Easy Ways to Understand Cardiac and Vascular Function Curves

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  • Опубликовано: 21 ноя 2024

Комментарии • 137

  • @LoveMedicine100
    @LoveMedicine100  12 лет назад +11

    Thank you....I did my best.....
    This topic is so high yield not only for the boards but in everyday practice....
    Glad you like it

    • @elonruok601
      @elonruok601 3 года назад

      Wow thanks a lot, i was in confusion about whats up RAP in different scenerios, very few videos on youtube touch on RAP. Thanks again

  • @NakulBansal-doc
    @NakulBansal-doc 9 лет назад +7

    Great job with the video! Many thanks.
    One anomaly that I find is that during a compensated heart failure, the renal compensatory mechanisms cause retention of fluid causing venous return to actually increase. Therefore, the VR curve also shifts up and to the right so as to maintain the steady state cardiac output to near normal.

  • @desidevi
    @desidevi 12 лет назад +13

    even BRS physio did not explain this as well as you did. well done! :)

  • @JoTKirk
    @JoTKirk 5 лет назад +1

    GREAT explanation. Professors didn't attempt to teach this, and Boards and Beyond was BEYOND confusing. This was perfect. Now I actually understand the variables and can predict how they will change in different situations as well as interpret graphs to know what underlying disease process would give such changes! THANK YOU!!

  • @BG-iu7nx
    @BG-iu7nx 3 года назад +8

    thank you! i was literally almost in tears because of this, and you explained it so simply

  • @zorrento14
    @zorrento14 4 года назад +9

    these curves are just evil, 8 years after your video was posted and people are still confused

  • @corely91
    @corely91 11 лет назад +4

    You have a simple God sent explanation to me this morning. Thank you

  • @hiphoproyalty5718
    @hiphoproyalty5718 2 года назад

    I have exams in a few days. And not even the textbooks brought clarity on this aspect for me. Thank you 🙏

  • @solomonmpalanyi7226
    @solomonmpalanyi7226 3 года назад

    100lurics I know it’s been many moons but we still need u buddy, to make these easy grasping concepts tutorials please. You are one of the few who are good at the game!

  • @nikkileclair81
    @nikkileclair81 7 лет назад +1

    I could never understand this EVER! Your video really helped clarify many concepts for me. Thank you.

  • @saul03
    @saul03 10 лет назад +29

    Great video!! Just note that during exercise the venous return curve s`X intercept or mean systemic pressure (10 mmHg) should stay in the same place. Because the total circulating volume was not altered. Greetings!

    • @shobanana1
      @shobanana1 9 лет назад +1

      But then the catecholamines released during exercise do cause venous constriction which does increase the mean systemic pressure.

    • @GuruSJolly
      @GuruSJolly 9 лет назад +8

      shobs iyer
      For those nerds wondering why?There are some flaws in your thinking, let me correct them for you. Follow along.
      flow characteristics of the systemic venous circulation are dependent on Vo (unstressed[reservoir] volume in veins), Vs(stressed volume in veins), Vt(total volume in veins), C(compliance), and Rv (Resistance to venous flow)
      recall that venous return; VR= ( Pms-Pra ) / Rv
      Pms is mean systemic pressure, Pms=Vs/C which can be written as Pms=(Vt-Vo)/C
      This new equation suggests that Pms can be altered through two basic mechanisms: (1) a change in the total volume in the reservoir(Vt); or (2) a change in the proportion of Vo and Vs.
      An alteration of autonomic tone, catecholamine stress responses, or infusion of exogenous vasoactive substances will alter the ratio of Vs to Vo without a change in C, thus changing Pms.
      Your partially right, but you should be thinking>exercise>SNS>increase in HR, venoconstriction in non vital organs and vasodilation in vital organs(heart, brain, muscle)>increased preload>increase in CO-->a change in proportion of Vs and Vo (volume of stressed venous blood vs Volume of unstressed venous blood) >increase in PMS
      A lot of books will says venoconstriction leads to a decrease venous compliance b/c of inverse relationship between resistance and compliance. They try to generalize it and make it simple, but compliance is way more complicated and depends on so many other factors
      The way I see it is that compliance in this model should be considered a static, passive mechanical property of veins. why?
      recall that venous system has two compartments; 1)venules and small veins, which lack smooth muscle layer and cannot constrict and account for 70-80% of bodies total blood reservoir, they have a very large crosssectional area contribute little to Rv and systemic compliance 2)Large veins and Medium sized veins, which can constrict, and contribute to compliance and they have small cross-sectional area and act as a valves. These two compartments work against each other under autonomic stress i.e increased stressed volume and Pms in the reservoir compartment (which increases VR) but decreased mean radius in the vena cava and large veins (which decreases VR). In conclusion its not the compliance/restriction of the vein, that increases Pms, but the change in proportion of Vs ans Vo.
      Yeah this shit is confusing, and a lot of books don't explain it properly.

    • @shobanana1
      @shobanana1 9 лет назад +1

      Guru Jolly thanks for this explanation. Made me realize I had one misunderstanding about why nitro is used in angina. I always thought that venodialation decreased venous return but I realize it's because nitro causes pooling of blood in the periphery hence causing decreased preload not just because of the venodialation which actually makes alot more sense.

    • @saul03
      @saul03 9 лет назад

      Guru Jolly Thanks for taking the time to explain this. Greetings :)

    • @akhileshakhil4390
      @akhileshakhil4390 6 лет назад

      yes there will be release of catacholamines but there will also be vasodilatation of arterioles causing drop in TPR arterioles are the main determinant of TPR and the local adenosine rise due to exercise causes vasodilation and opening of these capillaries ie arterioles also increases perfusion to sk.muscle viz required to the energy requirments of body

  • @Mindful_resting
    @Mindful_resting 3 года назад

    Amazing video

  • @bugMASTER1337
    @bugMASTER1337 11 лет назад +3

    Good video, however i have one remark: The curve that you mark as Cardiac output is actually the Cardiac Function curve. The whole point of the graph is to determine the Cardiac Output which lies at the point where the Cardiac function curve and the venous function curve cross.

  • @alejandrolopez379
    @alejandrolopez379 8 дней назад +1

    What happens if the CO stays the same and you increase or decrease TPR

  • @halaahmed2994
    @halaahmed2994 3 года назад

    thank you for this simple explanation, after 9 years

  • @keepitsimple3042
    @keepitsimple3042 5 лет назад

    really good efforts

  • @1006caraqueno
    @1006caraqueno 11 лет назад +2

    I take Step1 a week from tomorrow, thank you so much!

  • @ayepapito8490
    @ayepapito8490 9 лет назад +13

    Really good explanation, Uworld managed to confuse me somehow, this clears it up. Cheers

  • @AfriPrincess411
    @AfriPrincess411 11 лет назад

    Thank you so very much! I have an exam in a couple hours and you rescued me!

  • @walijan57
    @walijan57 2 года назад

    Hey! you are such an excellent teacher. really impressed...

  • @thoreric86
    @thoreric86 11 лет назад +1

    since u put the value as ~10mmHg. But this is MSFP we are talking about. A deeper concept involved. Even many comments in the journal said that Guyton's VRC has to be carefully interpreted, as it is not universally correct. If u r interested, u may google it. Happy learning...

  • @WildCat2002Russ
    @WildCat2002Russ 10 лет назад

    Thank you for making this video. It was made in 2012, but it's helping me out in 2014!

  • @inhkynguyen3792
    @inhkynguyen3792 8 месяцев назад

    absolutely amazing, tks maddam

  • @sleepbrown81
    @sleepbrown81 12 лет назад

    excellent job. you're a great teacher. very basic way to understand something that seems overwhelming at first. thanks!

  • @PesSarmiento88
    @PesSarmiento88 11 лет назад

    You are doing really well, Thanks a lot for explaining this.. And Please keep going whit your videos

  • @loliwemoyo5680
    @loliwemoyo5680 2 года назад

    Thanx your really great a simplifying things.

  • @wsuMD
    @wsuMD 12 лет назад

    Thank you so much. Made it very easy to follow. God bless.

  • @dr.joearul8946
    @dr.joearul8946 10 лет назад +1

    Thank you . Please make another video on anti hypertensive drugs with more details . Your explanation is more simple and interesting . Very informative too.Best regards Dr.Joe , India

  • @smartdarshini
    @smartdarshini 12 лет назад

    thank you very much.. u made this concept very easy for me now..

  • @saumyas4114
    @saumyas4114 5 лет назад

    Your video has given me hope ♥️

  • @LoveMedicine100
    @LoveMedicine100  11 лет назад +2

    Hi I use screen-o-matic which is a free screen recording website. I also use bamboo, which is like a tablet to draw my diagrams. If look onto youtube, you will find plenty of examples of what the are. Good Luck.

  • @yelzin1
    @yelzin1 10 лет назад +9

    in case of hemorrhage, the cardiac function curve should remain unchanged (because the contractility of heart is not affected by hemorrhage), please take a look at first aid 2014 page 269. practically the contractility is increased if you consider the increased sympathetic tone after hemorrhage, so the cardiac function curve should go up. Anyhow, the cardiac function curve should not go down as showed in this video

  • @gopesizdopes
    @gopesizdopes 11 лет назад

    you are right... mean systemic pressure only changes with blood volume and/or venous compliance. The specific examples used of hemorrhage and exercise do influence one or the other.
    Exercise leads to increased sympathetics, hence venoconstriction.
    Hemorrhage leads to blood loss, loss of volume.
    TPR has no influence because mean systemic filling pressure is measured when the heart has stopped or the organism is dead.

  • @LoveMedicine100
    @LoveMedicine100  11 лет назад

    Can you increase sympathetic only in veins? I doubt that is possible. But if you increase sympathetic stimulation the TPR increases. TPR is both for arteries and veins. Changing TPR will have effect on both and not only in veins. When you use this graph, think of situations only exclusive to CO and Venous return.

  • @LoveMedicine100
    @LoveMedicine100  12 лет назад +2

    Thank you......This was a sore topic for me......
    Glad I could make it a little easier for oyu as well..

  • @SaveTheWorldJD
    @SaveTheWorldJD 11 лет назад

    yes . increased RA pressure --> More Vent. filling ---> Increased SV and CO.

  • @veronicajordan1231
    @veronicajordan1231 2 года назад

    Great explanation! Thank you so much!!!!

  • @ambreenhamid5326
    @ambreenhamid5326 9 лет назад

    Great job

  • @Pro0osh
    @Pro0osh 4 года назад

    Amazing explanation.. thank you!

  • @congratulation46
    @congratulation46 11 лет назад

    Excellent! unbelievable . You made it so easy .Thanks
    Would you please tell me what kind of software you have used to write and draw the charts?

  • @hatemmostafa8020
    @hatemmostafa8020 3 года назад

    great thank you you are amazing

  • @owenqimd
    @owenqimd 11 лет назад +1

    So yes I think that the curve in question (the cardiac function curve) can be called the contractility curve, as it is the curve that demonstrates the Frank-Starling mechanism that can be shifted by changes in contractility. You can do a quick check of wiki for "cardiac function curve" or I can dig through to my costanzo book if necessary.

  • @sacchrine_
    @sacchrine_ 4 года назад

    Quick and easy. Thank you!!!!

  • @skull_btc
    @skull_btc 12 лет назад

    Excellent! 100 % recomended

  • @feyisayooguntuase3267
    @feyisayooguntuase3267 2 года назад

    Excellent!

  • @TheMRdarkcloud
    @TheMRdarkcloud 11 лет назад

    that is perfect nice job explaining it. in Anesthesia school and professor does bad in explaining. the other thing that is important is that if you have a increase in central venous pressure (RAP or LVEDV) you will have a decreased CO like in Failure. You have high pressures with poor CO because your SNS is increasing in venous tone (SNS activation) in order for response of failing CO. This is marvelous. Bottom line increased CVP = decreased contractility

  • @OptimusPrimalify
    @OptimusPrimalify 12 лет назад

    Great vid... Thanks a lot for the effort.

  • @oliviamorgan4161
    @oliviamorgan4161 4 года назад

    wow! so excellent! thank you

  • @LoveMedicine100
    @LoveMedicine100  12 лет назад

    Thank You.....Glad you liked the video.

  • @eminent8912
    @eminent8912 6 лет назад

    Hey greetings from India.. love ur videos..! Keep up the good work

  • @rahatamna9605
    @rahatamna9605 5 лет назад +6

    But in TPR changes, the mean systemic filling pressure remains the same.

    • @daturawhite215
      @daturawhite215 4 года назад +3

      Correct, but during sympathetic nerve activation (during exercise) you will also get an increase in venous tone (reduced capacitance) - increasing MSFP.

  • @LoveMedicine100
    @LoveMedicine100  11 лет назад

    In theory RAP is very low because right atrium has thin walls and the compliance is very high. The pressure is really the pressure of central venous pressure. So, RAP technically is not zero but very low. Think about it, how can the pressure be zero, then it will collapse.

  • @SaveTheWorldJD
    @SaveTheWorldJD 11 лет назад

    "mean systemic pressure" you/she are talking is called systemic function pressure which is a measure of venous return ( means at what pressure is VR=0 [check graph]) and is = BV/Complaince
    and below , what she is trying to explain is called "mean arterial pressure" which is = CO x TPR or HR x SV x TPR

  • @NY11
    @NY11 12 лет назад

    thanks for your help..

  • @nellyhoffman6194
    @nellyhoffman6194 8 лет назад

    Hey you ROCK ,,, Thanks a lot :) you have a beautiful voice also ,,, Upload more videos plz

  • @gopesizdopes
    @gopesizdopes 11 лет назад

    contractility affects SV and subsequently cardiac output. Hence, the curve can be interpreted as cardiac output or contractility curve

  • @NikolayIvanov45
    @NikolayIvanov45 5 лет назад

    Awesome explanation! Thank you!

  • @DrSharifulHalim
    @DrSharifulHalim 9 лет назад

    Neat explanation!

  • @Biman_Goswami
    @Biman_Goswami 9 лет назад +1

    thank you so much..I was having trouble understanding it..

  • @susankarki1295
    @susankarki1295 8 лет назад

    Thank u very much...Great explaination!!!

  • @thoreric86
    @thoreric86 12 лет назад

    I am not so sure. I think you might want to check the venous return curve again. When you change the TPR, the mean systemic pressure shouldn't be affected. The mean systemic pressure only change when you change the blood volume and the venous compliance. correct me if i am wrong. thanks

  • @LoveMedicine100
    @LoveMedicine100  11 лет назад +1

    Is it? Can you give me a reference?

  • @lumbarspine4637
    @lumbarspine4637 2 года назад

    What about myocardial infarction and Cardiac output curve vs Right Atrial pressure ? Where they will cross

  • @SalmaZaid
    @SalmaZaid Год назад

    THANK YOU !😃

  • @MaryamAhmed-cu7in
    @MaryamAhmed-cu7in 2 года назад

    Thanks a lot

  • @mathew555s
    @mathew555s 3 года назад +1

    @4:35 I am told by my professors that hemorrhage does not in fact affect the cardiac output and so we only see a drop in VR but CO and SV remain the same. Please clarify that point?

    • @saltnstreets
      @saltnstreets 3 года назад +1

      Hmm, First Aid also says CO should drop

  • @soniaw5771
    @soniaw5771 4 года назад +1

    2 mistakes
    No change in MSP with change in TPR
    No change in CO with acute hemorrhage

  • @Lumpycheeses
    @Lumpycheeses 7 месяцев назад

    My hero 😍

  • @mohamedmossa5120
    @mohamedmossa5120 3 года назад

    Thank you

  • @thoreric86
    @thoreric86 11 лет назад

    well, initially i tried to explain, but i guess it would be difficult if ur basic concepts about cardiac and vascular functions are not profound enough. Please refer to the website (google-->venous return curve-->click "CVphysiology: cardiac and systemic..." link, the 'systemic vascular function curve' aka venous function curve part.
    Ur explanation is actually right for mean arterial pressure as MAP=COxTPR. But i am assuming ur mean systemic pressure refers to mean systemic filling pressure...

  • @tbbyrdman
    @tbbyrdman 10 лет назад +1

    you. rock. seriously. you rock.

  • @akibreja7911
    @akibreja7911 2 года назад

    Thank you❤.

  • @hajarjk4421
    @hajarjk4421 2 месяца назад

    Thank you 😊❤
    2024

  • @munmunsha1
    @munmunsha1 9 лет назад +1

    hemorrhage only decreases the venous return but the CO slope doesn't change

    • @mobenkane2075
      @mobenkane2075 9 лет назад

      +sam s (ss) i think in mild hemorrahege , but in loss of high volume of blood could cause both decrease, cardiac out put as well as vr,

    • @PoldervaartRosalie
      @PoldervaartRosalie 9 лет назад

      +sam s (ss) 
      This is what I was thinking too... I even thought the curve would go up because of arterial vasodilatation, (causing the afterload to decrease), and a compensatory higher heart frequency and contractility because of sympathetic nervous system activation..
      Edit: www.ncbi.nlm.nih.gov/books/NBK54474/

    • @TexasPhotoVideoLLC
      @TexasPhotoVideoLLC 8 лет назад +1

      +Rosalie Poldervaart In hemorrhage the TPR increases (body's compensatory mechanism during blood loss is to vasoconstrict to prevent further blood loss) The Cardiac output drops because there isn't enough blood to pump forward (remember CO = SV x HR you may be thinking of increased HR to make up for the decrease in SV but ultimately SV drops so much that the racing heart just can't keep up and CO drops), and the Venous Return also drops, because of the same reason, loss of volume.

  • @osamuyiasemota4046
    @osamuyiasemota4046 8 лет назад

    Thank you so much for your great explanation!!!! i am glad!

  • @elcridebeer3501
    @elcridebeer3501 8 лет назад

    Thank you so much

  • @sunnyhehar6771
    @sunnyhehar6771 9 лет назад

    does anyone know where i can find the video when she about cardiogenic/hypovolemic/etc shock???!!! I saw it but now i cannot find it anymore...she describes how to use a specific formula including pulmonary wedge pressure, SV, etc

  • @LoveMedicine100
    @LoveMedicine100  11 лет назад

    I think what you are talking about is not CO but the operating point of heart.

  • @2009haidermughal
    @2009haidermughal 2 года назад

    Thank u sooo much :)

  • @Vehemiteplease
    @Vehemiteplease 6 лет назад

    Thankyou so much

  • @anikixvi
    @anikixvi 10 лет назад +1

    Thank you!!

  • @toota1991
    @toota1991 11 лет назад

    how is right atrial pressure 5 in the normal situation? i thought it should be 0. please explain.

  • @ssj6goku00
    @ssj6goku00 12 лет назад

    so what happens when you increase sympathic only to the veins? does TRP and slope in the venous return decrease? Please help

  • @ssj6goku00
    @ssj6goku00 12 лет назад

    same thing remember that an increase in CO is an increase in contractility

  • @thoreric86
    @thoreric86 11 лет назад +1

    well, it seems that the owner of the video doesn't care to correct his/her mistake and choose to continue to give wrong information to other people. clearly MSFP is something that i should explain further to my students next time. i guess cardiovascular physiology is something that we should not over-simplify rather should learn each and every fundamental aspects of it. otherwise, everything will go awry.

  • @ahmedelsakka9548
    @ahmedelsakka9548 11 лет назад

    in 1st case during exercise..how come mean arterial pressure will increase on the graph while TPR decreases due to arterial vasodilatation ???

  • @medman8297
    @medman8297 11 лет назад

    More accurate to call it the contractility curve. Algebra tells us (changes in Y)/(changes in X) is the crux of the definition of a line (slope). Since Y axis is cardiac output, the curve can't be cardiac output alone unless the X axis is Time. Going back to the Y axis, which is CO, CO = SV * HR. X axis is EDV. So, the curve represents Y/X or (SV * HR)/EDV. This is the same as SV/EDV * HR. SV/EDV = Ejection Fraction. So, you get EF * HR for the curve. EF is an index of Ventricular Contractility.

  • @EOGSMJ
    @EOGSMJ 10 лет назад

    Thank you very much u really made it easy :)

  • @sarap7879
    @sarap7879 8 лет назад

    Thank you so much!

  • @multihusain123
    @multihusain123 11 лет назад

    Thanks

  • @johannesdesilentio1035
    @johannesdesilentio1035 7 лет назад +7

    This explanation is completely wrong.
    The y axis represents both CO and VR, which are always the same in this steady state graph (the heart cannot put out more than its input!). CO and VR are not separate values.
    The curves do not represent CO and VR. They represent the positive influence of RAP on CO (the cardiac function curve) and the simultaneous negative influence of CO on RAP (the vascular function curve). e.g. in heart failure the CO is lower for any value of RAP, so the cardiac curve will be shifted down. If there is a compensatory increase in blood volume, the vascular curve will be shifted up, because there is a higher RAP for any value of CO. The intersection of the new curves will show a similar level of CO/ VR but a higher RAP (try drawing it).
    TPR declines in exercise to deliver higher flow through the tissues, not to the heart. The heart's job is always to match the changing flow from arteries to veins with an equal flow from veins to arteries. The vessels set the pace, the heart keeps up!

  • @gopesizdopes
    @gopesizdopes 11 лет назад

    I believe you are confusing mean systemic filling pressure with mean arterial pressure.

  • @dahis6763
    @dahis6763 Год назад

    6:14 why VR stay normal? Now the volume of blood that pumped is less so how it’s will not be affected?

    • @addictzzz1455
      @addictzzz1455 Год назад

      The venous return will actually increase Because of RAAS in kidney will cause fluid retention which increases venous return
      This usually confuses people because its said that CO=VR but if that was the case in heart failure there wouldn’t have been increased work load on the heart and diuretics would have been useful
      Thats how i like to think about it, hope i was able to help clear things up

  • @MustafaSaudiHalkOoOm
    @MustafaSaudiHalkOoOm 10 лет назад

    thank yoU!

  • @mohammad.shokrolahi
    @mohammad.shokrolahi 7 лет назад

    thanks

  • @sadafm7585
    @sadafm7585 7 лет назад

    Its awfuly gooooood

  • @LoveMedicine100
    @LoveMedicine100  11 лет назад

    When you change TPR, the Mean systemic pressure will be affected. I will tell you why. When you increase resistance, the blood is trapped longer in the aorta. This will increase stretch on the aorta. Hence, mean systemic pressure will go up. It will go up any time the stretch on the arteries goes up. It will go up with you increase CO, HR, TPR, SV because all these will increase stretch on the arterial vessel.

    • @sajjad90skid29
      @sajjad90skid29 4 года назад +1

      100lyric, this is a contradictory statement, as in the graph you decreased the MSP(moved it to left on x.axis) when you increased the TPR. And here you say the MSP will increase(go to right) if you increase TPR ?

    • @sajjad90skid29
      @sajjad90skid29 4 года назад +1

      IMO, the increase in VR, due to decreased arteriolar resistance and increased venous tone(decreased venous compliance) are two opposite forces and will balance out causing same MSP in exercise.

  • @akhileshakhil4390
    @akhileshakhil4390 6 лет назад

    does both MSP and TPR mean the same if yes then the changes seen with hemorrhage and exercise in this explanation is not shown properly .....

  • @cm6971
    @cm6971 11 лет назад

    she is correct

  • @owenqimd
    @owenqimd 11 лет назад +1

    I believe what goforkranthi was getting at is that the Y-axis labels as typically shown are Cardiac Output which equals Venous return (what comes into the heart must go out assuming no accumulation). So in fact the convex curve is a graphic demonstration of the Frank-starling curve (higher stretch yields a higher CO) as the x-axis of end diastolic volume can represent stretch as the volume and stretch are directly related. Therefore I think you misinterpreted the y-axis label.