Cardiac Output Flashcards

1
Q

What is the equation for Cardiac output?

A

SV x HR = CO

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2
Q

What is the definition of cardiac output?

A

Volume of blood ejected from the hear per unit time

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3
Q

WHat is the normal value of CO?

A

5 L/min in resting adutlt

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4
Q

What is the Left Ventricular outflow tract?

A

The path that blood will forllow to get out of the heart

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5
Q

What is the Cardiac index?

A

Volume of blood ejected from the hear per unit time per unit of body surface area.

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6
Q

What is the normal value of Cardiac index?

A

3 L/Min/M2 body surface area

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7
Q

What is the consequence of a rupture of the chrodae tendinae?

A

Severe mitral valve regurgitation

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8
Q

What is the long term effect of regurgitant flow?

A

Clotting and erosion of the mitral valve

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9
Q

What is the definition of Stroke volume?

A

Volume of blood ejected by the ventricle during each contraction

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10
Q

What are the determinants of SV?

A
  • EDV/preload
  • Ventricular Contractility
  • Afterload
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11
Q

What does the VEDV tell you?

A

Indicator of cardiac function and ventricular contraction

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12
Q

What are the determinants of VEDV?

A
BVol
Venous Return
Intrathoracic Pressure
Effective atrial contraction
AV valve function
Ventricular compliance
Pericardial condition
Heart rate
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13
Q

What can effect the determinants of VEDV?

  1. BVol
  2. Venous Return
  3. Intrathoracic Pressure
  4. Effective atrial contraction
  5. AV valve function
  6. Ventricular compliance
  7. Pericardial condition
  8. Heart rate
A
  1. Hemmhorage, dehydration, IV infusion
  2. Position, Physical Activity
    Strain Emphysema
  3. A-V synchrony: AV block, A fib
  4. Mitral Stenosis
  5. Restrictive 6.Cardiomyopathy, MI
  6. Pericardial Effusuon, COnstrictive pericarditis
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14
Q

What is Cardiac Preload?

A

Tension exerted on the cardiac ventricular muscle when it begins to contract

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15
Q

What is Cardiac Afterload?

A

Pressure that the ventricle has to overcome to produce SV

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16
Q

What are the determininants of Afterload?

A

VOT: Hypertrophic Myocardiopathy
AVF:
PAR:

17
Q

What are the determininants of EDV?

A

Preload, Ventricular Contrctility, after load

18
Q

What is the ESV

A

Intraventricular volume at the end of systole

Tells you systolic function

19
Q

What happens when preload increases with contractility and afterload stays constant?

A

SV increases as preload increases

20
Q

What is the Frank Starling Law of the heart?

A

Length Dependant activation: Force of V contraction is a function of VED Length of the cardiac muscle

21
Q

What is the Mechanism of the Frank Starling LAw?

A

Length of the Myocardial SarcomereDetermines its sensitivity to Ca2+

22
Q

Waht are the implications of FSL?

A

Balance between two ventricles
inAdequate preload can cause a decrease in CO and HypoTN
Excessive initial Stretch May Result in Decompensation and Dec. in CO

23
Q

What are the effects of Afterload on Stroke Volume keeping Preload and Contractility constant?

A

SV decreases with increasing afterload

24
Q

What is the classical cause of increased afterload?

A

HTN

25
Q

What is the ANREP effect?

A

Aortic pressure is elevated abruptly, a positive inotropic effect follows
Initial response: length dependant activation
Slow Force Respnse: independant of muscle length-true inotropic effect

26
Q

What is the mechanism of the ANREP Effect?

A

Inc. LV wall tension
> inc Cyt Na+
> inc MC Cyt Ca2+
> inc MC contraction

27
Q

What tje the relationship between contractility and SV?

A

Inc. Contractility > Inc SV

Dec Cont. > Dec SV

28
Q

How does eh heart compensate for an increase in demand in Heart Failure?

A

Stretching of Myocaardium/ VEDV inc more than SV

29
Q

What can effect contractility?

A
Catecholamines
Inotropic drugs
Force-Freq Rel
Hypoxia/Hypercapnia/ Acidosis
Intrinsic Depression
Myocardial Depressants 
PS and Symp impulses
30
Q

What is the Bowditch Staircase Phenomenon?

A

Inc HR progressively inc force of VC

Dec HR- Neg staircase effect

31
Q

What is an opposing factor of the BD S Phenom?

A

Decrease Vent filling

Stim too rapid > Force dec

32
Q

What is the cutoff for heartrate before opposing BDSP factors kick in?

A

180 BPM

33
Q

What is the most common method of measuring CO?

A

Pulm Artery Catheterization (PAC) thermodilution with bolus injection of cold fluid

34
Q

What is the Stewart Hamilton Eqn used for?

A

Pulm Artery Catheterization (PAC) thermodilution with bolus injection of cold fluid

35
Q

What is the relationship beween rate of temp change and and CO in PAC?

A

Faster rate == Larger CO

36
Q

What is a Swan Ganz Catheter

A

Device used in Pulm Artery Catheterization (PAC) thermodilution with bolus injection of cold fluid