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Jeannette Hafey Chemistry/Biology Dept Springfield College Springfield, MA To show the interrelationships among stroke volume, cardiac output and heart rate To demonstrate the effect of an increase in resistance on blood flow To discuss the factors affecting the Ejection Fraction To investigate the role of the heart as a pump by the use of a model to simulate the action of the heart To study the relationship between heart rate, stroke volume and cardiac output To demonstrate the impact of the radius of the blood vessel on the rate of blood flow and as a determinant of blood pressure To consider the effect of exercise on the End Diastolic Volume and Ejection Fraction Procedure: Equipment: Adapted from “The Heart as a Pump: Cardiac Mechanics Integrated with Anatomy for Introductory Human A&P” by Daniel E. Lemons, Ph. D. ©2009 Science Learning Workshop, Inc. cardio model- purchased from Denoyer-Geppert Science Co. Stroke Volume (SV) is the volume of blood ejected by the ventricle in a single beat or stroke. SV is measured in milliliters or liters Cardiac Output or CO is the volume of blood being pumped by the heart in one minute CO is measured in ml/minute or liters/minute Cardiac Output = Stroke volume x heart rate ml/min ml beats/min 1. If the average person’s heart rate is 72 beats per minute and the stroke volume is 70 ml, what is the approximate cardiac output of the average person’s heart at rest? A. 4950 ml/min B. 7000 ml/min C. 5040 ml/min D. 142 ml/min 2. During moderate exercise, such as walking, Susan’s heart rate increased to 110 beats per minute and her stroke volume increased to 100 ml. What is Susan’s CO during moderate exercise? A. 1100 ml/min B. 2100 ml/min C. 11,000 ml/min D. 110,000 ml/min 3. Appoximately _______ as much blood is pumped per minute by the heart during moderate exercise than at rest A. 2 times B. 3 times C. 4 times 4. Lance Armstrong’s resting heart rate is 34 beats per minute. If his resting cardiac output is the same as the average person’s CO, what is his stroke volume per cycle? A. 70 ml B. 100 ml C. 128 ml D. 148 ml 5. What would be the explanation as to how Lance Armstrong can achieve the same cardiac output as the average person with a heart rate of only 34 beats per minute compared to the average person’s heart rate of 72 beats per minute? A.longer time between beats to fill with blood B. greater force of contraction C. stronger muscle in ventricular wall D. more blood ejected per stroke E. all of the above The following demonstration will utilize a piece of equipment which will simulate the work of the ventricle in pumping blood. Measurements will be taken to determine stroke volume and cardiac output when heart rate is varied The diaphragm functions as the ventricle of the heart . Fluid enters the pump via gravity from the reservoir through the inflow valve. When the bulb is squeezed, pressure is applied to the outside of the diaphragm forcing fluid out the outflow valve into the metering tube. The scale on the metering tube is in 2 ml increments When the pump fills with fluid and then ejects it into the metering tube, this constitutes one pumping cycle – PC PC is comparable to the cardiac cycle of diastole/systole or heart rate The volume of fluid pumped with each pumping cycle is called the Cycle Volume- CV CV is comparable to the stroke volume (SV) The total amount of fluid pumped in one minute = Pump Output or PO PO is comparable to cardiac output CO in ml/min The following cases represent variations in the frequency of pumps per minute in order to determine the effect of pumping rate on pump output Purpose: to determine the most efficient rate of pumping in order to maximize the output Case #1: Measurement of cycle volume and pump output at Pumping cycle rate of 10 cycles (beats) per minute Timer: Pump every 6 seconds Pumping Cycle 1 2 3 4 5 6 7 8 9 10 Meter Tube Volume (ml) CV (ml) Average cycle volume (CV)= _________ Pump output (PO) in one minute = __________ ml at a rate of 10 cycles per minute (give total volume in cylinder) Case #2: Measurement of cycle volume and pump output at Pumping cycle rate of 30 cycles (beats) per minute Empty the metering tube and close the reset valve Time: Pump every 2 seconds Pumping Cycle 1 2 3 4 5 6 7 8 9 10 Meter Tube Volume (ml) CV (ml) Average cycle volume (CV)= _________ Pump output (PO)= __________ ml at a rate of 30 cycles per minute Case #3: Measurement of cycle volume and pump output at Pumping cycle rate of 60 cycles (beats) per minute Empty the metering tube and close the reset valve Time: One Pump every second Pumping Cycle 1 2 3 4 5 6 7 8 9 10 Meter Tube Volume (ml) CV (ml) Average cycle volume (CV)= _________ Pump output (P0)= __________ ml at a rate of 60 cycles per min Case #4: Measurement of stroke volume and cardiac output when Pumping as fast as the pumper can pump Empty the metering tube and close the reset valve Time: This is done for only 30 seconds Record: Count the number of times pumped in 30 sec Calculate: Pump Output volume for 60 seconds 30 sec 60 sec #Pumps PO = Meter Tube Volume (ml) Average CV Pumping rate in cycles per min ______ Average cycle volume (CV)= _________ PO/number of cycles Pump Output (PO) = __________ ml/60 seconds Table V. Comparing Cases 1-4 Case 1 2 PR (CPM) PO(ml/min) CV (ml) 6. Which case has the highest cycle volume? a. 1 b. 2 c. 3 d. 4 3 4 7. Which case had the highest Pump Output? a. 1 b. 2 c. 3 d. 4 Graph results: Cycle volume vs pumping rate Pump output vs pumping rate From the graph of the results make a statement about the results: 8. As the pumping rate increased, the cycle volume ____________________________________ 9. As the pumping rate increased, the pump output ____________________________________ 10.Pump output increases as the pumping rate increases A. true B. false 11. What would you say is the most efficient pumping rate? ______________ cpm Questions for discussion: 1. How does heart rate affect cardiac output? As the heart rate increases ______________ ___________________________________________ 2. What other factors could affect cardiac output other than heart rate? ________________________________________ 3. During exercise, the heart rate does increase, but, in comparison with the model, the stroke volume (cycle volume) does not decrease. This is important in maintaining the blood flow to the tissues. What factor in the living heart compensates so that, in spite of a more rapid heart rate during exercise, the stroke volume can also increase? ____________________________________________ Formula: Cardiac Output = stroke volume x heart rate 4. From the formula above, during exercise, what factors change in order to increase cardiac output so as to deliver more oxygen at a faster pace to the muscles? _____________________________________________ 5. Which factor becomes more important with more intense exercise? ________________________ The purpose of this demonstration is to determine if the diameter of the tubing has an effect on the rate of flow through a vessel Setup: remove connection to pump 1. Define – dilated blood vessel ____________________________________________ 2. Define – constricted blood vessel ______________________________________________ Remove tubing connecting reservoir to inflow valve and connect tubing to a “T” connector. Outflow from connector enters tubing with one outflow of 1/8” tubing and the other of ¼” tubing. The length of the tubing from each end of the connector is 14” each and each allows fluid to enter a 100 ml graduated cylinder. Close refill valve and fill metering tube Place a shut-off valve on tubing beneath reservoir, open refill valve and fill reservoir so liquid enters tubing When ready to begin, open shut-off valve for 5 seconds and then close Measure the volume of fluid in each graduated cylinder Blood vessels constrict and dilate in response to the needs of the body – How does this affect flow rates? Does this have an effect on the overall blood pressure? There will be three – 5 second trials with the average volume calculated Diameter of tubing Volume – trial #1 Volume – trial #2 Volume – Trial #3 Average volume 1/8” tubing ¼” tubing Calculate the rate of flow per minute : ml/5 sec x 60 sec/min = ml/min The flow rate per min for 1/8” tubing = ______ ml/min The flow rate per min for ¼” tubing = _______ ml/min The fastest flow occurred in the ________ tubing The flow of fluid through a tube is met with the friction of the walls of the tube. The smaller the diameter of the tube, the greater the friction and thus, the greater the resistance to flow. The arterioles have smaller diameters as well as more control over their diameters than other vessels and thus can offer the greatest resistance to flow. Assuming that the length of the tube and the viscosity of the blood are constant Resistance = 1/radius4 3. Which size tubing offered greater resistance to flow? ___________ R = 1/r4 Determine R for radius of ¼” _______ Determine R for radius of 1/8” _________ 4. How many times greater is the resistance in the smaller tube than the larger tube? ________ 5.How does the resistance affect the flow rate? A. greater R then faster flow B. greater R then slower flow 6. The larger the radius of the tube, the A. greater the flow rate B. slower the flow rate 7.The greater the diameter or radius of a vessel, the _____ the resistance A. greater B. lower 8. The smaller diameter tube, the _____ the amount of friction against the walls of the tube A. greater B. lower 9.As the arterioles constrict, the resistance A. increases B. decreases 10. In order to increase flow to tissues, the arterioles A. dilate B. constrict The formula below shows the relationship among Blood Pressure, resistance and flow Pressure = Flow (CO in ml/min) x Resistance (1/r4) 11. As the arteries constrict, resistance a. increases b. decreases 12. As the arteries constrict, therefore, blood pressure a. increases b. decreases The End Filling Volume (EFV), like the End Diastolic Volume, is the amount of fluid in the diaphragm immediately before it is compressed. The End Ejection Volume (EEV) , like the End Systolic Volume is the volume left inside the diaphragm at the end of the pumping stroke. Filling It can be very difficult to determine the value of EFV and EEV in either the model heart or in the human heart because there is no direct way to measure them. These volumes can be very useful clinically so indirect ways have been developed to obtain them. The fraction of the EFV that is pumped out in one cycle is called the Ejection Fraction (EF), and for the heart it is calculated as follows: EF = SV / EFV or SV/EDV End Filling Volume (EFV) Ejection End Ejection Volume (EEV) EF = SV/EDV Study this relationship: 1. As the stroke volume increases during exercise (assume constant EDV), the EF A. increase B. decrease 2. Therefore during exercise the heart is A. ejecting more of the end diastolic volume per stroke B. less of the end diastolic volume per stroke 3. If Harold’s stroke volume is 72 ml at rest and the End Diastolic Volume is 150 ml, then calculate the Ejection fraction for Harold EF = SV/EDV At rest then, the % of the Harold’s EDV that is ejected from the ventricle is about? A. 25% B. 50% C. 75% 4. Suggest a way that Harold’s heart could increase the EF during exercise? ____________________________________________ 5. During exercise, we would think that an increase in the EF would be due to A. greater filling of the heart B. more forceful contraction of the heart C. both of the above 6. The EF tells us relatively speaking a. how much of the blood filling the ventricle is pumped out with each stroke b. how much blood is left inside the ventricle after a forceful contraction c. both of the above 7.How would you think that the EF of Lance Armstrong’s heart would compare to the average person’s heart? A. higher B. lower C. the same 8.Discuss the reason for your answer ____________________________________________ 9. Assume that the EDV increases by 20% during exercise to 180 ml and the SV increases to 110 ml. What is the EF? a. 45% b. 61% c. 25% 10. Thus the EF during exercise shows that the heart a. ejects more blood per stroke b. ejects less blood per stroke 11. Anna is a 59 year old woman with heart failure. Her heart is enlarged and holds a large volume of blood. You would expect that her EF would be show that A. heart ejects a larger volume of blood with each stroke B. heart ejects a lower than normal volume of blood with each stroke C. EF would be normal for her age 12. If Anna’s EDV is 200 ml with an EF of 25%, what is her stroke volume? A. 100 ml B. 75 ml C. 150 ml D. 50 ml 13. How much blood is left in her ventricle after the contraction? ________ ml 14. What is the major problem in Anna’s heart to cause her to have an EF of only 25%? ____________________________________________ 15. With a resting heart rate of 100, Anna is experiencing ___ A. tachycardia B. bradycardia