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Physiology I (Exam II material) > Cardiac ouput > Flashcards

Cardiac ouput Flashcards

1
Q

Quantity of blood pumped into the aorta each minute by the heart

A

Cardiac output

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2
Q

quantity of blood that flows through the circulation

A

Cardiac Output

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3
Q

Sum of all the blood flows to all of the tissues of the body

A

Cardiac output

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4
Q

Cardiac output per square meter of body surface

A

Cardiac index

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5
Q

What is the cardiac index of a normal human being

A

70kg
body surface area= 1.7 square meters
Cardiac output=5L
Cardiac index=5/1.7 square meters= 3 L/min/m^2

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6
Q

is the quantity of blood flowing from the veins into the right atrium each minute

A

Venous return

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7
Q

Venous return and cardiac output must equal one another except

A

for a few heartbeats at a time when blood is temporarily stored in or removed from the heart and lungs

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8
Q

What 4 factors directly affect cardiac output

A

the basic level of body metabolism
whether the person is exercising
the person’s age
the size of the body

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9
Q

Cardiac index peaks around age ___ and then

A

10 (about 4 L/min/m^2) and then declines to about 2.4 L/min/m^2 at 80

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10
Q

What happens to the cardiac output and cardiac index as the oxygen consumption (during exercise increases)

A

They both increase at the same rate as increased oxygen consumption

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11
Q

What is normal cardiac ouput

A

about 5 L/min

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12
Q

What is the limit of cardiac output

A

about 13 L/min about 2.5 times the normal cardiac ouput of 5 L/min

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13
Q

A normal human heart, functioning without any special stimulation, can pump a venous return up to about ____ time the normal venous return before the heart becomes a limiting factor in the control of cardiac ouput

A

2.5 times

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14
Q

What are two factors that cause a hypereffective heart

A
  1. ) nervous stimulation

2. ) hypertrophy of the heart muscle

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15
Q

The flick principle of blood flow is used to calculate what

A

blood flow through an organ

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16
Q

what is the equation for flick principle

A

Cardiac output= Oxygen consumption/ (oxygen in pulmonary vein - oxygen in pulmonary artery)

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17
Q

What is the equation for stroke volume

A

stroke volume= cardiac ouput/HR

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18
Q

What is the determining factor that controls how much blood the heart pumps out?

A

The heart is a “demand” pump
the heart pumps out whatever blood comes back into it from the venous system
It is the amount of blood returning to the heart that determines how much blood the heart pumps out

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19
Q

The cardiovascular system consists of ______ pumps and _____ circuits connected in series

A

two, two

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20
Q

What are the two pumps of the heart

A

The left and right ventricles

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21
Q

What are the two circuits of the cardiovascular system

A

pulmonary and systemic circuits

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22
Q

Because the two circuits of the cardiovascular system are connnected in series

A

flow must be equal in the two circuits
cardiac output and rate of the two circuits are equal
all pressures are higher in the systemic circuit
chemical composition of pulmonary venous blood is similar to that of systemic arterial blood
chemical composition of venous blood entering the right atrium is the same as the composition of pulmonary arterial blood

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23
Q

What is the normal cardiac output for a young, healthy male

A

5.6 L/min

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24
Q

What is the cardiac output of a woman

A

4.9 L/min

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25
Q

What is the cardiac output of a resting adult

A

5.0 L/min

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26
Q

Control of cardiac output is primarily due to what

A

Venous return

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27
Q

What is the Frank-Starling Law

A

Heart automatically pumps whatever amount of blood that flows into the right atrium

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28
Q

Stretching of the heart causes what

A

the heart to pump faster and with more force

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29
Q

Stretching of the right atrium initiates what reflex

A

Bainbridge reflex

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30
Q

Under most normal non-stressful conditions, the cardiac output is controlled almost entirely by

A

Peripheral factors that determine venous return

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31
Q

What is ohm’s law in turn of cardiac ouput

A

any time the long-term level of total peripheral resistance changes the cardiac output changes quantitatively in exactly the opposite direction.

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32
Q

What are the most important controllers of cardiac ouput

A

Peripheral factors

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33
Q

Both the _____ and the ______ reflexes control heart rate

A

Bainbridge and baroreceptor reflex

34
Q

Stretching the Sinus node in the wall of the right atrium has a direct effect on the rhythmicity of the node to increase the HR as much as

A

10 to 15 percent

35
Q

The bainbridge relex (atrial stretch relex) responds to what

A

changes in blood volume as detected by stretch receptors in the right atrium, signals are sent form the right atria up the vagus nerve to the medulla, a signal is then sent back down to increase HR and contractile force. This is to prevent damming of blood in the heart and pulmonary system.

36
Q

What is the main difference between baroreceptor relfex and Bainbridge relfex

A

baroreceptors are due to atrial pressure and Bainbridge is due to atrial stretch

37
Q

The bainbridge reflex is not significant in humans except when

A

at birth when a large volume of the uteroplacental blood returns to the mother’s circulation and results in tachycardia.

38
Q

What happens to cardiac output as total peripheral resistance increases

A

it decreases

39
Q

what is the equation for cardiac output

A

cardiac output= arterial pressure/ total peripheral resistance

40
Q

What are three factors that cause hypereffective heart

A

Nervous stimulation
Hypertrophy of heart
Exercise via the nervous system
- intense increase in metabolism in active skeletal muscles
- This allows more blood into these arterioles
- Brain sends motor signals to the muscles and to the ANS centers of the brain to excite circulatory activity
- This causes a large vein constriction
- This leads to increased heart rate, and increased contractility of the heart

41
Q

Factors that cause a hypoeffective heart

A

Increased arterial pressure (i.e. Hypertension)
Inhibition of nervous excitation of the heart
pathological factors causing abnormal heart rhythm/rate
Coronary artery blockage
Valvular heart disease
Congenital heart disease
Cardiac Hypoxia

42
Q

In demonstration of the frank-starling mechanism as ventricles fill in response to higher atrial pressure, each ventricular volume and strength of cardiac muscle contraction

A

increases and results in an increase in an increase in cardiac output

43
Q

Factors causing that decrease cardiac ouput

A 
severe blood vessel blockage ----> MI
Severe valvular disease
Myocarditis
Cardiac Tamponade 
Cardiac metabolic arrangements
44
Q

Beriberi

A

Insufficient quantity of the vitamin thiamine (Vitamin B1) in the diet. Leads to nutrient lack in tissues and Vasodilation
This leads to increase in cardiac output and venous return, often twice the normal

45
Q

Atriovenous fistula effect on Cardiac ouput

A

connection between a major artery and major vein, decreases peripheral resistance, venous return, and cardiac ouput

46
Q

Hyperthyroidism effect on cardiac output

A

Metabolism of most tissues of the body becomes greatly increased. oxygen usage increases, and vasodilator products are released from the tissues. Venous return and Cardiac output often increase to 40 to 80 percent above normal

47
Q

Anemia effect on cardiac output

A

Two peripheral effects greatly decrease total peripheral resistance.
1.) reduced viscosity of the blood- from decreased RBCs
2.) diminished delivery of oxygen to the tissues, which causes vasodilation.
thus cardiac output greatly increases

48
Q

Conditions that cause low cardiac output fall into what two categories

A
  1. ) Abnormalities that decrease pumping effectiveness of the heart
  2. ) Those that decrease venous return
49
Q

How does decreased tissue/muscle mass effect Cardiac Output

A

decreases the total oxygen consumption and blood flow needs of the muscles, resulting in decreases in skeletal muscle blood flow and cardiac output

50
Q

How does hypothyroidism effect cardiac ouput

A

tissue metabolic rate is reduced thus oxygen and nutrition needs of tissues will also decrease, thus leading to reduced cardiac output

51
Q

Non-cardiac factors that decrease cardiac ouput

A 
Decreased blood volume
acute venous dilation
obstruction of large veins
decreased tissue mass (esp. muscle mass) 
Decreased metabolic rate of tissues
52
Q

Cardiac ouput=

A

arterial pressure/total peripheral resistance

53
Q

If all nervous circulatory reflexes are prevented form acting, venous return decreases to zero when the right atrial pressure rises to about

A

+7Hg

54
Q

If right atrial pressure is -2mm Hg then venous return reaches

A

a plateau, caused by collapse of veins entering the chest

55
Q

Venous return is affected by what 3 factors

A

right atrial pressure, degree of filling of the systemic circulation (measured by the mean systemic filling pressure)
Resistance to blood flow between the peripheral vessels and the right atrium

56
Q

what is mean systemic filling pressure

A

booth arterial and venous pressures come to equilibrium when all flow in the systemic circulation ceases at a pressure of 7mmHg

57
Q

What is mean circulatory filling pressure

A

When heart pumping stops, blood flow ceases

The mean circulatory pressure is the pressure that is constant throughout the body

58
Q

The greater the volume of blood the ____ the mean circulatory filling pressure

A

greater

59
Q

at 4 liters what is the mean circulatory pressure

A

about 0

60
Q

What is the mean circulatory pressure with 5 liters of blood

A

about 7 mmHg

61
Q

sympathetic nervous stimulation has what effect on the mean circulatory filling pressure

A

increases it

62
Q

The greater the difference between the mean systemic filling pressure and the right atrial pressure, the greater the

A

venous return

63
Q

The difference between the mean systemic filling pressure and the right atrial pressure equals

A

pressure gradient for venous return

64
Q

Venous return equals

A

(mean systemic filling pressure- Right atrial pressure)/resistance to venous return

(note that the numerator is pressure gradient for venous return)

65
Q

about ___of the resistance to venous return is determined by arteriolar and small artery resistance

A

1/3

66
Q

The normal resistance to venous return is

A

1.4 mm Hg per L/min of blood flow

67
Q

factors that affect venous return

A

right atrial pressure, mean systemic filling pressure (Psf), and blood flow resistance between peripheral vessels and right atrium

68
Q

What factors increase mean systemic pressure (Psf)

A
  • Increase vascular volume (this can be done by inusion or activation of renal-angiotensin-aldosterone system)
  • Decrease venous compliance (this can be done through sympathetic stimulation, muscle pump, exercise, lying down)
69
Q

An increase in Psf has what effect on the vascular return curve

A

shift the curve to the right

enhances filling of the ventricles

70
Q

Factors that decrease mean systemic pressure (Psf)

A
  • Decrease vascular volume (hemorrhage, burn trauma, vomiting, diarrhea)
  • Increase venous compliance (inhibit sympathetics, alpha block, venodilators, standing upright)
71
Q

Decrease in Psf has what effect on the venous return curve

A

it shifts to the left

Thus reduces filling of the ventricles

72
Q

sympathetic (positive inotropic effect) can increase Psf, venous return, and cardiac ouput while maintaining the same right atrial pressure. How?

A

Because the increase in stroke volume

73
Q

Large blood flow during skeletal muscle activity is due mainly to

A

chemicals that act directly on muscle arterioles to dilate them: ex. Reduction of oxygen, adenosine, potassium ion, ATP, Lactic acid, Carbon dioxide

74
Q

Two ways the nervous system controls blood flow through skeletal muscle

A

Sympathetic vasoconstrictor nerves: secrete norepiniephrine, which can decrease blood flow to as little as one-half to one-third
Adrenal medullae: secretes epinephrine and norepinephrine

75
Q

Explain the mass discharge of the sympathetic nervous system during exercise

A

-heart rate increases
-most peripheral arteries are strongly contracted except
those in active muscles
coronary arteries
cerebral arteries
-Muscle walls of veins are contracted: increases mean systemic filling pressure

76
Q

How does the sympathetic stimulation during exercise increase arterial pressure

A
  • vasoconstriction of arterioles and small arteries in most tissue
  • increased pumping activity of the heart
  • increase in mean filling pressure caused mainly by venous contraction
77
Q

coronary blood flow in the left ventricle during systole

A

falls to a low value

78
Q

What is the primary controller of coronary flow

A

local muscle metabolism

79
Q

Does Direct ANS stimulation acts on blood vessels themselves

A

Yes

80
Q

Indirect ANS stimulation is on the cardiac muscle tissue and

A

indirectly on the coronary vessels via local control mechanisms

81
Q

Causes of death caused by coronary occlusion

A

Decreased cardiac output
damming of blood in pulmonary blood vessels and death resulting form pulmonary edema
fibrillation of the heart
rupture of heart

Physiology I (Exam II material) (9 decks)

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