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Coupling Cardiac Output and Venous Return
N/A
36
Physiology
Graduate
01/20/2012

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Cards

Term
What are the 4 main factors that directly affect cardiac output?
Definition
Level of basal metabolic activity, level of exercise, person's age, person's size
Term
What is the normal cardiac output for men? For women?
Definition
5.6 L/min, 4.9 L/min
Term
What is the Frank Starling intrinsic mechanism?
Definition
If more blood is delivered, more blood will automatically be pumped out of the aorta, increasing cardiac output
Term
What effect does stretching of the SA node in the wall of the right atrium have on the rhythmicity of the node and the heart rate?
Definition
Increases heart rate by 10-15%
Term
What reflex is initiated by stretching of the right atrium?
Definition
Bainbridge reflex
Term
Change in blood flow to local tissues is proportional to what?
Definition
Each tissue metabolism
Term
Cardiac output is inversely proportional to what?
Definition
Peripheral resistance
Term
How is cardiac output related to arterial pressure and total peripheral resistance?
Definition
Arterial pressure/total peripheral resistance
Term
What four properties of heart function directly affect cardiac output?
Definition
Heart rate, myocardial contractility, preload, afterload
Term
The cardiac output curve are associated directly with heart rate and myocardial contractility and are directly related to what mechanism?
Definition
Frank-starling mechanism
Term
What factors contribute to a hyper-effective heart?
Definition
Nervous system stimulation, hypertrophy of heart muscles
Term
What factors contribute to a hypo-effective heart?
Definition
Increased arterial pressure, inhibition of nervous input, coronary blockage, valvular heart disease, congenital heart disease, myocarditis (inflammation of heart muscle), cardiac hypoxia
Term
What does the vascular curve describe?
Definition
Changes in central venous pressure (right atrial pressure) that occur due to changes in cardiac output
Term
What determines central venous pressure?
Definition
The heart
Term
What is the mean circulatory pressure at equilibrium?
Definition
7mmHg
Term
What is venous pressure at normal cardiac output?
Definition
2mmHg
Term
In all cases, central venous pressure is 7mmHg when cardiac output is what?
Definition
0
Term
The intersection of the vascular function and cardiac function curves represents what?
Definition
Stable values of cardiac output and central venous pressure at which the system tends to operate
Term
While a cardiac function curve supports the Frank-starling mechanism of increased CVP = increased CO, what inverse relationship does the vascular function curve describe?
Definition
A rise in CO = reduction of CVP
Term
An increase in myocardial contractility results in an increase in cardiac output. What effect does this have on central venous pressure?
Definition
Shifts blood from venous to arterial side of the circuit, lowering central venous pressure
Term
What effect does a blood transfusion have on cardiac output?
Definition
Shifts vascular function curve, enhances cardiac output to compensate
Term
What effect does increased resistance have on central venous pressure?
Definition
Decreases the volume in arterial vessels causing vascular curve to be depressed.
Term
What effect does increased resistance have on cardiac output?
Definition
Increases afterload, decreases cardiac output
Term
What autonomic effects increase cardiac output and shift the curve left (up)?
Definition
Decreased parasympathetic, increased sympathetic, heart hypertrophy
Term
What autonomic effects decrease cardiac output and shift the curve right (down)?
Definition
Increased parasympathetic, decreased sympathetic, heart failure
Term
Systolic failure is associated with loss of inotropy which means a loss in what?
Definition
Force of muscle contraction
Term
Pulmonary edema and decreased compliance is associated to what aspect of heart failure?
Definition
Diastolic failure
Term
What are short term responses to heart failure (dramatic decrease in cardiac output)?
Definition
Increased sympathetic reflexes via baroreceptors, chemoreceptors, and ischemic response, increased heart rate and contractility, increased venous return to arterioles, increased total peripheral resistance
Term
What are long term responses to heart failure?
Definition
Stimulation of adrenal medulla to release epi/norepi, release circulating hormones, increased fluid retention in the kidneys, remodeling of heart tissue
Term
The amount cardiac output can increase above normal is known as what?
Definition
Cardiac reserve
Term
Low cardiac reserve manifests as what symptoms?
Definition
Shortness of breath, muscle fatigue, excessive increase in heart rate
Term
Atrial baroreceptors detect what?
Definition
Changes in central venous pressure
Term
Angiotensin II stimulates the release of what?
Definition
Vasopressin (ADH) from the posterior pituitary, aldosterone from the adrenal cortex, constricts resistance vessels, stimulates thirst centers, cardiac vascular hypertrophy, increases volume, cardiac output, blood pressure
Term
What effect does hemorrhages and hypovolemic shock have on ADH levels?
Definition
Increases
Term
Central venous pressure increase causing stretching of atrial myocytes causes release of what?
Definition
Atrial natriuretic peptide (ANP)
Term
Atrial natriuretic peptide has what effects?
Definition
At kidney stimulates Na+ and water excretion
Results in ↓blood volume ↓CO and ↓BP
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