Term
| What are the three determinants of SV? |
|
Definition
| Preload, Afterload and Contractility. |
|
|
Term
|
Definition
| The pressure the heart has to overcome to push blood out of the heart into arteries. |
|
|
Term
| What do inotropic drugs do? |
|
Definition
| They increase heart contractility. |
|
|
Term
| What do chronotropic drugs do? Give an example of one, and how it affects heart function. |
|
Definition
| They affect the HR. ie: Beta Blockers decrease HR. |
|
|
Term
|
Definition
| the filling pressure in the ventricle at the end of diastole. |
|
|
Term
| What are the three major things that affect preload? |
|
Definition
| Venous return, starling's law, and posture - supine vs. standing. |
|
|
Term
| What three things affect venous return? |
|
Definition
| Muscle pump, respiratory pump, and venous constriction. |
|
|
Term
| What 4 major things will cause a decrease in preload? |
|
Definition
| Volume loass, venous dilation, volume displacement, dysrhythmias. |
|
|
Term
| What 4 major things will cause a decrease in preload? |
|
Definition
| Volume loss, venous dilation, volume displacement, dysrhythmias. |
|
|
Term
| What 2 major things will increase preload? |
|
Definition
| Volume overload and venous constriction. |
|
|
Term
| Gail listed three things in our handout that cause venous dilation. What were they? |
|
Definition
| Hyperthermia, medication and septic shock. |
|
|
Term
| Hypothermia, certain medications, and hypovolemia will cause what reaction in the venous system? |
|
Definition
|
|
Term
| What is the relationship between stroke volume and afterload? |
|
Definition
| They are inversely proportional. |
|
|
Term
| What is the most important determinant of afterload? |
|
Definition
|
|
Term
| What will lead to decreased afterload? |
|
Definition
| arterial dilation (shock and meds are two things that can lead to this) |
|
|
Term
| What can lead to increased afterload? |
|
Definition
| Lung disease (pulmonary vascular constriction), atherosclerosis (narrow vasculature), significant volume loss (compensatory vasoconstruction). |
|
|
Term
| Hypovolemia will result in a fluctuation of preload and afterload pressures. How will it affect each of them, specifically, and why? |
|
Definition
| It will result in decreased preload (not as much blood to fill the ventricles with) and increased afterload, because of compensatory vasoconstriction with the decrease in BP. |
|
|
Term
| Without drugs, what function in the body naturally increases contractility of the heart? |
|
Definition
| increased sympathetic activity (epinephrine, for example). |
|
|
Term
| What is a normal CVP (central venous pressure)? |
|
Definition
|
|
Term
| What is normal pulmonary artery diastolic pressure? |
|
Definition
|
|
Term
| Pulmonary Artery systolic pressure = ? |
|
Definition
29-30 mmHg
(R Ventricle & pulmonary circulation.) |
|
|
Term
| Pulm. Capillary Wedge Pressure = ? |
|
Definition
|
|
Term
| Systemic Vascular Resistance = ? |
|
Definition
|
|
Term
| Pulmonary Vascular Resistance = ? |
|
Definition
|
|
Term
| Follow the path of blood from the vena cava through the system back to the vena cava. (14 major landmaarks) |
|
Definition
| Vena Cava -> R Antrium -> Tricuspid Valve -> R Ventricle -> Pulmonic Valve -> Pulmonary Artery -> Lungs -> Pulmonary Veins -> L Atrium -> Mitral (Bicuspid) Valve -> L Ventricle -> Aortic Valve -> Aorta -> Body -> Vena Cava. |
|
|
Term
| What pressure is a direct indicator of the L ventricular pressure? |
|
Definition
| Pulmonary Capillary Wedge Pressure |
|
|
Term
| What pressure is a direct indicator of R Atrial pressure? |
|
Definition
|
|
Term
| Normal R atrial pressure =? |
|
Definition
|
|
Term
| What does a drop in the CVP always indicate? |
|
Definition
| Decreased circulating volume (hypovolemia). |
|
|
Term
| What are some primary causes of hypovolemia? (3) |
|
Definition
| fluid imbalance, hemorrhage, extreme vasodilation. |
|
|
Term
| What are some things that will increase CVP? |
|
Definition
| Hypervolemia, R heart probs ie: tricuspid valve stenosis, R ventricular failure, constrictive pericarditis. |
|
|
Term
| What are some conditions that would make the pulmonary artery systolic pressure? |
|
Definition
| constrictive pericarditis, hypoxemia (causes pulm. arteriole constriction), mitral stenosis, L ventricular failure. |
|
|
Term
| High pulmonary artery pressures could be caused by trouble in what two places? |
|
Definition
| The left heart, or the pumonary circulation. |
|
|
Term
| High CVP can be caused by trouble where? |
|
Definition
| Anywhere in the heart or pulmonary circulation. |
|
|
Term
| Increased PCWP indicates trouble where? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What four basic factors affect stroke volume? |
|
Definition
| Diastloic filling pressure (preload), distensibility of the ventricle, myocardial contractility, aortic pressure (afterload) |
|
|
Term
| Describe the process of cardiogenic pulmonary edema, from left ventricular damage to the resulting gas exchange problems. |
|
Definition
| LV damage -> Decreased Ejection Fraction -> Incr. Ventricular pressure - > Incr. L Atrial pressure -> incr. Pulmonary circulation pressure -> fluid leak to interstitial space. If prolonged, fluid -> alveoli -> diluted surfactant -> incr surface tension -> alveolar collapes -> very stiff lung, as well as gas exchange problems. |
|
|
Term
| What is the PT Tx for pulmonary edema? |
|
Definition
| There is none. Nothing we can do to change it, and deep breathing won’t help. |
|
|
Term
| What does an increase in pulmonary capillary wedge pressure indicate? |
|
Definition
|
|
