BP

SYSTOLIC= RESISTANCE
-stenosis
If both numbers are high, assume

VOL prob.

Yet, The # with the biggest

CO = SV X HR
Normal CO: 5L/minute
SV: how much blood you pump out with each beat
HR: how many beats in one minute
CO: how much blood pumped out in one minute. equal to blood FLOW
The body tries to keep CO constant, so It will change SV, HR or both in order to do this.

HYPOVOLEMIA:
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TPR
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Mean
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Early exercise: CO is kept by ^HR and ^SV. Late exercise: kept by ^HR only (SV plateus)
^HR leads to ^CO but also to v Diastole.
^^^HR >vvvDiastole(no time for blood to fill heart> vCO
this is why too much tachycardia(^HR) is bad!

an equal ^ CO (flow!) with little change in BP (MAP).

If a patient has tachycardia, give fluids, to ^SV, until the HR is back to normal.

BP (also be called MAP (Mean arterial Pressure))

is the average pressure (of syst and diast)
coming out of your left ventricle
BP=CO X TPR
BP= SV x HR x TPR

These are the 3 causes of hypertension(=^BP):

Volume: ^SV Treat with diuretics (Blacks, Hispanics (high sodium diet))
Rate: ^HR Treat with B-blockers (Middle-aged Whites (stressed out))
Resistance: ^TPR (Elderly (less compliance of arterioles))
^SV- by ^ contrxn: thus by ^catecholam, and by ^Ca+in, v Na+out. With ^preload and v
Afterload. **MI leads to death of myocardium(less muscle) and v contrxn, vSV.
HR- by temp; Autonomic NS; SA node, thus also by Na and K levels.
So all these factors if not compensated for, will affect CO and thus will affect BP.
Normal BP= 120/80
HTN= >135/85
-moderate HTN=>155/>100
-severe HTN= >175/>115
BP tells u if its resistance or volume problem!

blood= v acid protection)

So...
Hypovolemia:
* MAP=
BP= left ventricle p. *MVP= p. outside of Right Atrium= CVP(ce
^NE>
#1MVP
venoconstx
arteries
constrix
#3 arterioles dilate (NE stim B2.

is small#2
and
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As
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NARROWS
BP
INCREASES
A v TPR due to arteriolar dilation (seen in exercise) will lead to

Arterioles- have most smooth muscle so constx and dilate most. Have B2
#1 top auto regulator of BP, keeps it between 60-160 by chang

MAP-ICP = CPP
MAP= BP ICP= the pressure created by gravity pushing on your brain
pressure is circulating through the brain, keeps the brain perfused.
Pulse pressure
= Systolic - diastolic 120-80=40
= Span of time during which blood is entering aorta, but has not flowed thr
80: volume sitting on aortic valve
Need 1 mmHg > diastolic p. to open up the aortic valve (= 81mm
120: resistance in the aorta.
Need 1 mmHg > systolic p. to make blood flow through the aorta

^ Pulse P = ^resist = hyperthyroid, Aort regurge, Ateriosclerosis, Sleep a

v Pulse P= ^vol = aortic stenosis, cardiogenic shock, tamponade, advanc

In order to get sustained contraction, the systolic pressure of the LV must b

above the resistance in the aorta. This is why the left ventricle is always th
in systolic hypertension (htn due to resistance problem).
Pulmonary Capillary Wedge Pressure (PCWP)
Think of it as total volume in the lungs

DIASTOLIC= VOLUME (distention)

-regurgitation or shunting

Systolic heart failure= less contraction prob. Dilated cardiomyopathy. MI

Diastolic heart failure= less volume prob. Hypertrophyc cardiomyopathy

Preload is approximated by EDV (Related to Right Atrial P.) Rubber band.

How much you stretch before contrxn)
Afterload is approx. with BP (p. coming out of left ventr). Resistance in a
preventing blood from going in.
Thus: VEnodilators v PrEload and VAsodilators v Afterload
vPreload= vCO BUT! In CHF venodilators cause vPreload which ^CO (

Systolic heart failure has v EF (and thus v SV) because heart is not pumping well.
Diastolic heart fail has normal EF.

Chronic HTN(^BP) which implies a ^afterload, will cause LV hypertrophy

Can HTN cause dilated heart?? From like ^^CO?

Pulsus Alternans: seen with dilated cardiomyopathy, MI

Alternating strong and weak beats (contxns). MCC is left vent systolic failure.
v L.vent contxn > ^EDV> ^muscle distention (preload)> ^L.vent contxn
Pulsus Paradoxus: tamponade, pericarditis

ORTHOSTATIC HTN:
When you stand ^gravity causes ^venous blood pooling and vCO and v
Baroreceptors normally compensate for this. B-block and a-block screw
vCO causes vArterial BP, if Cerebral blood flow v enough, u get orthosta

EF= fraction of blood ejected in systole. = SV/EDV

EF is an index of Ventricular contractility,

systolic BP 10mmHg during inspiration

MCC is v Left vent capacity
Kussmaul sign: seen in Konstrictive pericard, restrict cardiomy, Right heart tumor
^ JVD on inspiration (instead of only in expiration). MCC is v R. ventricle capacity
blood backs up in Venae Cavae> JVD
* can also be seen in tamponade*

SA node: = sinus rhythm and controls HR

HR: normal: 60-100
*Max possible sinus Heart rate? 220- age (Anything above this is an ARR
*HR increases 10 points for every temp. degree above 100F. So this must
ACTUAL HR. (Ex. HR= 90 and 104F. subtract 40 from 90 = 50 HR. Heart

Arterial CLOTS: HTN> high velocity in artery > endothelial damage> platelets
aggregation> Arterial clots
Tx. ASPIRIN! DOC (block PlATELETS!)
Venous CLOTS: stasis> v skeletal movem.> ^blood accum> clotting factors build up and
form Venous clots
Tx. HEPARIN! DOC (stop clotting factors)
CAPILLARIES:

AORTA: Has special armor (SQUAMOUS cells, strong collagen BM, Vasa va

FF= Hydrostatic v + Oncotic v (v=vessel)

Blood passes at ~200 m/h. This speed cleans up possible placks.

BM has HEPARAN SULFATE

(- charge)

Dilated Cardiomyopathy > veloc blood less cleaning t4 more athero

Has FENESTRATIONS:

With age armor weakensexposed muscle(media) weakens t4 risk of a

EDEMA
Transudate = mostly water outside of vessel.
Exudate = mostly protein outside of vessel.
NITROGLYCERIN:
Dilates both Arteries and Veins! Thus blood of arteries moves faster! but Veins go
against gravity so blood moves up more slowly. = less EDV and ESV

Collagen dzs, BM dzs, syphilis, takyasu ALL cause weak armor t4 risk o

HTN:

risk of Atheroscler., LVH, lacunar strokes, CHF, renal fail. and Aortic
Atheroscler then risk of Aneurysm!.