Describe the factors that affect the output of the right ventricle
An approach that covered the main determinants of right ventricular cardiac output
including heart rate, right ventricular preload, contractility, afterload and the
relationship with left ventricular output, ventricular interdependence, and the
respiratory system would have provided the framework for a good answer. Some
candidates used this approach but described more features of left ventricular than
right ventricular output. The observation that the right ventricle is relatively thin
walled and its output is very sensitive to changes in right ventricular preload and
afterload particularly was central to this question. The unique shape of the right
ventricle and its contraction characteristics involving ventricular interdependence
were rarely mentioned. Also details on right ventricular afterload and the importance
of factors affecting pulmonary vascular resistance were lacking in most answers.
Recommended sources: Review of Medical Physiology, Ganong, Chps 31 and 33,
Textbook of Medical Physiology, Guyton & Hall Chp 9 and 20
as well as cellular and extracellular calcium concentrations and temperature
|Effect of ventricular interdependence||
Franklin, Dean L., Robert L. Van Citters, and Robert F. Rushmer. "Balance between right and left ventricular output." Circulation research 10.1 (1962): 17-26.
Vincent, Jean-Louis. "Understanding cardiac output." Critical care 12.4 (2008): 174.
WIGGERS, CARL J. "Determinants of cardiac performance." Circulation 4.4 (1951): 485-495.
Theres, Heinz, et al. "Phase-related changes in right ventricular cardiac output under volume-controlled mechanical ventilation with positive end-expiratory pressure." Critical care medicine 27.5 (1999): 953-958.