Dr.

Abdalla Adam
1. The volume of blood ejected by each ventricle per minute.
2. The volume of blood flowing through either the systemic or the
pulmonary circuit per minute.
 Expressed in L/min.
Normal Value
 Determined by heart rate (HR) X stroke volume(SV).
 For a resting average-sized adult man=
– 75 ml X 72 beats/min = 5.0 - 6.0 L/min

Physiological variation
 Age
 Sex
 Activity
 Body surface area…
The effects of various conditions on COP
 REGULATION OF COP
 Determinants = HR & SV.

Any change in HR Or SV Or Both

Will make change in COP
 Effect of factors on:
 HR  chronotropic action (+ve / -ve).
 SV  inotropic action (+ve / -ve).
I- Neural regulation:
A. Sympathetic =  increase heart rate.
B. Parasympathetic = Decrease heart rate.

Factors modulate neural control:

– Physiological
– Physical
– Chemical
 Hormones
 Drugs
Regulation of SV (inotropic)
Regulation of contractility (force of contraction)
A- Intrinsic
1- Preload (The Frank-Starling Mechanism):
» Venous return  end diastolic volume  contractility  stroke volume
2- Afterload:
» peripheral resistance, viscosity, and valves.
B- Extrinsic
1- Neural (Sympathetic)
2- Chemical (Hormones, ions, and Drugs)
DEFINITION

Preload:
– Degree of muscle tension when it begins to contract.
– It proportional to resting (diastolic) length of myocardial fibers.
Afterload:
– Resistance against muscle (ventricles) contraction…
 A- INTRINSIC FACTORS
1- Reload: The Frank-Starling Law of the Heart
(Length – Tension relationship)

Stroke volume (SV):

 Def: Volume pumped by each ventricle / beat.
 SV is proportional to contractility.

The Frank-Starling Law of the Heart

 Stretch of myocardium by blood causes it to contract more strongly.
– Stretch is proportional to initial length.
– Initial length is proportional to end diastolic volume (EDV).
– EDV is proportional to venous return...
 venous return
 EDV
 Initial length
 Stretch
 contractility
 SV