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CPR Exam 1 > Cardiac Function And Venous Return Curves > Flashcards

Cardiac Function And Venous Return Curves Flashcards

1
Q

As End Diastolic Volume increases on CO

A

The CO increase also

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2
Q

As EDV increases the, on Venous Return

A

The Venous Return stays steady and then decreases

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3
Q

What determines the Venous Return

A

The Right Atrial Pressure

The lower the RAP the more venous return

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4
Q

Another way of saying CO

A

ESCPR (End-Systolic-Venous - pressure- relationship):

=CO AND EDV - curve

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5
Q

What increases the CO and with the EDV staying the same

A

Inotropy (contractility) increases, CO increases and EDV stays the same

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6
Q

When is the venous return and EDV in equilibrium

A

At +2mmHg RAP

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7
Q

When does venous return stay the same

A

Any EDV when the RAP is 0mmHg or less

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8
Q

Pulmonary resistance goes up, what happens to venous return

A

Pulmonary HTN —> RV needs more force to push blood out —> RA increases P so blood can go into high P V——> decreases venous return

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9
Q

Mean Systemic Filling Pressure

A

Psf
= P in vasculature when there is no flow
= 7+ mmHG RAP ——> venous return = 0mmHg

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10
Q

When does the right amount of venous return occur

A

At +2mmHg RAP

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11
Q

Increased TPR on CO and VR

A

Decreases both
(Specifically in arterioles and arteries)
*Psf stays the same

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12
Q

What happens when TPR decreases

A

No change in Psf

Increased CO and VR

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13
Q

What causes the CO, VR, and Psf to increase all together

A
  1. RAPID BLOOD VOLUME INCREASE
  2. Increased venous tone
  3. Venoconstriction (unstressed volume)
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14
Q

When does the CO = Venous Return

A

EQUILIBRIUM = +2mmHg RAP*

(CO=+5 L/min, VR= +5 L/min) *

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15
Q

RAP in heart failure

A 
RAP increases
CO decreases (SV decreases, more blood left tin V)
Venous Return (+3mmHG)
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16
Q

Venous return is controlled more by what N

A

Alpha 1

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17
Q

CO is controlled more by what N

A

Beta1

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18
Q

Higher contractility does what to CO, VR, RAP

A 
RAP decreases (more blood ejected)
CO increases (higher SV and, less blood left in V)
Increased afterload
= 0mmHG RAP, venous return is plateau at 6mmHg
19
Q

Increased Blood Volume causes what to CO,VR, RAP

A

RAP increases
CO increases
Venous Return = 6mmHg
Contractility stays the same

20
Q

Blood volume increased
CO
RAP
Psf

A

CO : Increased (13L/min)
RAP : increased (+7mmHg)
Psf : increased to (+16mmHg)

21
Q

Decrease in TPR on
CO, VR
RAP
Psf

A

Increases CO (reduced afterload), increased VR
*new equilibrium at +2mmHG, (VR and CO = 6mmHG)
RAP STAYS THE SAME
Psf stays the same also (+7)

22
Q

Increased TPR (arteriole constriction, blood stays longer in arteries) on
CO, VR
RAP
Psf

A

Decreased CO, decreased VR
= * new equilibrium at +2mmHG (both CO and VR are +3L/min)
RAP and Psf stay the same

23
Q

EDV

ESV

A

Volume in Heart right before contraction

Volume in Heart right after contraction (usually 40%, 120mL-50mL)

24
Q

CO =

A

CO = SV x HR

SV influenced by myocardial contractility

25
Q

CO is influenced by what 4 things

A
  1. HR
  2. Contractility (effecting SV)
  3. Preload
  4. Afterload
26
Q

What is SV

A

V ejected by Ventricle each beat

SV = EDV -ESV (usually 70mL)

27
Q

What is the ejection fraction

A

Fraction of EDV ejected (usually 55%)
efficiency and contractility measured this way
EF = SV/EDV

28
Q

What is Cardiac Output (Q)

A

TOTAL volume of blood ejected by Ventricle PER MINUTE

CO = SV x HR (usually 5L/min)

29
Q

EDV is usually
ESV is usually
+ what happens in heart here

A 
EDV = 120mL (*mitral valve closes after SA node)
ESV = 50mL (*right before mitral valve opens)
SV= 70mL
EF= 58%
30
Q

Preload is what

A

Amount of blood ready to be pumped (EDV)
*effected by Venous Return ——> CO
= tension of Ventricular wall tension

31
Q

Afterload is what

A

Force to push blood out (or open valve)
LV afterload : effected by aortic P
*a little greater then the aortic P, or pulmonary A (for RV)
*estimated to = Diastolic Pressure or person

32
Q

Afterload and velocity of myocardial contraction

A

As afterload increases the velocity of the muscles contracting decreases

33
Q

Diastolic Pressure related to Systolic Pressure

=ESPVR (end systolic pressure volume relationship)

A

Diastolic P at 110ml - 160mL (in LV) = causes highest systolic pressure and CO

  • Titin is the ideal stretch here
  • higher and lower V in LV (and P in Diastolic P) will decrease the systolic P = myosin and actin overlap is not ideal
34
Q

Isometric contraction of V has what inside

A 
The EDV (end diastolic volume)
* valve opens = afterload pressure (around 80mmHG)
35
Q

After SV has been ejected and the aortic valve closes, what happens in the heart

A

The blood V left in the LV is contestant = isometric relaxation
LV V increases again when mitral valve opens again (when A pressure has increased, and LV pressure has decreased)

36
Q

ESPVR represents

A

Contractility

More contractility = peak of ventricular pressure = INCREASED ESP

37
Q 
Decrease in PRELOAD does what to 
EDV
ESV
SV
Afterload
Contractility
A 
EDV: decreased
ESV : no change 
SV : decreased
Afterload : no change
contractility: no change
38
Q 
increase in AFTERLOAD does what to 
EDV
ESV
SV
Afterload
Contractility
A

EDV : no change
ESV : increased
SV : decreases
Contractility : no change

39
Q

4 things causing increased afterload

A
  1. HTN, (increased TPR)
  2. Aortic Stenosis
  3. Increased blood viscosity
  4. Increased intrathoracic Pressure
40
Q

Causes for decrease in AFTERLOAD

A
  1. Hypotension (low TPR)
  2. decrease in blood viscosity
  3. A fistula (organs causing decrease resistance of blood in arteries)
41
Q 
Decrease in AFTERLOAD does what to 
EDV
ESV
SV
Contractility
A

Stays the same
Decrease
Increase
Stays the same

42
Q 
Increase in CONTRACTILITY does what to 
EDV
ESV
SV
Afterload
A 
EDV : no change
ESV : decrease
SV: increases
Afterload : no change 
* LV pressure at peak increased some
43
Q 
Decrease in CONTRACTILITY does what to 
EDV
ESV
SV
Afterload
A 
No change
Increase
Decrease
No change 
*negative inotropy 
* LV pressure decreased some at its peak

CPR Exam 1 (20 decks)

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