electrical activity of the heart Flashcards

(39 cards)

1
Q

T tubule

A

invagination of the sarcolemma deep into the muscle

AP travels down the T tubules

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2
Q

sarcolemma

A

muscle membrane

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3
Q

sarcoplasmic reticulum

A

calcium store inside the skeletal muscle

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4
Q

gap junction

A

electrical connection

NOT FOUND IN SKELETAL MUSCLE

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5
Q

desmosome

A

physical connection

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6
Q

which of skeletal and cardiac muscle can exhibit tetanus?

A

skeletal: can - contractions add up, sustained contraction
cardiac: can’t

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7
Q

why can’t cardiac muscle exhibit tetanus

A

long AP and long refractory period

this is good because we need the heart to contract then relax, not be continuously contracted

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8
Q

how does cardiac muscle form a functional syncytium

A

electrical connection: gap junctions
physical connection: desmosomes
these form intercalated discs

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9
Q

what is a functional syncytium

A

the cells act together as if they are one cell due to their electrical and physical connection

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10
Q

what is the length of a cardiac action potential and why is this important

A

~250ms compared to ~2ms in skeletal muscle
long AP and refractory period to inhibit tetanic contraction
Ca entry can regulate contraction

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11
Q

how does Ca entry from outside the cell regulate contraction strength

A

ca release doesnt saturate the troponin so regulation of ca release can be used to vary the strength of the contraction which therefore regulates stroke volume

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12
Q

unstable resting membrane potentials

A

some cardiac muscle cells have unstable resting membrane potentials and act as pacemakers
they continuously depolarise towards threshold

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13
Q

non pacemaker vs pacemaker action potentials

A

the majority of cardiac muscle cells stay at -90 until they are told to depolarise
some cells are pacemakers and spontaneously depolarise to threshold

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14
Q

non-pacemaker action potential electrophysiology

A

resting membrane potential: high resting PK+ due to leaky K channels
initial depolarisation: triggered by neighbouring cells depolarising, increase in PNa+ due to VG Na channels
plateau: increase in PCa2+ (L type channels: open slower but stay open for longer) and decrease in PK+
repolarisation: decrease in PCa2+ (channels shut) and increase in PK+ (leaky K channels open again)

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15
Q

pacemaker AP

A

AP: increase in PCa2+ by L type VG Ca channels, no sharp increase in MP
pacemaker potential: gradual decrease in PK+ (leaky channels shut)
early increase in PNa+ (PF, some Na moves in through unusual Na channels)
late increase in PCa2+ (T type, only lets in a small amount of Ca)
pacemaker explains autorhythmicity of the heart

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16
Q

modulators of electrical activity (5)

A
symp and parasymp NS
drugs
temperature
blood K levels 
blood Ca levels
17
Q

how to drugs modulate electrical activity

A

Ca2+ channel blockers: decrease force of contraction, mainly work on L type, reduce amount of Ca coming in during the AP

cardiac glycosides: increase force of contraction, increase amount of Ca being released, mainly from internal stored

18
Q

how does temperature modulate electrical activity

A

increases ~10bpm/C

19
Q

how does hyperkalemia modulate electrical activity

A

fibrillation: K depolarises cells, cells are pushed towards threshold and fire on their own in an uncoordinated manner

heart block: cells are depolarised, smaller electrical gradient so things happen slower, in some areas of the heart it is so slow that the heart stops

20
Q

how does hypokalemia modulate electrical activity

A

fibrillation and heart block

anomalous

21
Q

how does hypercalcaemia modulate electrical activity

A

increased HR and force of contraction

22
Q

how does hypocalcaemia modulate electrical activity

A

decreased HR and force of contraction

23
Q

Sino-atrial node

A

fastest pacemaker cells are located here
pacemaker region of the heart
~0.5m/s spread of contraction over the walls of the atria

24
Q

Annulus firbosis

A

division between the atria and ventricles
non-conducting
made of fibrous connective tissue

25
atrioventricular node
delay box slows things down until the atria have finished contracting conducts very slowly ~0.05m/s
26
purkinje fibres
rapid conduction system ~5m/s allows depolarisation to spread through the heart muscle so it all contracts roughly at the same time
27
how is electrical activity recorded as an ECG
an AP in a single myocyte evokes a very small extracellular electrical potential lots of small extracellular potentials evoked by many cells depolarising and repolarising at the same time can summate to create large extracellular waves these can be recorded at the periphery as the ECG
28
what does ECG tell you about the heart
only disorders of conduction or rhythm | doesnt tell you about the pumping ability of the heart
29
disorders of conduction
heart block - 1st/2nd/3rd degree
30
3 examples disorders of rhythm
atrial flutter atrial fibrillation ventricular fibrillation
31
1st degree block
longer interval between P wave and QRS complex | depolarisation spreading too slowly between atria and ventricle
32
2nd degree block
AP doesnt get through | increasingly longer gap between P and QRS then P followed by no QRS
33
3rd degree block
no transmission between atria and ventricle P waves are followed in any sensible way by QRS QRS is very slow and large
34
atrial flutter
SVT QRS complex preceded by p wave, sits on the back of previous T wave 150bpm normal conduction but too frequent
35
atrial fibrillation
no P waves parts of the atria are depolarising and contracting at different points some QRS complexes if the wave gets through to the ventricle not a major problem at rest
36
ventricular fibrillation
no coordinating QRS complexes contracting in different parts at different times treat by defibrillation
37
P wave
corresponds to atrial depolarisation
38
QRS complex
corresponds to ventricular depolarisation
39
T wave
corresponds to ventricular repolarisation