Rt Study Guide Cardiovascular II

Negative inotropism refers to a decrease in the force of contraction of the heart muscle. In this context, "decreased stroke volume for a given preload" means that the volume of blood pumped out of the heart with each contraction is reduced, even when the amount of blood returning to the heart (preload) remains the same. This can be caused by factors such as certain medications, heart failure, or damage to the heart muscle. Therefore, the correct answer "Negative Inotropism" accurately describes the situation where there is a decrease in stroke volume despite a normal preload.

Diastolic pressure refers to the pressure exerted on the walls of the arteries when the heart is at rest between contractions. During this relaxation phase of the heart, the ventricles fill with blood and the pressure in the arteries decreases. Diastolic pressure is an important measure of the health of the cardiovascular system and is typically lower than systolic pressure, which is the pressure exerted on the arterial walls when the heart contracts. Therefore, diastolic pressure is the correct answer in this context.

Mean arterial pressure refers to the average pressure in the arterial system over a given time. It is calculated by considering both the systolic and diastolic pressures during a cardiac cycle. This value is important as it represents the average pressure that is exerted on the walls of the arteries, ensuring adequate blood flow to the organs and tissues. It is used as an indicator of overall cardiovascular health and is often monitored in medical settings to assess the effectiveness of blood pressure management.

Systolic pressure refers to the maximum pressure exerted by the blood against the arterial walls during the contraction phase of the heart. This is the moment when the heart pumps blood out into the arteries. Diastolic pressure, on the other hand, refers to the minimum pressure in the arteries when the heart is at rest and refilling with blood. The pressure gradient refers to the change in pressure over a given distance, while osmotic pressure is the pressure exerted by the movement of water across a semipermeable membrane.

Cardiac output refers to the total amount of blood pumped by the heart per minute. It is a measure of the efficiency and effectiveness of the heart in delivering oxygenated blood to the body. Cardiac output is influenced by factors such as heart rate and stroke volume, which is the amount of blood pumped with each heartbeat. By measuring cardiac output, healthcare professionals can assess the heart's ability to meet the body's oxygen demands and identify any potential cardiovascular issues.

Preload refers to the amount of blood that fills the heart's ventricles before it contracts. When the preload is increased, it stretches the muscle fibers of the heart, leading to a more forceful contraction. This results in an increased stroke volume, which is the amount of blood pumped out of the heart with each contraction. Therefore, the greater the preload, the greater the tension on contraction affects the stroke volume.

Cardiac output is the amount of blood pumped by the heart per minute. It is calculated by multiplying the heart rate (number of heartbeats per minute) by the stroke volume (amount of blood pumped by the heart with each beat). Therefore, the correct answer is stroke volume because it is one of the factors that determines cardiac output.

End systolic volume (ESV) refers to the volume of blood remaining in the ventricle at the end of systole, or the contraction phase of the cardiac cycle. It represents the amount of blood that is not ejected from the ventricle during each heartbeat. The ESV is an important measure as it directly affects the stroke volume, which is the amount of blood pumped out of the heart with each contraction. Therefore, a higher ESV can indicate a decrease in cardiac function and a lower stroke volume, which can ultimately lead to a decrease in cardiac output.

Negative inotropism refers to a decrease in contractility of the heart muscle. Contractility is the ability of the heart to contract and pump blood. When there is negative inotropism, the force of contraction of the heart muscle decreases, leading to a decrease in the pumping efficiency of the heart. This can be caused by factors such as certain medications, heart disease, or an imbalance in electrolytes. Overall, negative inotropism indicates a decrease in the strength and effectiveness of the heart's contractions.

Preload refers to the amount of blood that fills the ventricles of the heart during diastole, the relaxation phase of the cardiac cycle. It represents the stretching of the myocardial fibers in the ventricles just before contraction. Preload is an important determinant of stroke volume, the amount of blood pumped out of the heart with each beat. An increase in preload leads to an increase in stroke volume and cardiac output. Therefore, preload is a term used to describe the filling of the ventricles before contraction occurs.

The normal value for cardiac output is 5 L/min. Cardiac output refers to the amount of blood pumped by the heart in one minute. It is an important measure of the heart's efficiency in delivering oxygen and nutrients to the body. A cardiac output of 5 L/min is considered within the normal range for a healthy individual.

Non-cardiogenic shock refers to a condition where the heart is functioning properly, but the body is unable to receive enough oxygen and nutrients. Diastolic pressure is the pressure exerted on the arteries when the heart is at rest between contractions. In non-cardiogenic shock, the diastolic pressure may be low, leading to inadequate blood flow to the organs and tissues. This can result in symptoms such as low blood pressure, organ failure, and decreased urine output. Therefore, diastolic pressure plays a crucial role in non-cardiogenic shock.

The mean arterial pressure (MAP) is a measure of the average blood pressure in the arteries during a single cardiac cycle. It is calculated by adding twice the diastolic pressure to the systolic pressure and dividing the sum by 3. In this case, the given values are 82, 90, 95, and 85. By calculating the MAP for each value, we find that the MAP for 82 is 84.67, for 90 is 91.67, for 95 is 95.67, and for 85 is 88.33. Therefore, the correct answer is 90, as it has the closest value to the calculated MAP.

Myocardial infarction (MI) is the correct answer because it is a condition that can cause a low cardiac output (CO), ejection fraction (EF), and blood pressure (BP). MI occurs when there is a blockage in the blood vessels that supply the heart muscle, leading to damage or death of the heart tissue. This can result in decreased pumping ability of the heart, reduced ejection fraction, and decreased blood pressure. Hypertension (HTN) and a heated humidifier are not directly related to the given symptoms, and hypothermia can cause low cardiac output and blood pressure, but not necessarily a reduced ejection fraction.

When the ventricles are being filled during preload, it affects stroke volume. Preload refers to the amount of blood that fills the ventricles before they contract. The more blood that fills the ventricles during preload, the greater the stretch on the ventricular walls, leading to a more forceful contraction and an increased stroke volume. Therefore, the factor of ventricular filling during preload has a direct impact on stroke volume, which is the amount of blood pumped out of the heart with each contraction.

As stroke volume increases, more blood is pushed out of the heart with each contraction. This leads to an increase in the amount of blood remaining in the heart at the end of systole, known as end systolic volume (ESV). Cardiac output is the amount of blood pumped by the heart in one minute, which is determined by multiplying stroke volume by heart rate. Therefore, as stroke volume increases, cardiac output also increases. Stroke index and cardiac index are similar measures, but they take into account the body surface area. Since stroke volume and cardiac output are directly related, an increase in stroke volume would also result in an increase in stroke index and cardiac index.

The normal value of diastolic pressure is typically between 60 - 90 mmHg. Diastolic pressure represents the pressure in the arteries when the heart is at rest between beats. This measurement is important because it indicates the resistance of blood flow in the arteries and reflects the health of the cardiovascular system. A diastolic pressure below 60 mmHg may indicate low blood pressure, while a diastolic pressure above 90 mmHg may suggest high blood pressure. Therefore, the range of 60 - 90 mmHg is considered the normal and healthy range for diastolic pressure.

Shock is a medical condition characterized by a sudden drop in blood pressure, leading to inadequate blood flow and oxygen supply to the body's organs and tissues. This can occur due to various reasons such as severe bleeding, dehydration, infection, or heart problems. Low blood pressure is a common symptom of shock, as the body is unable to maintain normal blood pressure levels. Therefore, low blood pressure is the correct answer in this case.

When the cardiac index goes up, it means that the heart is pumping more blood per minute. This increase in cardiac index is directly related to an increase in cardiac output, which is the volume of blood pumped by the heart in one minute. Therefore, when the cardiac index goes up, the cardiac output also increases.

When the cardiac index goes down, it means that the heart is pumping less blood per minute. This decrease in cardiac output is caused by a decrease in both stroke volume (the amount of blood pumped out of the heart with each beat) and heart rate. As a result, both end diastolic volume (the amount of blood in the heart at the end of filling) and end systolic volume (the amount of blood left in the heart after contraction) decrease. This reduction in cardiac output can be caused by various factors such as heart failure, dehydration, or certain medications.

The normal value of blood pressure is typically between 80 - 100 mmHg. Blood pressure is a measure of the force of blood against the walls of the arteries as the heart pumps it around the body. A reading of 80 - 100 mmHg is considered within the normal range and indicates a healthy blood pressure level. It is important to maintain a normal blood pressure to prevent cardiovascular diseases and other health complications.

The given answer, 5 L/min, represents the cardiac output. Cardiac output refers to the volume of blood pumped by the heart in one minute. It is calculated by multiplying the stroke volume (the volume of blood pumped by the heart in one beat) by the heart rate (the number of beats per minute). Therefore, a cardiac output of 5 L/min indicates that the heart is pumping 5 liters of blood per minute.

The normal value of systolic pressure is typically between 90 - 130 mmHg. This range indicates the pressure exerted on the walls of the arteries when the heart contracts and pumps blood. Systolic pressure is an important measure of cardiovascular health and can help identify conditions such as hypertension or hypotension. Values below or above this range may indicate abnormal blood pressure levels and may require medical attention.

When contractility increases, it means that the force of contraction of the heart muscle increases. This results in a stronger and more efficient pumping action of the heart, allowing it to eject a larger volume of blood with each beat. As a result, the stroke volume (SV), which is the amount of blood pumped out of the heart with each contraction, increases. The preload, which is the amount of blood filling the heart before it contracts, may or may not increase depending on other factors. The end-diastolic volume (EDV) and end-systolic volume (ESV) are not directly affected by contractility.

The left ventricular afterload refers to the resistance that the left ventricle must overcome to eject blood into the systemic circulation. It is a measure of the pressure against which the ventricle must pump, and is determined by factors such as arterial blood pressure and systemic vascular resistance. Therefore, in clinical practice, systemic vascular resistance is equal to left ventricular afterload.

The factors that fall under stroke volume include end systolic volume (ESV), end diastolic volume (EDV), and ejection fraction (EF). Stroke volume is the amount of blood pumped out of the heart with each contraction. End systolic volume refers to the amount of blood remaining in the ventricle after contraction, while end diastolic volume is the amount of blood in the ventricle before contraction. Ejection fraction is the percentage of blood pumped out of the ventricle with each contraction. Therefore, all of these factors contribute to stroke volume.

As the question suggests, the greater the "preload", the greater the tension on contraction. Preload refers to the amount of blood that fills the heart's ventricles before it contracts. When the preload is increased, it stretches the muscle fibers in the heart, resulting in a stronger contraction. Therefore, the correct answer is contraction.

During preload, the right atria fills with blood before it is pumped into the right ventricle. If there is a loss of blood in the right atria, it means that there is less blood available to fill the ventricle. As a result, the stretch of the ventricle will decrease because there is less blood volume to stretch the walls of the ventricle. This decrease in stretch can affect the efficiency of the heart's pumping action.

Contractility refers to the ability of the heart muscle to contract and generate force. It is independent of preload and afterload, which are factors that affect the amount of blood in the heart and the resistance the heart has to pump against, respectively. Stroke volume is the amount of blood ejected from the heart with each contraction, and end diastolic volume is the amount of blood in the heart at the end of diastole. Therefore, contractility is the correct answer as it specifically refers to the force exerted by the heart muscle during contraction, regardless of other factors.

The given blood pressure readings of 120/80 and 100/50 indicate a decrease in blood pressure, which is a characteristic of shock. However, the term "non cardiogenic" suggests that the cause of the shock is not related to the heart. Cardiogenic shock, on the other hand, is caused by a heart-related issue. Therefore, the correct answer is non cardiogenic shock.

Contractility refers to the force with which the heart muscle contracts during each heartbeat. It determines the amount of blood that is pumped out of the heart with each contraction. An increase in contractility leads to an increase in stroke volume (SV), which is the amount of blood ejected from the heart with each beat. This means that the heart is able to pump a larger volume of blood with each contraction. Therefore, contractility directly affects stroke volume (SV).

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Cardiogenic shock is exerted by systolic pressure because systolic pressure refers to the force exerted by the heart when it contracts and pumps blood into the arteries. In cardiogenic shock, the heart is unable to pump enough blood to meet the body's needs, leading to a decrease in systolic pressure. This can result in inadequate blood flow to vital organs and tissues, causing organ dysfunction and potentially life-threatening complications.

End diastolic volume (EDV) refers to the volume of blood that fills the ventricles during diastole, which is the relaxation phase of the cardiac cycle. During diastole, the ventricles are relaxed and the blood from the atria flows into the ventricles, increasing their volume. EDV is an important determinant of cardiac output, which is the amount of blood pumped by the heart per minute. An increase in EDV leads to an increase in stroke volume, the amount of blood pumped out of the ventricle with each heartbeat, and subsequently increases cardiac output. Therefore, EDV is the correct answer as it directly relates to the volume to which the ventricles fill during diastole.

Systolic pressure refers to the pressure in the arteries when the heart contracts and pumps blood out. It is the highest pressure reached during a cardiac cycle and is an important indicator of the heart's ability to pump blood effectively. This pressure is necessary to push blood through the arteries and deliver oxygen and nutrients to the body's tissues. Therefore, the systolic pressure reflects the work of the left ventricle pump, which is responsible for pumping oxygenated blood to the rest of the body.

Positive inotropism refers to an increase in the force of contraction of the heart muscle. This can be achieved by various mechanisms, such as increasing the sensitivity of the contractile proteins to calcium or enhancing calcium entry into the cells. When there is positive inotropism, the heart is able to generate higher stroke volumes (the amount of blood pumped out with each contraction) for a given preload (the amount of blood filling the heart before contraction). Therefore, positive inotropism can improve cardiac output and overall cardiac function.

Positive inotropism refers to an increase in the contractility of the heart. It means that the force of contraction of the heart muscle is enhanced, leading to a more efficient pumping of blood. This can be beneficial in conditions where the heart is weakened or when there is a need for increased cardiac output. Positive inotropes, such as certain medications or hormones, can stimulate the heart muscle to contract more forcefully, resulting in an improvement in ejection fraction (EF) and a decrease in end-diastolic volume (EDV).

Ejection Fraction refers to the proportion of the end-diastolic volume (EDV) that is ejected from the left ventricle with each stroke. It is a measure of the heart's efficiency in pumping blood out to the body. A higher ejection fraction indicates a stronger and more efficient heart, while a lower ejection fraction may indicate heart dysfunction or disease.

The cardiac index is a measure of the heart's efficiency in pumping blood per minute relative to the individual's body surface area. It is calculated by dividing the cardiac output (volume of blood pumped by the heart per minute) by the body surface area. This measurement is important in assessing cardiac function and determining if the heart is able to meet the body's demands for oxygen and nutrients.

Decreases in contractility lead to a decrease in the force with which the heart contracts. This results in a decrease in the amount of blood that is pumped out of the heart during systole, which is known as the end systolic volume (ESV). As a result, the remaining blood volume in the ventricle at the end of systole, known as the end systolic volume (EDV), will be higher.

Afterload refers to the force against which the heart must pump blood during systole. It is the resistance that the left ventricle has to overcome in order to eject blood into the systemic circulation. This resistance is determined by factors such as systemic vascular resistance and arterial blood pressure. A higher afterload can make it more difficult for the heart to pump blood, leading to increased workload and potentially causing cardiac dysfunction. Therefore, afterload is an important factor in determining cardiac output and overall cardiovascular function.

The given correct answer, 64%, is the normal value for Ejection Fraction (EF). Ejection Fraction is a measurement of how well the heart is pumping out blood from the left ventricle to the rest of the body. It is expressed as a percentage and represents the proportion of blood that is pumped out with each heartbeat. A normal EF value ranges between 50% and 70%, with 64% falling within this range. The other options provided, 80 - 100 mmHg and 4 - 8 Lpm, are not relevant to the measurement of Ejection Fraction.

Negative inotropism refers to a decrease in the contractility or strength of the heart's contractions. If the contraction or "contractility" of the heart is too high, administering a medication that causes negative inotropism can help bring the levels back to normal. This medication would decrease the force of the heart's contractions, allowing it to pump at a more appropriate level. Epinephrine, on the other hand, is a medication that increases the force of the heart's contractions, so it would not be the correct choice in this scenario.

Preload refers to the amount of blood that fills the ventricles of the heart during diastole, or the relaxation phase. The initial stretch of the ventricle, which is determined by the amount of blood returning to the heart, directly affects the preload. When the ventricle is adequately stretched, it allows for a greater force of contraction during systole, resulting in a higher stroke volume, or the amount of blood pumped out of the heart with each beat. Therefore, preload is the correct answer as it directly influences stroke volume.

Vasodilation refers to the widening of blood vessels, which can decrease afterload. Afterload is the resistance that the heart has to overcome to pump blood out of the left ventricle and into the systemic circulation. By dilating blood vessels, the resistance against which the heart has to pump is reduced, thus decreasing afterload. Blood thinners, such as anticoagulants, can also help decrease afterload by preventing the formation of blood clots that could obstruct blood flow and increase resistance. Therefore, both vasodilation and blood thinners can be administered to decrease afterload.

Positive inotropic medication refers to drugs that increase the force of contraction of the heart. When the contraction or contractility of the heart decreases, administering positive inotropic medication can help improve the strength of the heart's contractions. This can prevent multi-organ failure by ensuring that the heart is pumping enough blood to supply oxygen and nutrients to all the organs in the body. Positive inotropic medication can also improve cardiac output and overall cardiovascular function, which is crucial for maintaining organ health and preventing organ failure.

The normal value for stroke volume is typically between 6 and 30 ml/beat. Stroke volume refers to the amount of blood pumped out of the heart with each heartbeat. This range is considered normal as it can vary depending on factors such as age, sex, and physical activity level. A stroke volume below or above this range may indicate a potential cardiovascular issue.

Diastolic pressure refers to the lower number in a blood pressure reading and represents the pressure in the arteries when the heart is at rest between beats. It is an important indicator of the health of the cardiovascular system and can help identify conditions such as hypertension. The diastolic pressure reflects the resistance to blood flow in the arteries and the overall blood volume in the body.

The given statement "MI>120/80>100/80" suggests that the blood pressure is fluctuating, with the systolic pressure being higher than 120/80 and the diastolic pressure being lower than 100/80. This pattern is commonly seen in cardiogenic shock, which is a condition where the heart is unable to pump enough blood to meet the body's needs. In cardiogenic shock, the heart's ability to contract and pump blood is significantly impaired, leading to low blood pressure and inadequate blood flow to the organs. Therefore, the correct answer is cardiogenic shock.

A decrease in contractility refers to the weakening of the heart's ability to contract and pump blood effectively. This decrease in contractility directly affects stroke volume, which is the amount of blood pumped out of the heart with each beat. When contractility decreases, the heart is unable to pump as much blood, leading to a decrease in stroke volume. Myocardial infarction (heart attack) and acidosis (a condition of increased acidity in the blood) can both cause a decrease in contractility, further impacting stroke volume. Therefore, the correct answer is stroke volume.