TYK79: Difference between revisions

From PedsAnesthesiaNet
Jump to navigation Jump to search
m (1 revision imported)
No edit summary
 
(One intermediate revision by the same user not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
<div class="mw-collapsible mw-collapsed" style="width:100%">
Which of the following is TRUE concerning pediatric physiology?
Which of the following is TRUE concerning pediatric physiology?


Line 10: Line 9:


D. Neonates mainly increase cardiac output by increasing afterload
D. Neonates mainly increase cardiac output by increasing afterload
 
<div class="mw-customtoggle-TYK_Answer" style="text-align: right; color:#0000ff">Click for Answer</div>
 
<div class="mw-collapsible mw-collapsed" id="mw-customcollapsible-TYK_Answer">
<div class="mw-collapsible-content">  
==Answer==
==Answer==
The answer is A.
The answer is A.


I know, crazy. It is not intuitive as to why changes in heart rate alter contractility. The mechanism is known as the force-frequency relationship. Anderson and others conducted experiments  using controlled loading conditions with changes in heart rate.  They noted an increase in stroke volume with an increases in heart rate (at constant load conditions).Therefore, an increase in heart rate increased contractility.  Thus, an increased heart rate improves contractility. This increase in contractility with an increase in heart rate is due to the increase in intracelluar calcium. In the human population, this force-frequency relationships is most likely minimal at birth, but increases in infancy.<ref>Anderson, P. A., et al. "The effect of heart rate on in utero left ventricular output in the fetal sheep." The Journal of Physiology 372.1 (1986): 557-573.[http://onlinelibrary.wiley.com/doi/10.1113/jphysiol.1986.sp016025/abstract]</ref><ref>Parilak, Leonard D., et al. "Contribution of frequency-augmented inward Ca2+ current to myocardial contractility." Canadian journal of physiology and pharmacology 87.1 (2009): 69-75.[http://www.nrcresearchpress.com/doi/abs/10.1139/Y08-087#.VTAp4NJVhBc]</ref><ref>Wiegerinck, Rob F., et al. "Force frequency relationship of the human ventricle increases during early postnatal development." Pediatric Research 65.4 (2009): 414-419.[http://www.nature.com/pr/journal/v65/n4/abs/pr200980a.html]</ref>]
I know, crazy. It is not intuitive as to why changes in heart rate alter contractility. The mechanism is known as the force-frequency relationship. Anderson and others conducted experiments  using controlled loading conditions with changes in heart rate.  They noted an increase in stroke volume with an increases in heart rate (at constant load conditions).Therefore, an increase in heart rate increased contractility.  Thus, an increased heart rate improves contractility. This increase in contractility with an increase in heart rate is due to the increase in intracelluar calcium. In the human population, this force-frequency relationships is most likely minimal at birth, but increases in infancy.<ref>Anderson, P. A., et al. "The effect of heart rate on in utero left ventricular output in the fetal sheep." The Journal of Physiology 372.1 (1986): 557-573.[http://onlinelibrary.wiley.com/doi/10.1113/jphysiol.1986.sp016025/abstract]</ref><ref>Parilak, Leonard D., et al. "Contribution of frequency-augmented inward Ca2+ current to myocardial contractility." Canadian journal of physiology and pharmacology 87.1 (2009): 69-75.[http://www.nrcresearchpress.com/doi/abs/10.1139/Y08-087#.VTAp4NJVhBc]</ref><ref>Wiegerinck, Rob F., et al. "Force frequency relationship of the human ventricle increases during early postnatal development." Pediatric Research 65.4 (2009): 414-419.[http://www.nature.com/pr/journal/v65/n4/abs/pr200980a.html]</ref>]
==Notes==
==Notes==
<references />
<references />


==Keywords==
==Keywords==
:


</div>
</div>
----
----
----
----

Latest revision as of 23:32, 23 January 2022

Which of the following is TRUE concerning pediatric physiology?

A. An increase in heart rate will increase contractility in an infant

B. Neonatal cardiac circulation is a parallel circuit

C. Extremes of heart rate are well tolerated in neonates

D. Neonates mainly increase cardiac output by increasing afterload

Click for Answer

Answer

The answer is A.

I know, crazy. It is not intuitive as to why changes in heart rate alter contractility. The mechanism is known as the force-frequency relationship. Anderson and others conducted experiments using controlled loading conditions with changes in heart rate. They noted an increase in stroke volume with an increases in heart rate (at constant load conditions).Therefore, an increase in heart rate increased contractility. Thus, an increased heart rate improves contractility. This increase in contractility with an increase in heart rate is due to the increase in intracelluar calcium. In the human population, this force-frequency relationships is most likely minimal at birth, but increases in infancy.[1][2][3]]

Notes

  1. Anderson, P. A., et al. "The effect of heart rate on in utero left ventricular output in the fetal sheep." The Journal of Physiology 372.1 (1986): 557-573.[1]
  2. Parilak, Leonard D., et al. "Contribution of frequency-augmented inward Ca2+ current to myocardial contractility." Canadian journal of physiology and pharmacology 87.1 (2009): 69-75.[2]
  3. Wiegerinck, Rob F., et al. "Force frequency relationship of the human ventricle increases during early postnatal development." Pediatric Research 65.4 (2009): 414-419.[3]

Keywords



<Prev Question --- Next Question>

About Test Your Knowledge