E. Histology of Cardiac MuscleF. Electrical impulses of the HeartG. Cardiac PhysiologyH. Blood FlowI. Heart sounds1. End diastolic volume (EDV) = maximum ventricular load- first heart sound occurs right before thisa) Things that effect EDV(1) open cuspid valve- the valve must be open for the ventricle to fill during diastole(2) venous return- if there is deep vein thrombosis or clotting in the veins, this is then brought to the heart (pour venous return effects the hearts ability to fill)2. End systolic volume (ESV) = minimum ventricular load (second heart sound occurs right after this)a) Things that effect ESV(1) Strength of ventricular contraction(a) if weak, leaves blood behind to clot, and leaves the ESV elevated because not all of the blood was pumped out3. Stroke volume = EDV- ESV (stroke volume per one cycle and the amount of blood ejected is calculatedJ. Pressure/ Voume Loop1. Before “B”= this is the P wave, where pressure increases a little and contributes to the final volume of the ventriclea) P wave- atrial contraction- fills the last 10-20% of the ventricle2. “B”= EDV and start of P-R interval where cuspid valve closes, creating a drastic increase in pressure3. “B-C” = (P-R interval) = Isovolumetric phase – or initial contraction of the ventriclea) this is the build up of pressure before the pressure of the ventricle (preload pressure) is greater than the pressure outside the ventricle (after-load pressure)b) afterload pressure is the impedence of a ventricular event4. “C-D” = pressure continues to increase as volume decreases (the difference of volume C-D is stroke volume)5. “D-A” – closing of the semilunar valves happens at D and ESV, this is around the T wave and there is a drastic drop in pressure6. Heart sounds:a) at B (EDV- right after the P wave)b) at D (ESV- right around T wave)K. Cardiac Output1. Dependent on Heart Rate (HR)a) Low HR- (lowest HR = 60 bpm) – anything lower than 60 = bradycardia (unless have athletic bradycardia, this is bad)(1) only parasympathetic activity hereb) High resting HR (Highest resting HR =100 bpm) – anything higher at rest = tachycardic(1) still parasympathetic activity here for body at rest – resting heart rate should not be above 100 bpm- can indicate cancer or disease(2) use the sympathetic nervous system to get heart rates higher than 100 bpm(3) we increase cardiac contractility by adding epinephrine to the system(4) hypertrophy- increase in mass or thickness of muscles that have to work harder (usually under stress)(a) thickens the walls of the ventricle- causes a decrease in volume in the ventricle, creating less load(b) this is irreversible and effects the EDVc) Increase Preload to increase HR(1) skeletal pump can increase – causing preload to increase(2) respiratory pump can increase – causing preload to increase(3) Venous vasoconstriction is the main way preload increases(a) stimulated by epinephrine and sends a large amount of blood to the heart(b) causes BOTH EDV to increase and ESV to decrease!d) Frank-Starling effect on Heart rate – this is the stretch reflex in the heart(1) will decrease the ESV in the heart, increasing the heart rateBy 116 1st Edition Lecture 19Outline of Last Lecture E. Histology of Cardiac MuscleF. Electrical impulses of the HeartG. Cardiac PhysiologyH. Blood Flow Outline of Current Lecture I. Heart Sounds J. Pressure/ Volume LoopK. Cardiac Output Current Lecture ** Important notes: Rate – Cycles/minute, Cycles through Systole(33%) and Diastole(67%)Rhythm- Dependent on Atrial (systole/diastole) and Ventricular (systole/diastole)Output- volume moved through heart per minute Rate + Rhythm = Output (all dependent on eachother)I. Heart sounds 1. End diastolic volume (EDV) = maximum ventricular load- first heart sound occurs right before this a) Things that effect EDV(1) open cuspid valve- the valve must be open for the ventricle to fill during diastole (2) venous return- if there is deep vein thrombosis or clotting in the veins, this is then brought to the heart (pour venous return effects the hearts ability to fill)These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.2. End systolic volume (ESV) = minimum ventricular load (second heart sound occurs right after this)a) Things that effect ESV(1) Strength of ventricular contraction (a) if weak, leaves blood behind to clot, and leaves the ESV elevated because not all of the blood was pumped out3. Stroke volume = EDV- ESV (stroke volume per one cycle and the amount of blood ejected is calculated J. Pressure/ Voume Loop 1. Before “B”= this is the P wave, where pressure increases a little and contributes to the final volume of the ventricle a) P wave- atrial contraction- fills the last 10-20% of the ventricle2. “B”= EDV and start of P-R interval where cuspid valve closes, creating a drasticincrease in pressure 3. “B-C” = (P-R interval) = Isovolumetric phase – or initial contraction of the ventricle a) this is the build up of pressure before the pressure of the ventricle (preload pressure) is greater than the pressure outside the ventricle (after-load pressure) b) afterload pressure is the impedence of a ventricular event 4. “C-D” = pressure continues to increase as volume decreases (the difference of volume C-D is stroke volume)5. “D-A” – closing of the semilunar valves happens at D and ESV, this is around the T wave and there is a drastic drop in pressure 6. Heart sounds: a) at B (EDV- right after the P wave) b) at D (ESV- right around T wave) K. Cardiac Output 1. Dependent on Heart Rate (HR)a) Low HR- (lowest HR = 60 bpm) – anything lower than 60 = bradycardia (unless have athletic bradycardia, this is bad)(1) only parasympathetic activity here b) High resting HR (Highest resting HR =100 bpm) – anything higher at rest = tachycardic (1) still parasympathetic activity here for body at rest – resting heart rate should not be above 100 bpm- can indicate cancer or disease(2) use the sympathetic nervous system to get heart rates higher than 100 bpm(3) we increase cardiac contractility by adding epinephrine to the system (4) hypertrophy- increase in mass or thickness of muscles that have to work harder (usually under stress)(a) thickens the walls of the ventricle- causes a decrease in volume in the ventricle, creating less load(b) this is irreversible and effects the EDVc) Increase