • effect of gravity
  • vascular permeability
Term
Equation of absolute pressure
Definition
  • absolute pressure = gravity + driving pressure created by heart
Term
Clinical application- what is the importance of fact that if I am above the heart (head) the gravity effect will decrease absolute pressure?
Definition
If you have a crack in your skull, air moves into blood based on pressure differential (veins have negative absolute pressure), so you can get an embolism.
Term
effect of sympathetic stimulation of VENOUS VESSELS on venous return
Definition

cause venoconstriction, which will reduce venous compliance, increases venouse return

Term
Relation between vein complaince and venous return
Definition
decrease in venous compliance, means less flaccid veins, making our circuit more full, so MSFP increases, leading increase venous return
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