Origin and Conduction of Cardiac Impulse Flashcards

1
Q

Autorhythmicity

A

The can heart beat rhythmically without any external stimuli

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2
Q

Where does excitation of the heart normally originate?

A

The pacemaker cells of the SAN

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3
Q

Sinus rhythm

A

When the heart is controlled by the SAN

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4
Q

What generates regular spontaneous pacemaker potentials?

A

The cells in the SAN, which have no stable resting membrane potential;

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5
Q

What does the spontaneous pacemaker potential do?

A

Takes the membrane to a threshold, thus creating an action potential

This results in regular spontaneous action potentials in the SAN cells

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6
Q

Define pacemaker potential

A

Slow depolarisation of membrane potential to a threshold

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7
Q

what generates the pacemaker potential?

A

Decrease in K+ efflux
Na+ influx (If)
Transient Ca2+ influx (T-type Ca2+ channels)

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8
Q

Rising phase of pacemaker action potential

A

Depolarisation caused by activation of L-type Ca2+ channels once threshold is reached

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9
Q

Result of rising phase of pacemaker AP being reached

A

Ca2+ influx

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10
Q

Falling Phase of pacemaker Action Potential

A

Repolarisation, resulting in K+ efflux

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11
Q

what causes falling phase of pacemaker action potential?

A

Inactivation of L-type Ca2+ channels and activation of K+ channels

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12
Q

Spread of excitation across heart

A

SAN->AVN->Bundle of His->L+R branches of bundle->Purkinje fibres

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13
Q

How does cell to cell spread of excitation occur from SAN to AVN?

A

Via gap junctions

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14
Q

Where is the only point of electrical contact between atria and ventricles?

A

AVN

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15
Q

Why is conduction in AVN delayed?

A

It allows atrial systole to precede ventricular systole

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16
Q

What allows rapid spread of action potential to ventricles?

A

Bundle of His, its branches and purkinje fibres

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17
Q

Resting membrane potential on atrial and ventricular myocytes

A

-90mV

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18
Q

Cause of rising phase of contraction cardiac muscle cell AP (phase 0)

A

Fast Na+ influx, causing membrane potential to reverse to 20mV

19
Q

Phase 1 of ventricular muscle AP

A

Na+ channels close; transient K+ efflux

20
Q

Phase 2 of ventricular muscle AP

A

Plateau phase

Ca2+ influx

21
Q

Phase 3 of ventricular muscle AP

A

Ca2+ channels close; K+ efflux

22
Q

Phase 4 of ventricular muscle AP

A

Resting membrane potential

23
Q

What causes plateau phase/ phase 2?

A

Influx of Ca2+ through L-type Ca2+ channels

24
Q

Main influence of heart rate

A

Autonomic Nervous system

25
Which nerve continuously influences SAN under resting conditions?
Vagus (parasympathetic) nerve
26
Role of vagal tone
Reduces intrinsic HR from around 100bpm to about 70bpm
27
What does the vagus nerve supply?
SAN and AVN
28
Neurotransmitter for vagus nerve and which receptor it acts on
Acetyl Choline | M2 muscarinic receptors
29
Competitive inhibitor of Acetyl Choline, used in extreme cases of bradycardia
Atropine
30
Effect of vagal stimulation on threshold, slope of PMP, frequency of AP and +/-ve chronotropic effect
Longer to reach threshold slope decreases frequency of AP decreases -ve chronotropic effect
31
What do cardiac sympathetic nerves supply?
SAN AVN Myocardium
32
Neurotransmitter for cardiac sympathetic nerve and which receptor it acts on
Noradrenaline | B1-ADR
33
Effect of sympathetic stimulation on threshold, slope of PMP, frequency of AP and +/-ve chronotropic effect
Threshold reached quicker Slope increases Frequency of AP increases +ve chronotropic effect
34
ECG
Recording of depolarisation and depolarisation cycle of cardiac muscles taken from skin surface
35
What does LI connect in a 12 lead ECG?
RA-LA
36
What does LII connect in a 12 lead ECG?
RA-LL
37
What does LIII connect in a 12 lead ECG?
LA-LL
38
What does the P wave represent?
Atrial depolarisation
39
What does the QRS complex represent?
Ventricle depolarisation (masks atrial repolarisation)
40
What does the T wave represent?
Ventricular repolarisation
41
What does the PR interval represent?
Largely AVN delay
42
What does the ST segment represent?
Ventricular systole
43
What does the TP interval represent?
Diastole