Electrical Properties of the Heart Flashcards

1
Q

What is excitation contraction coupling?

A

Electrical signals causing physical contraction

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2
Q

What are the main differences between skeletal and cardiac muscle?

A
  • Skeletal muscle is a syncytium (one large fused cell) - Cardiac muscle acts as a syncytium (known as a functional syncytium
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3
Q

What is the function of gap signals in the myocardium?

A

Allow a signal to be propagated from cell to cell

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4
Q

What is the definition of an intercalated disc?

A

Desmosome followed by gap junction followed by desmosome and so on

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5
Q

Why is the AP of cardiac muscle 10 times longer that skeletal?

A
  • Requires calcium from outside the cell as the calcium released from the sarcoplasmic reticulum isn’t enough to saturate enough troponin
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6
Q

What is calcium dependent calcium release?

A

Calcium from outside the cell causes the sarcoplasmic reticulum to release more calcium

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7
Q

What is the strength of heart contraction directly proportional to?

A

How much calcium enters the cell

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8
Q

Why can cardiac muscle not display tetanus?

A

Has a long refractory period and has to relax before it can contract again

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9
Q

What is the resting potential for pacemaker cells?

A
  • Cells sit at an unstable RP - Roughly -60mV
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10
Q

What is the RP of non pacemaker cells?

A
  • About -90mV
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11
Q

What is the permeability of the non pacemaker cells membrane to potassium at RP?

A

High K moves out

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12
Q

What ion causes the rapid depolarisation of non pacemaker cells

A
  • Increase in Na+ permeabilty
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13
Q

What ions permeability changes result in the plateau of repolarisation that allows the refractory period?

A
  • Permeability to Ca2+ which moves in - Permeability to K reduced so more K stays in the cell
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14
Q

What type of calcium channels are responsible for the plateau?

A

L type

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15
Q

How much calcium do L type channels let in?

A

A lot

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16
Q

What allows the actual repolarisation of non pacemaker cells?

A
  • Decrease in Ca2+ permeability - Increase in K+ permeability
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17
Q

STUDY THE DIAGRAM

A
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18
Q

Why is the depolarisation of pacemaker cells slower than non pacemaker cells?

A

Only affected by L type calcium channels and not sodium

19
Q

What is the pacemaker potential?

A

Pre AP potential

20
Q

What causes the pacemaker potential?

A
  • Gradual decrease in PK+
  • Early increase in PNa+ (=PF on diagram)
  • Late increase in PCa2+ (t type calcium channels, small amount of Ca2+)
21
Q

What are the endogenous modulators of electrical activity?

A
  • Autonomic nervous system
  • Temperature (an increase in 1 degree increases the HR by 10bpm)
22
Q

What drugs modulate electrical activity?

A
  • Ca2+ channel blockers that target L type channels
  • Cardiac glycosides
23
Q

How do cardiac glycosides work and what is the most infamous cardiac glycoside?

A
  • Increase force of contraction
  • Digoxin
24
Q

What will be caused by hyperkalemia & hypokalemia?

A
  • Fibrillation and heart block (kalemia refers to serum potassium)
25
What will hypercalcemia cause?
- Increase HR and force of contraction
26
What will hypocalcemia cause?
Decreased HR and force of contraction
27
Where are the fastest pacemakers in the heart?
Sinoatrial node
28
What is the annulus fibrosis?
Non conducting insulator between atrium and ventricle
29
What is the function of the AV node?
Delay the AP potential from the SA node to let the left atrium inject it's blood into the left ventricle
30
What is the first structure that the AP potential travels through in the ventricular wall?
Bundle of HIS
31
What is the name of the fibres after the bundle of HIS that the AP travels through to reach bilaterally to both ventricles?
Purkinje fibres
32
STUDY THE DIAGRAM
33
What is shown by the P wave?
Atrial depolarisation
34
What is shown by the QRS complex?
Ventricular depolarisation
35
What is shown by the T wave?
Ventricular repolarisation
36
What are the 2 types disorders shown by an ECG?
- Disorders of rhythm - Disorders of conduction
37
What are the 3 different traces shown by disorders of conduction?
- 1st degree block - 2nd degree block - 3rd degree block
38
What effect does 1st degree block have on an ECG?
Time between P wave and QRS complex much longer
39
What effect does 2nd degree block have on an ECG?
- Sometimes no conduction - Some P waves followed by no QRS complex
40
What effect does 3rd degree block have on an ECG?
- No QRS complex generated directly by P wave - QRS complex strange shape as it is innervated by a different pacemaker
41
What are the 3 disorders of rhythm?
- Atrial flutter - Atrial fibrillation - Ventricular fibrillation
42
What is shown by an atrial flutter
150 bpm HR
43
What is shown by atrial fibrillation?
- No coordinated P waves - Random atrial depolarisations
44
What is shown by ventricular fibrillation
No coordinated QRS complex