Cardiovascular Flashcards
The pulmonary circuit goes from the ______________ ventricle to the _____________ atrium.
Right
Left
The systemic circuit can be described as going from the ___________ ventricle to the __________
atrium
Left
Right
2 functions of the fibrous connective tissue valves between the chambers and major arteries
- Preventing backward flow
2. Acts as electrical insulator
What is the significance of the heart valves blocking most of the electrical signals between the atria and ventricles
This ensures the electrical signals can be directed through a specialized conduction system to the apex of heart for bottom to top contraction.
The special connections between cardiomyocytes are called
Intercalated disks
What 2 functional features does the intercalated disks contain
- Gap Junctions
2. Desmosomes
What are 2 functions provided by gap junctions and desmosomes
- Gap junctions allow electrical signals to pass rapidly from cell to cell
- Desmosomes transfer force from cell to cell
How are 1% of myocardiocytes specialized
They generate action potential spontaneously
Define myogenic
This means it or originates within the heart muscle itself. This allows the heart to contract without connections to other parts of the body.
Where does the action potential originate in the heart
Pacemakers cells
How does the action potential spread into the contractile cells
Gap junctions
The rapidly rising phase of the contractile cell action potential is based on what 2 ions
Ca++
Na+
L type calcium channels on the membrane of the cardiac contractile cells are what type
Voltage gated
The influx of calcium releases the calcium from the SR by activating what channels
Ryanodine receptor calcium release channels (RyR)
What percentage of calcium is released from the SR that is needed for muscle contraction
90%
The strength of cardiac contraction depends on what 2 things
- Sarcomere length at the beginning of contraction
2. The amount if calcium released into the cell
How do calcium and the amount of active crossbridges play a role in the force a muscle generates
The force generated by cardiac muscle is proportional to the number of cross bridges that are active. The more calcium that goes into the cell, the more calcium that is released from the SR, and the more calcium that binds to troponin, enhancing the ability of myosin to form crossbridges with actin and creating additional force.
In cardiac muscle, what happens when cytoplasmic calcium concentrations decrease
Calcium unbinds from troponin which leads to myosin to release actin, this causes contractile filaments to slide back and muscles to relax
What are 2 ways that calcium is removed from the cytoplasm of cardiac muscle cells
- Calcium is transported back into SR with help of calcium ATPase
- Calcium is removed from cell via Na+ -Ca++ exchange (NCX)
How does the NCX antiport work
1 Ca++ moves out of the cell for every 3 Na++ moving into the cell
The number of active cross bridges is determined by what
How much calcium is bound to troponin
What role does the length tension relationship play in the contractile strength of cardiac muscle
- Longer sarcomere length can lead to stronger contraction
- Greater sarcomere length means larger internal volume
- Greater volume needs a stronger contraction to push it out
The Frank Starlin’s law of the heart states that
When cardiac muscle is stretched more, It contracts more forcefully
In the contractile myocardiocytes the resting membrane potential is about
-90mV
During the contractile cells action potential, the plateau phase is caused by what 2 ions
K+ and Ca++ ions
What ion is effluxing and influxing during the plateau phase of the contractile cells AP
K++ effluxing, Ca++ influxing
What causes the repolarization phase of the contractile cells
Potassium ion efflux
For the autorhythmic cells, the membrane potential is not stable, but fluctuates from what to what
-60mV to -40mV
What is the threshold for If channels
-40mV
When the If channel opens what comes out of the cell and what goes into the cell
Na+ influx
K+ efflux
What is another name for the unstable membrane potential or type of graded potential of the myocardio autorrhythmic cells
Pacemaker potential
What causes the are autorrhythmic cells rapid rising phase of depolarization
Ca++ion influx
What causes the autorhythmic cells repolarization phase
Ca channels close, slow K channels open, resulting in the efflux of K+ ions
What to type of myocardial muscle does the heart have
Autorhythmic cells and myocardial contractile cells
The autorhythmic cells are also called
pacemakers
The term intrinsic myogenic indicates that the heart muscle is the source of
The electrical signal that stimulates heart contraction
The Na+ influx during the action potential in a cardiac contractile cell causes
The opening of L type calcium channels
What is a key property of cardiac muscle cells
The ability of a single muscle fiber to execute graded contractions
What does it mean to execute a graded contraction
The fiber varies the amount of force it generates
The flattening of the action potentials of myocardial contractile cells, called the plateau phase, is due to a combination of
K+ efflux and Ca++ influx at the same time
The end of the plateau phase of cardiac contractile cell action potentials is due to the
Closing of Ca++ channels and opening of K+ channels
- A typical action potential of a myocardial contractile cell lasts?
- What does this prevent ?
- At least 200 msec
2. Wave summation and tetany
Autorhythmic cells can generate action potentials spontaneously because they have
An unstable membrane potentials at -60mV which slowly drifts up towards threshold
Autorhythmic cells are also called
Pacemakers because they set the rate of the heartbeat
List the order of events of electrical conduction in the heart
SA node–>Internodal pathways–>AV node–>AV bundle if His–>Bundle branches–> Purkinje fibers
How does electrical conduction in the myocardial cells transfer or spread
Autorhythmic cells spontaneously fire action potentials. Depolarizations of the autorhythmic cells then spread rapidly to adjacent contractile cells through gap junctions
What is the pacemaker of the heart
Sinoatrial node
What is pacemaker potential
When the potential for autorhythmic cells drifts up slowly to threshhold, causing an action potential
What is the threshold for autorhythmic cell
-40mV
Once autorhythmic cells reaches its threshold, which channels open and which channels close, and what ion influx occurs
Voltage gated calcium channels open, I f channels close, Ca++ influx occurs
Diastole is
The time during which cardiac muscle relaxes
Systole is
The time during which the cardiac muscle contracts
When both atria and ventricles are relaxing, which valves are open
AV valves
Is the heart in atrial and ventricular systole at the same time
No
When both aria and ventricles are relaxing, where is blood flowing
Into the ventricles
What percentage of ventricular filling depends on atrial contraction
20%
What wave or wave segment on the ECG is associated with ventricular filling
P wave
What electrical event precedes ventricular systole
Ventricular Depolarization
As the ventricles contract, why do the AV valves close
Because ventricular pressure is higher than atrial pressure
What creates the heart sounds
Vibrations following AV closure and semilunar closure
Explain what is happening during isovolumetric ventricular contraction
Force without movement or change in volume. The 1st phase of ventricular contraction pushes AV valves closed but does not create enough pressure to open semilunar valves. The volume in the ventricles has not changed. It maintains the end diastolic volume or maximal volume from the end of atrial systole.
What happens to pressure in the ventricles during isovolumetric then ventricular contraction
It is increasing rapidly
What causes the semilunar valves to open, allowing blood to be ejected into the arteries
As then ventricles contract, enough pressure is generated to open the semilunar valves and push blood into the arteries. This is the driving force for blood flow
How is ventricular pressure in comparison to arterial pressure when blood flows out of the ventricles
Then vetricular pressure is higher than arterial pressure
What happens to ventricular pressure as the ventricles relax
Then ventricular pressure decreases
What causes the semi lunar about to close
Once then ventricular pressure falls below the pressure in the arteries, blood starts to flow backward in the heart. This back flow of blood fills the cup-like cusps of semilunar valves, forcing them together into the closed position
When do AV valves open
When ventricular relaxation causes ventricular pressure to become less than arterial pressure
What is stroke volume
That amount of blood pumped by one ventricle during a contraction
What is the calculation equation for stroke volume
Volume of blood before contraction - volume of blood after contraction
EDV-ESV=SV (mL [per beat])
If the EDV increases and the ESV decreases, has the heart pumped more or less blood
More
What is the calculation equation for cardiac output
CO (mL / min) =HR × SV
What is an average value for (70kg male) stroke volume
70 mL