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Lesson 1 Flashcards

1
Q

Ca++ channels initially open to continue the process of

A

depolarization

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2
Q

The rhythm’s isoelectric line reflects __ of the AP

A

phase 4

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3
Q

Bachman’s bundle is

A

an interatrial tract

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4
Q

The anterior-superior fascicle of the LBB supplies

A

the septum

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5
Q

During ventricular systole

A

The tricuspid and mitral valves close

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6
Q

In the event of low osmolarity imbalances

A

ADH levels decrease

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7
Q

The primary area of infarction after occlusion of the RCA is the

A

inferior wall of the LV

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8
Q

Normal LV musculature is approximately __ in thickness

A

8-15mm

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9
Q

The MP is the electrical voltage of the

A

polarized cell

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10
Q

During phase 2 of the AP

A

K+ leaves the cell

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11
Q

The LAD artery supplies a major portion of the heart’s __surface

A

Anterior

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12
Q

Sinus arrhythmias can be found following Inferior wall MIC because the RCA supplies

A

the SA node

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13
Q

Actin and myosin

A

Are muscle proteins, responsible for cardiac muscle contraction & relaxation

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14
Q

How does the PSNS impact cardio-regulation & what hormones are involved

A

PSNS supplies SA, atrial muscle, AV, some purkinje-fibres- they have a SUPRA-VENTRICULAR effect, acetylcholine is released with vagal stimulation, slows SA & AV node

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15
Q

Polarized ventricular cells

A

Are impermeable (at MP of -90mV)

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16
Q

The posterior-inferior fascicle of the LBB supplies

A

the lateral wall of the LV

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17
Q

Spread of ventricular depolarization occurs from

A

Endocardium to Epicardium (Endo closes to heart, Myocaridum (thick), epicardium)

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18
Q

What are the primary extracellular electrolytes

A

Na+ & Ca++

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19
Q

The main event occurring in phase 0 of the AP is

A

opening of the Na+ channels

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20
Q

The vulnerable period of the AP

A
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21
Q

During RRP (relative refractory period)

A

the ventricular cell’s MP is -60 to -90mV

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22
Q

What does aldosterone do

A

promotes fluid retention by promoting retention of Na+ & H2O, & Cl- - increase plasma volume & BP

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23
Q

Cells in the AV node ..

A

slow impulses

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24
Q

Flow of blood during atrial diastole account for about __% of total ventricular volume

A

80%

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25
Ventricular cells with automaticity cannot generate impulses slower then their intrinsic ability of 20-40 impulses/minute because
acetylcholine effects are supra-ventricular
26
Threshold potential (TP) represents the
increased voltage required to depolarize the cell (gets more positive)
27
The initial part of the R wave reflects __ of the AP
phase 0
28
Bundle branches are mostly supplied by
the LAD
29
If sarcomeres are to contract they must receive energy from _
ATP
30
The first heart sound (S1) indicates
the onset of ventricular systole & the closing of
31
Normal RV musculature is approx __ thick
4-5mm
32
What is automaticity, excitability, conductivity & contractility
Automaticity- ability to initiate impulse (pacemaker cells) Excitability - respond to impulse Conductivity - pass impulse along Contractility - contraction/shortening of cardiac fibers
33
Rate of SA node
60-100 it is the original initiator & SA node has automaticity
34
What are the internodal/interatrial tracts
Internodal pathway - through RA to AV node, influence conduction time from SA to AV Interatrial Tract - Bachmann's bundle, travels through LA
35
What is the purpose of the AV node & AV junction
The AV node slows the conduction of the impulse before it reaches the ventricles, thus giving time fro the atrium to contract before the ventricles - creates the PR interval The AV junction has automaticity, at a rate of 40-60bpm
36
What is the rate of automaticity of the bundle of HIS
20-40
37
What does the R bundle branch supply
septum & RV
38
What does the anterior superior fascicle of the LBB supply & posterior inferior fascicle of the LBB supply
Anterior - septum, lateral LV & anterior LV Posterior - septum, lateral LV & posterior LV
39
Path of conduction of caridiac AP
SA -- internodal trach (&interatrial bachmann bundle) -- AV- bundle of HIS - RBB & LBB (posterior & anterior) - purkinje fibres
40
What is important to note about purkinje fibres
they have FAST conduction for simultaneous ventricle contraction
41
Direction that coronary arteries supply
outside to inside Pericardium to endocardium
42
What does the RCA supply, common infarct & arrhythmia to anticipate
RA, RV, inferior LV, posterior LV & posterior septum SA, AV, bundle of HIS, LBB Infarct- 1.inferior wall of LV, 2posterior LV, 3. RV Arryth- Sinus arryth. Junctional, heart blocks
43
What does the LAD supply, common infarct & arrhythmia to anticipate
Anterior LV, anterior RV, anterior septum RBB & large area of LBB (part posterior & anterior) Infarct - Anterior LV, anterior septum arryth- BBB, complete heart block
44
What does the Circ supply, common infarct & arrhythmia to anticipate
LA, lateral LV, posterior LV SA, proximal BB Infarct- Lateral LV, posterior LV Arryth - Sinuse arryth, BBB
45
What is the entire cardiac muscle structure & what carries in the impulse
T-tubule carry impulse to Sarcoplasmic reticulum (mesh coating around myofibril, stores Ca++) - Myofibril, made up of sarcomeres - made up of A band(actin) I band (myosin) & Z-band
46
What is diastole, what vales are open, what veins/arteries are open(in use)
Diastole is the resting state, superior/inferior vena cava bring in un-oxygenated blood from body to RA, oxygenated blood flows into LA from pulmonic veins, MV& TV are open, blood flows passively into ventricles - accounts for 80% of blood volume
47
What happens in atrial systole
Blood is ejected from atria into partially filled ventricles, adds 20% of ventricular blood volume "atrial kick"
48
What happens in ventricular systole
MV&TV close (d/t pressure in ventricle), PV & AV open, ventricles contract, RV eject out pulmonic artery, LV eject out aorta, PV & AV close
49
What makes S1 & S2 sound
S1- closing of MV & TV S2 - PV & AV
50
What are the two cardio-regulatory mechanisms
ANS (SNS & PSNS) & specialized defense mechanism ( receptors, osmo,pressor, chemo)
51
How does the SNS impact cardio-regulation & what hormones are involved
SNS supplies atria & ventricles, epinephrine & nor-epinephrine, increase hearts excitability, increase force of contraction, increase HR, increase conduction through AV
52
How does the PSNS impact cardio-regulation & what hormones are involved
PSNS supplies SA, atrial muscle, AV, some purkinje-fibres- they have a SUPRA-VENTRICULAR effect, acetylcholine is released with vagal stimulation, slows SA & AV node
53
What is the primary intracellular electrolyte
K+
54
What two hormones assist with fluid homeostasis
Aldosterone (form adrenal) & ADH (from pituitary)
55
What does ADH do
conserves water, stimulates re-absorption of water - urine volume decreases & concentration increases
56
what do osmoreceptors do (l& ow vs high osmolarity response)
- detect changes in concentration or osmolarity - cause hormonal response, ADH - LOW - hypotonic, osmorecptors decrease impulse on pituitary gland thus decreasing ADH - cause diuresis - HIGH - hypertonic, osmoreceptors increase impulse on pituitary gland to increase ADH, increase water re-absorption in kidneys
57
What do pressoreceptors / baroceptors do (high vs low reaction)
they are sensitive to changes in BP, HR & CO - effect BV constriction - ANS & hormonal (aldosterone response) - Increase HR, BP, CO -- ANS (PSNS is stimulated, decrease HR, decrease CO) hormone (aldosterone is inhibited, loss of Na+ & water, BP decrease) -- Decrease in HR, BP, CO - ANS (PSNS is inhibited, decrease HR) hormonal (aldosterone is secreted, retention of Na+ & H2O, fluid volume increase)
58
what do chemoreceptors do
Respond to low O2, & severe drops in CO & BP - stimulate ANS response SNS - stimulated release nor-epi & epi - increase HR, vasoconstriction, increase force of contraction - increase BP - Also send impulse to respiratory centre, alveolar ventilation improves- increase O2 intake by lungs- increase O2 sat
59
What is polarization or polarized state
- polarization is the resting state of the cell, iso-electrical line, end to T wave to next beat, phase 4
60
What is depolarization
Cells state of excitability, cells are stimulated Na+ enters cell P wave is atrial depolarization & & QRS is ventricular depolarization
61
What is repolarization
restoration of cells to resting/polarized state, K+ ions move out Ta wave is atrial repolarization (inside QRS) T waves is ventricular repolarization
62
What is membrane potential & threshold potential
MP - voltage when polarized at rest TP - voltage needed before it can be activated - at this point depolarization can occur for an AP
63
What is a pacemakers cell MP & TP
-since pacemaker cell much less the non-pacemaker cell MP -40mV to -70mV, TP -35mV to -50mV - they can spontaneously depolarize and initiate an AP
64
What is a non-pacemakers cell MP & TP
MP -90mV TP - 70mV to -80mV these cells need an impulse to commence depolarization to reach the TP
65
What are the 5 phases of an AP
Phase 0 - cell voltage goes up till it reaches TP- depolarization occurs from fast Na+ channels until cell is at -60mV - second wave of Na+ and Ca++ slow channels start to open - creates the R wave Phase 1 - abrupt closure of Na channels, start of S wave Phase 2 - slighlt plateau, Ca still open to help with contraction & allow one full contraction to occur before another is initiated, K+ is moving out to balance Phase 3 - Ca channel close - increase in K+ lea ing - sodium-potassium pump restores cell to MP Phase 4 - cell at MP, iso-electric line
66
What is the absolute refractory period
cells cannot respond to a stimulus, phases 1,2&3. still cell reaches approx -60mV - QRS and initial part of ST segment
67
What is the relative refractory period & vulnerable period
corresponds to the -60mV to -90mV in phase 3, where a premature impulse is possible to initiate a cycle - vulnerable period is the end of phase 3 - highest excitability just prior to MP, -85mV to -90mV, a weaker stimulus then normal can initiate an AP- this can cause R on T phenomena (peak of the T wave - cause VT &N VF

CC2 (1 decks)

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