# 19.4 Cardiac physiology

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By the end of this section, you will be able to:
• Relate heart rate to cardiac output
• Describe the effect of exercise on heart rate
• Identify cardiovascular centers and cardiac reflexes that regulate heart function
• Describe factors affecting heart rate
• Distinguish between positive and negative factors that affect heart contractility
• Summarize factors affecting stroke volume and cardiac output
• Describe the cardiac response to variations in blood flow and pressure

The autorhythmicity inherent in cardiac cells keeps the heart beating at a regular pace; however, the heart is regulated by and responds to outside influences as well. Neural and endocrine controls are vital to the regulation of cardiac function. In addition, the heart is sensitive to several environmental factors, including electrolytes.

## Resting cardiac output

Cardiac output (CO) is a measurement of the amount of blood pumped by each ventricle in one minute. To calculate this value, multiply stroke volume (SV)    , the amount of blood pumped by each ventricle, by heart rate (HR)    , in contractions per minute (or beats per minute, bpm). It can be represented mathematically by the following equation:

CO = HR × SV

SV is normally measured using an echocardiogram to record EDV and ESV, and calculating the difference: SV = EDV – ESV. SV can also be measured using a specialized catheter, but this is an invasive procedure and far more dangerous to the patient. A mean SV for a resting 70-kg (150-lb) individual would be approximately 70 mL. There are several important variables, including size of the heart, physical and mental condition of the individual, sex, contractility, duration of contraction, preload or EDV, and afterload or resistance. Normal range for SV would be 55–100 mL. An average resting HR would be approximately 75 bpm but could range from 60–100 in some individuals.

Using these numbers, the mean CO is 5.25 L/min, with a range of 4.0–8.0 L/min. Remember, however, that these numbers refer to CO from each ventricle separately, not the total for the heart. Factors influencing CO are summarized in [link] .

SVs are also used to calculate ejection fraction    , which is the portion of the blood that is pumped or ejected from the heart with each contraction. To calculate ejection fraction, SV is divided by EDV. Despite the name, the ejection fraction is normally expressed as a percentage. Ejection fractions range from approximately 55–70 percent, with a mean of 58 percent.

## Exercise and maximum cardiac output

In healthy young individuals, HR may increase to 150 bpm during exercise. SV can also increase from 70 to approximately 130 mL due to increased strength of contraction. This would increase CO to approximately 19.5 L/min, 4–5 times the resting rate. Top cardiovascular athletes can achieve even higher levels. At their peak performance, they may increase resting CO by 7–8 times.

Since the heart is a muscle, exercising it increases its efficiency. The difference between maximum and resting CO is known as the cardiac reserve    . It measures the residual capacity of the heart to pump blood.

To know the part of human body
Anatomy refers to as structure of human body
Sarah
so is the macroscopic and microscopic the types of anatomy
is microscopic and macroscopic a type of anatomy
Gloria
yes
Maxine
yes
Yabsra
yes
Sarah
Please can someone explain three glands in endocrine system?
josh
.
Robin
can someone explain disease and the category
gege
type 2 is controled by diet
Diet and life style
Paias
Diet how? maybe eating food containing less sugar?
BTS
we must eat protein food to check our diet
Sarah
type 2 diabetes cannot be controlled by insulin so therefore your diet should be well balanced especially you shouldn't eat foods with high sugar level or stopping sugar at all so that the sugar content needed by your body will be provided by the balanced diet taken
what is hypotension
hypotension is when the blood pressure is less than 60/50
Mursal
hypo means low so it implies low blood pressure
Isaac
ok
Mursal
what is mild DKA
Mursal
mild diabetic ketoacidosis is when there is high level of sugar in the blood and the ketone bodies build up in the body ,is a type 1 which can lead to type 2
Isaac
what is the normal range for blood pressure?
BTS
120 over 80
Danielle
low blood pressure; opposite of high blood pressure which is hypertension
Regina
what if your a type 2 diabetic and you have no way to get meds due to no insurance what is some good over the counter medications to take?
Ashley
type 2 diabets is controlled by diet not meds.type 1 is contolled by insulin.
Chloe
type 1 diabets cant be controlled type 2 can be controlled.type 1 is worse than type 2 diabets.
Chloe
type 2 is purely a lifestyle disease, eat healthy, fresh, natural unprocessed real foods.
Danielle
sometime , we already eat diabetic diet than the results of blood sugar level not turn good , what is the reason ?
What is a "diabetic diet" though? Be specific. Juvenile diabetes and/or Type 1 diabetes is something that one can be born with, this needs medical diagnosis and intervention.
Danielle
what i mean by diabetic diet is we take fiber-rich food like vegetables,nut and also fish.
ok, no cause a doctor told me I needed metformin and my suger won't go under 300
Ashley
what is the difference between plasma and serum
Plasma contains fibrinogen while serum doesn't
Kateregga
plasma ----- fibrinogen = serum
Sneha
In what time stomach empty it's content in to doudemun? what is chyme?
write the chemical and mechanical digestion which occurs in stomach?
Sneha
Does absorption take place in stomach? what are absorption in the stomach by which cell?
Sneha
Chemical digestion---Mixtures of the food with the gastric acid Mechanical digestion--- churning of the food in the stomach making it become more involved into chyme
Mercy
absorption takes place in the small intestine because of the presence of the villi
name the muscles supplied redina nerve
mechanism of hormone releasing by gland
why is muscle tissue not considered to be a type of connective tissue?
A Skeletal muscles consist of numerous muscles cells called Muscle Fibers . Three layers of connective tissues surrounded these fibers to make the muscles tissues
Manisha
that's wny connective tissues is not considered as muscles fibers
Manisha
there are 4 types of tissues : epithelial, connective tissue, nervous tissue and muscle tissue, each one has its own properties. The main function of connective tissue is nutrition, it supplies nutrientes to epithelial tissues that are responsible for protection.
Ariete
Muscle tissue has properties that allow movement, the function here is movement and not nutrition like connective tissue.
Ariete
In what time stomach empty it's content in to doudemun?
Sneha
write the chemical and mechanical digestion which occurs in stomach?
Sneha
Does absorption take place in stomach? what are absorption in the stomach by which cell?
Sneha
Does absorption take place in stomach? what are the absorption in the stomach by which cell?
Sneha
mechanism of hormone controlling releasing by gland
said
please can someone explain renin angiotensin aldosteron system for me
okolie
name the joint present between epichysif and diachysif
what is arteries
JAYKISHAN
oxygenated blood carrying vessels
Karanpreet
I think oxygenated blood carrying pulmonary vein
Omaryare
ya this stetment is right 4 pulmonary vein carrying the oxygenated blood
Sneha
What is the relation between cold and clammy skin and disorders that cause poor perfusion?
name the instruments used to measure the gas volume and flow in pulmonary function test
Spirometer
Ravi
In a spirometry test, While you are sitting, you breath into a mouthpiece that is connected to an instrument called a spirometer . The spirometer records the amount and the rate of air that you breath in and out over a period of time. When standing, Some numbers might be slightly different.
Ravi
tq soo much
Preethi
u most wlcm
Ravi
what is signal transduction?
Bahle
Signal Transduction (Also know as cell signaling) is the transmission of molecular signal from a cell exterior to its interior.Signals receive by cells must be transmitted effectively into the cell to ensure an appropriate response. This step is initiated by cell - surface receptors.
Ravi
i know now didn't know
Cypline
that's great respond
Feng
what is histological anatomy?
what is histological anatomy?
Thelma
the study of form of structure seen under the microscope
Metinah
is the branch of biology which studies the microscopic anatomy of biological tissues.
Jeffrey
it's the study of the microscopic anatomy of cells and tissues in the plants and it's carried out by examining a thin slice of tissues under a microscope light / or an electronic microscope
Manisha
is the study of anatomy in a microscopic level
simon
thank you
Thelma
what are the significance differrences can be donated between the female and male skeleton..
charles
What is Ions and Ionic bonds
2 less stable atoms
Hope
Ionic bonding is the complete transfer of valence electron(s) between atoms. It is a type of chemical bond that generates two oppositely charged ions. In ionic bonds, the metal loses electrons to become a positively charged cation, whereas the nonmetal accepts those electrons to become a negatively
Hope
what is osmosis
it's out Body Fluid.
Sa
high pressure to low pressure flow
Sneha
Osmosis is the movement of solvent from a region of lower solute concentration to a region of higher solute concentration through a semi- permeable membrane.
Ravi