Regulation of stroke volume and heart rate Flashcards

1
Q

What is the control mechanism of heart rate ?

A

Neural

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2
Q

What is the regulation mechanism for stroke volume ?

A

Preload

Afterload

Neural

Pathological

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3
Q

What is the regulation mechanism for stroke volume ?

A

Preload
Afterload
Neural
Pathological

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4
Q

How does the sympathetic nervous system regulate heart rate ?

A

Sympathetic nerves release noradrenaline
Plus circulating adrenaline from adrenal medulla
Both act on B1 receptors on SAN
Increases slope of the pacemaker potential
Increases heart rate = tachycardia

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5
Q

What is the effect of the parasympathetic nervous system on heart rate ?

A

Vagus nerve releases Ach
Acts on muscarinic receptors on SAN
Hyperpolarises cells and decreases slope on pacemaker potential
Decrease heart rate = bradycardia

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6
Q

What does starlings law state ?

A

Starling’s Law states - the energy of contraction is proportional to the initial length of the cardiac muscle fibre

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7
Q

In vivo, what is preload affected by ?

A

Preload is affected by the end diastolic volume

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8
Q

What does increased venous return do ?

A

Increases EDV and therefore increases stroke volume

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9
Q

What does decreased venous return do ?

A

Decreases EDV and therefore decreases stroke volume

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10
Q

What ensures self regulation of stroke volume of left and right ventricles ?

A

The proportional relationship between the volume of venous return and the stroke volume

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11
Q

What is afterload ?

A

Load against which the muscles tries to contract

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12
Q

What is the aortic pressure affected by ?

A

How much blood is pushed into the aorta (cardia output)

How easy it is for the blood to get out of the aorta (total peripheral resistance)

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13
Q

Why does an increase in TPR result in a reduction in stroke volume ?

A

Aortic pressure will increase, the ventricle will have to work harder to push open the aortic valve, and it will have less energy left to do the useful bit of ejecting blood

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14
Q

What is responsible for the variable portion of the total peripheral resistance ?

A

The arterioles

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15
Q

What is the total peripheral resistance set by ?

A

The arterial pressure - what sets the afterload

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16
Q

What affects preload ?

A

Venules/veins and capacitance vessels

These all affect the venous return

17
Q

What affects afterload ?

A

Arterioles and resistance vessels

18
Q

What does a bigger end diastolic volume mean ?

A

Bigger pre-load and therefore more tension and more strength of contraction

19
Q

How does the sympathetic nervous system affect stroke volume ?

A

Noradrenaline from nerves and the adrenal medulla act on beta 1 receptors of the myocytes - which increases contractility - stronger but shorter contraction

20
Q

What does ionotropic refer to ?

A

The strength of contraction

21
Q

What is the effect of the parasympathetic nervous system on the contractility of the heart ?

A

Little effect - vagus nerve does not innervate the ventricular muscle

22
Q

How is cardiac output calculated ?

A

HR X SV = cardiac output

23
Q

Why does stroke volume decrease with an increased heart rate ?

A

Shortened cardiac cycle cuts into rapid filling stage - smaller EDV (small length of muscle), less tension and therefore less stroke volume

24
Q

What are the combined mechanisms that increase heart rate ?

A

Via decreased vagal tone and increased sympathetic tone

25
Q

What shortens systole ?

A

Effect of increased sympathetic tone on the contractility - alters ionotropic state

26
Q

How does venous return increase ?

A

Via venoconstriction and skeletal / respiratory pumps

Maintains preload when we expect it to fall with a reduced EDV brought on with a fast heart rate

27
Q

Why does total peripheral resistance fall with a fast heart rate ?

A

Arteriolar dilation in muscle, skin & heart

Reduced afterload - makes it easier for heart to pump out blood