PREREEE OPPO rerePereeErErerrerrrrrrrrrrrrrrrnt | Cacdive Cycle ~ Pars 1 One Corche Cycle = 1 Sysicle + 1 Digstole, 7 When le}t atrum contract atrium valve open Ue lata Wealiel dusted oP aeraein et phoebe pitium + lef vent bot mot Gash laff. vent. & Bora ley vent, inpul workirg but ned out put - B07 « Wri illing dens beer ria S07, ventficaler filly bar jece atria) 214 Bria mechanically net workiv ne significant sygering. 5 7 = Altium contraction mone imptttomt for ex arsise. - Meal contraction ~ Artal pres: vt a "A- Wave produce Ser = With, contraction of Meum , ventricle. pressure T ~ Current,’ olepolaizdion core to. ley! vert. > Pressure in aorta side wor atcund BC aml = Veninida stots contraction, pressure in vent, 5-6 rm) which ® mor hon Aitial gredsure. bul cant go bad = When venitich sar> comracting Mural valve’ closes which produced Sd sound Con right + jy see) = Venirick closer contfects a5 clesed chamber. = Pressure gees up Mapas — Isqvoleetrig, Contraction + Pe hose o} Ventriculer Bre me Pitle — When Mra contracted ia 1” Phase > A-Wove when finn A wave Vedi coniebetion starts, back pressure te Adviom, feel ‘uplve, closes - peck aig bulge in atram , slighty Inc Wn rial pressure > YC-wdve115 = Vent bleod lu do Arron but bi Vere Bere dale? Kecwid Sectmutates Hoce from lungs, slighy Wi. pressured! e = Riview e} Isovelumainic Conroction = Veniticles start contraction tral valves closeo Breasuce Te SRL act enough +e open A. Valve ium war ts fe of Ceo ree er m Atrium \< id cca 40 ich ee ousen, ( fenyect ote {Raf ee = Pressure in vert. more then Aorta (Roce valve opens, 6 = Jp pant phase bleed pumped jrom Veniriele 40 Aerie Eiitettataies “our eer a = Pressure in vert. may reach SO \em lig - Pressure in Aorta es to [LO mm He = Baga Eyection oh Cood jrom Borie also slows com = Atrium still working 23 bloccl bank Weave, coming, e = When venincls contracting, Mfum yo resavr. BAER Ae oi ye rf cack) = Neninga onl facta loukaves 39, Sag, che chombe~ Bpid Ventricular Eyechior > Slow Veniuler Gecion Phase. e CUATT TART TTAATTTATATT TT TTT TERTSOSISSISISSIISIIITISITIIIIIIII IIIa aaa ~ Arium still Resevoir, V-wave stil T = Mitral, “still closet | = Veniticle finished Isevdumedric, and Rapid Ejection hae, nsw in Slaw Ejection Phase. lmita- vent. pressure shi higher than intra- Aortic eed still ghiny to Aoci= but pressure Starts failieg ia vent.9 + Berts, > ISovolumettic Relaxadion ~ left vent. starts relaxing, pressure L = Onset on vent. dliastola Crelarofion), pressure In eH cay lt v ~ Biccdd in kein? anes +e, fall back now. bud immedi ah, clusuw oy AbiHe valve ~ [Rinpectan Youn Ronis # EIS Vaal aiscon. - Aorta pressure S47 igh “Vent. lewer recived, ) U clsed ohh arainds, the Valves 4 1 t. = Wresoure: “in Uni casg lie galling shill high than ~ \sovelumetrie Eelaxati on. Omed Sustole 9 Iscrolumedric Contraction Onset Diasiele > Inovolunetiie laxation > Repicl Passive Ventriculer Filling Phase. - End Systolic Volueme = Blood Le over in ventricle i apier Soarele COU Pressure in vent. became less? aan aia a} Atrium Maral valve opens enn, yale os Z| & 6 = hed en in eerie Cao etnial Comtracticn) Copel Pade WA Culee filling, > Slow Passive Vemiiculer Filey / Diastasis ~ventsiculee Diastole continues . = Aortic Valve alrercdy closed = UMGcal open = Gd Sythe 4 Bagi 0. v. FillinyPO — venoWs blood from lungs Cirectl el, Serineder pivkg DT rede Ateium only @ conn. vebween lung + vert = no Combesttion = Slow Passive Ventricular Filling CDiastess ) > Atdal Contrachon (Fre Back 40 beginning) = Mriuin has been relaxing right up until pow 2 Rite Contes, OP ine © Rete Phase > Points to Remember Thane Oiasicla ts very long ghas< Venirialar Sysfiole 03 see Ventricular Bastole + 0.8 Sec Heart fade 2 2 bens per minute = Indvolymescie Contraction = closing 4 pineal +: Teteugicl valve ah omet jerieulgt Systel produces, First Wenrt Sout = Repicl Vent Eyecteri (Pinpse rR FA ning, ©! Re [ve Sow FE Sh COE SINS soe Be Takaa = Rapid Ejection Phase 4 Slow @, Phase -no somd. - Isovolumestric Beloxation = Agnke Valve , Pulmonary Con Wyt) alse closes SD at ena” of verindler syentee fo btwn $2. ¢ S2 ventricular systiole occurs Rapid Passive vi Fall Phase. Spee ine oc CELE ET + ther re Att fracting, Wainst stiyeneot Uptets Bie aR anna erage, he Maar rest ssue in florian Bo ~U = Pressures ie Bighy sic go ahan leg+ | imenay 8-2 PERT TET EAT TATTTTT TTT TTT TT TTT TTS TGAAGTIAGAAG =e Le Vent. Presser O- (20 mmWi. Cirtghee) = Shee rei oe ee cite = SS wsually Ayer, oe funet Popat Versus Return Physi Jogit. nee erect. hope Vem ung ee me tte aoe ete Acderial Contraction Isovolumetric Comte evoke 7; Vent. See Slow Passive Vea Fill, Phase Vent. $554 Auch Diesto Vent. 0, Ne $2 SUSSSUSUSSUSSSS DDS SD ADDR ASST RID a Raa Daa a aaeCardiac Cycle ~ fact 2 = Cardia Gye as 2 Graph = fressure in Airium, Venti, + Aerts ¥ Asal Aen ieee Sh ae DR = Peeve ‘pot ° = Volume tn Ventre. T with fal Coniench un With Isowstumetrie T vin eve * wish Slow Se Brees » Cdn Seve e A-w ion coaconced Reeds eerie sHm_ Pope bepre A - sal 2 We nese = Venivicalar’ Degolanetion seen vn 2 phase | VeerececeereeagageragerrererssesgesTFFFTIFTGGG iif O- Gardic Output Cardiac Ovtpus (3:1) WEN ena Venifeulee conty: Seeote Volume = EDV~ ESV = Ejection Fraction — fraction of EDV sjected fe Ejection Fincher + jee |F OS cha Pie leondrghic. agent (n eS RB a ey. FS 90 BF >: 084 ~ Belated fo Epicien ney ventricle in yolnot nae? F may be less 9. EF: SYS = 033 eov se = Cardinc Ouipat + nouns oy leah ected = Cosually marsured mnaied FO % 5 = 5250 ab fia + = When Sv Po 7 COR — Cheart cate uncherpel) She St tt cet Cie ae oa SSUSSSSSSD STARA ADDR RSD S DDD R DDR A Raa Dada a eee = Stroke Volume + FOml Amoum af bleed ejectect et on, Ventecder’ cavtrackon yet) = 1g Adrelink glee gl veil uenicods, or, Cardiac Ourgus = SV * Head Cate fminute= Bur AR mnctersed so much that Diastolic Time shrinks foo muct , let vent. filing Peducecl leads 40 decrease in’ sév in this case COV CO4= SVL * HRT = Cardiac Ovig measurng > FICKs Principle For egy in Lwin, 25001 ated, 5 * 0m! added =In mised venovs blood - 140s! oxygen litte Cardiac Ouigut 16 the amovit of bleved jected! b yh weriele fer minutes 3 Cardiac ovtgas of layt vent. always eqye! +o C0 ay bejt vent ger minute, = same Smobna is also passed thewgh (ung > Coulonzry plies “Ak we fnew pulmonary plow we com detente, nes. : [ee Lew i = wi 235 gulmon: Ongen Consue gion eae SOF acum th Manoa) ath renal sides 4 Calculate conc. clijf = Cont: ef O2 in pulmonary ortery - cr vn right Pea” ¢ Seer e ~ cone. Jin pulmonary Wein sam 2s in Jemor! artery, TTATITr eee aaaaa a aeeeeeeeaaeaaaaaqaaaga 4| SHSSSSUSSU SSDS SDSS DDD D DDD DDD R DDD aad aaaaeeD = So, we pass (oinicr = the vein 40, right heard « baske sample of bleed por right Vhwart - For, hex can +; ble, > or, fl heart we ake any blood srom any = Clute the di - Then find how much O2 persen is Ssi er x sd # se CEB Oh ea @ + MQRee 6 280 2 BE jan So, Cardiac otput = S$ ¢/min - Cardiac Work afore ty etal Yo Stroke Work = SVX Aortic Pressure. Minute Conia Work > C.0 * Aortic Pressure, voles ae ~ Heart must cade certeiin pressure te eject Cetein Nolen i = In normal person is volume work, Cexitesal werk) or pressure. Kuurk’ Cinternal work) larger 7 MES UL heart works more, uses mar 01, works Les, tes 0), Igdhumie’ Raart diseases ‘patients rmbatedes fonen 0; sugely 20d denfand «In these gaberts O2 cwrsumppion very mportant. Qi & miavle cardiac work = CO¥ Aortic Pressure,= gafierts vith cocomary heart aliserse have Ischenra > supe less Oa = wel stduld edie 02 demand = 2 We should make Cardiac work less = We should charge CO belum work) oc Aorkc pressure C presute werk) tod cardiac work, - we need to know which work rayuiras more Op? sure or WOLUM Work ? 70 Toft and nigh, ©. ore both same lat Aoi pressuld is’ diss. ert neon owt mean | Wownlky 2 eh heord eects more. Oy F more energy, used if Presmre work = In Systemic. Hypertension pressure work on Shan oe i ie Bh et ersion pressure work on right wae # NOR t mM pbent with T blood pressure we give them aier\e-daletor su let vend. pumgs Oagainst bss pressure, less work, ss Oy edo = In Aorkc Stenosis gakents left heurh meds ra Rae Sienonis queens Gi Hep ‘ TTT TTTT ETT RTTTTITATTTITTTTATT EEK AAAaaaaaggaggga:SSSSSSSSSDSSSSD IDI SA DIDI I DSSS D dasa aaa aeeees a pressure work 17, CO work UO TS more Oy neeclea\ © ghemgy more. sed in pressure work = im strenos excercise TC.O bul Aordic press. norm 2. Oy demand more ~ inbealthy persens cardiac exurcise COT, but pressure “Leork dies net because change = CO may werense from SL? IOC while Bortic ressure sfeys the came, ~mnagimmum energy used when heart is workin Grown pois Dds Ss pressure. work 3 Edv= tlo- (ae Esv+ 60 %Cardiac Ovtgut C32) - leh vent. prodwas tension jn WS wall +e pre, gar pede en Lapieais Law ps 28 Temicn x Tekress Radis 1 in Congested Cardiac Cailure heart 4s dialate Becdines tess Eyres * S Wetrincalee contnchon be cgeres geor a Pleod coming in not ejecting, Cell = when hese Was Pagal sontarepig Cant 12 eeiteath tS less) cagahdy te grec penser TS less capz bility Mo" grett: plessue tess = iw chalated hort, radius 1S mere J less pressute. prea. at some Hewsl ony > less Stroke volume = Jor more Rasion more Op Is requinedl. = whan you give veno-dialetor - you horde the radius 5 Batale veins which reduc Veners refumn, which reduc’ ventranlee filing 20 Size’ of heart reduce, 3 More pressure Ot Same nsion, 3 tore "Stroke volume 2 EF more > yall les. = Sez 04 heart failing + yo wank mere C0. deed more. 5. More pressures S gre vencaboletors. = Also gue Dievre tics = THN vleod Volome is meduea 3 Venus voluwe reduad creer wa eeaeSEEETEEE OEE E PE) > venous retuin reduad 7 cudius smaller pre Blnmegile Congested Cordizc Feilue = YP = HE te ee venodiles FRE amen = more eressure P more CO, ~ The reason we Any te de pressure is Jo over-come Total Sper! Resides, THe ey Helpiag 2 failing heort 3. Reda Radius — venodiatere's dieuretics 21 Increase Tarsion- + ionetrophic TAY arlenes very qarrow 150 mits th cardiac gxhent has mean arterial gresrure of (BO milly art strug te produce more tho this = af yen gue Varta dvalseety Grenruve wey drop te 1b mk «fear ean amd akis (rome easily “heack More efficient 3, Pressure o} -load should be las - Hariedivtatec Store 1SN pred i Lapeces Law tells us when hard dialates te becomes weaker Counc oy Mart is se grad. pressure) O, damona % Miwwie Cardiac Work = @.C.0, x Mecic fore Vola wel x Oreps ek ~ Patent Witte achenic hears ai 5 2 Se imyecardhaeet 3 eae yer ho Pe) eeti = In Aschamic Heart Disses P nplieee carer, 39 + VO sugply? JO suoely 2 danced ff oe naed to edu Oy demand V cardiac work Oy demand & CW, = CO ~ Aortic Pressure hare t = aa Teedy obey ee eal ay oe Kau = pressure _vark darends on Borla pressure a phecodislator glen > gressure in gorta’ y ~ hwart beats ogdinsy Lolo pressure = less work rkuired Hy yer get venedialoten pe Be Tawien Ths Y Rodius baat ~% fedius 5 small We verodialios ore initiates emer all veins dialate , veaous eeturn to heart 1s ss = TF Tedtks small, 94 less tension, more pressure 1 Tees asied, Us 2 Used - In Angina \, ou give the pahent nitcates ened Bhat OF Aird hens ody G bos preomue, 7 CO Review = hart Ischemic, ceronic arly Was a ~yscmmna, norrow Coronmy “anery, Less bleod +e fear = best aku to Ao is ofen coronie acter = but in Adina you ey not he able open = ign Of teying te ncrease 02 intake you ‘Should recta mad for cing vote oy heart fr Pee TS m4e redudl Work 0} heart you should reduce pressuce work = five cgned alates ae L areroles dita; heart has to aopins less resistance mB Tnea "Wager has se genciate as pressure, = Vp heart has yo davelog less gressure, it has € g ; e e e a eeeeceeeeeeeeeccceceqegeeeceeegaaaaaagaaagaggSSUUSSSS TASS U SSDS SDSS SSDS SDSS ISD I SID aa aS 40 doveleg lass demion. Sess Oy Usect 9 \scuudia Fixed ywe veno-dialatos tradi v ; = Fer Same pressure, les eusion required = In heart, maim user of O2 js temion = Femsion rquined por pressure So ; IY wag te edu tension Lb red pressure need arteiedialator®. 1 for gecd/ CO Walle less drsion recluce rads by vend Hh patient has \schemia and heart © dita 4 AP Sera fenton, lose treasure preci 2” = Vierensed iensicn will be required ¢ severe o-cardtial infarction, will Ccceuy Weert BHacr Indices « plenary vein Pre-iea Map ray Conteockliay, Agler- load - pining 2009 Prigat bent = Pre-load - load on muscle contract uyhen rele HER Gorkge pew = Asevcalled Ene Dirsiciic: Volume” CEDy) = witht more EDV) more End-Diartelic Pressure, Rre-luad o ZV % EDF * lepe pasial_presure. = Up any ef those increase natdrolt Guertast, Vein Qressure alse increases Mimonarg Wedge gresoue. - gasg Cadhuster Copecial > Suan Fone CotbeterS fe determine Dulmamey. W. pressure. nan = Jor eg. We gass st uy mayer vein in Fetes ee lgiee ue a essere = manner Cadkuler Wie. igh Nventrick then| PETAR EAAAAATTTITTETTLUGELTVELILLLLLLLLLLLLLLL llmonery artery. —Paweough “pulorertiy Srtery inte guimenery cagitter = BET wedge We block > small gulmonsiy vessel, We Wwiplever pesoure present during Lyf4 veut diaitere . false present in legt aifial pressure 7 alse Areceny in YA gulonenary vein, 1 pulmenday ceptllocrs and acl ey pulimonary ‘artery. = at Aha dip of catheter hare iS in ure Bae eaters eat gr EDP indirectly, Review © Indices of Preleacl Pretoad = EDV, EOE sacial Pressure. hence Vein Orssure enor Wedge Pressure 4 ontrautiity 5 one indica is velocity oy davelyment it ere 7 contraction 2% ‘au haw §P\ doe contrachon develop = Hee = cronge in pressure over change in nee = whan Logs Bowel vent. 15 contachag Me tat vent mag be hyperahgnmamie, or hecde ° Fira Emr If hyperdyaame - eT © fa w sqced of contrachon wl ES Behe vg wns peak pressure + deterninas cok of presure div. during Ygo~ volumesric contraction ya S Ejection Fraction ¥ “reskee CF EDY ejected gr contraction =n stres in ~ larger EDV ajeckeal a sraeg tonal ape pe BV sjeo) ;He! SSSS SST SSSA SSDS SDD A SASS DIDD DADA D DRDO et wcrctilidy seen a Heart #2 oF ira Batty 3 lonotepkic drugs 7 EF Y mofophic dogs > EFT Tar, = Rormal = In symgathetic, velocity, with which gressure Tis ste Chan, DT Yee» over 4 ure Wncreasing more i Te leieia eating orone rapidly © T perk Iejt vot. pressure + + lonetroghy. ® Cuelecty of relaxation © De to € wl + #3 oF DeGsecue inset Nowe: Systolic Iniewal inversely related to Coneact lity 2 Systolic Interval % Conmacsnay vere Diastolic Interval inversely teleked te Heart Rate.lonotroghic digs reduce sysiclie Interv! Wegatle \onetophie drugs increase sgstolie inberval agridie Weel with pesto sonemeghie diag : — Ap heart rate increases systolic interval decreas slighily /"aisstolic Weal decrenses largely ~ ly hazed rate dacrenses, diastolic interval T So; ~ We can hereby say thet Systolic Interim) madly dagends on Coviractiliy Divstelic mservar on lord pate Review Indice of Comtcoctilisy Conrochlity = Speed Coke elopment = ee Oren a Ejection. Frachon sosiolic tnkeevel Ajterload \ Pressure against which left venice is 4 gens. *S a z load on muscle duris comtracion. "APC toad on muscle duritg’ clred stake + pelord > ISPD RPERSRPRORPRRRRRRSRSSSSRPPPeeeeeeesesesePEPE PD PP PP Perererererrererrreren) ~ Adlerleed or riven (6 Atuly dependant 04 Bethe” ASRS Pecoaure od “tabher Tors! Peripharic: Resistance More TAR 7 — More Rertic Presson? - More Aper leacd = \g patient given atteito-constricler , Sep tere aimee dinate” Remember, majoe work of heard ix, pressure work Cpressure burl 35 isovolumic comb Beton). ~ This pressure cequired is dagendant on what TPR is Comat ier -lcad sy Sy Pre-load 1 Determine how_much a vent can + Comeactility ) produce S.V. Aper-leacl F Inversely Aatermine, Sv & Pre-load BU of Conttaent SV + Agke-l puddn ct lead is wereased then lejt yer yale e REAEE menses shan Lg > Threaper it's EDV will be increased for next cle > Muscle will stretch more 2 According, to Frank Starling VA will combeacp more leading ° to. a Tighte Sv = Chronic increase in After-lord leads to Uyper ti ay Mecandbete) Tie atestoiel Bet CO apne Me Kigh Sapier-lenat 7 Chossic Example » Systemic Hyper tension| Cardiac Ouipus (3.5) Cardiac Output & Venous Retuen ow WR = Cardiac Outgur degendent on Pre- toxd oo ~ Ay Frank ass, states, a5 Evy sg EDP Anitial Strereh ecucclial ig ° progress wely \ndeeastt, on aoanttg oe S¥ 3 CO. RI ey > ee > - epv = [Gee = Bet Ee ie Legenda on Aitial Pressure = Up Atal Pressole te ventricular filling fast = Ate 8 ends on Venous Pekan C Shon Eee En Big Weare TER 5 hd hes 4 deg mH on EDV Jor hes Shots heart eee sn Sch ah TATE TT ITTITITTTTTIETUTILTTULETLIIVVIGAVIAAGYUTA R RAR a aS | fig Bdrm pressure which chepends en Venous Refurn So; MY right otfial presure T , vent gilling 7 i} vent. fillyg T , Cot fs RA Pres T) Cot CWere: C.0 in right © Gyi vend, egal > = Whatever is gumged threvgh pulmenay circ, +6 lejt vert. by rigmt vent? af one widute. “is sae lig Soe pe Vp Right vent C0 = 54 /min \ vent. C.0 7 $28 dmin - s0°%Ro accumulation ¢f bleed im pulm. circ. Relationsbue ef Right Araal Pressure with Venos lun, 4 Meni feturn is nthe settpin rtssure gradient fin gressucer push’ bleed probe vanes ays te mony bebrt ¢ = YOR AR ss venous return con easily come in tf RAPD Aifeult Jor venous sye Fe entply tse. LAP RAR low, venous return mcrerse, csise tents eve from pressures behween -2 4 ty he TELL iaent erat peeeenate 8 ar - Bter pressure Of $4 ne el dutther increment of 6.0) Cee (= AR pressure ef 65; ne VR a 1 Cmca’ ggatene “prssere’ C6 not) ele aieemelalar —.) A Apsystemic pressure ene! AP equal, ‘no yessuce gradient wuealer fine curve for manned os Vimovs bho cok t: -AS RACY V.RT ~ when RA." less then zero, sf RAP enters a wenguis a eo I A major VeiMs S30 aps 1 yer rence lene eroCr gill i Cardiac Fue. Cu, att © bereheght e Real beckon - I patient given @ ionctrophic agent, for ever UW per GoB concent gts Sate PT ete Pyee given Pre-tcod > cot = Fer every given Right APrem . Cot — Ay, pan ven © ionotroghic » Ca® channel S feces. Oger very ERS He Sy Vascular Fone, Curves | were Ne mek fat eens, veces 7 ‘@ ene fs aap Ene = AM mean systemic pressure CMSP) , Venow reiuen 2éfo, unkill at Aggetive gressure vel Start "collapsing e = Uy ypu give pouiens Veno- dialator, veins clialnte Jet ‘Docent larger pool 0 drug,” venous return Y ~ For every guen WAG, 14 Paine ielmed, venous retuen = Nittats are good Veno~dhlatocs = Li Somecte: Kis hemorrhage > reciucect blood vot, Yencus reaum les Cog: Pbiceel leaking eur) = Ip pavent given veno —consticters ; ween PSOne anak see te adores WE Concept of Stressed + Unsiressed vel of Blood = Tehri" st? bic 42 mostly on venns Sicte TL on arterial sie. EL] = Veins are wide , so York pressure in veins less,” bloect in veins aKirejere adn’ gut vely highSOT TUFF RRND DAD aaa aaa e ada aede ressute on Valves Of veins. > Lnstressed volume EZ you don't eel pulsations on the veins. = only 12 blood on arterial site producing 2 let 9 producing, sue On the Walls Of the orden, Strestir Rel Sal PCCePert 9 F Sressecl volume = most of your blood Clr) 1s im unstressed volume Alo; = Gtress vole Maintains the maivy System! Pressure. responsible et vencur Cebuen ~ lk veins too clilated, ley heart pumps into Sdrese/ cae a ds Wie clit = Since “umptressecl comeartmant larger due tc Vencditabion . venus return will Thecome tess > be CO Uy Aight) becomes less ein-qurn C0 of lejt also 2V > sceol vilume also becure less. > mean systemic pressure ~ when you use venedilation you are re-distri bugis The Ue ea Stressed velumred + unstressed vol PS > mean aytiemic pressure © * Veno-dilators reducing blocd volume J mean syskmic pressure > when you increase bleed volume eg- bleed sans fusion; VRT, COT, Stress velumd + Te mada systemic. prfsure ® — vasculer June. curve moves upward + rightward in veno“coupwichon "+ increasing, blued Pelume F Combination of Cardiac 4 Vasculer Func. Curves & = Intersections 9} these Paes é tisotnn a ige St VRS CO. heal be Equal 1 heal 1504, « diletes t+ Fi Makes 4 e075 Jo hears te pum, since, resis tance earl 40 pusap foguinst a Tee te ese Vege > Ajigrleed ¥ a eee fe WP! Aptertuad is stress on myocordial muscle chur donsraction tr arts Aterilocomtrictor gwen ; Ariericls marrow - 3 eet pete to empty itsel in OTRa Chany in Aider-lozd oh BEC Vascalse, Fane. Curve AwrWlation freenle-Gnst ction » VR y hee = Arteries, dilakal apart bleeal te venous Wate Since ede ea ae SS Venous seat * ~ Us fcterien | comirctecl Ilcod te Venous stole 1 = aes ei Vinng, 6 Ceoumbe eleckiise. mtoenert) In PPRO OP PPR Range eaaeeeaeaggccanagggggaaaageSUSTUSSSSPA SESS S DSSS DDD SND a ae aS Cardiac Ooreus (3.4) Combination of Cardio Func. 4 Vascular func. Conve, = After Agplicerion of + lone~ acne rant fons ee etaotl tore: - moved t 7 Cot ~ moved Let; RAP ment LY ~ when heart, vortrichs, become nore espcient) C-0 Hhrewaraus “amore pcre ring, Elling “ghase dhe Becept Roce rapa! Gremosdriew® Sarecejer? Atal Pressure deege b = Aghe Apglication of — lonotrophic, agent» curve higis dows peronng pede ares tet > fetgven Bea pT conatility hence CO b. = UpeBaies ei "higher Ainal Pressure = This graph studied in ancther vay — oiptaet ~ if biced 4ransfusion given, f Vpscuinep gene. curve change c cing T= : RP pen? COT, with more Adcial “pressure T oy — In positive loestropl, 1 Cot, RAP YL = In Mncreased blebePebme : COT, RAPT Wihesecton at = With veno-dilater oc J bleed vol. > pot +5 = COv RAP LY Gor, viet RAP —he change ~ Wien ayterload dacreatec, Fight «lage vent. more ive, FOmcce We. Bua UH EO wre, BAA VR also more, Aue ae increased CO; Wy pressore Drog expecka wt ts “counter balanact by increasing vik = Neer-ly Prgpalecpretae tat gven, C.OF — Less bled aise mover to venous sda 7 Med = Ne chang in R.A0 but 6.3 + ~ When C.0 4, VR asow, 4% remoins S4abe Summac yt = Talked about: C.O relationship with VR. deci ait eae ee Contractility re-load parlor ie Ree be bettas ge see = teats by vague a iia Acteriole = Caml Drenalie Dealotes: ee Dereon PLA jaro = ugpern Cpting Hs) Pre-twod ty Ph, cot Yl coy Yb blood veiume T , vRT , Pre-loaa f if blocd volume y 7 URL Pre-Ladd =ly Venmotor Tona is more , Vein squeree rare bieod 40 heort so Prextosa tO ~"Wavpregueer (bee use Cyene-atinter) Bleod peels WA veins, URI less Peleod ¢ = Disstolic (ntervel determins filling Hime; Din Sages on Mesa Gadel. T> yre-load | Resistance prs whi vertnck 6 Apron ean. ~ Uy Ackeicconstictes gon, TPR T, So Meceea be, Oe = New Gyuilibrium point atteZ, e e sp eeeeeeaaagagaaqagernanccgaaaanaaanaaaaaqqqang=\y Aree dilaice sven, TPRY % Ayierleed Wo com” Be C07 Ater-lord All his inje: presented Graphically 9 contrachlity changes, CO eYechel eS ogiat 7 > Cordise Func, Curve; = + T aot, BAPL 2 eg: — ietetwphic agin > Careline Func. Curve; 4 > Col, RAPT —\, lovd charged, C-O *pected a Preleee chara cio, wet > Pre-lued T % \escaler Func. Curve; 2 4 T 2 cot, RAPT 7 veno- dilator, hamecrey > Pre- lead - 9 Vaseuter Gunc, Curve; ia Lb > colt RR’ ~ Ip Adterload changed, C-O eypctect po ete eae ebay Oe > Ajker-tead > Cardive Function Carve, — T 3 Weneo= vase! Rinction Cane? > 77 > COT, RAP no chenge” = Wy 9. arterio- comnisions » TPR T es Agtee=tead ? . > Cardiac Func. Curve > > LL 9 Vasc. Func. Cove 7 OLY COV RAP no champ = = = = = = _ ~ = = — = ~ _ — - = -” _ —_ — - — _ _ a — - = — _ — =Mgocardial Conteactiliiy C4) Cardiac Muscle Contraction Electrical Activity starts_jrom SA~ nod ies pute PAiiar Threwgis AV ees de) vertick Wren it Peaches first call Cin diagrae) ~ Electrical activi es te 2 cell Lal ~ bow @esistank Connections present loedween Myocardial cells called © Gop Junctions Func. of Gap Junctions. = When one cell undergoing Aapolarizatien, it means +his cell aquived- a lod of Cations ~ Cations 4rickie throegh next call 4 roug bh ahese Gap Junctions windows gar cation passage te Epi —— - = Cell receiving cations approach Threshold Threchold wsfecnl tyre ay voltage ot URich SERS lapel” Correrth will) erat Cog, here v8 -Fomuv) = Herevolteue- azied No’ channels ill open which allow Nx 4 come in Cusually cone: outsida) Ki well conc. insicle Cees are bays gy Kt in see 0) Ne ci’) = When RMP reaches Threshold. Threshold Induced ActWotion 0) Voltege gaicd Na! chymels occur | PR RRRRORRRRRRRRRRRRRRRRRRRRRRREEE REE EERE GEES St |