BIO 132 – Anatomy and Physiology II

LECTURE 16:  CARDIAC PHYSIOLOGY II: REGULATION OF CARDIAC OUTPUT

Study Outline

 

16.1.  Determinants of Cardiac Output:

a.       Cardiac output (CO) is computed from the product of ____________________________ and _____________________________.

b.      At rest, cardiac output is typically on the order of ______________________, but can increase to about _____________________________ during extreme exercise. 

c.       A general term for the ratio between a person’s maximum CO and their CO at rest is called the _________________________________ which is typically on the order of about __________________________________.

 

16.2.  The Fick Principle:

a.       Cardiac output can be determined using a method called the __________________________________.

b.      In this technique, the quantity of O2 that leaves the lungs in the pulmonary veins must be equal to the quantity of O2 in the ________________________ plus the quantity of O2 that enters ___________________________________.

c.       The quantity of O2 present in the pulmonary artery or pulmonary vein is equal to the O2 concentration in that vessel multiplied by ___________________________________, which in this case is equal to ___________________________________.

d.      In its final form, the formula used in the Fick principle states that cardiac output is equal to the ratio of _________________________________ and the difference between the O2 concentration in the ________________________ minus the __________________________________.

 

16.3.  Regulation of Stroke Volume:

a.       The _____________________________________ of a given cardiac cycle represents the amount of blood that leaves the ventricle each beat.

b.      Stroke volume (SV) is determined by the difference between the ______________________________ and the ________________________.

c.       The ________________________________ is the amount of blood left in the ventricle after ventricular ejection.

d.      The three most important factors which affect stroke volume are _________________________________, __________________________, and _________________________________.

e.       The __________________________________ refers to the amount that the ventricles are stretched just before contraction.  According to the Frank-Starling Law of the Heart, SV increases as the _________________________ increases.

f.        Preload can be indicated as either ___________________________ or by _______________________________________.  In general a curve which relates some measure of ventricular performance with some index of cardiac muscle fiber length is called a __________________________________.

g.       Preload will increase when heart rate ___________________________ or during exercise because contracting muscles increase _______________________________.  By contrast excessive heart rate will ________________________ ventricular filling and thus ________________.

h.       The Frank-Starling Law of the Heart ensures that the _____________________ and ______________________________ remain equal.

i.         A shift in the ventricular function curve to the left indicates an increase in __________________________________.  Any agent that causes such a change is called a ________________________________.

j.        Enhanced contractility results in a more complete ejection of blood per beat, thus reducing _________________________________.

k.      An increase in contractility is a direct result of an increase in intracellular ______________________________ levels.  This occurs in the presence of ___________________________, and _______________________________, and the hormones __________________________, ____________________, and ____________________________________.

l.         Any agent that results in a shift in the ventricular function curve to the right is called a __________________________________, one example being _______________________________________.

m.     _________________________________ refers to the pressure that must be overcome for the ventricles to eject blood from the heart.  In the case of the left ventricle, afterload refers to the _______________________________.  Afterload can become significant in patients suffering from _______________________________, which will reduce stroke volume due to an increase in ____________________________________.

 

16.4.  Regulation of Heart Rate:

a.       Although ___________________________ cells are able to generate and maintain a basic rate of heart beat, the activity of these cells is influenced by the _____________________________________ system consisting of ____________________________ and ______________________ divisions.

b.      The __________________________ system acts to increase heart rate, which is called a ______________________________ effect.  Conversely the _____________________________ system acts to decrease heart rate, which is called a ______________________________ effect.

c.       Both divisions of the autonomic nervous system are controlled by ________________________________ centers located in the medulla.

d.      While sympathetic nerves distribute to the SA node, AV node, atrial and ventricular muscle, parasympathetic nerves distribute primarily to the _____________________________ and _____________________________.

e.       Increased parasympathetic input to the SA node results in a _______________ in the slope of the pacemaker potential and a reduction in ________________.  Sympathetic input to the SA node results in a _______________________ in the slope of the pacemaker potential.

f.        While a denervated heart will beat at rate of about _____________________, under the influence of parasympathetic nerves, the rate falls to about ____________________________.  The term which describes how heart rate is under the dominant influence of the parasympathetic system is called _________________________________.

 

16.5.  The Baroreceptor and Bainbridge Reflexes: 

a.       An elevation in blood pressure results in a __________________________ in heart rate, mediated by _______________________________ nerves.  This is called the ___________________________ reflex.

b.      When blood pressure is low, heart rate _____________________________, mediated by _____________________________ nerves.

c.       An increase in blood volume will result in increased atrial stretch, which in turn will lead to ___________________________ in heart rate.  This is called the _____________________________ reflex. 

d.      Increased atrial stretch will also stimulate the release of ______________________________ which stimulates the kidney to increase ________________________ and __________________________ excretion.

 

16.6.  Summary of Factors that Regulate Cardiac Output:

a.       Stroke volume will be increased when ___________________________ is increased due to increased venous return during exercise or with increased ________________________________.

b.      Stroke volume will be decreased when ___________________________ is decreased due a fall in ___________________ or ____________________.

c.       An increase in afterload will increase _________________________ which will __________________ stroke volume.

d.      Heart rate is increased in response to sympathetic nerves which in turn are stimulated by ___________________________, _____________________, _____________________________, or ____________________________.

e.       Heart rate is decreased in response to parasympathetic nerves in response to an increase in _____________________________.