MS 7

FRONT:
What is the heart, and where is it located?

BACK:
The heart is a hollow muscular organ responsible for pumping blood throughout the body.

Tinatawag itong hollow dahil may mga chambers o espasyo sa loob nito kung saan dumadaan at naiipon ang dugo. Muscular naman ito dahil ang walls ng heart ay gawa sa cardiac muscle na kayang kumontra para itulak ang dugo.

Ang heart ay matatagpuan sa middle mediastinum, ang central compartment o bahagi ng chest cavity na nasa pagitan ng dalawang lungs.

SCENARIO:
Halimbawa, isipin mo ang heart na parang muscular pump. Kapag kumontra ang heart, pinipilit nitong lumabas ang dugo mula sa chambers papunta sa lungs para sa oxygenation at papunta sa buong katawan para ma-deliver ang oxygen at nutrients.

MEMORY TIP:
Heart = hollow + muscular + middle mediastinum + blood pump.

FRONT:
What are the five properties of the heart?

BACK:
May 5 important properties ang heart:

1. Contractility → ability ng heart muscle na mag-contract at gumawa ng force.

2. Conductivity → ability na magpasa ng electrical signal sa ibang cardiac cells.

3. Rhythmicity → ability na magkaroon ng regular na pattern ng heartbeat.

4. Automaticity → ability na gumawa ng sariling electrical signal.

5. Excitability → ability na tumugon sa electrical signal o stimulus.

Lahat sila may different jobs, pero nagtutulungan sila para magkaroon ng normal at organized heartbeat.

SCENARIO:
Parang kapag ikaw ay gagawa ng isang action:

May nagsisimula, may nagpapasa ng message, may tumatanggap, may gumagawa ng action, tapos ginagawa ito sa regular na pattern.

Ganyan mo lang isipin ang five properties ng heart. Different jobs, pero one goal: maayos na heartbeat.

MEMORY TIP:
C-C-R-A-E
Contractility → Conductivity → Rhythmicity → Automaticity → Excitability.

FRONT:
What is contractility?

BACK:
Ang contractility ay ability ng heart muscle na mag-contract at gumawa ng force.

Kapag sinabi nating contract, isipin mo lang na gumagana o kumikilos ang muscle.

Bakit kailangan ito ng heart? Kasi kailangan niyang gumawa ng enough force para ma-push ang blood palabas ng heart.

SCENARIO:
I-close mo yung kamay mo into a fist. ✊

Para magawa mo yun, gumagana yung muscles ng kamay mo at nakakagawa sila ng force.

Ganoon ang idea ng contractility sa heart:

Heart muscle works → makes force → pushes blood.

MEMORY TIP:
Contractility = muscle works → makes force.

What is conductivity?

BACK:
Ang conductivity ay ability ng heart cells na magpasa ng electrical signal from one cardiac cell to another.

Ang electrical signal ay parang message o utos na nagsasabi sa heart cells na kailangan nilang mag-act.

So ang pinaka-simple meaning ng conductivity ay:

“May signal → ipinapasa sa next cell.”

Importante ito para hindi random ang activity ng heart. Kailangan makarating ang signal sa mga tamang cells.

SCENARIO:
May nag-message sa group chat: “Guys, punta tayo sa room.”

Binasa mo yung message, tapos sinabi mo rin sa ibang kasama mo.

Yung important part dito ay naipasa yung message.

Ganoon ang conductivity:

Electrical signal → ipinasa sa ibang cardiac cells.

MEMORY TIP:
Conductivity = PASS THE SIGNAL.

FRONT:
What is rhythmicity?

BACK:
Ang rhythmicity ay ability ng heart na magkaroon ng regular at paulit-ulit na pattern ng activity.

Hindi dapat random ang heartbeat. May pattern kung kailan nag-a-act ang heart at kailan ito nagre-rest.

Kaya ang rhythmicity ay basically about having a regular rhythm.

SCENARIO:
Pumalakpak ka:
👏 → pause → 👏 → pause → 👏

May pattern, diba?

Hindi ka basta pumapalakpak nang random.

Ganoon ang idea ng rhythmicity sa heart: may paulit-ulit at regular na pattern.

MEMORY TIP:
Rhythmicity = regular pattern.

FRONT:
What is automaticity?

BACK:
Ang automaticity ay ability ng heart na gumawa ng sariling electrical signal.

Ibig sabihin, may special cells sa heart na kayang magsimula ng electrical activity on their own.

Hindi kailangan na may external person o device na paulit-ulit magsabi ng, “Heart, beat ka na.”

May sariling ability ang heart na simulan ang electrical activity na kailangan para sa heartbeat.

SCENARIO:
Huminga ka nang normal.

Hindi mo kailangang isipin every second:

“Okay, inhale.”
“Okay, inhale ulit.”
“Okay, inhale ulit.”

May mga processes sa body na kusang nagsisimula at nagpapatuloy.

Ganoon ang basic idea ng automaticity:

The heart can start its own electrical signal.

MEMORY TIP:
Automaticity = sariling start ng electrical signal.

FRONT:
What is excitability?

BACK:
Ang excitability ay ability ng heart cells na tumugon kapag may electrical signal o stimulus.

Ang stimulus ay something na nagbibigay ng signal para mag-response ang isang cell.

So ang simple meaning:

May signal → nakatanggap ang cell → nag-response ang cell.

Ito ang dahilan kung bakit important ang excitability sa cardiac cells.

SCENARIO:
May tumawag sa pangalan mo: “Uy, Zhy!”

Ano ang natural mong gagawin? Lilingon ka o sasagot ka.

May nangyari muna:

May tumawag → narinig mo → nag-response ka.

Ganoon ang idea ng excitability:

May stimulus/signal → cardiac cell responds.

MEMORY TIP:
Excitability = receive signal → respond.

FRONT:
What is the difference between automaticity and excitability?

BACK:
Ito yung madaling paghiwalayin:

Automaticity = ability na IKAW ang magsimula ng signal.

Excitability = ability na TUMUGON kapag may signal.

So:

Automaticity → “Ako ang magsisimula.”

Excitability → “May signal? Sige, magre-response ako.”

SCENARIO:
Automaticity: Ikaw mismo ang nagsabi, “Tara, kain tayo.” Ikaw ang nag-start.

Excitability: May nagsabi sa’yo, “Tara, kain tayo.” Tapos sinabi mong, “Sige.” Nag-response ka.

So:

Automaticity = START.
Excitability = RESPOND.

MEMORY TIP:
Automaticity = START.
Excitability = RESPOND.

FRONT:
How do the five properties of the heart work together?

BACK:
Think of them as five different jobs na nagtutulungan:

Automaticity → starts the electrical signal.

Conductivity → passes the signal.

Excitability → responds to the signal.

Contractility → heart muscle works and makes force.

Rhythmicity → ginagawa ang process in a regular pattern.

So basically:

Start → Pass → Respond → Contract → Repeat regularly.

SCENARIO:
Imagine na may group of friends kayo.

Una, may nagsabi: “Tara, alis na!”
→ Automaticity = may nag-start.

Sinabi niya sa iba: “Tara, alis na raw.”
→ Conductivity = naipasa ang message.

Narinig ng friend mo at sinabi niyang: “Okay, tara!”
→ Excitability = nag-response.

Tumayo at naglakad na kayo.
→ Contractility = may actual action/movement.

Tapos paulit-ulit kayong sumusunod sa same routine.
→ Rhythmicity = regular pattern.

MEMORY TIP:
START → PASS → RESPOND → WORK → REPEAT.

FRONT:
What is the main function of the heart?

BACK:
Ang heart ay ang pumping organ ng katawan.

Ibig sabihin, ang main job niya ay mag-pump o magtulak ng blood para umikot ito sa buong katawan.

Kailangan ito dahil ang blood ang nagdadala ng oxygen at nutrients papunta sa mga cells ng katawan. Kinukuha rin nito ang ilang waste products para ma-process at maalis ng katawan.

SCENARIO:
Maglakad ka nang ilang minuto. Mapapansin mong patuloy na gumagana ang katawan mo kahit hindi mo iniisip ang bawat heartbeat.

Habang gumagalaw ka, kailangan ng muscles mo ng oxygen. Kaya kailangan ding patuloy na i-pump ng heart ang blood para makarating ang oxygen sa mga parts ng katawan na nangangailangan nito.

MEMORY TIP:
Heart = pumping organ → nagpapagalaw ng blood sa katawan.

FRONT:
What are the atria?

BACK:
Ang atria ay ang dalawang upper chambers ng heart.

Ang chamber ay parang isang space sa loob ng heart kung saan maaaring pumasok o dumaan ang blood.

May dalawang atria:

Right atrium → upper chamber sa right side.
Left atrium → upper chamber sa left side.

Simple lang: atria = nasa taas ng heart.

SCENARIO:
Itaas mo ang dalawang kamay mo. ✋✋

Isipin mo na ang dalawang kamay mo ay parang two upper spaces. Ang mahalaga lang tandaan ay nasa upper part sila.

Ganoon ang atria: sila ang dalawang chambers na nasa upper part ng heart.

MEMORY TIP:
Atria = 2 upper chambers.

FRONT:
What are the ventricles?

BACK:
Ang ventricles ay ang dalawang lower chambers ng heart.

May dalawang ventricles:

Right ventricle → lower chamber sa right side.
Left ventricle → lower chamber sa left side.

Ang ventricles ay important dahil sila ang chambers na nagpo-pump ng blood palabas ng heart.

Simple lang:

Atria = upper
Ventricles = lower

SCENARIO:
Ilagay mo ang isang kamay mo sa upper part ng chest at isa sa lower part.

Isipin mo na parang may upper area at lower area ang heart.

Ang upper chambers ay atria, habang ang lower chambers ay ventricles.

MEMORY TIP:
Ventricles = 2 lower chambers → push blood out.

RONT:
What are the atrioventricular valves?

BACK:
Ang atrioventricular valves, or AV valves, ay mga valves na nasa pagitan ng atria at ventricles.

Ang valve ay parang gate. Ang trabaho nito ay tumulong na kontrolin kung saan dapat pumunta ang blood.

Ang AV valves ay tumutulong para hindi basta bumalik ang blood sa atria kapag nag-contract ang ventricles.

May dalawang AV valves:

Tricuspid valve → right side
Mitral valve → left side

SCENARIO:
Isipin mo ang isang door sa bahay.

Kapag gusto mong pumasok, binubuksan mo ang door. Kapag nasa loob ka na at ayaw mong bumalik-balik ang tao, sinasara mo ang door.

Ganoon ang basic idea ng valve: tumutulong itong kontrolin ang direction ng movement.

Sa heart, ang AV valves ay tumutulong para manatiling proper ang direction ng blood flow between the atria and ventricles.

MEMORY TIP:
AV valves = gates between atria and ventricles.

FRONT:
What is the tricuspid valve?

BACK:
Ang tricuspid valve ay ang valve na nasa pagitan ng right atrium at right ventricle.

So kapag tinanong kung saan ang tricuspid valve:

Right atrium → Tricuspid valve → Right ventricle

Isa itong atrioventricular valve dahil nasa pagitan siya ng atrium at ventricle.

SCENARIO:
Isipin mo na may door sa pagitan ng dalawang rooms.

Ang first room ay right atrium.
Ang second room ay right ventricle.
Ang door between them = tricuspid valve.

Kaya kapag narinig mo ang “tricuspid,” isipin mo agad: right side + between atrium and ventricle.

MEMORY TIP:
Tricuspid = RIGHT AV valve.

FRONT:
What is the mitral valve?

BACK:
Ang mitral valve ay ang valve na nasa pagitan ng left atrium at left ventricle.

So:

Left atrium → Mitral valve → Left ventricle

Isa rin itong atrioventricular valve dahil nasa pagitan siya ng atrium at ventricle.

SCENARIO:
Same idea sa tricuspid.

Isipin mo na may door between two rooms.

Ang first room ay left atrium.
Ang second room ay left ventricle.
Ang door between them = mitral valve.

Kaya kapag narinig mo ang “mitral,” isipin mo agad: left side + between atrium and ventricle.

MEMORY TIP:
Mitral = LEFT AV valve.

FRONT:
What are the pulmonic and aortic semilunar valves?

BACK:
Ang pulmonic semilunar valve at aortic semilunar valve ay valves na tumutulong kontrolin ang blood flow palabas ng ventricles.

Pulmonic semilunar valve → controls blood flow from the right ventricle toward the lungs.

Aortic semilunar valve → controls blood flow from the left ventricle toward the body through the aorta.

Tinatawag silang semilunar valves dahil pareho silang valves na nasa outflow side ng ventricles.

SCENARIO:
Isipin mo na may two doors palabas ng isang building.

Isang door ang ginagamit para pumunta sa lungs.
Isang door naman ang ginagamit para pumunta sa rest of the body.

Ang valves ay parang doors na tumutulong kontrolin ang paglabas ng blood sa tamang direction.

MEMORY TIP:
Pulmonic → right ventricle → lungs.
Aortic → left ventricle → body.

FRONT:
What is the difference between tricuspid and mitral valves?

BACK:
Pareho silang atrioventricular valves, pero magkaiba ang side ng heart na kinaroroonan nila.

Tricuspid valve → between right atrium + right ventricle.

Mitral valve → between left atrium + left ventricle.

So ang easiest way to remember:

Tricuspid = RIGHT
Mitral = LEFT

SCENARIO:
Imagine na may two sides ng isang room.

Sa right side, may door na tinatawag na tricuspid.

Sa left side, may door na tinatawag na mitral.

Pareho silang doors, pero magkaiba ang side kung saan sila nakalagay.

MEMORY TIP:
TRI = RIGHT. MITRAL = LEFT.

FRONT:
What is the difference between AV valves and semilunar valves?

BACK:
Ang AV valves ay nasa between the atria and ventricles.

Tricuspid → right atrium ↔ right ventricle
Mitral → left atrium ↔ left ventricle

Ang semilunar valves naman ay nasa labasan ng ventricles.

Pulmonic → right ventricle → lungs
Aortic → left ventricle → body

So:

AV valves = between atria and ventricles.

Semilunar valves = ventricles going out.

SCENARIO:
Isipin mo ang isang bahay na may rooms at exit doors.

Ang AV valves ay parang doors between two rooms.

Ang semilunar valves naman ay parang doors papalabas ng building.

MEMORY TIP:
AV = between chambers.
Semilunar = out of ventricles.

FRONT:
What is the SA node, and what does it do?

BACK:
Ang SA node (Sinoatrial node) ay ang natural pacemaker ng heart.

Ang pacemaker ay parang natural na taga-start ng heartbeat. Ang SA node ang unang gumagawa ng electrical impulse, o signal, na nagsasabi sa heart na magsimula ng activity.

Kaya kapag tinanong kung saan nagsisimula ang electrical activity ng heart, ang sagot ay:

SA node → starts the impulse.

SCENARIO:
Isipin mo na may isang tao sa classroom na unang nagsabi, “Guys, start na tayo!”

Hindi pa gumagawa ng activity ang ibang classmates. Siya muna ang nagsimula.

Ganoon ang SA node: siya ang natural na nagsisimula ng signal para sa heartbeat.

MEMORY TIP:
SA node = START ng heartbeat.
SA = Start Activity.

FRONT:
What is the pathway of the heart’s electrical impulse?

BACK:
Ang electrical impulse ng heart ay dumadaan sa specific na pathway:

SA node → AV node → Bundle of His → Right & Left Bundle Branches → Purkinje fibers

Ito ang sequence na kailangan mong tandaan.

Ang purpose nito ay para kumalat ang electrical signal sa heart in the correct order, kaya coordinated ang contraction.

SCENARIO:
Isipin mo na may group chat announcement.

Una, may isang tao na nag-send ng message.
→ SA node

Pagkatapos, natanggap ito ng next person.
→ AV node

Ipinasa niya sa dalawang tao.
→ Right & Left Bundle Branches

Tapos ipinasa naman sa maraming tao sa group.
→ Purkinje fibers

Ang importanteng idea: may signal na dumadaan step-by-step sa tamang order.

MEMORY TIP:
SA → AV → Bundle of His → Branches → Purkinje

FRONT:
What is the AV node?

BACK:
Ang AV node (atrioventricular node) ay isang importanteng part ng heart’s electrical conduction system.

Pagkatapos magsimula ang impulse sa SA node, pumupunta ito sa AV node.

So remember:

SA node = starts the impulse
AV node = next stop of the impulse

SCENARIO:
Isipin mo na may friend kang nagpasa ng message sa’yo.

Hindi ikaw ang gumawa ng original message. Natanggap mo lang ito at ikaw ang next person na involved sa pagpapasa nito.

Ganoon ang basic idea ng AV node sa pathway: pagkatapos ng SA node, ang impulse ay pumupunta sa AV node.

MEMORY TIP:
SA → AV
SA starts, AV comes next.

FRONT:
What is the Bundle of His?

BACK:
Ang Bundle of His ay bahagi ng electrical conduction pathway ng heart.

Pagkatapos dumaan ang impulse sa AV node, susunod itong dumadaan sa Bundle of His.

Mula rito, ang signal ay nagpapatuloy papunta sa right and left bundle branches.

So ang sequence ay:

SA node → AV node → Bundle of His → Bundle branches

SCENARIO:
Isipin mo na may message na ipinapasa sa magkakasunod na tao.

Pagkatapos ng first person at second person, may next person na tatanggap at magpapasa ng message.

Ganoon mo isipin ang Bundle of His: isa itong next part ng pathway na dinadaanan ng electrical signal.

MEMORY TIP:
AV node → Bundle of His → Branches

FRONT:
What are the right and left bundle branches?

BACK:
Ang right and left bundle branches ay dalawang pathways na dinadaanan ng electrical impulse pagkatapos ng Bundle of His.

Ang signal ay nahahati papunta sa:

Right bundle branch → right side
Left bundle branch → left side

Tinutulungan nitong maipasa ang electrical signal sa magkabilang side ng ventricles.

SCENARIO:
Isipin mo na may isang road na nahati sa dalawang direction.

Pagdating sa isang point, may:

Road papunta sa right → right bundle branch
Road papunta sa left → left bundle branch

Parehong galing sa same pathway, pero magkaibang direction ang pinupuntahan.

MEMORY TIP:
Bundle branches = one pathway → splits into RIGHT + LEFT.

FRONT:
What are the Purkinje fibers?

BACK:
Ang Purkinje fibers ay nasa dulo ng electrical conduction pathway na tinatahak ng impulse.

Ang signal ay dumadaan sa:

SA node → AV node → Bundle of His → Bundle branches → Purkinje fibers

Tinutulungan ng Purkinje fibers na maipasa ang electrical signal sa heart muscle, lalo na sa ventricles, para ma-trigger ang contraction.

SCENARIO:
Isipin mo na may message na ipinasa sa isang group, at sa dulo, may mga taong responsible na iparating ang message sa maraming members.

Ganoon ang idea ng Purkinje fibers: nasa dulo sila ng pathway at tumutulong na iparating ang electrical signal sa heart muscle.

MEMORY TIP:
Purkinje fibers = last part → signal reaches heart muscle.

FRONT:
How does the heart’s electrical conduction system make the heart contract?

BACK:
Ganito ang basic sequence:

1. SA node → nagsisimula ng electrical impulse.
2. AV node → next stop ng impulse.
3. Bundle of His → dinadaanan ng signal.
4. Right & Left Bundle Branches → nahahati ang pathway sa right at left.
5. Purkinje fibers → ipinapasa ang signal sa heart muscle.

Kapag nakarating ang electrical signal sa cardiac muscle, nai-stimulate nito ang muscle para mag-contract.

SCENARIO:
Isipin mo na may isang tao na nagsabi ng “GO!”

May taong unang nakarinig → ipinasa ang message → nahati ang message sa dalawang direction → kumalat hanggang makarating sa lahat ng taong kailangang kumilos.

Kapag narinig na nila ang “GO!”, saka sila gumagawa ng action.

Ganoon ang heart:

Electrical signal → travels through the pathway → reaches cardiac muscle → heart muscle contracts.

MEMORY TIP:
SA → AV → His → Branches → Purkinje → CONTRACTION

FRONT:
What is an action potential in cardiac muscle?

BACK:
Ang action potential ay isang electrical change/signal na nangyayari sa cardiac muscle cells.

Kapag dumating ang appropriate electrical signal, nagkakaroon ng action potential sa cardiac muscle. Ito ang tumutulong para ma-activate ang cells at mag-contract ang heart muscle.

So simple version:

Electrical signal → action potential → cardiac muscle contracts.

SCENARIO:
Isipin mo na may nagsabi sa’yo ng “GO!”

Yung “GO!” ang signal. Kapag narinig mo ito, mag-a-act ka.

Sa cardiac muscle, ang action potential ay bahagi ng process kung saan ang electrical signal ay nagti-trigger ng activity ng cell, na humahantong sa contraction.

MEMORY TIP:
Action potential = electrical signal/change → helps trigger contraction.

FRONT:
What is the complete electrical pathway of the heart?

His → Branches → Purkinje → Contract.

BACK:
Tandaan ang exact order:

SA NODE
↓
AV NODE
↓
BUNDLE OF HIS
↓
RIGHT & LEFT BUNDLE BRANCHES
↓
PURKINJE FIBERS
↓
CARDIAC MUSCLE CONTRACTS

Ang pinaka-importanteng idea: SA node ang nagsisimula, tapos dumadaan ang impulse sa pathway hanggang makarating sa cardiac muscle at ma-trigger ang contraction.

SCENARIO:
Isipin mo na may sunod-sunod na tao sa isang linya.

Person 1: “GO!”
↓
Person 2 receives it
↓
Person 3 receives it
↓
Nahati ang message sa right at left
↓
Kumalat sa mga taong kailangang kumilos
↓
Everyone does the action.

Ganoon mo i-visualize ang heart’s electrical pathway: isang signal na nagsisimula sa SA node at dumadaan step-by-step hanggang ma-activate ang heart muscle.

MEMORY TIP:
SA → AV →

FRONT:
What happens during atrial depolarization?

BACK:
Ang atrial depolarization ay yung part kung saan nagsisimula ang electrical activity ng atria.

Una, ang SA node ang gumagawa ng electrical impulse. Parang ito ang “START” signal ng heart.

Pagkatapos, kumakalat ang signal sa atria, kaya nai-stimulate ang atrial muscle at nagko-contract ang atria.

Ang contraction na ito ay tumutulong para maitulak ang blood mula sa atria papunta sa ventricles.

SCENARIO:
Parang may nag-message sa group chat na “GO!”

Yung SA node ang parang unang nag-send ng “GO!”. Pagkatapos, natanggap ng mga nasa group ang message at gumawa sila ng action.

Ganoon din sa atria:

SA node → electrical signal → atria activated → atria contract.

MEMORY TIP:
SA node starts → atria depolarize → atria contract.

FRONT:
What is the role of the SA node during atrial depolarization?

BACK:
Ang SA node ang nagsisimula ng electrical impulse.

Ito ang tinatawag na natural pacemaker ng heart.

Kapag gumawa ang SA node ng impulse, kumakalat ang electrical signal sa atria. Dahil dito, na-a-activate ang atrial muscle at nagko-contract ang atria.

SCENARIO:
Parang may class leader na nagsabing, “Okay guys, start na!”

Siya ang unang nagbigay ng signal. Pagkatapos, gumalaw ang ibang classmates dahil narinig nila ang signal.

Ganoon ang SA node:

SA node = nagbibigay ng unang “GO” signal.

MEMORY TIP:
SA node = natural pacemaker = START.

FRONT:
What does the Na⁺/K⁺ pump do during this process?

BACK:
Ang Na⁺/K⁺ pump ay isang system sa cell membrane na tumutulong magbalik ng sodium (Na⁺) at potassium (K⁺) sa tamang arrangement pagkatapos ng electrical activity.

Simple version:

Kapag ginagamit ng heart cells ang electrical activity, may pagbabago sa ions sa loob at labas ng cell.

Ang Na⁺/K⁺ pump ay tumutulong na ibalik at panatilihin ang normal ion balance ng cell para maging ready ulit ito sa susunod na electrical activity.

SCENARIO:
Parang pagkatapos mong gamitin ang phone mo nang matagal, kailangan mo itong i-charge para maging ready ulit gamitin.

Hindi ibig sabihin na literal na “charger” ang Na⁺/K⁺ pump. Ang point lang ay may system na tumutulong mag-restore para maging ready ulit ang cell.

MEMORY TIP:
Na⁺/K⁺ pump = helps restore ion balance → cell gets ready again.

RONT:
What happens at the AV node after the atrial impulse?

BACK:
Pagkatapos dumaan ang electrical impulse sa atria, pumupunta ito sa AV node.

May short delay sa AV node.

Ang delay na ito ay important dahil nagbibigay ito ng konting extra time para ma-pump ng atria ang blood papunta sa ventricles bago magsimula ang ventricular contraction.

So:

Atria contract → AV node delay → ventricles get more time to fill.

SCENARIO:
Parang may taong nagsabi ng “Wait lang!” bago ka magsimula.

Halimbawa, may ipapasa kang gamit sa isang tao. Sinabihan ka muna ng, “Wait, kunin ko muna.”

Yung maliit na pause ay nagbibigay ng time para makapag-ready muna yung kabilang side.

Ganoon ang AV node delay: nagbibigay ito ng konting time para matapos muna ng atria ang pag-push ng blood papunta sa ventricles.

MEMORY TIP:
AV node delay = extra time for atria to empty into ventricles.

FRONT:
Why is the AV node delay important?

BACK:
Important ang AV node delay dahil nagbibigay ito ng konting extra time para maitulak ng atria ang blood papunta sa ventricles.

Kung walang enough time, mas mahirap magkaroon ng proper filling ng ventricles bago sila mag-contract.

So ang simple idea:

AV node delay → extra time → atria finish pushing blood → ventricles fill better.

SCENARIO:
Parang kapag nagsasalin ka ng tubig sa baso.

Hindi mo agad aalisin ang lalagyan habang nagsasalin ka pa. Kailangan mong bigyan ng konting time para matapos munang mapuno ang baso.

Ganoon ang idea ng AV node delay: binibigyan muna ng time ang atria para maipasa ang blood sa ventricles.

MEMORY TIP:
AV delay = “Wait muna” → let the ventricles fill.

FRONT:
What is the sequence of atrial depolarization and AV node delay?

BACK:
Ganito ang madaling sequence:

1. SA node starts the impulse.
→ Nagsimula ang electrical signal.

2. Impulse spreads through the atria.
→ Na-activate ang atrial muscle.

3. Atria contract.
→ Napupush ang blood papunta sa ventricles.

4. Impulse reaches the AV node.
→ May short delay.

5. The delay gives the atria time to finish pushing blood into the ventricles.

SCENARIO:
Parang group activity na may “GO” at “WAIT.”

GO! → SA node starts the signal.
Everyone moves → atria become activated and contract.
WAIT muna → AV node delay.
Finish muna → atria finish pushing blood into ventricles.
Then continue → electrical signal continues toward the ventricles.

FRONT:

What happens during Phase 0 – Ventricular Depolarization?

BACK:

Ang Phase 0 ay yung part kung saan biglang nagiging more positive ang loob ng ventricular cardiac cell.

Bakit?

Kasi nag-o-open ang sodium (Na⁺) channels, tapos ang Na⁺ pumapasok sa cell.

Remember:

• Influx = papasok

• So Na⁺ influx = Na⁺ pumapasok sa cell

• Since ang Na⁺ ay positive, habang maraming Na⁺ ang pumapasok, nagiging more positive ang loob ng cell.

• This change from less positive/more negative toward positive is called depolarization.

Basically:

Na⁺ opens → Na⁺ enters → inside becomes more positive → depolarization.

And this electrical change helps activate the ventricular muscle, which leads to contraction.

SCENARIO:

Parang may room ka.

At first, hindi siya positive. Tapos biglang binuksan yung door at maraming positive people ang pumasok.

Syempre, dahil maraming positive na pumasok, magiging more positive yung room.

Ganun yung idea sa cell kapag pumapasok ang Na⁺.

MEMORY TIP:

Phase 0 = Na⁺ IN → Positive → Depolarization

FRONT:

What does “Na⁺ influx” mean?

BACK:

Na⁺ influx simply means sodium ions are moving INTO the cardiac cell.

Yung word na influx, isipin mo lang:

IN = papasok

So:

Na⁺ influx = Na⁺ papasok.

And because Na⁺ is positively charged, pag maraming Na⁺ ang pumasok, mas nagiging positive ang inside ng cell.

SCENARIO:

May friend kang pumasok sa room mo.

Pumasok = IN.

Same idea:

Na⁺ → papasok → INFLUX.

MEMORY TIP:

INflux = IN.

FRONT:

What happens during Phase 1 – Early Rapid Ventricular Repolarization?

BACK:

After Phase 0, hindi naman pwedeng manatiling super positive forever yung cell. Kailangan niyang bumalik toward its normal resting state.

So sa Phase 1, may temporary opening ng potassium (K⁺) channels.

Kapag nag-open ang K⁺ channels:

K⁺ moves OUT of the cell.

This is called efflux.

Remember:

• Influx = IN

• Efflux = OUT

Since K⁺ is positive, kapag positive K⁺ ang lumabas, nababawasan ang positive charge inside the cell.

So the inside starts becoming more negative.

That’s why Phase 1 is called early repolarization.

SCENARIO:

Imagine may room na maraming positive people.

Tapos may ilang positive people na nagsabing:

“Okay, alis muna kami.”

Lumabas sila.

So mas kaunti na yung positive people inside → the room becomes less positive/more negative.

Ganun yung basic idea ng K⁺ leaving the cell.

MEMORY TIP:

Phase 1 = K⁺ OUT → starts becoming negative.

FRONT:

What happens during Phase 2 – Slow Ventricular Repolarization?

BACK:

Ito yung interesting part kasi hindi agad tuloy-tuloy na bumababa yung membrane potential.

During Phase 2, nag-o-open ang calcium (Ca²⁺) channels.

So:

Ca²⁺ enters the cardiac cell.

That’s called calcium influx.

Remember:

Influx = IN

So:

Ca²⁺ influx = calcium goes IN.

Now, bakit siya important?

Kasi ang Ca²⁺ ay positive.

So habang may Ca²⁺ na pumapasok, nakakatulong ito na i-hold muna yung membrane potential, instead na biglang bumaba agad.

That’s why makikita natin yung plateau.

SCENARIO:

Imagine may number ka sa screen na slowly going down.

Pero habang pababa siya, may ginagawa na parang:

“Wait lang, hold muna.”

So hindi siya agad bumababa nang mabilis.

That’s the idea of the plateau—the membrane potential stays relatively steady for a while because of the balance between ion movements, especially Ca²⁺ entering while K⁺ is also leaving.

MEMORY TIP:

Phase 2 = Ca²⁺ IN → PLATEAU → “hold muna.”

FRONT:

What is the plateau in the cardiac action potential?

BACK:

The plateau is the part during Phase 2 where the membrane potential stays relatively stable for a while instead of immediately dropping.

Main reason:

Ca²⁺ enters the cell while K⁺ continues to move out.

So may positive charge coming in through Ca²⁺ while positive charge is also leaving through K⁺.

Because of this balance, the membrane potential stays almost level for a period of time.

This is important because it helps make the cardiac muscle contraction last longer, giving the ventricles enough time to pump blood.

SCENARIO:

Parang may score na dapat bumaba, pero may pumipigil muna kaya:

“Wait, stay muna diyan.”

After a while, saka ulit bumaba.

MEMORY TIP:

Plateau = hindi agad bumababa → Phase 2 → Ca²⁺ IN.

What happens during Phase 3 – Final Rapid Ventricular Repolarization?

BACK:

Now, tapos na yung plateau. The cell needs to go back toward its resting state.

So during Phase 3:

K⁺ channels open, and K⁺ continues to leave the cell.

Since K⁺ is positive:

Positive K⁺ leaves → less positive inside → membrane becomes more negative.

At the same time:

• Ca²⁺ channels close

• Na⁺ channels close

• K⁺ continues moving OUT

This causes the membrane potential to become more negative, bringing the cell back toward its resting state.

That’s why this is called final rapid repolarization.

SCENARIO:

Imagine may room na maraming positive people.

Then:

Na⁺ door = closed
Ca²⁺ door = closed
K⁺ exit = open

So yung positive K⁺ lang ang patuloy na lumalabas.

The more positive people leave → the room becomes more negative.

MEMORY TIP:

Phase 3 = K⁺ OUT → more negative → back toward REST.

FRONT:

What is the easiest sequence to remember for ventricular action potential Phases 0–3?

BACK:

PHASE 0
→ Na⁺ IN
→ becomes more positive
→ DEPOLARIZATION

PHASE 1
→ K⁺ OUT
→ starts becoming more negative
→ EARLY REPOLARIZATION

PHASE 2
→ Ca²⁺ IN
→ creates the PLATEAU
→ “hold muna”

PHASE 3
→ K⁺ OUT
→ becomes more negative
→ FINAL REPOLARIZATION

So literally:

0 = Na IN
1 = K OUT
2 = Ca IN
3 = K OUT

SCENARIO:

Imagine ikaw yung cell:

Phase 0: “PASOK Na⁺!” 😭
Phase 1: “Okay, labas muna K⁺.”
Phase 2: “Wait, Ca²⁺ papasok. HOLD MUNA.”
Phase 3: “Okay, Ca²⁺ and Na⁺ closed. K⁺, labas na lahat.”
→ back toward resting state

FRONT: What is depolarization?

BACK: Depolarization is the electrical activation of the heart muscle cells.

Basically, may electrical signal na nag-a-activate sa cardiac muscle cells. Kapag na-activate sila, this electrical activity helps stimulate the cells to contract.

So simple flow:

Electrical signal → cardiac cells activate → muscle contracts

Important: Depolarization is the electrical event. Yung contraction is the mechanical response ng muscle pagkatapos ma-activate.

SCENARIO: Parang may nagsabi ng “GO!” sa isang group. Pag narinig nila yung signal, saka sila sabay-sabay kikilos. Yung “GO!” signal = depolarization, tapos yung pagkilos = contraction.

MEMORY TIP: Depolarization = electrical activation → contraction.

FRONT: What is repolarization?

BACK: Repolarization means the heart muscle cell is going back toward its original electrical/resting state after being activated.

During the action potential, nagbago ang movement ng ions tulad ng Na⁺, K⁺, at Ca²⁺. During repolarization, the cell gradually returns toward its resting membrane potential.

So:

Depolarization = activated
Repolarization = balik toward resting state

SCENARIO: Parang nagising ka dahil may nag-call sa’yo. After mong sumagot at gumalaw, eventually bumalik ka sa normal mong relaxed state.

MEMORY TIP: Repolarization = balik sa resting state.

FRONT: What is the cardiac cycle?

BACK: The cardiac cycle refers to all the events that happen in the heart during one complete heartbeat.

Kasama dito yung mga nangyayari habang ang heart ay:

• nagfi-fill ng blood

• nagco-contract

• nagpu-pump ng blood

• then nagre-relax ulit

So kapag sinabi nating one cardiac cycle, ibig sabihin one complete heartbeat from one heartbeat to the next.

SCENARIO: Isang buong heartbeat:

Fill → squeeze/pump → relax → fill again

Yung buong sequence na yan = one cardiac cycle.

MEMORY TIP: Cardiac cycle = lahat ng nangyayari sa heart sa isang buong heartbeat.

FRONT: What does the right atrium receive?

BACK: The right atrium receives venous blood from the systemic circulation.

Venous blood = blood na galing na sa iba’t ibang parts ng body at mas mababa na ang oxygen dahil ginamit na ng tissues.

Systemic circulation = blood circulation between the heart and the rest of the body, except the lungs.

So:

Body → right atrium

The right atrium receives blood coming back from the body.

SCENARIO: Imagine nag-deliver ka ng oxygen sa buong bahay. Pagkatapos mong mag-deliver, babalik ka sa starting point. Ganun yung blood: after going around the body, bumabalik siya sa right atrium.

MEMORY TIP: Right atrium = receives blood BACK from the body.

FRONT: What does the left atrium receive?

BACK: The left atrium receives reoxygenated blood from the lungs.

Reoxygenated blood = blood na nakakuha ulit ng oxygen sa lungs.

So the blood flow is:

Lungs → left atrium

After blood gets oxygen from the lungs, babalik ito sa heart and enters the left atrium.

SCENARIO: Parang nagpunta ka sa charging station para mag-recharge. After getting what you need, babalik ka sa next station. The lungs are where the blood gets oxygen, then the blood returns to the left atrium.

MEMORY TIP: Left atrium = receives oxygenated blood FROM THE LUNGS.

FRONT: What is stroke volume (SV)?

BACK: Stroke volume (SV) is the amount/volume of blood ejected by a ventricle during one systole.

Systole = phase kung saan ang ventricle contracts and pushes blood out.

So kapag sinabi:

Stroke volume = 70 mL/beat

Ibig sabihin, around 70 mL of blood is ejected from a ventricle during one heartbeat’s ventricular contraction.

The usual average range given in your notes is 50–100 mL per beat.

SCENARIO: Imagine may bottle ka na may 70 mL na laman, tapos pinisil mo at 70 mL ang nailabas. Sa heart, similar idea: during ventricular contraction, a certain amount of blood gets pushed out.

MEMORY TIP: Stroke volume = blood pumped OUT per beat.

FRONT: What is systole and why is it important for stroke volume?

BACK: Systole is the phase when the ventricles contract.

Kapag nag-contract ang ventricles, may force sila para itulak ang blood palabas ng heart.

Yung amount ng blood na nailabas during that contraction is called the stroke volume (SV).

So:

Ventricular systole → ventricles contract → blood is ejected → stroke volume

SCENARIO: I-close mo yung kamay mo into a fist. Gumagana yung muscles and may force. Sa heart, kapag nag-contract ang ventricular muscle, may force din para ma-push ang blood palabas.

MEMORY TIP: Systole = squeeze → blood goes OUT.

FRONT: What is the average stroke volume?

BACK: Based on your notes, the average stroke volume is around 50–100 mL per beat.

Meaning, during one ventricular contraction, approximately 50–100 mL of blood can be ejected.

Remember na stroke volume is measured per beat, not per minute.

SCENARIO: If the stroke volume is 70 mL/beat, every heartbeat ejects around 70 mL of blood from a ventricle.

MEMORY TIP: SV = 50–100 mL/beat.

FRONT: What are the major factors affecting stroke volume?

BACK: May 3 major factors na kailangan mong tandaan:

1. Preload – gaano karaming blood ang nasa ventricle bago ito mag-contract.

2. Afterload – gaano kahirap itulak palabas ang blood mula sa ventricle.

3. Contractility – gaano kalakas mag-contract ang heart muscle.

Sa notes mo ngayon, focus tayo sa PRELOAD at AFTERLOAD.

MEMORY TIP: Preload = laman bago squeeze. Afterload = resistance habang nagpu-pump.

FRONT: What is preload?

BACK: Preload is the amount of blood inside the ventricle before the ventricle contracts.

Mas specifically, ito yung filling volume ng ventricle at the end of diastole.

Diastole = time na relaxed ang heart at filling up with blood.

So kapag sinabi nating end of diastole, ibig sabihin tapos na yung filling ng ventricle, right before it contracts.

Yung blood na bumabalik sa heart through the veins is called venous return, and this contributes to the amount of blood filling the ventricle.

So madaling flow:

Venous return → blood enters ventricle → ventricle fills → preload → contraction

SCENARIO: Imagine may balloon ka. Before mo siya pisilin, may laman muna siya. Kung mas maraming laman bago mo pisilin, mas full siya.

Sa heart, yung blood inside the ventricle before contraction = preload.

MEMORY TIP: PREload = PRE-SQUEEZE blood volume.

FRONT: What does “filling volume of the ventricle at the end of diastole” mean?

BACK: Ibig sabihin, gaano karaming blood ang nasa ventricle pagkatapos nitong matapos mag-fill, bago siya mag-contract.

Break it down:

Diastole → relaxed ang ventricle → pumapasok ang blood.

End of diastole → tapos na ang filling.

Blood present at that moment → that’s the ventricular filling volume, which relates to preload.

SCENARIO: Parang nagfi-fill ka ng tumbler.

Habang pinupuno mo → diastole.

Pag sinabi mong “Okay, puno na bago ko gamitin” → that’s like the end of diastole.

MEMORY TIP: End of diastole = ventricle is filled BEFORE contraction.

FRONT: What is venous return, and how is it related to preload?

BACK: Venous return means the blood coming back to the heart through the veins.

Kapag mas maraming blood ang bumabalik sa heart, mas maraming blood ang puwedeng pumasok at mag-fill sa ventricle.

So generally:

↑ Venous return → ↑ ventricular filling → ↑ preload

And if venous return decreases:

↓ Venous return → ↓ ventricular filling → ↓ preload

SCENARIO: Imagine may mga taong bumabalik sa isang room.

Kung mas maraming bumalik, mas maraming tao ang nasa room.

Same basic idea:

More blood returning → more blood filling the ventricle.

MEMORY TIP: Venous return = blood coming BACK to the heart.

FRONT: How does body position affect preload?

BACK: Position can change how much blood returns to the heart.

Standing

Kapag nakatayo ka, gravity pulls more blood toward the lower parts of your body, especially the legs.

So less blood returns to the heart.

Standing → ↓ venous return → ↓ preload

Supine

Supine means nakahiga ka flat on your back.

Kapag supine, mas kaunti ang effect ng gravity na nagpo-pool ng blood sa legs, so more blood can return to the heart.

Supine → ↑ venous return → ↑ preload

SCENARIO: Tumayo ka nang matagal. Mas maraming blood ang naiipon toward your legs because of gravity.

Tapos humiga ka. Mas madaling bumalik ang blood toward the heart.

MEMORY TIP:

Standing = ↓ preload
Supine = ↑ preload

FRONT: Why does standing decrease preload?

BACK: Kapag standing, gravity pulls blood toward the lower extremities, especially the legs.

Because some blood stays down there, less blood returns to the heart.

Less venous return means less blood enters the ventricle.

Therefore:

Standing → ↓ venous return → ↓ ventricular filling → ↓ preload

SCENARIO: Tumayo ka nang matagal. Mapapansin mo na yung legs mo yung nasa lowest position. Gravity helps keep more blood down there, so hindi kasing dami ang bumabalik agad sa heart.

MEMORY TIP: Standing → blood down → less return → less preload.

FRONT: Why does the supine position increase preload?

BACK: Supine means nakahiga ka flat on your back.

When you’re supine, gravity has less effect on keeping blood pooled in the lower extremities. So more blood can return to the heart.

More venous return means more blood enters the ventricle.

Therefore:

Supine → ↑ venous return → ↑ ventricular filling → ↑ preload

SCENARIO: Compare:

Standing: blood tends to stay more in the legs.

Lying down: mas madaling bumalik ang blood toward the heart.

MEMORY TIP: Supine = more blood returns → more preload.

FRONT: How does deep inspiration affect preload?

.

BACK: Deep inspiration means humihinga ka nang malalim papasok.

During deep inspiration, the pressure changes inside the chest help increase venous return to the right side of the heart.

So:

Deep inspiration → ↑ venous return → ↑ preload

SCENARIO: Huminga ka nang sobrang lalim:
“Haaaaa—” 🫁

The pressure changes inside your chest help pull more venous blood toward the heart.

MEMORY TIP: Deep inspiration = more venous return = more preload

FRONT: What is the Valsalva maneuver, and what does it do to preload?

BACK: The Valsalva maneuver is when you try to breathe out forcefully while your airway is closed.

Example: parang pinipilit mong mag-exhale pero hindi mo talaga pinapalabas yung hangin.

This increases pressure inside the chest, which can reduce venous return to the heart.

So:

Valsalva → ↓ venous return → ↓ preload

SCENARIO: Parang pinipilit mong mag-push while holding your breath.

Because the pressure inside your chest increases, less blood returns to the heart temporarily.

MEMORY TIP: Valsalva = ↓ venous return → ↓ preload.

FRONT: What is afterload?

BACK: Afterload is the resistance or pressure that the ventricle has to overcome to push blood out.

For the left ventricle, one major resistance comes from the pressure in the aorta.

Think about it this way:

The left ventricle wants to push blood into the aorta.

But the aorta already has blood and pressure inside it.

So the left ventricle needs to generate enough pressure to overcome that pressure before blood can be ejected effectively.

That’s why:

Afterload = resistance the ventricle pumps against.

SCENARIO: Imagine you’re trying to push a door open.

If the door is easy to push → little resistance.

If the door is very hard to push → you need to use more force.

Same basic idea with the heart:

More resistance → heart needs more force to eject blood.

MEMORY TIP: Afterload = resistance AGAINST the ventricle.

FRONT: What happens to afterload when blood pressure increases?

BACK: If blood pressure (BP) increases, especially the pressure in the aorta, the left ventricle has to work against greater pressure to push blood into the aorta.

So:

↑ BP → ↑ afterload

The heart has to generate more pressure/force to eject blood.

SCENARIO: Imagine pushing a door.

Normal door resistance:
“Push lang.”

Very heavy/stuck door:
“Kailangan kong gumamit ng mas malaking force.”

Same idea: higher pressure = harder for the left ventricle to push blood out.

MEMORY TIP: High BP = high afterload.

FRONT: How does hypertension affect afterload?

BACK: Hypertension means high blood pressure.

Kapag mataas ang blood pressure, mataas din ang pressure na kailangang lampasan ng left ventricle para maitulak ang blood into the aorta.

Therefore:

Hypertension → ↑ afterload → heart works harder to eject blood.

Kung matagal na mataas ang resistance na nilalabanan ng heart, the left ventricle has to keep working harder.

MEMORY TIP: Hypertension = high pressure → high afterload.

FRONT: How does atherosclerosis of the aorta affect afterload?

BACK: Atherosclerosis means may fatty/cholesterol-containing plaque buildup sa wall ng artery.

Kapag may plaque buildup sa aorta, puwedeng maging mas narrow at less flexible ang blood vessel.

This can increase the resistance against which the left ventricle has to pump.

So:

Atherosclerosis → increased resistance → ↑ afterload

SCENARIO: Imagine may pathway na dati maluwag, pero nagkaroon ng buildup sa loob kaya mas naging mahirap daanan.

Hindi ibig sabihin na completely blocked agad ang artery. Ang point lang: mas may resistance sa blood flow.

MEMORY TIP: Atherosclerosis → narrower/stiffer vessel → more resistance → ↑ afterload.

FRONT: What is the easiest way to differentiate preload and afterload?

BACK:

PRELOAD

“How much blood is there BEFORE the squeeze?”

→ Blood filling the ventricle
→ End of diastole
→ Related to venous return

AFTERLOAD

“How hard is it to push the blood OUT?”

→ Resistance against ventricular ejection
→ Related to aortic pressure/BP

Super simple:

PREload = BEFORE contraction → laman muna

AFTERload = resistance AGAINST contraction → gaano kahirap ilabas

SCENARIO:

Imagine may balloon ka.

PRELOAD: Gaano karaming hangin ang nasa balloon before mo pisilin?

AFTERLOAD: Gaano kahirap para mailabas yung laman kapag pinisil mo?

MEMORY TIP:

PRE = laman BEFORE squeeze
AFTER = resistance AGAINST squeeze

FRONT:
What is contractility?

BACK:
Contractility is the strength of the heart muscle fibers during systole, meaning kung gaano kalakas mag-contract ang heart muscle kapag pinupush nito palabas ang blood.

Ang myocardial fibers ay basically muscle fibers/cells ng heart. Kapag mas malakas ang contraction, mas malakas din ang force na ginagamit ng heart para i-eject ang blood.

Kaya kapag increased ang contractility, mas maraming blood ang nailalabas during systole, so tumataas ang stroke volume. Kapag decreased ang contractility, mas mahina ang contraction, so bumababa ang stroke volume.

SCENARIO:
I-close mo yung kamay mo into a fist. Kapag mahina lang yung pagpisil mo, maliit lang yung force. Pero kapag malakas mong pinisil, mas malaking force yung nagawa ng muscles. Ganun din sa heart: mas malakas na contraction → mas maraming blood ang nai-eject.

MEMORY TIP:
Contractility = strength of the heart’s squeeze.

FRONT:
What happens to stroke volume when contractility increases or decreases?

BACK:
Kapag tumataas ang contractility, mas malakas ang contraction ng heart muscle, kaya mas maraming blood ang nai-eject during systole. Therefore, stroke volume increases.

Kapag bumababa ang contractility, mas mahina ang contraction ng heart muscle, kaya mas kaunting blood ang nai-eject. Therefore, stroke volume decreases.

So remember:

↑ Contractility → ↑ Stroke Volume

↓ Contractility → ↓ Stroke Volume

SCENARIO:
Parang pinipiga mo yung sponge. Kapag malakas ang squeeze, mas maraming tubig ang lalabas. Kapag mahina ang squeeze, mas kaunting tubig ang lalabas. Same basic idea sa heart and blood.

MEMORY TIP:
Stronger squeeze → more blood out → ↑ SV.

FRONT:
What is the Frank-Starling Law?

.

BACK:
The Frank-Starling Law says, “The greater the stretch, the greater the force of the next contraction.”

Meaning, kapag mas maraming blood ang pumasok sa ventricle, mas nai-stretch ang heart muscle fibers. That stretch helps the heart produce a stronger contraction on the next beat.

So the basic flow is:

More blood enters → more stretch → stronger contraction → more blood ejected.

This is one reason why the amount of blood entering the heart can affect the amount of blood it pumps out.

SCENARIO:
Imagine may rubber band ka. Kapag hinila mo nang appropriate amount, may force itong gustong bumalik. Sa heart, kapag mas napuno ang ventricle, mas nai-stretch ang muscle fibers, which helps produce a stronger next contraction.

MEMORY TIP:
More filling → more stretch → stronger squeeze

FRONT:
What are the factors that affect heart rate?

.

BACK:
Heart rate means kung ilang beses tumitibok ang heart in one minute.

According to your notes, the factors that can affect heart rate are:

1. Sympathetic Nervous System – generally makes the heart beat faster.

2. Parasympathetic Nervous System – generally slows the heart down, especially during rest.

3. Thyroid hormones – can increase the body’s activity and make the heart beat faster.

4. Temperature – changes in body temperature can affect heart rate; higher temperature generally increases heart rate.

5. Exercise – during exercise, the body needs more oxygen and nutrients, so the heart usually beats faster to deliver more blood.

SCENARIO:
Kapag nakahiga ka lang and relaxed, usually mas calm and slower ang heartbeat. Pero kapag tumakbo ka or nag-exercise, kailangan ng muscles mo ng mas maraming oxygen, kaya bumibilis ang heartbeat para mas maraming blood ang ma-deliver.

MEMORY TIP:
SNS, PNS, thyroid, temperature, exercise → can change HR

FRONT:
What is the Sympathetic Nervous System and how does it affect heart rate?

BACK:
The Sympathetic Nervous System (SNS) is part of the nervous system that prepares the body for action or stress.

When sympathetic activity increases, the heart is generally stimulated to beat faster and contract more strongly.

So:

↑ Sympathetic activity → ↑ Heart Rate

SCENARIO:
Imagine biglang may nagsabi sa’yo, “Bilisan mo! May exam na!” 😭 Biglang kinakabahan ka and your body goes into action mode. One response can be a faster heartbeat.

MEMORY TIP:
Sympathetic = speed up.

FRONT:
What is the Parasympathetic Nervous System and how does it affect heart rate?

BACK:
The Parasympathetic Nervous System (PNS) helps the body stay in a more resting and relaxed state.

When parasympathetic activity increases, it generally slows down the heart rate.

So:

↑ Parasympathetic activity → ↓ Heart Rate

SCENARIO:
After a stressful activity, umupo ka na, relaxed ka na, and wala ka nang ginagawa. Your body is shifting back toward a resting state, so your heartbeat can become slower.

MEMORY TIP:
Parasympathetic = slow down.

FRONT:
How can thyroid hormones affect heart rate?

BACK:
Thyroid hormones help regulate the body’s metabolism, or kung gaano ka-active ang processes ng body.

They can also make the heart more responsive to sympathetic stimulation. Because of this, increased thyroid hormone activity can contribute to a faster heart rate.

So generally:

More thyroid hormone effect → faster HR

SCENARIO:
Imagine your body is running on a faster setting. Mas active ang body processes, and the heart can also beat faster to keep up with the body’s needs.

MEMORY TIP:
Thyroid hormones → can increase HR.

FRONT:
How does temperature affect heart rate?

BACK:
Temperature can affect how fast the heart beats.

In general, when body temperature increases, heart rate can also increase. Kapag bumababa naman ang temperature, many body processes slow down, which can also affect heart rate.

SCENARIO:
Kapag may fever ka, one thing that can happen is mas mabilis ang heartbeat compared with your normal resting heart rate.

MEMORY TIP:
Higher temperature → generally faster HR.

FRONT:
How does exercise affect heart rate?

BACK:
During exercise, your muscles are working harder, so they need more oxygen and nutrients and produce more metabolic waste.

To meet the increased demand, the heart usually beats faster, allowing more blood to circulate to the working muscles.

FRONT:
What is Mean Arterial Pressure (MAP)?

BACK:
Mean Arterial Pressure (MAP) is the average pressure in the arteries during one complete cardiac cycle, or basically the average pressure that helps push blood through the body’s tissues.

The formula from your notes is:

MAP = SP + 2DP / 3

More clearly written:

MAP = (SP + 2DP) ÷ 3

Where:

SP = Systolic Pressure
DP = Diastolic Pressure

We multiply the diastolic pressure by 2 because the heart spends more time in diastole than in systole during a normal cardiac cycle.

For example, if BP is 120/80 mmHg:

MAP = (120 + 2[80]) ÷ 3

MAP = 280 ÷ 3 ≈ 93 mmHg

So the MAP is approximately 93 mmHg.

SCENARIO:
Imagine you’re checking someone’s BP and you get 120/80. Instead of simply taking the normal average of 120 and 80, we give more weight to the diastolic value because the heart spends more time in diastole.

MEMORY TIP:
MAP = (SP + 2DP) ÷ 3.

FRONT:
What is blood pressure (BP)?

BACK:
Blood pressure is the pressure or tension exerted by blood against the walls of the arteries as blood flows through them.

Basically, habang dumadaloy ang blood inside the arteries, it pushes against the artery walls. That pressure is what we measure as blood pressure.

For example, in 120/80 mmHg:

120 = systolic pressure, the pressure when the ventricles contract and eject blood.

80 = diastolic pressure, the pressure when the heart is relaxed between contractions.

SCENARIO:
Imagine may tubig na dumadaloy inside a hose. The moving water creates pressure against the walls of the hose. Similar idea sa blood: blood flowing through the arteries creates pressure against their walls.

MEMORY TIP:
BP = pressure of blood against artery walls.

What is the relationship between Blood Pressure, Cardiac Output, and Total Peripheral Resistance?

BACK:
According to your notes:

BP = CO × TPR

or

BP = CO × SVR

Where:

BP = Blood Pressure
CO = Cardiac Output
TPR = Total Peripheral Resistance
SVR = Systemic Vascular Resistance

Total Peripheral Resistance means the overall resistance that blood has to move against while flowing through the systemic blood vessels.

So generally, kapag mas maraming blood ang napo-pump ng heart per minute, blood pressure can increase. And kapag mas mataas ang resistance sa blood vessels, blood pressure can also increase.

SCENARIO:
Imagine may maraming tao na dumadaan sa isang hallway.

Kung mas maraming tao ang pinapadaan mo at the same time, mas busy yung hallway. If the hallway is also tighter or harder to pass through, mas mataas ang resistance sa movement.

Same basic idea: cardiac output and vascular resistance both affect blood pressure.

FRONT:
What is Cardiac Output (CO)?

BACK:
Cardiac Output (CO) is the amount of blood ejected by the heart in one minute.

Important yung “one minute” because cardiac output is not just about one heartbeat. It tells us the total amount of blood pumped by the heart in 1 minute.

The formula is:

CO = SV × HR

Where:

SV (Stroke Volume) = amount of blood ejected per beat

HR (Heart Rate) = number of beats per minute

So if you know how much blood comes out each beat and how many times the heart beats in one minute, you can calculate the total blood pumped per minute.

SCENARIO:
Imagine every time you squeeze something, 70 mL comes out. If you squeeze it 70 times in one minute, then the total amount that came out during that minute is:

70 mL × 70 beats = 4,900 mL/min

That’s the basic idea behind cardiac output.

MEMORY TIP:
CO = total blood pumped in 1 minute.

FRONT:
What is the difference between Stroke Volume (SV) and Cardiac Output (CO)?

BACK:
Stroke Volume (SV) is the amount of blood ejected during one heartbeat.

Cardiac Output (CO) is the total amount of blood ejected in one minute.

That’s why we use:

CO = SV × HR

For example:

SV = 70 mL/beat
HR = 70 beats/min

Therefore:

CO = 70 × 70 = 4,900 mL/min

So the heart is ejecting approximately 4.9 liters of blood per minute in this example.

SCENARIO:
Think of it like this:

SV: “How much comes out every time?”

CO: “How much came out altogether in one minute?”

MEMORY TIP:
SV = per beat.
CO = per minute.

FRONT:
What is Systemic Vascular Resistance (SVR)?

BACK:
Systemic Vascular Resistance (SVR) is the resistance that blood has to overcome as it flows through the systemic blood vessels.

Basically, iniisip natin kung gaano kahirap para sa blood na dumaloy through the blood vessels.

Kapag nagkaroon ng vasoconstriction, meaning sumisikip ang blood vessels, tumataas ang resistance sa blood flow.

So:

Vasoconstriction → narrower vessels → ↑ SVR

Kapag naman mas relaxed at mas open ang blood vessels, mas mababa ang resistance.

SCENARIO:
Imagine may hallway na dinadaanan ng maraming tao.

Kapag maluwag yung hallway, madaling dumaan → low resistance.

Kapag masikip yung hallway, mas mahirap dumaan → high resistance.

Ganun yung basic idea ng SVR sa blood vessels.

MEMORY TIP:
SVR = resistance sa blood vessels.
Vasoconstriction = ↑ SVR

FRONT:
What happens when SVR increases?

BACK:
Kapag tumataas ang SVR, ibig sabihin mas mataas ang resistance na nilalabanan ng blood habang dumadaloy sa systemic blood vessels.

Dahil mas mataas ang resistance, mas kailangan ng left ventricle na mag-work harder para ma-pump ang blood through the circulation.

Because the heart is working harder, tumataas din ang myocardial oxygen consumption, meaning mas maraming oxygen ang kailangan ng heart muscle para magawa yung increased work.

So:

↑ SVR → ↑ workload ng heart → ↑ myocardial oxygen consumption

SCENARIO:
Imagine ikaw yung nagtutulak ng isang box.

Kung smooth yung floor, madali lang.

Pero kung mas mahirap itulak yung box, kailangan mong gumamit ng mas maraming force and you get tired faster.

Ganun ang basic idea: higher resistance → heart works harder.

MEMORY TIP:
↑ SVR = heart works harder + needs more oxygen.

FRONT:
What happens when SVR decreases?

BACK:
Kapag bumababa ang SVR, ibig sabihin mas kaunti ang resistance sa blood flow.

Mas madaling dumaloy ang blood through the systemic blood vessels.

According to your notes, when SVR decreases, cardiac output (CO) increases in an attempt to maintain blood pressure.

Remember:

BP = CO × SVR

So kapag bumaba ang SVR, puwedeng bumaba ang BP. The body can respond by increasing cardiac output, helping maintain blood pressure.

SCENARIO:
Imagine may hallway na biglang naging mas maluwag. Mas madaling dumaan ang mga tao, so mas maraming tao ang makakapag-pass through.

Sa body, kapag mas mababa ang resistance, the circulation can respond by increasing cardiac output to help keep the blood pressure maintained.

MEMORY TIP:
↓ SVR → body can increase CO → helps maintain BP.

FRONT:
What is vasoconstriction, and how does it affect SVR?

BACK:
Vasoconstriction means sumisikip ang blood vessels.

Kapag sumikip ang blood vessel, mas maliit ang space na pagdadaanan ng blood, so mas mataas ang resistance against blood flow.

Therefore:

Vasoconstriction → ↑ SVR

And because the heart is pumping against greater resistance, the workload of the heart increases.

SCENARIO:
Imagine may doorway na dati maluwag enough para dumaan ka easily. Tapos biglang naging masikip yung doorway.

Mas mahirap dumaan, right?

Same basic idea: narrower blood vessels → more resistance.

MEMORY TIP:
Vasoconstriction = vessel gets narrow → ↑ SVR.

FRONT:
What is Left Ventricular End-Systolic Volume (LVESV)?

BACK:
LVESV means the amount of blood that remains inside the left ventricle at the end of systole.

Break it down:

Left ventricular = left ventricle.

End-systolic = after the ventricle has finished contracting/ejecting blood.

Volume = amount of blood.

So LVESV is basically:

“How much blood is LEFT inside the left ventricle after it finishes squeezing?”

Hindi naman lahat ng blood sa ventricle ay normally nailalabas during one contraction. Yung blood na naiwan after systole is the LVESV.

SCENARIO:
Imagine may bottle na may laman, tapos pinisil mo para maglabas ng tubig.

After mong pisilin, may konting tubig na naiwan sa bottle.

That remaining amount is like the idea of LVESV.

MEMORY TIP:
LVESV = blood LEFT after systole.

FRONT:
What does “end-systolic” mean in LVESV?

BACK:
End-systolic means katatapos lang ng ventricular contraction.

During systole, the left ventricle contracts and ejects blood into the aorta.

Pagkatapos ng contraction, may blood na maaaring manatili inside the ventricle.

That remaining blood is measured as the Left Ventricular End-Systolic Volume (LVESV).

So:

Systole → ventricle contracts → blood is ejected → whatever remains = LVESV

SCENARIO:
Parang may juice ka sa bottle. Pinisil mo yung bottle para may lumabas. After mong bitawan, may konting juice na naiwan.

MEMORY TIP:
End-systolic = AFTER the squeeze.

FRONT:
What is Left Ventricular End-Diastolic Volume (LVEDV)?

BACK:
LVEDV means the amount of blood inside the left ventricle just before ventricular ejection occurs.

Basically, ito yung blood volume na nasa left ventricle after it has filled and right before it contracts/ejects blood.

Break it down:

Left ventricular = left ventricle.

End-diastolic = katatapos lang ng filling/diastole.

Volume = amount of blood.

So:

LVEDV = blood inside the left ventricle BEFORE it ejects blood.

This is closely related to preload, because preload refers to the amount of blood filling the ventricle before contraction.

SCENARIO:
Imagine may bottle ka na pinupuno ng water.

Habang pinupuno mo → diastole.

Pag puno na at ready mo nang pisilin → that’s like the end-diastolic point.

Yung amount of blood inside the ventricle at that moment = LVEDV.

MEMORY TIP:
LVEDV = blood IN before the squeeze.

FRONT:
What is the difference between LVEDV and LVESV?

BACK:
The easiest way to remember them is to focus on BEFORE vs AFTER the ventricular contraction.

LVEDV = amount of blood in the left ventricle at the end of diastole, BEFORE ejection.

LVESV = amount of blood left in the left ventricle at the end of systole, AFTER ejection.

So:

LVEDV = blood BEFORE the squeeze

LVESV = blood LEFT AFTER the squeeze

And the difference between these two is related to stroke volume:

SV = LVEDV − LVESV

Meaning, kung halimbawa may 120 mL before contraction and 50 mL remains after contraction:

SV = 120 − 50 = 70 mL

So 70 mL ang na-eject during that contraction.

SCENARIO:
Imagine may bottle kang may 120 mL before mo pisilin.

After mong pisilin, 50 mL ang naiwan.

So:

120 mL → before squeeze (LVEDV)
50 mL → left after squeeze (LVESV)
70 mL → nailabas (Stroke Volume)

MEMORY TIP:
EDV = End of Diastole = BEFORE squeeze.
ESV = End of Systole = AFTER squeeze.
SV = EDV − ESV.

FRONT:
What is hemodynamics?

BACK:
Hemodynamics is the study of how blood moves through the cardiovascular system and the different factors that affect that movement.

Basically, tinitingnan natin kung paano dumadaloy ang blood, gaano ang pressure, at paano gumagana ang heart and blood vessels para ma-deliver nang maayos ang blood sa buong body.

Kasama dito kung paano naaapektuhan ng heart function, blood pressure, and blood flow ang cardiac performance and cardiac output.

SCENARIO:
Imagine may delivery service sa buong body. Yung heart ang nagpu-push ng delivery, yung blood vessels ang daanan, at yung blood ang delivery. Hemodynamics is basically understanding kung okay ba ang delivery system and kung maayos bang nakakarating ang blood sa body.

MEMORY TIP:
Hemodynamics = how blood moves + pressure + heart performance.

FRONT:
What are the physiologic principles of hemodynamics?

BACK:
According to your notes, hemodynamics focuses on three important things:

1. Factors that affect myocardial function
Tinitingnan kung ano ang mga bagay na nakakaapekto sa myocardial function, or kung paano gumagana ang heart muscle.

2. Regulation of blood pressure
Tinitingnan kung paano kino-control at napapanatili ang blood pressure.

3. Cardiac performance and cardiac output
Tinitingnan kung gaano kahusay mag-perform ang heart at kung gaano karaming blood ang nai-eject ng heart per minute.

So basically, hemodynamics helps us understand:

How the heart works → how blood pressure is maintained → how blood is pumped around the body.

SCENARIO:
Parang chine-check mo ang performance ng isang delivery system:
Okay ba yung machine? → okay ba yung pressure? → sapat ba yung deliveries na nakakarating?

MEMORY TIP:
Hemodynamics = heart function + BP + cardiac output.

FRONT:
What is hemodynamic monitoring?

BACK:
Hemodynamic monitoring is the process of measuring pressures and other important information from the cardiovascular and circulatory system.

Basically, ginagamit ito para malaman kung kumusta ang heart and circulation ng patient.

Tinitingnan natin ang pressures within the cardiovascular system to help determine kung sapat ba ang blood flow and perfusion.

Perfusion means kung sapat ang blood and oxygen na nakakarating sa tissues and organs.

So kapag nag-hemodynamic monitoring tayo, hindi lang tayo basta kumukuha ng numbers. Ginagamit natin yung measurements para malaman kung okay ba ang circulation ng patient and kung kailangan bang baguhin ang treatment.

SCENARIO:
Parang may dashboard ka sa isang car. Hindi mo kailangang hulaan kung okay ang car—may numbers and indicators kang chine-check.

Same idea: hemodynamic monitoring gives healthcare providers measurements that help them understand how the cardiovascular system is doing.

MEMORY TIP:
Hemodynamic monitoring = measure cardiovascular pressures → assess circulation.

FRONT:
What are the goals of hemodynamic monitoring?

BACK:
The main goals are:

1. Ensure adequate perfusion
Gusto nating siguraduhin na sapat ang blood flow papunta sa tissues and organs.

2. Detect inadequate perfusion
Gusto nating ma-detect kung hindi sapat ang blood flow papunta sa tissues.

3. Titrate therapy to a specific endpoint
Titrating therapy means ina-adjust ang treatment step-by-step based on the patient’s measurements until maabot yung desired or target result.

4. Qualify the severity of illness
Ginagamit ang information para makatulong malaman kung gaano kalala ang condition ng patient.

5. Differentiate system dysfunction
Tinutulungan tayo nitong malaman kung aling part ng cardiovascular/circulatory system ang hindi gumagana nang maayos.

SCENARIO:
Imagine may patient na hindi okay ang circulation.

Instead na hulaan lang kung ano ang problem, gumagamit ang healthcare team ng measurements para malaman:

“Sapat ba ang blood flow?” → “May problem ba?” → “Gaano kalala?” → “Anong treatment ang kailangan?” → “Effective ba yung treatment?”

MEMORY TIP:
Ensure → Detect → Titrate → Qualify → Differentiate.

FRONT:
What does adequate perfusion mean in hemodynamic monitoring?

BACK:
Adequate perfusion means sapat ang blood flow na nakakarating sa tissues and organs, including enough oxygen and nutrients to support their normal function.

The heart needs to pump enough blood, and the circulation needs to deliver that blood properly.

So kapag adequate ang perfusion, nakakatanggap ang tissues ng enough blood and oxygen para gumana nang maayos.

SCENARIO:
Imagine may delivery rider na kailangang mag-deliver ng supplies sa iba’t ibang houses.

Kung lahat ng houses ay nakakakuha ng enough supplies, adequate ang delivery.

Same basic idea sa body: adequate perfusion = enough blood and oxygen reaches the tissues.

MEMORY TIP:
Adequate perfusion = enough blood + oxygen reaches tissues.

FRONT:
What does inadequate perfusion mean?

BACK:
Inadequate perfusion means hindi sapat ang blood flow na nakakarating sa tissues and organs.

Kapag hindi sapat ang blood flow, maaaring hindi makakuha ang tissues ng enough oxygen and nutrients para gumana normally.

That’s why one goal of hemodynamic monitoring is to detect inadequate perfusion early.

SCENARIO:
Parang may delivery na dapat dumating pero kulang or hindi enough yung supplies na nakarating sa bahay.

Sa body, kapag kulang ang blood flow, kulang din ang oxygen and nutrients na nakakarating sa tissues.

MEMORY TIP:
Inadequate perfusion = not enough blood/oxygen reaching tissues.

FRONT:
What does titrating therapy to a specific endpoint mean?

BACK:
Titrating therapy means gradually adjusting the treatment based on the patient’s response and measurements.

Hindi ibig sabihin na isang fixed amount lang ng treatment ang ibibigay at hindi na babaguhin.

Instead, chine-check ang patient’s hemodynamic measurements, then ina-adjust ang therapy hanggang maabot ang specific target or desired result.

SCENARIO:
Parang ina-adjust mo yung volume ng electric fan. Hindi mo agad alam kung anong exact setting ang comfortable, so you adjust it until sakto na yung airflow na kailangan mo.

Sa patient, treatment is adjusted based on measurements and response.

MEMORY TIP:
Titrate = adjust treatment until target is reached.

FRONT:
What does qualifying the severity of illness mean?

BACK:
It means using hemodynamic information to help determine kung gaano kalala ang condition ng patient.

The measurements can give healthcare providers more information about how well the cardiovascular and circulatory systems are functioning.

So hindi lang natin tinatanong na “May problem ba?”

We also want to understand:

“Gaano kalala yung problem?”

SCENARIO:
Parang may exam score ka. Hindi lang natin alam na “may mali.” Tinitingnan din natin kung 1 mistake lang ba or 30 mistakes para malaman kung gaano kalaki ang problem.

MEMORY TIP:
Qualify severity = malaman kung gaano kalala.

What does differentiating system dysfunction mean?

BACK:
This means using hemodynamic information to help determine kung anong part ng cardiovascular or circulatory system ang may problem.

For example, maaaring may problem related to the heart’s pumping function, blood pressure, or vascular resistance.

The goal is to use the available measurements to help identify where the dysfunction is coming from.

SCENARIO:
Parang may phone na hindi gumagana properly. Instead na sabihin lang na “sira yung phone,” chine-check mo kung battery ba, charger ba, or screen ba ang problem.

Same idea: hemodynamic monitoring helps identify what part of the system may be dysfunctional.

MEMORY TIP:
Differentiate = alamin kung saan nanggagaling ang problem.

FRONT:
What are the things that can be monitored in hemodynamic monitoring?

BACK:
According to your notes, the important measurements include:

1. Direct Blood Pressure Monitoring
Directly measuring blood pressure using an invasive monitoring method.

2. CVP monitoring
CVP = Central Venous Pressure. It measures the pressure in the central venous system, commonly used to assess pressure on the right side of the heart and information related to venous return.

3. Indirect measurement of left ventricular pressure
This can be done using devices such as a pulmonary artery catheter, also called a Swan-Ganz catheter.

The purpose of these measurements is to get more detailed information about cardiovascular pressures and heart function.

MEMORY TIP:
Monitor BP → CVP → pressures related to the left side/ventricular function.

FRONT:
What is direct blood pressure monitoring?

BACK:
Direct BP monitoring means measuring blood pressure directly from within the arterial system, usually through an invasive arterial catheter connected to a pressure-monitoring system.

Instead of using a cuff outside the body, the system directly measures the pressure inside the artery.

This can provide continuous blood pressure information, which is useful when very close monitoring is needed.

SCENARIO:
Normal BP measurement is like checking your temperature using a thermometer every now and then.

Direct BP monitoring is more like having a monitor that continuously shows the pressure in real time.

MEMORY TIP:
Direct BP = pressure measured directly inside the artery.

FRONT:
What is CVP monitoring?

BACK:
CVP stands for Central Venous Pressure.

It measures the pressure in the central venous system, close to the right side of the heart.

CVP can provide information about venous return and right-sided cardiac filling.

Basically, it helps healthcare providers understand how much pressure is present in the central veins and how the right side of the heart is handling incoming blood.

SCENARIO:
Imagine may blood na bumabalik sa heart through the veins. CVP gives us a measurement that helps us understand what’s happening around the central venous side near the heart.

MEMORY TIP:
CVP = Central Venous Pressure → right side/incoming blood side.

RONT:
What is a pulmonary artery catheter or Swan-Ganz catheter?

BACK:
A pulmonary artery catheter, commonly called a Swan-Ganz catheter, is a special catheter used for advanced hemodynamic monitoring.

It is inserted through a large vein and advanced through the right side of the heart into the pulmonary artery.

It can measure important cardiovascular pressures and provide information about cardiac function and circulation.

Your notes mention it as a way to obtain indirect information about left ventricular pressure/function, because some left-sided pressures can be estimated from pressures measured in the pulmonary circulation.

SCENARIO:
Parang may technician na gustong malaman kung ano ang nangyayari sa isang part ng system na hindi niya directly nakikita. Instead, gumagamit siya ng measurements from another connected part to get useful information about it.

MEMORY TIP:
Swan-Ganz = advanced hemodynamic monitoring through the pulmonary artery.

FRONT:
What are the types of hemodynamic monitoring?

BACK:
There are 4 main types of hemodynamic monitoring in your notes:

1. Non-invasive hemodynamic monitoring – walang kailangang ipasok sa loob ng body.

2. Minimally invasive hemodynamic monitoring – may limited vascular access, meaning may maliit na access sa blood vessel, pero hindi umaabot sa pulmonary artery.

3. Invasive hemodynamic monitoring – gumagamit ng catheter na pumapasok sa cardiovascular system para makakuha ng mas detailed na measurements.

4. Advanced/Adjunct hemodynamic monitoring – gumagamit ng advanced imaging para makita at ma-assess nang mas detailed ang cardiac hemodynamics.

The main difference is basically kung gaano ka-invasive yung method and kung gaano ka-detailed ang information na nakukuha.

SCENARIO:
Parang may problem ka sa isang machine.

First, puwede mo siyang tingnan from the outside.

If you need more information, puwede kang gumamit ng small access point.

If you need very detailed measurements, you may need to directly measure inside the system.

Then, for very advanced assessment, you can use special imaging.

MEMORY TIP:
Non-invasive → Minimally invasive → Invasive → Advanced/Adjunct.

FRONT:
What is non-invasive hemodynamic monitoring?

BACK:
Non-invasive hemodynamic monitoring means we can assess the cardiovascular system without inserting a catheter or instrument into the body.

Basically, nasa outside lang ang equipment or method na ginagamit, pero nakakakuha pa rin tayo ng useful information about the heart and circulation.

Examples include:

• Blood Pressure Monitoring (NIBP)

• Electrocardiography (ECG)

• Echocardiography

• Doppler Ultrasound

SCENARIO:
Parang gusto mong malaman kung okay ang isang machine pero hindi mo muna bubuksan or papasukan. Gagamit ka muna ng tools na makikita or makakasukat from the outside.

MEMORY TIP:
Non-invasive = no entry into the body.

FRONT:
What is minimally invasive hemodynamic monitoring?

BACK:
Minimally invasive hemodynamic monitoring means the method requires some limited access to the vascular system, pero hindi ito umaabot sa level ng pulmonary artery catheterization.

So may instrument or catheter na involved, pero mas limited ang invasion compared with fully invasive monitoring.

Examples in your notes are:

• Arterial Line Monitoring

• Central Venous Pressure (CVP) Monitoring

• Esophageal Doppler Monitoring

SCENARIO:
Parang kailangan mong magkaroon ng small access point para makakuha ng mas detailed information, pero hindi mo kailangang pumunta all the way inside the system.

MEMORY TIP:
Minimally invasive = may limited access, but no pulmonary artery catheter.

FRONT:
What is Arterial Line Monitoring (IBP)?

BACK:
Arterial Line Monitoring, also called Invasive Blood Pressure (IBP) monitoring, uses an arterial catheter placed inside an artery.

Because the catheter is directly inside the artery, it can provide continuous measurement of arterial blood pressure.

Unlike NIBP, na kinukuha lang periodically using a cuff, an arterial line can continuously show the patient’s arterial pressure.

So:

NIBP = cuff outside

IBP/Arterial line = catheter inside artery

SCENARIO:
Normal BP cuff is like checking your BP every few minutes.

An arterial line is more like having a system that continuously watches the pressure and sends the information to a monitor.

MEMORY TIP:
Arterial line = catheter in artery → continuous BP.