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Cardiopulmonary pathology > Cardiac Arrhythmias > Flashcards

Cardiac Arrhythmias Flashcards

(53 cards)

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1
Q

arrhythmias

What is the cause?

A

abnormal heart rhytms

altered impulse formation, impulse conduction or both

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2
Q

bradycardias

It has ______ (increase/decrease) firing rate

A

slow heart rhythms

decreased

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3
Q

tachycaridas

It has _________ (decrease/increase) firing rate

A

fast heart rhytms

increased

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4
Q

What are the factors cause the altered impulse formation in tachycardias?

A

increase automaticity of SA node & of latent pacemakers

automaticity of atrial/ ventricular myocytes

triggered activity

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5
Q

What are the factors cause the altered impulse formation in bradycardias?

A

decrease automaticity of SA node

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6
Q

What are the factors cause the altered impulse conduction in tachycardias?

What are the factors cause the altered impulse formation in bradycardias?

A

unidirectional block & reentry

conduction block

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6
Q

T/F: In normal conditions, only SA node cells are able to depolarize itself to threshold

A

False.

AV node, Bundle of His & Purkinje fibers cells can also depolarize itself

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7
Q

Why does triggered activity lead to the tachycaridas?

A

some action potentials can trigger abnormal depolarizations that result in extra heart beats or rapid arrhythmias

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8
Q

T/F: cardiac tissue damage can cause myocytes outside the specialized conduction system to acquire automaticity

A

True

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8
Q

Which pacemaker cells have the fastest firing rate? 2nd & 3rd?

A

SA node > AV node & Bundle of His > Purkinje fibers

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9
Q

Describe the cells depolarization & repolarization

A

1) phase 4 depolarization: the Na+ channels slowly open
2) phase 0: progressive decline in K+ efflux & Na+ channels is inactive while Ca2+ slowly influx
3) K+ efflux progressively while Ca2+ channels slowly closes

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10
Q

What are factors that determine firing rates?

A

slope of phase 4 depolarization

the maximum negative diastolic potential

the threshold potential

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11
Q

the rate of pacemaker current (If) is equivalent to ___________

What does If depend on?

A

the slope of phase 4 depolarization

the # and kinetics of individual pacemaker channels through the current flows

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12
Q

The more negative MDP (maximum diastolic potential), the _______ firing rate as the slop of phase 4 depolarization _________ (less steeper/ more steeper)

A

longer

less steeper

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13
Q

The less negative threshold potential, the ______ firing rate as the slope of phase 4 depolarization is ________ (longer/shorter)

A

longer

longer

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14
Q

What modulate SA node?

A

sympathetic nervous system

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15
Q

Why do we say that SA node is a native pacemaker?

A

Because it has the highest firing rate -> set the HR

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16
Q

True/False: Automaticity of SA node can increase under exercise or emotional stress

A

True

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17
Q

Through what cells receptors does sympathetic system stimulate SA node?

what are hormones that these receptors react with?

A

ß-adrenergic receptors

epinephrine or norepinephrines

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18
Q

What are two factors of firing rate depends on that sympathetic stimulation affect?

A

steeper the slope of phase 4 depolarization

shift threshold to more negative values

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19
Q

What are the factors of firing rate depends on that parasympathetic system affect?

A

shifts maximum negative diastolic potential (MDP) is more negative

decreases the slope of phase 4 depolarization

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20
Q

How does PNS decrease the slope of phase 4 depolarization?

Study These Flashcards
A

by decreasing the probability of pacemaker channels being open

21
Q

what are the arrhythmias as consequences of decreased SA node?

Study These Flashcards
A

escape rhythm

supraventricular arrhythmias

ventricular arrhythmias

22
Q

escape rhythms

what will happen to impulse formation in escape rhythms

Study These Flashcards
A

SA node is suppressed -> decreased firing rate

impulse formation is shift to latent pacemakers cells

23
What are the types of escape rhythms in heart? Explain each
nodal or junctional escape beat: originate in AV node through His-Purkinje fibers (normal QRS) ventricular escape beat: originate from Purkinje fibers (abnormal QRS)
24
What is the cause of escape rhythms?
strong parasympathetic stimulation
25
Where does supraventricular arrhythmias occur? Does it have normal or abnormal QRS? What are types of Supraventricular arrhythmias?
above the ventricle normal PSVT, Atrial flutter & atrial fibrilation
26
Describe the ECG of atria flutter
rapid succession of identical, back to back atrial depolarization waves (P wave)
27
atria flutter T/F: all atrial impulses are transmitted to ventricles in atria flutter
regular rapid arrhythmias False. Not all because AV node is in refractory period
28
T/F: SA node is more sensitve to parasympathetic stimulation than latent pacemakers cells
29
T/F: ventricular escape beat have normal QRS complex
False abnormal
30
atrial fibrilation Describe the ECG
irregular rapid impulses from atrial foci depolarize atria chaotic & erratic baseline with no discrete P waves & irregular space QRS complex
31
Ventricular arrhythmas has ______ (normal/abnormal) QRS complex
abnormal
32
What are the symptoms of ventricular arrhythmias?
premature ventricular contraction ventricular tachycardiacs ventricular fibrilation
33
premature ventricular contraction (PVC)
ectopic beat
34
ectopic beats What are the causes of ectopic beats?
when latent pacemaker develops rate of depolarization faster than of SA node -\> disturbance of impulse formation ischemia, electrolyte disturbance & hypoxemia
35
T/F: The impulse in ectopic beats are premature relative to normal rhythm
True
36
What is the cause of ventricle tachycardia? What can ventricle tachycardia lead to?
the re-entry mechanism ventricular fibrilation
37
ventricular fibrilation
rapid, irregular ventricular depolarization due to the impulse generated from ventricular foci
38
early after depolarizations Why does this happens?
changes in membrane potential in the positive direction that interupt normal repolarization because action potential duration is longer than normal
39
What phase does early after depolarization occur in?
phase 2 (plateau) and phase 3 (during repolarization)
40
T/F: early after depolarization can be self-pertuating & lead to repeated depolarizations and tachycaridas
True
41
When does delayed after depolarization occur?
after repolarization but before another normal action potentials would occur
42
True/False: the impulses can't be blocked when it enters the region of the heart that is non-conductive
false
43
fixed block
the block is caused by a barried in which fibrosis or scarring replaces conducting myocytes
44
What does block within the AV node or His/Purkinje system do?
prevent the impulse propagation to the more distal sites
45
1st degree of AV block What are the causes?
delayed conduction between atria & ventricle vagal stimulation, beta-receptor antagonist, amyloidosis, sarcoidosis
46
2nd degree of AV block 3rd \_\_\_\_\_\_
intermitten or cyclical failure of impulse conduction failure of impulses conduction
47
What are the causes of 3rd degree of AV block?
atria & ventricle beat independently; ventricle escape rhythm (atrial rate is faster than ventricular rate)
48
His/Purkinje block
failure of impulse conduction through one of bundle branches -\> ventricle depolarize much slowly
49
unidirectional block & re-entry
an electrical rhythm circulates repeatedly around a re-entry path & recurrently depolarize a region of cardiac tissue
50
What type of heart diseas is this?
Mobitz type 1 - 2nd degree block
51
What type of heart disease is this?
mobitz type II - 2nd degree block no R wave

Cardiopulmonary pathology (12 decks)

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