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from basics to clinical application of physiology
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The volume of blood pumped by each ventricle per minute is called cardiac output Cardiac output = Stroke Volume X Heart Rate Normal value = 5 Liters /Minute Cardiac output = Stroke Volume X Heart Rate The factors which regulate stroke volume and Heart rate are basically regulating Cardiac output Volume of blood ejected by each ventricle in single systole; Normal Value = 70 ml/beat Stroke Volume = End diastolic Volume – End Systolic Volume So stroke volume is mainly controlled by EDV ESV VENOUS RETURN: What ever blood volume returns to the heart, same is pumped forward through the Frank’s Starlings Law. According to this law 13- 15 liters of blood volume can be pumped out without cardiac stimulation. DURATION OF DIASTOLE OR FILLING TIME: ventricular filling occurs during diastole, so there must be adequate ventricular filling time. DISTENSIBILITY OF THE VENTRICLES: Normally ventricles are distensible to accommodate adequate blood volume. Infarction decreases the distensibility which decreases the EDV. ATRIAL CONTRACTION: There must be adequate atrial contraction to have adequate EDV. If atrial function is not adequate then EDV will decrease. E.S.V is basically CONTROLLED BY MYOCARDIAL CONTRACTION FORCE OF MYOCARDIAL CONTRACTION: It depends upon the initial length of muscle fibers according to frank’s starlings law. PRELOAD: The effect of EDV on initial length is called preload. So EDV also effects the ESV. AFTER LOAD: Force of contraction is also dependant upon the resistance against which the ventricles have to pump CONDITION OF THE MYOCARDIUM : It also effects the force of contraction. AUTONOMIC NERVES : Sympathetic stimulation increases and parasympathetic stimulation decreases force of contraction HORMONES: Catecholamines, thyroxine, glucagon, digitalis, calcium, increased temp, caffeine, theophyline increase the force. Force decreases by hypoxia, acidosis, barniturates, procainamide and quinidine decrease the force of contraction.
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Cardiac cycle refers to a complete heartbeat from its generation to the beginning of the next beat. Cardiac events that occur from – beginning of one heart beat to the beginning of the next are called the cardiac cycle.
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The volume of blood pumped by each ventricle per minute is called cardiac output Cardiac output = Stroke Volume X Heart Rate Normal value = 5 Liters /Minute Cardiac output = Stroke Volume X Heart Rate The factors which regulate stroke volume and Heart rate are basically regulating Cardiac output Volume of blood ejected by each ventricle in single systole; Normal Value = 70 ml/beat Stroke Volume = End diastolic Volume – End Systolic Volume So stroke volume is mainly controlled by EDV ESV VENOUS RETURN: What ever blood volume returns to the heart, same is pumped forward through the Frank’s Starlings Law. According to this law 13- 15 liters of blood volume can be pumped out without cardiac stimulation. DURATION OF DIASTOLE OR FILLING TIME: ventricular filling occurs during diastole, so there must be adequate ventricular filling time. DISTENSIBILITY OF THE VENTRICLES: Normally ventricles are distensible to accommodate adequate blood volume. Infarction decreases the distensibility which decreases the EDV. ATRIAL CONTRACTION: There must be adequate atrial contraction to have adequate EDV. If atrial function is not adequate then EDV will decrease. E.S.V is basically CONTROLLED BY MYOCARDIAL CONTRACTION FORCE OF MYOCARDIAL CONTRACTION: It depends upon the initial length of muscle fibers according to frank’s starlings law. PRELOAD: The effect of EDV on initial length is called preload. So EDV also effects the ESV. AFTER LOAD: Force of contraction is also dependant upon the resistance against which the ventricles have to pump CONDITION OF THE MYOCARDIUM : It also effects the force of contraction. AUTONOMIC NERVES : Sympathetic stimulation increases and parasympathetic stimulation decreases force of contraction HORMONES: Catecholamines, thyroxine, glucagon, digitalis, calcium, increased temp, caffeine, theophyline increase the force. Force decreases by hypoxia, acidosis, barniturates, procainamide and quinidine decrease the force of contraction.
Cardiac output (The Guyton and Hall Physiology)
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Cardiac cycle refers to a complete heartbeat from its generation to the beginning of the next beat. Cardiac events that occur from – beginning of one heart beat to the beginning of the next are called the cardiac cycle.
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BLOOD PRESSURE The pressure exerted by the blood on vessel wall is known as blood pressure. SYSTOLIC BLOOD PRESSURE The maximum pressure exerted in the arteries during systole of heart. Normal systolic pressure: 120 mm Hg. DIASTOLIC BLOOD PRESSURE The minimum pressure exerted in the arteries during diastole of heart. Normal diastolic pressure: 80 mm Hg. PULSE PRESSURE The difference between the systolic pressure and diastolic pressure. Normal pulse pressure: 40 mm Hg (120 – 80 = 40). MEAN ARTERIAL BLOOD PRESSURE The average pressure existing in the arteries. Mean Arterial Blood Pressure = Diastolic Pressure + 1/3 Pulse Pressure Pulse Pressure = (Systolic – Diastolic) Mean Arterial Blood Pressure =Diastolic Pressure+1/3(Systolic – Diastolic)
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