cardiac electrophysiology Flashcards

(31 cards)

1
Q

what is meant by myogenic?

A

The heart generates electrical activity and contraction without the need for nerves

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2
Q

How does SAN generate APs?

A

generates action potentials (APs) with rhythmical pacemaker activity in absence of any nerve stimulation

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3
Q

Hr and SAN

importance?

A

Firing rate of APs (resting about 1/s) equals heart rate (resting about 60-70bpm)
Therefore SAN controls HR

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4
Q

SAN cells not contractile?

A

generate electrical activity

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5
Q

why does SAN node keep generating AP?

A

unstable/non-equilibrium resting membrane potential (RMP)

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6
Q

what are If channels? (funny current)

what do they do?

A

Hyperpolarisation-activated Na+ channel (sometimes termed Ih)
Na+ influx produces depolarising slope (Phase 4)

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7
Q

explain phase 4 for SAN

what sets it off and what do they do?

A

If activated by hyperpolarisation

open If Na+ channels and the influx causes depolarisation till threshold hit

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8
Q

threshold hit leading to phase 0, explain (SAN)

A

Voltage-gated Ca2+ channels open leading to Ca2+ influx and rapid Depolarisation so AP generated

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9
Q

why is Ca2+ and Na+ depolarisation different? (3 things)

A

Na+ nerves
Ca2+ slow upstroke compared to Na+ due to opening slower
Ca2+ is open longer so wider AP

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10
Q

Phase 3 (SAN)

A

Voltage-gated K+ channels open leading to K+ efflux and rapid Repolarisation

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11
Q

conduction pathway from SAN through heart

A

conduction across both atrium to AV nodes to Bundle of His to purkinje fibres

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12
Q

why does Av node slow down conduction rate?

how does it slow it down?

A

has fatty insulated tissues to slow down conduction rate so it allows time for the ventricles to fill with blood from atrium

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13
Q

importance of purkinje fibres

A

allow both ventricles to be stimulated at the same time hence can contract and eject blood at the same time

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14
Q

what allows FAST electrical conduction in heart

A

Via low resistance pathways between myocytes called intercalated discs

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15
Q

how are APs generated in atrium/ventricles?

A

from electrical stimulation arising in S-A node

atrial/ventricular cells have a stable resting membrane potential

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16
Q

phase 0 in a/v ap

what opens, why and what does it do?

A

AP from SAN lead to Voltage-gated Na+ channels open and high Na+ influx leading to Depolarisation

17
Q

phase 1 (a/v) - what opens?

A

k+ channels breifly open for repolarisation

18
Q

phase 2 - plateau stage (a/v)

what opens and why plateau?

A

Voltage-gated Ca2+ channels (VGCCs) open and Sustained Ca2+ influx leading to Depolarisation
plateau cos k+ out and ca2+ in

19
Q

importance of plateau stage

what does it prevent and what is it essential for?

A

Myocytes are unexcitable or REFRACTIVE – CANNOT fire more APs, no twitching
One AP only produce ONE contraction
ESSENTIAL for proper ejection of blood from heart
This is all due to Na+ channels being inactivated so can’t lead to another AP firing

20
Q

phase 2 to 3 (a/v) - what close/open?

A

VGCCs switch off and K+ channels switch on

21
Q

Phase 3 (a/v) - what open and effect?

A

Voltage-gated K+ channels open leading to K+ efflux and rapid Repolarisation

22
Q

How does a/v APs produce a contraction?

A

Contraction occurs by an INCREASE in cytosolic Ca2+ levels
Higher increases in Ca2+ lead to increased force of contraction
Ca2+ rises from 0.1 µM to about 2-10 µM

23
Q

difference between smooth and cardiac muscle contraction (2 things)

A

CICR (Ca2+-induced Ca2+ release) via RyR and contraction via troponin system are DIFFERENT to smooth muscle (IP3R + MLCK)

24
Q

Link between Electrical Excitability and Contraction

A

1 heart beat = SAN AP to atrial contraction to electrical activity to AV node to ventricular contraction

25
Ecg and pqrst wave | what do the different waves correspond to?
P wave - atrial depolarisation QRS wave - ventricle depolarisation T wave - ventricle repolarisation
26
what effect does stimulation of the sympathetic nerves have on the heart? 2 effects?
Stimulation of these nerves as an effect on, Heart rate : Positive chronotropic effect Contractility : Positive inotropic effect ↑ If ----> ↑ Pacemaker frequency -----> ↑ Heart rate ↑ ICa + ↑ RyR ----> ↑ influx of Ca2+ levels + ↑ CICR ------> Contractility
27
what sympathetic nerves have an effect on the heart? | what nerves and what do they stimulate?
Sympathetic nerves from T1-T5 of spinal cord innervates both S/A node and atria/ventricles
28
How does the sympathetic nerves have an effect in the heart? what is released and act on what receptors?
Releases noradrenaline which acts at B1 adrenoceptors on S-A node cells and cardiac myocytes
29
what effect does stimulation of the parasympathetic nerves have on the heart? ( 1 effect)
Heart rate : Negative chronotropic effect only | ↓ If ----> ↓ Pacemaker frequency -----> ↓ Heart rate
30
what parasympathetic nerves have an effect on the heart?
Parasympathetic nerves from brainstem innervate S/A node | vagus nerve
31
How does the parasympathetic nerves have an effect in the heart? what is released and what receptor?
Releases Ach which acts at muscarinic (M2) receptors | on S-A node cells