Cardiac Muscle Mechanics Flashcards

1
Q

What are the 3 independent variables that influence systolic performance..

A

preload
contractility
afterload

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2
Q

What are the best indices of preload?

A

left ventricular end diastolic volume (LVEDV)
left ventricular end diastolic pressure (LVEDP)

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3
Q

What are some other indices for measuring preload that are considered less reliable?

A

central venous pressure (CVP)
pulmonary capillary wedge pressure (PCWP)
Rt atrial pressure (RAP)

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4
Q

What are some indices for contractility?

A

EF ejection fraction

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5
Q

Label the numbers and what this graph is saying.

A
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6
Q

If contractility determines systolic interval; then what determines diastolic interval?

A

HR

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7
Q

What are 3 main situations in which afterload is affected?

A

when aortic pressure is increased because of HTN

When SVR increased

aortic stenosis

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8
Q

How would increasing afterload and decreasing contractility affect a ventricular function curve?

A

shift curve down and to the right

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9
Q

How would decreasing afterload and increasing contractility shift a ventricular function curve?

A

shift it up and to the left

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10
Q

What does the Y axis on a ventricular function curve represent?

A

systolic peformance

may be also referred to as:
stroke work
stroke volume
cardiac output

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11
Q

What does the X-axis on a ventricular function curve represent?

A

the preload

may be referred to as:
ventricular end-diastolic volume or pressure
RAP, CVP

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12
Q

What does A represent in this graph?

A

decreased performance due to a reduction in preload

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13
Q

What does B represent in this graph?

A

increased performance due to an increased preload

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14
Q

What does point N to C represent on this graph?

A

increased performance due to an increase in contractility or reduction in afterload

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15
Q

What do point C, D, E in this graph represent?

A

different levels of performance due to changes in preload only all three points have the same contractility

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16
Q

What does Vector I represent?

A
17
Q

What does Vector II represent?

A
18
Q

What does Vector III represent?

A
19
Q

What does Vector IV represent?

A
20
Q

What is End-diastolic volume (EDV)?

A

volume of blood in the ventricle at end of diastole

21
Q

What is ESV?

A

end systolic volume is volume of blood in ventricle at end of systole

22
Q

What is Stroke volume?

A

volume of blood ejected by the ventricle per beat

23
Q

Formula for SV?

A

SV = EDV - ESV

24
Q

What is the formula for EF?

A

ejection fraction is EF = SV/EDV

25
Q

What is EF?

A

The fraction or percentage of blood pumped out of the heart

26
Q

What is normal EF?

A

> 55%

27
Q

Systolic dysfunction.

A

an abnormal reduction in ventricular emptying due to impaired contractility or excessive afterload

28
Q

What is diastolic dysfunction?

A

a reduction in ventricular compliance i.e the ventricle is stiffer

29
Q

What is dilated cardiomyopathy?

A

ventricular dilation with only a modest hypertophy leads to systolic dysfunction

30
Q

What is restrictive cardiomyopathy.

A

is decreased ventricular compliance with diastoic dyfunction

31
Q

What is hypertrophic cardiomyopathy.

A

septal or left ventricular hypertrophy unrelated to pressure overload

diastolic dyfunction due to increased muscle stiffness and impaired relaxation

hypertrophy may be related to “septal fiber disarray”