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Human physiology PT > Chapter 20- Exam 3 > Flashcards

Chapter 20- Exam 3 Flashcards

1
Q

what is Q

A

the sum of all tissue flows and is affected by their regulation

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2
Q

what is the average Q in an adult

A

5 l/ min

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3
Q

what is cardiac index

A

Cardiac Output relative to Body Surface Area

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4
Q

what is the average cardiac index

A

3L/min/m2

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5
Q

what is the equation for Cardiac index

A

CI = CO / BSA

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6
Q

what is Q proportional to

A

tissue used of O2

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7
Q

look at slide

A

3

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8
Q

what happens if flow in the tissue increase

A

the VR increases

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9
Q

what is the frank starling law

A

that if VR increased Z shoudl increase too

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10
Q

what is the normal ranges for Cardiac index

A

2.6-4.2 L/min/m2

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11
Q

when will there be cardiogenic shock in relation to CI

A

less than 2.2 L /min/m2

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12
Q

what does right atrial pressure represent

A

venous return

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13
Q

what happens when RAP increases

A

it represents more blood flowing into right atria

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14
Q

why does a platue happen in the Q curve graph

A

this is showing how the heart limits Q as it can not longer fill anymore

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15
Q

what is hypereffective heart

A

this increase Q above normal

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16
Q

what are two factors that can make the heart a better pump than normal

A

1 SNS stimulation

2 hypertrophy of the heart

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17
Q

what is hypoeffective heart

A

this is a decrease in Q form the normal

– Or anything that decrease the hearts ability to pump the blood

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18
Q

what are some things that decrease the hearts ability to pump

A
  • Increased arterial pressure against which the heart must pump, such as in hypertension
  • Inhibition of nervous excitation of the heart
  • Pathological factors that cause abnormal heart rhythm or rate of heartbeat
  • Coronary artery blockage, causing a “heart attack”
  • Valvular heart disease
  • Congenital heart disease
  • Myocarditis, an inflammation of the heart muscle
  • Cardiac hypoxia
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19
Q

what is one way you can effect Q

A

is by changing the external pressure on the outside of the heart

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20
Q

what is intraplueral pressure

A

= pressure in the chest cavity) is an external pressure on the heart

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21
Q

what is the typical intraplueral pressure

A

about -4 mmHg

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22
Q

what happens with and increase in intraplueral pressure

A

Increase IPP from -4 to -2mmHg shifts Q curve to right

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23
Q

what must happen to fill chambers

A

Must increase RAP to fill chambers to overcome the external pressure

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24
Q

what is Cardiac tamponade

A

fluid accumulation between the heart and the pericardium that compresses the heart

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25
Q

what are some factors that can alter external pressure and shift the Q curve

A
  • Cyclical changes of intrapleural pressure during respiration
  • Breathing against a negative pressure
  • Positive pressure breathing
  • Opening the thoracic cage
  • Cardiac tamponade
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26
Q

what are the pressure of VR

A
  • right atrial pressures (RAP)

- Central Venous Pressure (CVP)

27
Q

what is RAP

A

–Pressure in Right Atrium
–Reflects venous return
–Influences/determines preload
–~ = 0 mmHg

28
Q

What is CVP

A 
–Pressure in the venae cavae near the Right atrium 
–Approximates RAP
–CVP and RAP often different
–Influences/determines preload
–~ = 2 to 6 or 3 to 8 mmHg
29
Q

what are 3 principles that influence the VR curve

A

1.Right Atrial Pressure
2.Mean Systemic Filling Pressure  Next
• Forces blood toward the heart
3.Resistance to blood flow

30
Q

what is the mean systemic filling pressure

A

Both the arterial and the venous pressures equilibrate when all flow in the systemic circulation ceases at a pressure of 7 mm Hg

31
Q

what happens to VR when RAP increases

A

it will decrease

32
Q

when will mean systemic filling pressure be relavent

A

if the heart pumping is compromised causing right atrial pressure to rise

33
Q

what happens to VR when RAP is 7 mmHG

A

it will fall to 0

34
Q

what happens when VR = 0 mmHg

A

cardiac pumping = 0

35
Q

what is the VR equation

A

VR = Psf - PRA
—————–
RVR

36
Q

what is Psf

A

Systemic Filling Pressure

37
Q

what is PRA

A

Right Atrial Pressure

38
Q

what is RVR

A

Resistance to Venous Return

39
Q

what is normal Psf

A

7mmHg

40
Q

what is normal PRA

A

0mmHg

41
Q

what is normal RVR

A

1.4 mmHg/ L*MIn^-1

42
Q

when does the VR curve Plateaus at

A

-2 mmHg

43
Q

when does the plateau of the VR occur

A

even when right atrial pressure falls to −20 mm Hg, −50 mm Hg, or

44
Q

what is the platueau caused by

A

This plateau is caused by collapse of the veins entering the chest.

45
Q

what happens with the great the volume of blood of the circulation

A

the greater is the mean circulatory filling pressure

46
Q

what happens 4000 ml blood

A
47
Q

what happens at normal blood volume of 5 L

A

MCFP is ~7mmHg  Purple Line

If Blood Volume Increases, MCFP Increases  Orange Line
look at slide 18

48
Q

what happens with sns stimulation of the blood

A

smaller container,
At normal blood volume, MCFP Increases  Green Line
(look at slide 18)

49
Q

what happens with PNS stimulaiton

A

larger container

look at slide 18

50
Q

what happens with higher MSFP

A

VR curve shifts upward and to the right.

look at slide 19

51
Q

what happens with lower MSFP

A

VR curve shifts downward and to the left

look at slide 19

52
Q

what is an equation for VR (another one )

A

VR = CVP – RAP

look at slide 19

53
Q

what happens with the resistance in the veins increase

A

blood is less able to move out of v( look at slide 20)eins

54
Q

why is it so hard for the venous pressure to rise

A

Because veins are highly distensible venous pressure rises very little
( look at slide 20)

55
Q

what happens with the RAP rises to the MSFP

A

VR =0

look at slide 20

56
Q

to complete ciruclation what needs to work together to make this happen

A

the heart and the systemic circulation must operate together.

57
Q

what must happen with the heart and the systemic circulation to complete circulation

A

(1) the venous return from the systemic circulation must equal the cardiac output from the heart
(2) the right atrial pressure is the same for both the heart and the systemic circulation

58
Q

look at slide

A

23, 24

59
Q

what happens if the Q does NOT = VR

A

then all blood would either accumulate or be removed from the chest

60
Q

what happens if left ventricle output is 6 and venous return = 5

A

all blood would be shifted to the periphery.

61
Q

how do you measure Q

A
  • Electromagnetic flowmeter
  • Indicator dilution (dye such as cardiogreen)
  • Thermal dilution
  • Oxygen Fick Method
62
Q

what is the Oxygen Fick Method equation

A

O2 consumption = Q x (A-V O2 difference)

63
Q

look at slide

A

28 at the equation written out

Human physiology PT (12 decks)

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