Cardiac Function and Indexing Concepts
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Questions and Answers

How is cardiac index calculated?

  • Cardiac output multiplied by body surface area
  • Cardiac output divided by body surface area (correct)
  • Cardiac output divided by blood volume
  • Cardiac output divided by body weight

    • What does the term 'indexed measurements' refer to?

  • Measurements that vary based on patient size (correct)
  • Measurements adjusted for age and gender
  • Measurements solely based on weight
  • Measurements standardized across all patients

    • Which statement best illustrates the concept of 'normal' in measurements?

  • Normal measurements are static and do not consider individual variability.
  • All patients should have the same measurements regardless of size.
  • Every patient must have the same cardiac output.
  • Normal measurements can differ based on body composition. (correct)

    • Why is cardiac output alone insufficient to assess heart function?

    <p>Cardiac output does not account for patient size. (A)</p> Signup and view all the answers

    Which example best emphasizes the relativity of normal measurements?

    <p>A sumo wrestler's cardiac index compared to an average adult's. (C)</p> Signup and view all the answers

    What is the definition of stroke volume?

    <p>The volume of blood ejected with each heartbeat (A)</p> Signup and view all the answers

    During moderate to high heart rates, which factor limits stroke volume?

    <p>Insufficient filling time for the heart (A)</p> Signup and view all the answers

    What is the average stroke volume for a person at rest?

    <p>70 - 100 mL (B)</p> Signup and view all the answers

    How is stroke volume calculated?

    <p>EDV - ESV (A)</p> Signup and view all the answers

    Which factor is unlikely to contribute to higher stroke volume?

    <p>Increased heart rate (B)</p> Signup and view all the answers

    Katy has a higher stroke volume than Jessica primarily because:

    <p>Katy exercises regularly while Jessica does not (C)</p> Signup and view all the answers

    What is the significance of EDV and ESV in relation to stroke volume?

    <p>EDV is the volume before contraction, while ESV is after, affecting stroke volume (B)</p> Signup and view all the answers

    An elite athlete's stroke volume during cardio training can reach approximately:

    <p>150 - 220 mL (B)</p> Signup and view all the answers

    What is considered a normal range for cardiac output (CO)?

    <p>4-8 l/min (D)</p> Signup and view all the answers

    Which formula correctly represents the calculation for cardiac output?

    <p>CO = HR x SV (B)</p> Signup and view all the answers

    When attempting to increase cardiac output during physical activity, which of the following actions may NOT contribute?

    <p>Decreasing heart rate (C)</p> Signup and view all the answers

    What does the Mosteller formula calculate?

    <p>Body surface area (C)</p> Signup and view all the answers

    What is the average body surface area (BSA) for an adult?

    <p>1.73 m² (D)</p> Signup and view all the answers

    Which factors primarily influence an individual's body surface area (BSA)?

    <p>Height, weight, gender, and age (A)</p> Signup and view all the answers

    In the equation CO = HR x (EDV - ESV), what do EDV and ESV stand for?

    <p>End-Diastolic Volume and End-Systolic Volume (D)</p> Signup and view all the answers

    Which of the following actions would primarily increase stroke volume (SV)?

    <p>Increasing myocardial contractility (C)</p> Signup and view all the answers

    What is the effect of the strain phase of the Valsalva Maneuver on cardiac output?

    <p>Decreases cardiac output (B)</p> Signup and view all the answers

    What occurs during an inhalation of Amyl Nitrate?

    <p>Increased stroke volume (D)</p> Signup and view all the answers

    Which maneuver is associated with a decrease in venous return?

    <p>Standing (D)</p> Signup and view all the answers

    In which area of the heart are apical wall segments located?

    <p>At the tip of the ventricles (C)</p> Signup and view all the answers

    What impact does inspiration have on cardiac parameters?

    <p>Increases venous return and cardiac output (D)</p> Signup and view all the answers

    During the release phase of the Valsalva Maneuver, which of the following is true?

    <p>Cardiac output increases (B)</p> Signup and view all the answers

    What is the correct relationship between the heart's walls and their respective segments?

    <p>Basal wall segments are closest to the atria (B)</p> Signup and view all the answers

    Which of the following results from the inhalation of Amyl Nitrate?

    <p>Increased heart rate and decreased systemic resistance (B)</p> Signup and view all the answers

    What is the primary function of the Autonomic Nervous System?

    <p>To respond to the metabolic needs of the body (D)</p> Signup and view all the answers

    What is an example of a tissue controlled by the Autonomic Nervous System?

    <p>Heart (B)</p> Signup and view all the answers

    Which description is associated with the Sympathetic Nervous System?

    <p>Increases heart rate during 'fight or flight' (C)</p> Signup and view all the answers

    Which of the following best describes the Parasympathetic Nervous System?

    <p>Facilitates digestion and relaxation (B)</p> Signup and view all the answers

    What is the main purpose of the Valsalva Maneuver?

    <p>To alter cardiac physiology (A)</p> Signup and view all the answers

    During which phase of the Valsalva Maneuver does one bear down and hold their breath?

    <p>Strain Phase (B)</p> Signup and view all the answers

    Which physiological response is most closely associated with a decreased heart rate?

    <p>Parasympathetic Nervous System activation (B)</p> Signup and view all the answers

    What action should be taken during the Release Phase of the Valsalva Maneuver?

    <p>Breathe out normally (D)</p> Signup and view all the answers

    What is the normal range for Cardiac Index (CI)?

    <p>3-4 l/min/m² (C)</p> Signup and view all the answers

    Which formula correctly relates Cardiac Output (CO) to Stroke Volume (SV) and Heart Rate (HR)?

    <p>CO = SV x HR (A)</p> Signup and view all the answers

    How is Stroke Volume (SV) determined based on the provided information?

    <p>SV = EDV - ESV (C)</p> Signup and view all the answers

    What value did the calculation yield for the Cardiac Index (CI) in the example provided?

    <p>3.18 l/min/m² (D)</p> Signup and view all the answers

    Which of the following factors does NOT influence Cardiac Output?

    <p>Respiratory Rate (B)</p> Signup and view all the answers

    What is meant by the term 'Preload' in relation to Cardiac Output?

    <p>The amount of blood that stretches the ventricle during diastole (A)</p> Signup and view all the answers

    If a patient has an End-Diastolic Volume (EDV) of 150 ml and an End-Systolic Volume (ESV) of 50 ml, what is the Stroke Volume (SV)?

    <p>100 ml (C)</p> Signup and view all the answers

    What is the expected normal range for Cardiac Output (CO) in liters per minute?

    <p>4-8 l/min (D)</p> Signup and view all the answers

    Flashcards

    Stroke Volume (SV)

    The volume of blood pumped out of the left ventricle with each heartbeat.

    Cardiac Output (CO)

    The amount of blood the left ventricle pumps out each minute.

    Heart Rate (HR)

    The number of times the heart beats per minute.

    Cardiac Output Equation

    The formula used to calculate Cardiac Output, which is the product of Heart Rate and Stroke Volume.

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    Normal Cardiac Output

    The average Cardiac Output for a healthy individual.

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    Body Surface Area (BSA)

    The total surface area of the body, encompassing the entire outer layer.

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    Body Surface Area (BSA)

    A measure of the body's size relative to its age and gender.

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    Indexed Measurements

    A measurement used to help determine the appropriate dosage of medications for different patients. It is calculated using the Mosteller formula.

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    Cardiac Output

    Blood volume pumped by the heart in one minute. It's measured in liters per minute.

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    Cardiac Index

    Cardiac Output divided by Body Surface Area (BSA). It's measured in liters per minute per square meter.

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    Normal Values are Relative to Individual Size

    Normal values depend on the patient's size. What's normal for a sumo wrestler might be different for someone smaller.

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    What is stroke volume?

    The amount of blood ejected from the left ventricle with each heartbeat. It's essentially how much blood is pumped out with each contraction of the heart.

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    How is stroke volume measured?

    Stroke volume is typically measured in milliliters (mL).

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    What is the typical resting stroke volume?

    At rest, stroke volume is typically between 70 - 100mL. During exercise, this volume can significantly increase!

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    What are the stroke volumes of elite athletes?

    Elite athletes can have stroke volumes between 90-110mL at rest and an astounding 150-220mL during cardio training!

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    What factors influence stroke volume?

    Stroke volume is influenced by factors like heart size, fitness level, and even the amount of blood filling the heart before contraction.

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    Why do men typically have larger stroke volumes?

    Men often have larger stroke volumes than women due to their generally larger heart size.

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    How does fitness impact stroke volume?

    Individuals with a higher level of physical fitness tend to have larger stroke volumes.

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    How is stroke volume calculated?

    Stroke volume can be calculated by subtracting the end systolic volume (ESV) from the end diastolic volume (EDV).

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    Cardiac Index (CI)

    The ratio of cardiac output to body surface area, adjusted for body size. Measured in liters per minute per square meter (l/min/m²).

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    Preload

    The amount of stretch in the left ventricular muscle at the end of diastole (relaxation) before the heart contracts.

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    Afterload

    The force the heart must overcome to eject blood out of the left ventricle during contraction.

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    Chronotropic Force

    The heart's ability to control its own rate of contractions (heart rate).

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    Inotropic Force

    The strength of the heart's contractions, or how effectively the heart pumps.

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    End-Systolic Volume (ESV)

    The amount of blood remaining in the left ventricle after contraction, measured in milliliters (ml).

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    What is the autonomic nervous system?

    It is also known as the involuntary nervous system. It controls important bodily functions like heart rate and gland secretions.

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    What does the sympathetic nervous system do?

    It acts as the "fight or flight" response, increasing the heart rate when you are startled or in danger.

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    What does the parasympathetic nervous system do?

    It acts as the "rest or digest" response slowing heart rate when you are relaxed or resting.

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    What is the Valsalva maneuver?

    It is used in echocardiograms to better visualize the heart.

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    What is the strain phase of the Valsalva maneuver?

    It involves holding your breath and tightening your abdominal muscles, increasing pressure in the chest cavity.

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    What is the release phase of the Valsalva maneuver?

    It involves releasing the breath and allowing the pressure in the chest cavity to return to normal.

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    What does the Valsalva maneuver do to the heart?

    It alters the pressure in the chest cavity, affecting blood flow and heart function.

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    Why is the Valsalva maneuver important?

    It is a technique that may help in diagnosing and evaluating heart conditions.

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    What increases venous return?

    A maneuver that increases venous return, stroke volume, cardiac output, and heart rate.

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    What decreases venous return?

    A maneuver that decreases venous return, stroke volume, cardiac output, and heart rate.

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    What is the effect of amyl nitrate?

    A medication that decreases peripheral resistance, increases heart rate, increases stroke volume, and increases cardiac output.

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    What are basal wall segments?

    The area of the heart closest to the atria, usually involves the segments nearest to the atria.

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    What are mid wall segments?

    The area of the heart between the atria and the apex, usually involves the segments around the papillary muscles.

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    What are apical wall segments?

    The area of the heart closest to the apex, usually involves the segments at the tip of the ventricles.

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    What does 'I Saw A Lot of Inf-Ants' stand for?

    A mnemonic to remember the apical wall segments, where each letter represents a segment: I - Inferior, S - Septum, A - Anterior, L - Lateral, O - Infero-Lateral, T - Antero-Lateral, I - Inferior, I - Inferior, I - Inferior, N - Non-Infarct, F - Free Wall, A - Anterior, A - Anterior, N - Non-Infarct, T - Transmural, S - Septum.

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    What is the septum?

    The segment of the heart directly on the opposite side from the right ventricle. It's not directly attached to the right ventricle.

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    Study Notes

    Cardiac Function Review

    • The heart's job is to pump enough oxygenated blood to the whole body. Supply and demand must be equal.
    • The heart's ability to achieve this depends on cardiac function, involving both systolic and diastolic components.
    • A normal heart should:
      • thicken its walls concentrically during systole and thin/relax during diastole
      • decrease in chamber size during systole and increase during diastole

    More on Cardiac Function

    • The body's demand for oxygenated blood can change, more active = more needed, more relaxed = less needed (e.g., running a marathon vs. sleeping).

    Cardiac Output

    • Cardiac output is the volume of blood the heart pumps per minute.
    • It depends on heart rate (HR) and stroke volume (SV).
    • Cardiac output (CO) is calculated as CO = HR x SV.

    Heart Rate (HR)

    • Heart rate is the number of heart beats per minute.
    • Normal range is 60-100 bpm.

    Stroke Volume (SV)

    • Stroke volume (SV) is the amount of blood ejected from the ventricles with each heartbeat.
    • Normal range is 70-100 ml.
    • SV is calculated as SV= EDV-ESV
      • EDV = end diastolic volume (largest volume of blood in the heart when diastole is finished)
      • ESV = end systolic volume (smallest volume of blood in the heart when systole is finished)

    Cardiac Output Equation

    • Cardiac output (CO) = heart rate (HR) x stroke volume (SV)

    What does this all mean?

    • The body can increase cardiac output by increasing its heart rate and/or stroke volume.

    Body Surface Area (BSA)

    • Body surface area (BSA) is a total surface area of the body, dependent on height, weight, gender, and age.
    • It's a more accurate indicator of body mass compared to body weight alone.
    • Average BSA is 1.73 m².
    • Mosteller formula is most common to calculate BSA.

    Why is Body Surface Area relevant?

    • BSA is relevant for calculating indexed measurements, as "normal" is relative to patient size.

    Cardiac Index (CI)

    • Cardiac index (CI) = Cardiac output (CO) / Body surface area (BSA)
    • It corrects CO for BSA, providing a more accurate measure for different patient sizes, normal range is 3-4 l/min/m².

    Equations Recap

    • SV(ml) = EDV(ml)- ESV(ml)
    • CO(l/min) = SV(ml) x HR(bpm)
    • CI (l/min/m²) = CO (l/min) / BSA (m²)

    Preload

    • Preload is the degree of ventricular muscle cell stretch at the end of diastole.
    • It depends on the end-diastolic volume (EDV).
    • Increased preload is due to higher end-diastolic volume and increased fluid overload. Examples include regurgitation and shunts.

    Afterload

    • Afterload is the resistance the left ventricle must overcome to circulate blood.
    • Increased afterload can be due to hypertension and certain conditions affecting valve stenosis.

    Inotropic and Chronotropic Force

    • Inotropic force is the strength of heart muscle contraction.
    • Chronotropic force is the rate of heart contraction.
      • The autonomic nervous system (involuntary) influences both forces.

    Autonomic Nervous System

    • The autonomic nervous system controls involuntary actions, like heart rate and glandular secretion.
    • It is divided into sympathetic and parasympathetic systems.

    Sympathetic Nervous System

    • The sympathetic nervous system increases heart rate.
    • It's associated with the "fight-or-flight" response, increasing alertness in stressful situations.

    Parasympathetic Nervous System

    • The parasympathetic nervous system decreases heart rate.
    • It's associated with the "rest-and-digest" response, allowing the body to relax and recover.

    Maneuvers that alter Cardiac Physiology

    • Valsalva maneuver, Amyl Nitrate inhalation, and other methods can increase or decrease venous return, stroke volume, cardiac output, and heart rate.

    Apical Wall Segments

    • Heart anatomy, especially the relative positions of segments.

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    Cardiac Physiology Part 2 PDF

    Description

    This quiz explores key concepts related to cardiac index and output, emphasizing the significance of indexed measurements in heart function evaluation. It also addresses the relativity of 'normal' measurements in the context of cardiac health, enhancing your understanding of cardiovascular metrics.

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