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37 Cards in this Set
- Front
- Back
SV =
|
EDV - ESV
how much blood pumps out |
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EDV determines
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preload
|
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increase PL effect
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inc EDV
inc SV |
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afterload determines
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ESV
|
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inc AL effect
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inc ESV
dec SV |
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Ejection fraction
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ejection fraction: what part of EDV is getting pumped out
|
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EF =
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EDV - ESV
_________ EDV |
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dec EF effect
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dec LV function/ filling or ejection
|
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inc EF effect
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ejects more blood
inc EF inc SV |
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bowditch effect
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preload plateaus: not enough time to refill
SERCA is maxed out (Ca+) can't take up anymore |
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increase myofiber length effect
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inc cadiac sensitivity to Ca+/troponin (more cross bridges!)
|
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determinants of in preload
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venous tone
total BV skeletal muscle activity gravity/posture |
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isotonic
? vs ? |
velocity vs. force
|
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isotonic:
F=0 = F=infinity = |
Vmax
0 |
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increase afterload effect
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dec SV
|
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afterload is dependent on
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arterial pressure
system vascular resistance resistance of valve ventricular wall tension |
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inc Ca+ effect
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inc contractility
|
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swan ganz cath
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into RA -> RV -> PV into PA
proximal: RA PRELOAD distal: wedge in PA as a balloon: PCWP: into lungs and out estimate of LA to detect LV preload |
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swan ganz direct measurements
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VO2 concentration (arterial/venous difference)
ability to oxygenate blood, pump out, tissues to take O2 system vascular resistance (afterload) |
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VO2 =
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CO x A-V
|
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driving pressure =
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=MAP - RAP
=CO x SVR |
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MAP =
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S + 2D
_____ 3 |
|
hypovolemic shock effects
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dec PL
dec CO inc SVR |
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septic shock effects
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dec PL
inc CO dec SVR |
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cardiogenic effects
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inc PL
dec CO ince SVR |
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Tx of hypovolemic shock
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fluids
|
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tx of septic shock
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treat SVR with DA, epi, NE, ABs
|
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tx of cardiogenic shock
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B1 stim and B2 to dec SVR
vasodilating dec AL |
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tx for elevated PCWP
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inc filling pressure with diuretics
|
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tx of low PCWP
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dec filling pressure with fluids
|
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Low CO tx
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B agonist - milrinone or dobutamine
|
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high SVR tx
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vasodilator
|
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low SVR tx
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CA - NE, DA, a1 effect
|
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myocardial relaxation
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-SERCA removes inc Ca+
-1 ATP for 2 Ca+ reuptake -Ca+ stored on calsequestrin -dec Ca+ dec I-E -tropomyosin returns to groove on A inhibiting A-M |
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Ca+ rises effect
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Ca+ binds to TC which interacts with IT leading toa very strong bond
-strength increases position on actin; weaking top T and tropomyosin bond -tropomyosin moves into the groove exposing A to M |
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EC coupling
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diastole
-Ca+ inflow into myoctyre during AP plateau through voltage sensitive channels (occurs in T-tubules) |
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calcium-induced calcium released
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systole
-Ca+ released from SR -rise in intraCa+ during contraction phase |