Final-Chapter 12 Part 2 Cardiac Physiology Flashcards Preview

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Flashcards in Final-Chapter 12 Part 2 Cardiac Physiology Deck (23):

Describe pacemaker cells.

Pacemaker cells do not have a steady resting membrane potential. They spontaneously depolarize and fire action potentials. Unique in that they don’t have a steady resting Membrane Potential. There is an AP that is produced and then at the very end of that AP, the undershoot phase results in another AP is produced. These cells are constantly producing APs – this is good because you don’t want these cells to take a break on you. A hyperpolarization results in a depolarization and back and forth. The Membrane potential never steadies out – one AP followed by the next.


Describe pacemaker action potentials?

Cardiac pacemaker cells spontaneously depolarize because of the activity of “funny” channels. “Funny” channels are activated by hyperpolarization of the membrane. “Funny” channels = HCN channels (HCN = hyperpolarization-activated and cyclic nucleotide-gated channels).


What is the first step in creating an action potential in pacemaker cells.

1. Pacemaker potential (orange/bottom of slow depolarization): Following an AP, at the end of the undershoot phase, the potassium channels are closing and funny channels open. Funny channels are permeable to Na and K [Na in, K out] due to the activity of HCN/Funny channels. Voltage-gated K+ channels close. Permeability for Na increased and permeability for K decreases – this is because K channels were open before. These cells have a lot more voltage.


What is the second step in creating an action potential in pacemaker cells.

2. Top of slow depolarization (Yellow): T-type voltage-gated calcium channels open (T for transient) purpose of T channels is to get the cell to threshold quickly. Funny channels close. The cells’ permeability to sodium decreases and permeability to Calcium increase. Purpose of T-type channels is to bring membrane to threshold.


Why would the cell shut down permeability to Na instead of Ca?

The goal is the get the cell to threshold as quickly as possible. Calcium is twice as positive as sodium, so more positive charge is going into the cell, also, the driving force is way larger for Ca than Na.


What is the third step in creating an action potential in pacemaker cells.

3. Rapid depolarization (blue):
T-type channels close and voltage gated L-type Ca channels open. L type channels mean we have a LOT of positive charge going in, which gives us such a steep riding phase. Voltage-gated Na channels open causing the inside to get really positive real quick and really permeable to Ca than is to Na.


What is the fourth step in creating an action potential in pacemaker cells.

4. Peak of AP causing repolarization (purple): voltage-gated K channels open and voltage-gated L-type Ca channels close. Voltage-gated Na channels inactivate and no there is a low permeability to Na and Ca.
A high permeability to potassium is the falling phase. Very large potassium current, because of how far the membrane potential is from equilibrium potential of potassium which is why you get such a steep falling phase.


What are the special ions of cardiac muscle cells?

Cardiac Pacemakers cells have “Funny” Channels (HCN Channels) which allow allow for spontaneous depolarization. T-Type voltage gated calcium channels allow membrane to reach AP threshold.
Contractile Cells have L-Type voltage gated calcium channels allowing for long duration APs.


Why must Cardiac APs be so long?

Long refractory period makes summation (tetanus) of contraction impossible. AP lasts about the same amount of time as contraction. Potassium is leaving but Calcium channels are still open, so Ca is leaking in, creating a sort of plateau phase, which gives a long AP. The length of the contraction is about the same length as the AP and during this time, you cannot produce another AP. The heart has time to contract and relax before it gets told to relax again. You will never get summation [or tetanus] in the heart. If this AP was short, this cell could potentially get another AP while it was already contracting, that would NOT good.


Describe excitation contraction coupling in cardiac muscle.

1. The current spreads through gap junctions to contractile cell. The presynaptic cell could be a pacemaker, contractile, or whatever – current spreads through gap
junction, produces an AP.
2. AP travels along membrane and makes it way down T tubule. As it propagates down the membrane, it opens Ca channels down the membrane and Ca enters from the outside.
3. Ca2+ channels open in plasma membrane and SR. Calcium induced Calcium release – the calcium coming inside the cells, opening up the channels on the
SR and causes more calcium to leave the SR. 95% Ca2+ released from SR, 5% comes from outside of cell.
4. Ca2+ induces Ca2+ release from SR.
5. Ca2+ binds to troponin, exposing myosin-binding sties.
6. Crossbridge cycle begins (muscle fiber contracts).
7. Ca2+ is actively transported back into SR and ECF.
8. Tropomyosin blocks myosin-binding sites (muscle fiber relaxes).
Three ways Ca levels are lowered:
SERCA pumps, Ca2+ pump on plasma membrane moves Ca2+ out of cell using ATP, An exchanger doesn’t use ATP. Uses Na going down it’s gradient to move Ca2+ against its gradient.


Describe Excitation Contraction coupling in Skeletal muscles vs. Cardiac muscles.

In Skeletal muscles, AP triggered by motor neuron and ACh release. DHP voltage sensors on plasma membrane open ryanodine receptors on SR. Ca is released from SR. Calcium is removed from cytosol by SERCA pumps on SR. In Cardiac muscle AP triggered by positive current spread through gap junctions. DHP voltage sensors open ryanodine receptors on SR. Voltage-gated Ca channels on plasma membrane also open. 95% Ca released from SR, 5% comes from outside cell. Ca-induced Ca release (CICR) and Ca removed by SERCA pumps, pm Ca ATPase, and pm Na/Ca exchanger.


Describe the cardiac cycle.

The cardiac cycle Involves rhythmic changes in Valve opening and closing, Atrial, ventricular, and aortic pressure, and Ventricular blood volume. Patterns of opening and closing of valves in response to changes of pressure, which results in changes of volume of blood in the heart chambers. Composed of 4 stages, 2 stages are diastole and 2 are systole. Diastole are ventricular relaxation. Systole is ventricular contraction. Important to note: IT ALL HAS TO DO WITH THE VENTRICLES. Each of the phases are classified by what the
ventricles are doing.


What are the phases of the cardiac cycle.

1. Ventricular filling and Atrial Contraction [diastole]. Two different phases in one.
2. Isovolumetric Contraction [systole]
3. Ventricular Ejection [systole], also known as the payoff phase – what we’re aiming for. If phase 3 doesn’t go well, the other phases don’t matter.
4. Isovolumetric relaxation [diastole]. Phases 2 and 4 – isovolumetric [means that the volume of blood in the ventricles is not changing]. WHEN YOU SEE THIS TERM, IMMEDIATELY THINK THAT ALL VALVES ARE CLOSED.


Important to note!

Pressure is higher in the ventricles than in the atria to close the AV valves. The pressure is higher in the aorta than in the ventricles to close Semilunar valves. To increase pressure add blood or contract.


Describe the valves?

Atrioventricular valves found between atrium and ventricles. Aortic and pulmonary semilunar valves separated the ventricles from the arteries that come out of them. Pressure causes these valves to open.

The AV valves: When the pressure in the atria is higher than the pressure in the ventricles the AV valves open. They close when pressure in ventricles is higher than the pressure in the atria.

Both semilunar valves: SL valves open when pressure in ventricles is higher than pressure in the arteries. They are closed when pressure in the arteries is higher than pressure in the ventricles.


How do AV valves work?

AV valves open: when ventricles are relaxed and when atrial pressure is greater than ventricle pressure. Papillary muscle relaxed.

When AV valves are close when ventricles are contracting and when ventricular pressure is higher than atrial pressure. Papillary muscle contracted


How do SL valves work?

When SL valves are open the ventricle are contracting and Ventricular pressure is greater than aortic pressure.

When SL valves are closed the ventricles are relaxed and aortic pressure is greater than ventricular pressure.


What happens during isovolumetric contraction and relaxation?

During isovolumetric contraction and relaxation: atrial pressure is less than ventricular pressure which is less than aortic pressure.


What is phase one ventricular filling of the cardiac cycle?

Phase 1: Ventricular Filing [diastole].
Blood from systemic and pulmonary circuits flows through atria into ventricles. Atrial pressure is higher than ventricular pressure meaning AV valves are OPEN. When there is more blood in the atria than the ventricles, the AV valves open and blood diffuses into the ventricles – this is passive. Ventricular pressure is less than aortic pressure; SL valves are CLOSED. SL valves are closed because the pressure in the aorta is greater than the pressure in the ventricles. Because the aorta is huge it carries with it a ton of blood. This part is diastole because ventricles are relaxed. AV valves are open and blood flows from the atria to the ventricles (atria pressure is higher than ventricular pressure).


What is phase 2 atrial contraction?

Phase 2: atrial contraction [diastole]. At the end of diastole, atria contract, driving more blood into ventricles. Atria begin to relax. AV valves still open, SL valves still closed. The purpose of atria contraction is to keep valve open to get as much blood into the ventricles as possible. You can only add blood or contract to make more pressure. We can’t add more blood to the atria, but it can contract – this keeps the pressure higher in the atria than the ventricle and will keep the AV valve open long enough to completely fill up ventricles.
When atria contacts and the atrial and ventricle pressure goes up Ventricular pressure get higher also because it gets more blood. Atrial pressure got higher because it contracted. This is Diastole becausep the ventricles aren’t contracting! Atria contract to keep the pressure higher and push more blood into the ventricles. Blood was already flowing into the ventricles, this is a way to get more blood.


What is phase 2 isovolumetric contraction?

Phase 2: isovolumetric contraction.
Ventricles begin to contract (systole) – no blood is entering or leaving. Atrial pressure is lower than ventricular pressure because AV valves are CLOSED.
Ventricular pressure is less than aortic pressure because SL valves still CLOSED. Ventricular pressure is way lower than aortic pressure and needs to build up the pressure to open the values. Ventricles are contracting (pressure is rising). But blood volume in ventricles stays the same— isovolumetric. Systole: ventricles are contracting. This is a shorter phase than phase 1. There is a brief period of time when the ventricles contract, but arent open yet but are about to be.


What is phrase 3 ventricular ejection, the pay off.

Phase 3: ventricular ejection, the PAY OFF.
Ventricles are contracting (systole). The atrial pressure is lower than ventricular pressure because AV valves are closed.
Ventricular pressure is higher than aortic pressure, SL valves open.
Opening of SL valves allows ventricles to eject their contents into the systemic and pulmonary circuits.
SL valves are open and AV valves close because we don’t want blood going back into the atrium. Even at MAXIUM CONTRACTION, ventricle pressure only just barely makes it. So when someone talks about bypass surgeries, no one gets clogged aortas, but the tiny vessels that supply blood to the wall of the heart to keep it strong enough to contract and pump blood.


What is phase 4 isovolumetric relaxation.

Phase 4: isovolumetric relaxation. Ventricles relaxing (diastole) are in the process of relaxing. To get the SL valves to open, it took a huge contraction from the ventricles and will take a second to relax. The pressure of the ventricles is still higher [even empty] than the atria that is filling up with blood. It is dropping quickly, but it still more. Atrial pressure is less than ventricular pressure, AV valves are still closed. Ventricular pressure is lower than aortic pressure, SL valves close. Closing of SL valves maintains same level of blood in ventricles—isovolumetric relaxation. The ventricles are in the process of relaxing. The valves are closed. There is less pressure in the ventricles than in the aorta, the atria are filling with blood-Diastole.