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AP + Phys > Venous Return/ PV Loop > Flashcards

Venous Return/ PV Loop Flashcards

1
Q

Frank starling relationship

A

An increase in preload increases SV

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2
Q

The cardiac response to changes in venous return depends on __ and doesnt depend on ____

A

Dependent on intrinsic function
Not dependent on extrinsic neurohumoral mechanisms

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3
Q

Frank starling graph

A

Normal is an s
Low CO is lower- high afterload or decreased inotropy
High line is decreased afterload or increased inotropy

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4
Q

Non venous blood reservoirs

A

Heart
Lungs

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5
Q

Specific Reservoirs

A

Spleen
Liver
Large abdominal veins
Venous plexus beneath the skin largely controls via temperature

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6
Q

2 things that effect MCFP (mean circulating filling pressure)

A

Total blood volume
Compliance of the circulatory system
Because most blood is in venous system, venous compliance has a greater impact

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7
Q

Venous return- decrease vs increase from resistance change

A

Increase height by decrease in resistance
Decrease height by increase in resistance

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8
Q

Venous return- decrease vs increase from blood volume change

A

Graph shifts up or down
Up with more bv
Down with less bv

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9
Q

Venous return graph

A

straight, then downslope
Moves up and down (parallel) for volume change
Moves up and down (not parallel) but same end point for change in resistance

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10
Q

Why isnt frank starling parallel?

A

Bc no volume is added, only a change in pressure

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11
Q

MCFP

A

Mean circulating filling pressure
The pressure when cardiac output is 0
Arterial pressure drops
Venous pressure rises until there is no more flow
Pressure is steady until CO is 0, then it downslopes

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12
Q

VP loop

A

ACAO
MOMC
right and top- systole/ejection
left and bottom- diastole/ refilling

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13
Q

Ventricular Pressure volume loop determining SV

A

MC-MO

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14
Q

Each line of ventricular pressure volume loop

A

L isovolemic relaxation
B diastolic refilling
R isovolemic contraction
T ejections

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15
Q

What does ESV AC on PVL indicate?

A

inotropy
Further up and left- increased inotropy
Further in and right- decreased inotropy

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16
Q

Decreased EDV causes what to PVL

A

Makes it skinny by moving r line to the left
Decreased preload

17
Q

Increased preload does what to LV pressure loop

A

widens square to the right

18
Q

How does increased contractility / inotropy effect LV loop?

A

Increases height and decreases ESV (makes it taller and brings it to the left)

19
Q

How does decreased contractility effect LV pressure loop

A

Shorter, higher ESV
moves in and to the right

20
Q

How does an increase in afterload effect LV pressure loop

A

Makes pressure go high, but esv doesnt increase like in increased inotropy, esv actually is higher
Taller and skinnier

21
Q

Decreased afterload in LV pressure loop

A

Shorter (less pressure from svr), lower esv (gets more blood out of heart bc low pressure to overcome)
Makes it a small little chubby graph

22
Q

Aortic regurg vs mitral regurg on LV pressure loop

A

Unsure how to differentiate
Circle blob tall bc
Short blob

23
Q

Aortic stenosis on LV pressure loop

A

Cause super high pressure, tall and skinny, high afterload

24
Q

What is the cardiac function curve?

A

Frank starling curve

25
Q

What will increase/ decrease the cardiac function curve?

A

Increase- decreased afterload or increased inotropy
Decrease- increased afterload or decreased inotropy

26
Q

Volume/ pressure curve for veins vs arteries

A

Veins require more volume before they creat a pressure
Arteries create a higher max pressure, and start to create a pressure at lower volumes

27
Q

What is unstressed volume

A

The amount of blood in a vein before it creates a pressure

28
Q

When is unstressed volume decreased?

A

During hypovolemic states as an attempt to vasoconstrict and increase blood pressure

29
Q

What is stressed volume

A

The amount of blood that participates in pressure generation

30
Q

What can increase Venous return graph parallel vs not parallel

A

Parallel increase: increased blood volume or decreased venous compliance/ venous constriction
Not parallel increase: Decreased SVR/ arteriolar dilation

31
Q

What is the PV loop useful for?

A

Assessing preload, afterload, and inotropy

32
Q

When is MC pushed to left AND up? Examples?

A

NOT decreased preload!
During diastolic dysfunction
Chronic htn
Coronary heart disease
Aging
Aortic stenosis
Hypertrophic CMP
Restrictive CMP

33
Q

How does a decrease in preload affect PV loop?

A

Shift to the left, also makes loop smaller

34
Q

espvr reps

A

inotropy

35
Q

PV loop acute and chronic HF

A

Inotropy keeps getting less steep
Graph just keeps shifting right

36
Q

PV loop aortic regurgitation

A

Shifted to the right, a blob
Major huge R shift EDV bc the ventricle is getting hella fluid from RA and atrium

37
Q

PV loop mitral regurg

A

Like AR but ESV is lower bc it pushes more out bc the floppy mitral valve, so it actually increases SV more than AV but not truly bc that blood is going to RA

AP + Phys (38 decks)

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