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Flashcards in Week 1 Deck (44):
1

Define contractility

The amount of tension that can be developed at any given stretch of cardiac muscle.

2

What two factors determine the amount of tension that is generated when a healthy cardiomyocyte contracts?

1. Amount of Ca2+ in sarcoplasm
2. Length of cardiomyocyte before contraction

3

How might you increase the amount of tension a cardiomyocyte can generate for a given length?

Increase intracellular calcium (increase its contractility)

4

What is an inotrope?

A physiological or pharmacological agent that alters contractility of cardiac muscle (may be positive or negative)

5

Define preload

The degree of tension on a muscle when it begins to contract

6

Define afterload

The load against which the muscle exerts its contractile force

7

Give an example of 'afterload'

Arterial blood pressure

8

An ECG measures:

Electrical activity on the surface of the heart cells

9

Regarding the ECG, what does dipole magnitude depend on (2 things)?

1. How many cells are depolarising at that instant
2. Which direction is the wave heading? (vector analysis of dipoles)

10

What is an ECG 'lead'?

A particular configuration of electrodes that compares the electrical potential between the two points in relation to the direction of net depolarisation ( of the heart)

11

What event is responsible for the first heart sound?

The closure of the mitral (mainly) and tricuspid valves (AV valves)

12

What event is responsible for the second heart sound?

The closure of the aortic (mainly) and pulmonic valves.

13

What is the electrical axis of the heart?

The orientation of the ECG vector at its maximum amplitude

14

What two things could change the electrical axis of the heart?

1. A change in position of the heart
2. Increase in mass in one of the ventricles e.g hypertrophic cardiomyopathy

15

Give three examples of an altered sinus rhythm

Sinus tachycardia
Sinus bradycardia
Sinus arrhythmia

16

Give four possible sources of abnormal heart rate or rhythm

1. Vagal or SNS input to SA node (physiological) e.g sinus bradycardia

2. A block in impulse conduction either through SA or AV node e.g SA block

3. Premature beats e.g ventricular premature contractions

4. Fibrillation of heart muscle e.g atrial fibrillation

17

What is a premature atrial contraction? What might lead to this developing?

Occurs when an ectopic pacemaker develops in the atrial muscle that depolarises spontaneously and sends out impulses in addition to those coming from the SA node. Some of these may make it through the AV node. May develop when an area of muscle has experienced ischaemia resulting in dysregulation of its Ca2+ ATPase pumps, leading to a less stable resting membrane potential

18

Define end diastolic volume

The volume of blood in the ventricles in the period after atrial systole has finished and before ventricular systole starts

19

In which phase of the cardiac cycle might you see both the C wave and the QRS complex?

Isovolumetric phase of ventricular systole

20

When in the cardiac cycle does the C wave occur, and what does it represent?

At the beginning of ventricular systole - once the AV valves have closed, and the continuous rise in pressure in the ventricles causes the AV valves to bulge into the atria, creating the 'C wave' of pressure transmitted to the great veins

21

When in the cardiac cycle does the A wave occur and what does it represent?

Occurs at atrial systole; there are no valves between the atria and great veins, so when they contract there is some blood and pressure pushed back into the great veins.

22

When in the cardiac cycle does the V wave occur and what does it represent?

Occurs at the end of ventricular systole, during atrial diastole. Build up of blood in the atria generates the pressure wave back into the great veins.

23

What are the three phases of ventricular diastole?

1. Isovolumetric relaxation
* AV valves closed
* SL valves closed
2. Rapid ventricular filling
* AV valves open
* elastic recoil of ventricles
3. Reduced refilling
* ventricles truly relax

24

Does systole or diastole contribute more to MAP? Why?

Diastole - because heart spends more time in diastole

25

How to calculate SV?

SV = EDV - ESV

26

Define stroke volume

The volume of blood ejected from the heart with each contraction

27

Define ejection fraction

The proportion of EDV ejected with each contraction

28

How to calculate EF?

EF = SV/EDV

29

What will happen to EF as the heart fails?

It will decrease

30

In which two species does the R interventricular artery come from the R coronary artery?

The horse and the pig. Cats variable

31

In which species does the R interventricular artery come from the Left coronary artery?

Ruminants, and the dog. Cats variable

32

Which species have only the R azygous vein?

Horse and carnivores

33

Which species have both R and L azygous veins?

Ruminants
- right to the cranial VC
- left to the coronary sinus

34

Which species has only the L azygous vein?

Pigs

35

In which species do the brachycephalic trunk and the left subclavian artery arise from the aorta independently?

Carnivores and pigs

Not ruminants or horses

36

What distinguishes the pig's brachycephalic trunk from carnivores'?

Pig has extended bicarotid trunk

37

What sort of sternal attachment does the heart make in the horse? What layer of pericardium is this made of?

Single sternopericardiac ligament

Fibrous pericardium - shallow to parietal pericardium

38

What sort of sternal attachment does the heart make in ruminants?

Paired sternopericardiac ligaments

39

What sort of sternal attachment does the heart make in the pig? Do any other species have this arrangement?

Single phrenicopericardiac ligament
Yes cats and dogs

40

What structures does the vertebral artery supply?

The cervical spine and the brain

41

What structure does the internal thoracic artery supply?

The thoracic wall

42

What structure does the superficial cervical artery supply?

The base of the neck and the adjacent scapular region

43

What causes nodal cell membrane potentials to decay spontaneously and become gradually more positive?

Passive diffusion of Na+ into the cell down its concentration gradient

44

At about -60mV, what event occurs in nodal cells? How does this compare to cardiomyocytes?

Voltage-gated Ca channels are activated and Ca enters the cell

Cardiomyocyte cell membranes are activated by influx of Na via voltage gated Na channels when they are stimulated. Na channels will open when membrane potential exceeds -90mv