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Control Of Cardiac Output Flashcards

1
Q

What is total peripheral resistance?

A

The resistance to blood flow caused by all the systemic vasculature

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2
Q

What is afterload?

A

The load the heart must eject blood against (roughly equivalent to aortic pressure)

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3
Q

What is preload?

A

The amount the ventricles are stretched in diastole

Is related to EDV or central venous pressure

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4
Q

What is the pressure of the RA?

A

0-4mmHg

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5
Q

Pressure RV

A

25/4

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6
Q

Pressure of PA

A

25/10 mmHg

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7
Q

pressure LA

A

8-10mmHg

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8
Q

Pressure LV

A

120/10 mmHg

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9
Q

Pressure Aorta

A

120/80mmHg

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10
Q

What is compliance?

A

The amount the ventricle walls stretch increases with pressure- can be increased or decreasd in disease states

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11
Q

What is frank starlings law?

A

The higher the venous pressure the more the heart fills

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12
Q

What is the intrinsic control mechanism?

A

The more the heart pumps out means that the higher the pressure blood it will recieve into the RV which will stretch more so keeping up with the LV

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13
Q

What is typical stroke volume of a 70kg man?

A

70 ml

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14
Q

How much of the EDV is the stroke volume?

A

67%

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15
Q

CO=?

A

SV*HR

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16
Q

SV=?

A

EDV-ESV

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17
Q

What is blood a mixture of? What does it behave like?

A

A mixture of cells and plasma but behaves like a fluid

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18
Q

Why does blood slow down at the peripheries?

A

It is colder so is more viscous

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19
Q

What is turbulent flow?

A

Blood flows in all directions and continually mixes

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20
Q

When does turbulent flow occur?

A 
Rate of blood flow becomes too great
Blood passes by an obstruction
Blood makes a sharp turn
Blood passes over a rough surface
Increased resistance to blood flow
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21
Q

What is laminar flow? What is special about the way the blood flows?

A

Each layer of blood remains the same distance from the wall- the centre is the fastest as there is the least resistance so there is a parabolic curve

22
Q

How does the descending aorta pressure change with time?

A 
Systolic uptake- rapid rise
Peak systolic pressure
Systolic decline
Dicrotic notch- caused by elastic recoil of aorta
End diastolic pressure
23
Q

Pulse pressure=?

A

Peak systolic pressure- end diastolic pressure

Commonly 120-80= 40mmHg

24
Q

How can mean arterial pressure be estimated?

Below what value is organ perfusion impaired?

A

Diastolic pressure+ 1/3 pulse pressure.

If MAP falls below 70 then organ perfusion is impaired

25
What is retrograde flow?
Blood in arteries flows backwards briefly during diastole and is greatest when TPR is high
26
What is the pulse?
A shockwave that arrives slightly before the blood itself
27
What is strength of the pulse determined by?
Force of ejection from LV Therefore reduced pulse strength results from LV failure, aortic valve stenosis, hypovolaemia Pulse pressure
28
What is a weak pulse often described as?
Thready
29
What effect does bradycardia have on pulse pressure?
Increases time in diastole so end diastolic pressure is lower so pulse pressure is greater
30
What effect does a decreased peripheral resistance have on pulse pressure?
Pressure falls more rapidly so end diastolic volume is less so pulse pressure is larger
31
What are the 7 stages of the cardiac cycle?
``` Atrial systole Isovolumetric contraction Rapid ejection Reduced ejection Isovolumetric relaxation Rapid filling Reduced filling ```
32
How much of the ventricular filling does atrial systole account for?
10%
33
How is atrial systole represented on the ECG?
The p wave
34
On the wiggers diagram which wave does atrial systole cause?
The a wave
35
What happens after atrial systole?
AV valves close- this causes S1. | This closing causes a c wave in the atrial pressure curve
36
What comes after atrial systole? What does this cause pressure wise?
Isovolumetric contraction | Causes a rapid rise in intraventricular pressure
37
How is isovolumetric contraction represented on the ECG?
The QRS complex
38
What happens after isovolumetric contraction?
Aortic/ PV open
39
What happens after the aortic and pulmonary valves open?
Rapid ejection- rapid decrease in ventricular volume as blood is ejected into the aorta
40
What effect does rapid ejection have on the atrial pressure on the WD?
D descent- atrial base is pulled downward as ventricle contracts
41
What is happening as during rapid ejection?
Blood is flowing into atria from venous inputs
42
What follows rapid ejection?
Reduced ejection- ventricles start to repolarise
43
How is reduced ejection shown on the ECG?
The T wave
44
What effect does repolarisation of the ventricles have on muscle tension?
Repolarisation leads to a decline in tension
45
What is happening to atrial pressure during reduced ejection?
It is gradually rising due to continued return from venous supply This creates the V wave on the WD
46
How is the aortic valve made to close?
Ventricular pressure falls below aortic pressure which causes a brief backflow of blood This makes the sound S2
47
What phase follows reduced ejection
Isovolumetric relaxation- rapid decline in ventricular pressure but volume is constant as all valves are closed
48
How is the dicrotic notch created ?
Is created during isovolumetric relaxation phase as aortic valve closes
49
What happens to make the AV valves open? What effect does the opening of these have on atrial pressure?
IV pressure falls below atrial pressure so AV valves open which causes Y descent in atrial pressure
50
What phase follows isovolumetric relaxation? What sign of pathology can sometimes be heard in this phase?
Rapid filling | S3 heart sound
51
What is diastasis? Which phase of the cardiac cycle does this occur?
Reduced filling stage- Rate of filling slows down as the ventricle reaches its inherent relaxed volume- further filling is driven by venous pressure and atrial contraction

CVS (6 decks)

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