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CVS 1 Flashcards

1
Q

Ventricle AP Phase 0

A

Rapid upstroke- fast Na channels open, inward Na flow

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2
Q

Ventricle AP Phase 1

A

Initial repolarization- K channels open, outward K flow

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3
Q

Ventricle AP Phase 2

A

Plateau- Ca channels open (L-type), inward Ca flow

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4
Q

Ventricle AP Phase 3

A

Rapid repolarization- K channels open more, massive outward K flow

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5
Q

Ventricle AP Phase 4

A

Resting membrane potential- high K permeability through leaky K channels

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6
Q

SA node AP Phase 0

A

Depolarization- inward Ca current

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7
Q

SA node AP Phase 3

A

Outward K current

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8
Q

SA node AP Phase 4

A

Slow depolarization- inward Na current

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9
Q

How does sympathetic stimulation affect SA node AP?

A

Increases rate of phase 4 depolarization & frequency of APs d/t increased permeability to Na & Ca

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10
Q

How does parasympathetic stimulation affect SA node AP

A

Decreases rate of phase 4 depolarization & hyperpolarizes the max diastolic potential to decrease frequency of APs d/t increased K permeability

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11
Q

_______ has stable RMP, while ____ has unstable RMP

A

Ventricular AP; SA node AP

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12
Q

Accounts for the pacemaker activity of the SA and AV nodes (automaticity)

A

Phase 4 depolarization (Na)

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13
Q

CCB effect on vascular smooth muscles (greatest to least)

A

Nifedipine > diltiazem > verapamil

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14
Q

CCB affect on Heart (greatest to least)

A

Verapamil > diltiazem > nifedipine

Verapamil = Ventricle

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15
Q

Adverse effects of CCB:

A

Flushing, dizziness, fatigue, constipation, headache, hypotension

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16
Q

Drug of choice for prevention of SVT

A

Digoxin

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17
Q

Reflects the time required for excitation to spread throughout cardiac tissues

A

Conduction velocity

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18
Q

Conduction velocity is fastest in ______; slowest in ______

A

Purkinje Fibers; AV node

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19
Q

Why is conduction velocity slowest in AV node?

A

Few gap junctions allowing time for ventricular filling

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20
Q

The ability of cardiac cells to initiate AP in response to inward depolarizing current

A

Excitability

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21
Q

Begins with upstroke of AP & ends after plateau;
NO AP can be initiated;
250 msec

A

Absolute refractory period

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22
Q

Slightly longer than ARP;

No AP can be generated

A

Effective refractory period

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23
Q

Period immediately after ARP;

AP can be elicited but more than usual inward current is required

A

Relative Refractory period

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24
Q

+ dromotropic effect

A

Increases conduction velocity through AV node, speeding conduction of AP from atria to ventricles and decreasing the PR interval

25
Sympathetic receptor on heart & parasympathetic receptor on heart
B1; muscarinic
26
S4 (atrial kick) is associated with?
A hypertrophic ventricle
27
‘a’ wave on venous pulse curve
Increase in atrial pressure caused by atrial systole
28
P-wave
Represents electric activation of the atria
29
7 phases of cardiac cycle
1. Atrial systole; 2. Isovolumetric ventricular contraction; 3. Rapid ventricular ejection; 4. Reduced ventricular ejection; 5. Isovolumetric ventricular relaxation; 6. Rapid ventricular filling; 7. Reduced ventricular filling (diastasis)
30
What causes the fourth heart sound?
Filling of the ventricle by atrial systole
31
Closure of AV valve represents
First heart sound
32
Marks the end of both ventricular contraction and rapid ventricular ejection. Represents repolarization of ventricles
Onset of T wave
33
Second heart sound is created by closure of?
Semilunar valves (aortic & pulmonic)
34
What happens when ventricular pressure becomes less than atrial pressure?
Mitral valve opens
35
Rapid blood flow from atria into ventricle cause? This is normal in ____ but is associated with _____
Third heart sound; children; CHF in adults
36
stroke volume=?
End-diastolic volume - end systolic volume (nl = 75 ml)
37
stroke index=?
Stroke volume / body surface area
38
MAP = ?
DBP + 1/3 pulse pressure Pulse pressure = SBP- DBP
39
Contractility (and SV) increase with:
Catecholamines (increased activity of Ca pump in SR); Increased intracellular Ca; Decreased extracellular Na; Digitalis (increased intracellular Na, resulting in increased Ca)
40
Contractility (and SV) decrease with:
B1 blockade; Heart failure; Acidosis; Hypoxia/hypercapnia
41
Ejection fraction =
SV / end diastolic volume
42
Sympathetic stimulation via B1 receptor increases _________ current during the plateau of AP
Inward Ca
43
Period of highest O2 consumption in pressure-volume loop
B to C (Isovolumetric contraction)
44
What happens from C to D on pressure-volume loop
Ventricular ejection
45
D to A on pressure-volume loop
Isovolumetric relaxation
46
A to B on pressure-volume loop
Ventricular filling + atrial kick
47
Atrial kick accounts for ____% filling
20
48
Refers to an increase in ventricular end-diastolic volume (filling)
Increased preload
49
Preload (ventricular) increases with
Exercise; Increased blood volume (pregnancy or over transfusion); Excitement (sympathetic)
50
stroke volume is affected by?
Contractility, Afterload, Preload
51
Order of excitation of heart
SA node > internodal tracts > AV node > Bundle of His > Bundle branches > Purkinje fibers > Ventricular muscle
52
P-R interval
Conduction through AV node (<200 msec)
53
AV node is bypassed making PR interval < 0.12 sec and leads to early depolarization of ventricle. Most commonly seen as?
Pre-excitation syndrome; Wolf-Parkinson-White syndrome
54
Cessation of P waves
Sinoatrial block
55
Occurs with inferior wall MI
2nd degree Type 1
56
Occurs with anterior wall MI
2nd degree Type 2
57
Complete AV block comes & goes; Ventricles stop contracting for 5-30 sec b/c of overdrive suppression (used to atrial drive) then ventricle escape occurs with AV nodal or AV bundle rhythm (15-40 bmp)
Stokes-Adams Syndrome
58
Impulse is sometimes blocked and sometimes not in peripheral portions of Purkinje system resulting in abnormal QRS waves
Incomplete Intraventricular Block (electrical alternans)

Patho (13 decks)

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