Conduction of Impulses in the heart Flashcards

(36 cards)

1
Q

What is unique about the heart’s nervous supply?

A

it exhibits autorhythmicity it triggers its own impulse from the SA node which will cause contraction independent of the wider nervous system

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2
Q

where does the excitation of the heart normally originate?

A

The sinoatrial SA node which is located in the right upper atrium where the superior vena cava enters the heart

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3
Q

when is the heart said to be in sinus rhythm?

A

when the heart beat is being controlled by the sinoatrial node

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4
Q

what is the resting membrane potential of the pacemaker cells in the SA node?

A

The pacemaker cells have no stable resting potential, they generate regular spontaneous pacemaker potentials

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5
Q

How is an action potential fired in the pacemaker cells of the SA node?

A

The pacemaker potential increases until the membrane potential reaches a threshold and an action potential is fired

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6
Q

The SA node generates

A

regular spontaneous action potentials

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7
Q

what is the pacemaker potential?

A

the slow depolarisation of a membrane potential to a threshold

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8
Q

the pacemaker potential is due to

A
  • decrease in K+ efflux
  • Na+ influx (the funny current)
  • transient Ca2+ influx (T-type channels)
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9
Q

What causes repolarisation of the SA node?

A
  • L-type Ca2+ channels are inactivated

- K+ channels are activated causing K+ efflux

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10
Q

How does cardiac excitation normally spread across the heart?

A
  • SA node
  • cell-to-cell conduction through the atria and to the AV node (although there are a few internodal pathways)
  • AV node to the bundle of His
  • Down the left and right fibres of the bundle to the Purkinje fibre
  • Purkinje fibres deliver the excitation to the ventricles
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11
Q

How does cell-to-cell spread of excitation occur?

A

The excitation spreads between cells through the desmosomes and the gap junctions

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12
Q

What it the atrioventricular AV node?

A
  • small bundle of specialised cardiac cells

- the only point of electrical conductivity between the atria and ventricles

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13
Q

Where is the AV node?

A

The base of the right atrium just above the atrioventricular junction

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14
Q

Why is conduction delayed in the AV node?

A
  • the cells are small in diameter and have slow conduction velocity
  • to allow atrial systole to precede ventricular systole
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15
Q

What is the resting membrane potential of the cardiac myocytes?

A

-90mV until the cell is excited

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16
Q

What causes depolarisation of the cardia myocytes?

A

fast Na+ influx

17
Q

What is Phase 0 of action potential in contractile cardiac muscle cells?

A

The rapid rising phase of the action potential, from -90mV to +20mV

18
Q

what are the phases of ventricular muscle action potential?

A
  • Phase 0 (fast Na+ influx)
  • Phase 1 (closure of Na+ channels and transient K+ efflux)
  • Phase 2 (mainly Ca++ influx)
  • Phase 3 (closure of Ca++ channels and K+ efflux)
  • Phase 4 (resting membrane potential)
19
Q

What is the Plateau Phase of Ventricular muscle action?

A
  • a unique characteristic of contractile cardiac muscle cells
  • it’s mainly due to the influx of Ca++ through L-type Ca++ channels balancing the efflux
20
Q

What causes repolarisation in cardiac muscle cells?

A
  • the inactivation of Ca++ channel and activation of K+ channels resulting in K+ efflux
21
Q

What is the part of the nervous system which influences heart rate?

A

The autonomic nervous system

22
Q

What is the effect of sympathetic stimulation on heart rate?

A

it increases heart rate

23
Q

What is the effect of parasympathetic stimulation on heart rate?

A

it decreases the heart rate

24
Q

What is the influence of the autonomic nervous system on heart rate under resting conditions?

A
  • vagus nerve (parasympathetic) exerts continuous influence on the SA node under resting conditions
  • vagal tone is dominant
  • slows the intrinsic heart rate from ~100bpm to normal resting heart rate of ~70 bpm
25
What is considered normal heart rate?
Between 60 and 100 bpm
26
What is bradycardia?
resting heart rate less than 60bpm
27
What is tachycardia?
resting heart rate more than 100bpm
28
What effect does the vagal nerve have?
- supplies the SA and AV node - slows heart rate - increases AV nodal delay
29
What is the mechanism of the parasympathetic effect on heart rate?
- acetylcholine acting through muscarinic M2 receptors
30
What effect does atropine have?
It is a competitive inhibitor of acetylcholine, so is used to speed up the heart rate in extreme bradycardia
31
How does vagal stimulation effect the pacemaker potential?
it has a negative chronotropic effect - the slope of the potential decreases and hence it takes longer to reach the threshold
32
What effect does sympathetic stimulation have on the heart?
- sympathetic nerves supply SA node, AV node and the myocardium - increases heart rate - decreases AV nodal delay - increases force of contraction
33
What is the neurotransmitter of the sympathetic supply?
noradrenaline acting on B1 adrenoreceptors
34
What is the effect of noradrenaline in pacemaker potential?
Positive chronotropic effect Slope of pacemaker potential increases, threshold is reached quicker
35
Phases of action potential in a cardiac pacemaker myocyte
- Phase 0 (Ca++ influx) not as steep as ventricular muscle action - Phase 3 (repolarisation) - Phase 4 (pacemaker potential)
36
What is special about the refractory period of the heart?
Tetanic contraction isn't possible each contraction of the heart is completely independent