Venous Return
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Venous Return
Venous return is the rate of blood flow back to the heart. It normally limits cardiac output. Superposition of the cardiac function curve and venous return curve is used in one hemodynamic model. __TOC__ Physiology Venous return (VR) is the flow of blood back to the heart. Under steady-state conditions, venous return must equal cardiac output (Q), when averaged over time because the cardiovascular system is essentially a closed loop. Otherwise, blood would accumulate in either the systemic or pulmonary circulations. Although cardiac output and venous return are interdependent, each can be independently regulated. The circulatory system is made up of two circulations (pulmonary and systemic) situated in series between the right ventricle (RV) and left ventricle (LV). Balance is achieved, in large part, by the Frank–Starling mechanism. For example, if systemic venous return is suddenly increased (e.g., changing from upright to supine position), right ventricular preload increases ...
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Heart
The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide to the lungs. In humans, the heart is approximately the size of a closed fist and is located between the lungs, in the middle compartment of the chest. In humans, other mammals, and birds, the heart is divided into four chambers: upper left and right atria and lower left and right ventricles. Commonly the right atrium and ventricle are referred together as the right heart and their left counterparts as the left heart. Fish, in contrast, have two chambers, an atrium and a ventricle, while most reptiles have three chambers. In a healthy heart blood flows one way through the heart due to heart valves, which prevent backflow. The heart is enclosed in a protective sac, the pericardium, which also contains a small amount of fluid. The wall of ...
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Cardiac Output
In cardiac physiology, cardiac output (CO), also known as heart output and often denoted by the symbols Q, \dot Q, or \dot Q_ , edited by Catherine E. Williamson, Phillip Bennett is the volumetric flow rate of the heart's pumping output: that is, the volume of blood being pumped by both ventricles of the heart, per unit time (usually measured per minute). Cardiac output (CO) is the product of the heart rate (HR), i.e. the number of heartbeats per minute (bpm), and the stroke volume (SV), which is the volume of blood pumped from the left ventricle per beat; thus giving the formula: :CO = HR \times SV Values for cardiac output are usually denoted as L/min. For a healthy individual weighing 70 kg, the cardiac output at rest averages about 5 L/min; assuming a heart rate of 70 beats/min, the stroke volume would be approximately 70 mL. Because cardiac output is related to the quantity of blood delivered to various parts of the body, it is an important component of how eff ...
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Cardiac Function Curve
A cardiac function curve is a graph showing the relationship between right atrial pressure (x-axis) and cardiac output (y-axis).Superimposition of the cardiac function curve and venous return curve is used in one hemodynamic model. __TOC__ Shape of curve It shows a steep relationship at relatively low filling pressures and a plateau, where further stretch is not possible and so increases in pressure have little effect on output. The pressures where there is a steep relationship lie within the normal range of right atrial pressure (RAP) found in the healthy human during life. This range is about -1 to +2 mmHg. The higher pressures normally occur only in disease, in conditions such as heart failure, where the heart is unable to pump forward all the blood returning to it and so the pressure builds up in the right atrium and the great veins. Swollen neck veins are often an indicator of this type of heart failure. At low right atrial pressures this graph serves as a graphic dem ...
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Right Ventricle
A ventricle is one of two large chambers toward the bottom of the heart that collect and expel blood towards the peripheral beds within the body and lungs. The blood pumped by a ventricle is supplied by an atrium, an adjacent chamber in the upper heart that is smaller than a ventricle. Interventricular means between the ventricles (for example the interventricular septum), while intraventricular means within one ventricle (for example an intraventricular block). In a four-chambered heart, such as that in humans, there are two ventricles that operate in a double circulatory system: the right ventricle pumps blood into the pulmonary circulation to the lungs, and the left ventricle pumps blood into the systemic circulation through the aorta. Structure Ventricles have thicker walls than atria and generate higher blood pressures. The physiological load on the ventricles requiring pumping of blood throughout the body and lungs is much greater than the pressure generated by the at ...
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Left Ventricle
A ventricle is one of two large chambers toward the bottom of the heart that collect and expel blood towards the peripheral beds within the body and lungs. The blood pumped by a ventricle is supplied by an atrium, an adjacent chamber in the upper heart that is smaller than a ventricle. Interventricular means between the ventricles (for example the interventricular septum), while intraventricular means within one ventricle (for example an intraventricular block). In a four-chambered heart, such as that in humans, there are two ventricles that operate in a double circulatory system: the right ventricle pumps blood into the pulmonary circulation to the lungs, and the left ventricle pumps blood into the systemic circulation through the aorta. Structure Ventricles have thicker walls than atria and generate higher blood pressures. The physiological load on the ventricles requiring pumping of blood throughout the body and lungs is much greater than the pressure generated by the at ...
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Capacitance Of Blood Vessels
Compliance is the ability of a hollow organ (vessel) to distend and increase volume with increasing transmural pressure or the tendency of a hollow organ to resist recoil toward its original dimensions on application of a distending or compressing force. It is the reciprocal of "elastance", hence elastance is a measure of the tendency of a hollow organ to recoil toward its original dimensions upon removal of a distending or compressing force. Blood vessels The terms elastance and compliance are of particular significance in cardiovascular physiology and respiratory physiology. In compliance, an increase in volume occurs in a vessel when the pressure in that vessel is increased. The tendency of the arteries and veins to stretch in response to pressure has a large effect on perfusion and blood pressure. This physically means that blood vessels with a higher compliance deform easier than lower compliance blood vessels under the same pressure and volume conditions. Venous compliance ...
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Vasomotor
Vasomotor refers to actions upon a blood vessel which alter its diameter. More specifically, it can refer to vasodilator action and vasoconstrictor action. Control Sympathetic innervation Sympathetic nerve fibers travel around the tunica media of the artery, secrete neurotransmitters such as norepinephrine into the extracellular fluid surrounding the smooth muscle (tunica media) from the terminal knob of the axon. The smooth muscle cell membranes have α and β-adrenergic receptors for these neurotransmitters. Activation of α-adrenergic receptors promotes vasoconstriction, while the activation of β-adrenergic receptors mediates the relaxation of muscle cells, resulting in vasodilation. Normally, α-adrenergic receptors predominates in smooth muscle of resistance vessels.Robert C. Ward et al. (2002). In Foundations for osteopathic medicine'. Lippincott Williams & Wilkins. 2nd edition. p. 98. . Google Book Search. Retrieved on 5 December 2010. Endothelium derived chemicals Endoth ...
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Central Venous Pressure
Central venous pressure (CVP) is the blood pressure in the venae cavae, near the right atrium of the heart. CVP reflects the amount of blood returning to the heart and the ability of the heart to pump the blood back into the arterial system. CVP is often a good approximation of right atrial pressure (RAP), although the two terms are not identical, as a pressure differential can sometimes exist between the venae cavae and the right atrium. CVP and RAP can differ when arterial tone is altered. This can be graphically depicted as changes in the slope of the venous return plotted against right atrial pressure (where central venous pressure increases, but right atrial pressure stays the same; VR = CVP − RAP). CVP has been, and often still is, used as a surrogate for preload, and changes in CVP in response to infusions of intravenous fluid have been used to predict volume-responsiveness (i.e. whether more fluid will improve cardiac output). However, there is increasing evidence t ...
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Vena Cava
In anatomy, the venae cavae (; singular: vena cava ; ) are two large veins (great vessels) that return deoxygenated blood from the body into the heart. In humans they are the superior vena cava and the inferior vena cava, and both empty into the right atrium. They are located slightly off-center, toward the right side of the body. The right atrium receives deoxygenated blood through coronary sinus and two large veins called venae cavae. The inferior vena cava (or caudal vena cava in some animals) travels up alongside the abdominal aorta The aorta ( ) is the main and largest artery in the human body, originating from the left ventricle of the heart and extending down to the abdomen, where it splits into two smaller arteries (the common iliac arteries). The aorta distributes o ... with blood from the lower part of the body. It is the largest vein in the human body.
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Valsalva Maneuver
The Valsalva maneuver is performed by a forceful attempt of exhalation against a closed airway, usually done by closing one's mouth and pinching one's nose shut while expelling air out as if blowing up a balloon. Variations of the maneuver can be used either in medical examination as a test of cardiac function and autonomic nervous control of the heart, or to clear the ears and sinuses (that is, to equalize pressure between them) when ambient pressure changes, as in scuba diving, hyperbaric oxygen therapy, or air travel. A modified version is done by expiring against a closed glottis. This will elicit the cardiovascular responses described below but will not force air into the Eustachian tubes. History The technique is named after Antonio Maria Valsalva, a 17th-century physician and anatomist from Bologna whose principal scientific interest was the human ear. He described the Eustachian tube and the maneuver to test its patency (openness). He also described the use of th ...
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