Elina_Physiology_Cardiac Muscle Mechanics

Front 1

SYSTOLIC PERFORMANCE OF THE VENTRICLE
What Systolic performance does means?

Back 1

Systolic performance actually means the overall force generated by the ventricular muscle during
systole.

Front 2

SYSTOLIC PERFORMANCE OF THE VENTRICLE
what systolic performance is determined by ?

Back 2

This is determined by the number of cross-bridges cycling during contraction.The greater the number of cross-bridges cycling, the greater the force of contraction.

Front 3

SYSTOLIC PERFORMANCE OF THE VENTRICLE
what the number of cross-bridges cycling is determined by

Back 3

The number of cross-bridges cycling is determined by independent variables: the amount
of preload on the muscle and the level of contractility.

Front 4

SYSTOLIC PERFORMANCE OF THE VENTRICLE
what two factors are summed together to determine the overall force of ventricular contraction.?

Back 4

the amount of preload on the muscle and the level of contractility.

Front 5

SYSTOLIC PERFORMANCE OF THE VENTRICLE
What is preload in cardiac muscle?

Back 5

it is the load or prestretch on ventricular muscle at the end of diastole.

Front 6

SYSTOLIC PERFORMANCE OF THE VENTRICLE
The best indices of preload are?

Back 6

Left ventricular end-diastolic volume (LVEDV)
• Left ventricular end-diastolic pressure (LVEDP)

Front 7

SYSTOLIC PERFORMANCE OF THE VENTRICLE
What are less reliable(надежные) indices of left ventricular preload are those measured in the
venous system.

Back 7

Left atrial pressure
Pulmonary venous pressure
Pulmonary wedge pressure

Front 8

SYSTOLIC PERFORMANCE OF THE VENTRICLE
как измеряют Pulmonary wedge pressure?

Back 8

the tip of a Swan-Ganz catheter вводят в правое предсердие,в првый Желудочек и в легочную артерию. давление в легочную артерию примерно одинаково с давлением в легочных капилярах.и также приблизительно одинаково с давлением в Левом предсердии.

Front 9

SYSTOLIC PERFORMANCE OF THE VENTRICLE
The resting length of skeletal muscle in vivo is at a sarcomere length close to the optimum for...

Back 9

The resting length of skeletal muscle in vivo is at a sarcomere length close to the optimum for
maximal cross-bridge linking between actin and myosin during contraction (Lo) .

Front 10

SYSTOLIC PERFORMANCE OF THE VENTRICLE
Как зависит сила сокращения во время систолы от длины саркомера?

Back 10

increased preload
increases sarcomere length toward the optimum actin-myosin overlap. This results in more
cross-linking and a more forceful contraction during systole.

Front 11

SYSTOLIC PERFORMANCE OF THE VENTRICLE
Frank-Starling Mechanism?

Back 11

Зависимость объема выброса от индекса preload (Left Ventricular End-Diastolic Volume
(mL)

Front 12

SYSTOLIC PERFORMANCE OF THE VENTRICLE
preload and contractility It's independence or dependence factors in acute situation?

Back 12

independence

Front 13

SYSTOLIC PERFORMANCE OF THE VENTRICLE
If preload is increased - force of contraction
during systole is?

Back 13

increased

Front 14

SYSTOLIC PERFORMANCE OF THE VENTRICLE
preload is one factor that determines ?

Back 14

preload is one factor that determines the overall force of
ventricular contraction.

Front 15

SYSTOLIC PERFORMANCE OF THE VENTRICLE
if increase sympathetic activity to the ventricle, at the same preload -. force of contraction
during systole is?

Back 15

increase sympathetic activity to the
ventricle, we also observe an increased force of contraction, but at the same preload.

Front 16

SYSTOLIC PERFORMANCE OF THE VENTRICLE
what two factors that determine the overall force of ventricular
contraction are:

Back 16

there are two factors that determine the overall force of ventricular
contraction: preload and contractility.

Front 17

SYSTOLIC PERFORMANCE OF THE VENTRICLE
как влияет увеличение preload contractility на performance (точки ABCD график)

Back 17

A --+ B increased performance due entirely to preload
A --+ C increased performance due entirely to contractility
A --+ D increased performance due to an increase in both preload and contractility

Front 18

SYSTOLIC PERFORMANCE OF THE VENTRICLE
как влияет сократимость на performance?

Back 18

contractility would be a change in performance at a given preload.

Front 19

SYSTOLIC PERFORMANCE OF THE VENTRICLE
как сократимость влияет на силу сокразения и длину саркомера?

Back 19

contractility is a change in the force of contraction at any given sarcomere length.

Front 20

SYSTOLIC PERFORMANCE OF THE VENTRICLE
С чем связаны острые изменения в сократимости?

Back 20

Acute changes in contractility are due to changes in the intracellular dynamics of calcium. Drugs
that increase contractility usually provide more calcium and at a faster rate to the contractile
machinery. More calcium increases the availability of cross-link sites on the actin, increasing
cross-linking and the force of contraction during systole.

Front 21

SYSTOLIC PERFORMANCE OF THE VENTRICLE
С чем связаны хроническая потеря сократимости?

Back 21

Calcium dynamics do not explain
chronic losses in contractility, which in most cases are due to overall myocyte dysfunction.

Front 22

SYSTOLIC PERFORMANCE OF THE VENTRICLE
indices of contractility is?

Back 22

indices of contractility
include the rate ofpressure development during isovolumetric contraction and ejection fraction.

Front 23

SYSTOLIC PERFORMANCE OF THE VENTRICLE
ejection fraction is?

Back 23

ejection fraction (stroke volume/end-diastolic volume

Front 24

SYSTOLIC PERFORMANCE OF THE VENTRICLE
как влияет сократимость на силу сокращения?

Back 24

When contractility increases, increased force of contraction.

Front 25

SYSTOLIC PERFORMANCE OF THE VENTRICLE
The overall changes induced by increased contractility are?

Back 25

Increased dpldt: increased slope, thus increased rate of pressure development
2. Increased peak left ventricular pressure due to a more forceful contraction
3. Increased rate of relaxation due to increased rate of calcium sequestration
4. Decreased systolic interval due to effects #1 and #3

Front 26

SYSTOLIC PERFORMANCE OF THE VENTRICLE
Что будет протсходить при увеличении прелоад и сократимости?

Back 26

Both an increased preload and an increased contractility will be accompanied by an increased
peak left ventricular pressure, but only with an increase in contractility will there be a decrease
in the systolic interval.

Front 27

SYSTOLIC PERFORMANCE OF THE VENTRICLE
какой интервал сердца(систолический\диастолический )обуславливает сократимость и ЧСС

Back 27

contractility affects systolic interval, heart rate determines diastolic interval.

Front 28

SYSTOLIC PERFORMANCE OF THE VENTRICLE
increased sympathetic activity to the heart will produce the following:

Back 28

Systolic interval decreased: contractility effect
• Diastolic interval decreased: heart rate effect

Front 29

SYSTOLIC PERFORMANCE OF THE VENTRICLE
Index of systolic performance:

Back 29

Index of systolic performance, e.g., stroke work stroke volume, stroke power
(cardiac output). All are indices of the force of ventricular contraction.

Front 30

SYSTOLIC PERFORMANCE OF THE VENTRICLE
Index of ventricular preload,:

Back 30

Index of ventricular preload, e.g., ventricular end-diastolic volume or pressure,
atrial or venous pressure.

Front 31

SYSTOLIC PERFORMANCE OF THE VENTRICLE
The pericardium normally prevents...

Back 31

The pericardium normally prevents the large increases in preload

Front 32

SYSTOLIC PERFORMANCE OF THE VENTRICLE
что будет с performance при снижении preload?

Back 32

decreased performance due to a reduction in preload

Front 33

SYSTOLIC PERFORMANCE OF THE VENTRICLE
что будет с performance при учеличении preload?

Back 33

increased performance due to an increased preload

Front 34

SYSTOLIC PERFORMANCE OF THE VENTRICLE
что будет с performance при учеличении сократимости?

Back 34

increased performance due increased
contractility (close to the situation during exercise

Front 35

SYSTOLIC PERFORMANCE OF THE VENTRICLE
if a loss in preload, e.g., hemorrhage

Back 35

of a loss in preload, e.g., hemorrhage
• Performance decreases because of a loss in preload.
• The loss of venous return and preload reduces cardiac output and blood pressure and
via the carotid sinus reflex sympathetic stimulation to the heart increases.
• The increased contractility partially compensates for the loss of preload.
• When there is a loss of either preload or contractility that compromises performance,
the other factor usually increases to return performance toward normal. However, the
compensatory mechanism is usually incomplete.

Front 36

SYSTOLIC PERFORMANCE OF THE VENTRICLE
if a loss in contractility, e.g., congestive heart failure...

Back 36

of a loss in contractility, e.g., congestive heart failure
Performance decreases because of a loss in contractility.
• A decrease in contractility decreases ejection fraction, which increases preload.
The increased preload partially compensates for the loss of contractility

Front 37

SYSTOLIC PERFORMANCE OF THE VENTRICLE
if an acute increase in contractility

Back 37

of an acute increase in contractility
Performance increases.
• The increased contractility increases ejection fraction.
• The increased ejection fraction decreases preload.

Front 38

SYSTOLIC PERFORMANCE OF THE VENTRICLE
if an acute increase in preload, e.g., volume loading the individual

Back 38

consequences of an acute increase in preload, e.g., volume loading the individual
• The increased venous return increases preload, which increases performance and cardiac
output.
The increased cardiac output would raise blood pressure and via the carotid sinus
reflex sympathetic stimulation to the heart decreases.
The decreased sympathetic stimulation would decrease contractility.

Front 39

SYSTOLIC PERFORMANCE OF THE VENTRICLE Determinants of Cardiac Output
what parameters isdetermine cardiac output.?

Back 39

Venous parameters, not arterial parameters, normally determine cardiac output.

Front 40

SYSTOLIC PERFORMANCE OF THE VENTRICLEDeterminants of Cardiac Output
на что влияет на что нет увеличение резистентности артерий

Back 40

Increased resistance of arteries raises blood pressure but does not affect venous return
and cardiac output

Front 41

SYSTOLIC PERFORMANCE OF THE VENTRICLE
влияет ли ЧСС на сердечный выброс? если влият,то когда?

Back 41

Heart rate does not normally affect cardiac output but very low and very high heart
rates impede venous return and cardiac output.

Front 42

SYSTOLIC PERFORMANCE OF THE VENTRICLE
на что влияют Bblockers?

Back 42

ventricular muscle is operating below its pumping capacity, e.g., B blockers that
mildly reduce contractility do not reduce cardiac output..

Front 43

SYSTOLIC PERFORMANCE OF THE VENTRICLE
как влияет венозный возврат на Сердечный выьрос?

Back 43

Чем больше В.В тем больше сердечный выброс

Front 44

SYSTOLIC PERFORMANCE OF THE VENTRICLE
как влияет артрериальная дилятация на Сердечный выброс

Back 44

Сердечный выброс увеличивается

Front 45

SYSTOLIC PERFORMANCE OF THE VENTRICLE
как влияет arteriolar constriction на Сердечный выброс

Back 45

Сердечный выброс уменьшается

Front 46

SYSTOLIC PERFORMANCE OF THE VENTRICLE
как влияет increased vascular volume на Сердечный выброс

Back 46

Сердечный выброс увеличивается

Front 47

SYSTOLIC PERFORMANCE OF THE VENTRICLE
как влияет decreased vascular volume на Сердечный выброс

Back 47

Сердечный выброс уменьшается

Front 48

SYSTOLIC PERFORMANCE OF THE VENTRICLE
a combination of diuretics and inotropic agents are given ?

Back 48

In many cases, a combination of diuretics and inotropic agents are given to relieve congestion
and return cardiac performance toward normal.

Front 49

SYSTOLIC PERFORMANCE OF THE VENTRICLE
End-diastolic volume (EDV):

Back 49

Volume of blood in the ventricle at the end of diastole

Front 50

SYSTOLIC PERFORMANCE OF E VENTRICLETH
End-systolic volume (ESV):

Back 50

End-systolic volume (ESV): Volume of blood in the ventricle at the end of systole

Front 51

SYSTOLIC PERFORMANCE OF THE VENTRICLE
Stroke volume (SV):

Back 51

Stroke volume (SV): Volume of blood ejected by the ventricle per beat
SV= EDV -ESV

Front 52

SYSTOLIC PERFORMANCE OF THE VENTRICLE
Afterload is

Back 52

the force that the muscle must generate to eject
the blood into the aorta.An approximation for the left ventricle is aortic diastolic pressure,
which is primarily determined by the resistance of the arterioles (TPR).

Front 53

SYSTOLIC PERFORMANCE OF THE VENTRICLE
indices of afterload on the left ventricle are the following

Back 53

Mean aortic pressure
• Hypertension: increased afterload
• Hypotension: decreased afterload
Peak left ventricular pressure

Front 54

SYSTOLIC PERFORMANCE OF THE VENTRICLE
Systolic dysfunction can be defined as ?

Back 54

Systolic dysfunction can be defined as an abnormal reduction in ventricular emptying
due to impaired contractility or excessive afterload,

Front 55

SYSTOLIC PERFORMANCE OF THE VENTRICLE
Diastolic dysfunction is

Back 55

Diastolic dysfunction is a decrease in ventricular compliance during the filling phase
of the cardiac cycle due to either changes in tissue stiffness or impaired ventricular
relaxation. The consequence is a diminished Frank-Starling mechanism.

Front 56

SYSTOLIC PERFORMANCE OF THE VENTRICLE
Examples of a pressure overload on the left ventricle would include ?

Back 56

Examples of a pressure overload on the left ventricle would include hypertension and
aortic stenosis

Front 57

SYSTOLIC PERFORMANCE OF THE VENTRICLE
Pressure Overload характеризуется?

Back 57

-из-за гипертензии и стеноза аорты
-развитие концентрической гирертрофии ЛЖ т е увеличение толщины стенки и уменьшение камер Ж
-снижение вентрикулярной податливости и диастолической дисфункции( проявляется как систолическая дисфункция и вентрикулярное расстройство

Front 58

SYSTOLIC PERFORMANCE OF THE VENTRICLE
Volume Overload

Back 58

-include mitral and aortic
insufficiency, patent ductus arteriosus.
-dilated left ventricle must develop a greater wall
tension to produce the same ventricular pressures.
-ventricle develops an eccentric hypertrophy
-Eventual failure is usually a consequence of systolic dysfunction

Front 59

SYSTOLIC PERFORMANCE OF THE VENTRICLE
как влияет радиус на стеночное напряжение?

Back 59

P =Tfr
The greater the raotus, the greater
the wall tension needed to generate
the same ventricular pressure.

Front 60

SYSTOLIC PERFORMANCE OF THE VENTRICLE
Кардиомиопатия это

Back 60

-сердечная недостаточнасть или застояноее расстройство сердца с многими причинами.связаная с поражением миоцитов.

Front 61

Cardiomyopathy

Back 61

valvular heart disease,
afterIoad problems,
and coronary heart disease

Front 62

Cardiomyopathy
three basic types of cardiomyopathy:

Back 62

three basic types of cardiomyopathy:
Dilated cardiomyopathy
Restrictive cardiomyopathy
Hypertrophic cardiomyopath

Front 63

Cardiomyopathy
Dilated cardiomyopathy

Back 63

-вентрикулярная дилятация с небольщой гипертрофией
-поражение Левого .правого сердца или обоих
-диастолическая функция интактна т.к. компенсуется дилятацией полостей
-ув. симпатической стимуляции миокарда(компенспция)
-ув сократимости
-систолическая дисфунеция
-в будущем-полная недостаточность сердца

Front 64

Cardiomyopathy
Restrictive cardiomyopathy

Back 64

-снижение вентрикулярной податливости
-диастолическая жисфунеция
-уменьшение размеров полостей жел.
-увеличение давление приводящая к перегрузке
-вентрикул гмперипрфия может быть может нет
-систолическая функция почти в норме

Front 65

Cardiomyopathy
Hypertrophic cardiomyopathy

Back 65

-септальная и жел гмперирофия не связанная с pressure overload
-диастолическая дисфункция из-за увел мышесной плотности и уменьш релаксации
-ассиметрия гипертрофии перегородкиidiopathic hypertrophic subaortic stenosis и легочный застой
-