4-Cardiac Action Potentials Flashcards

1
Q

What establishes the resting membrane potential of cardiac myocytes?

A

The permeability to K+ ions

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2
Q

Does resting membrane potential = Ek?

A

No, RMP is reached at Ek but are not equal

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3
Q

Describe the stages of a ventricular myocyte action potential

A

1-upstroke, as opening of voltage gated Na+ channels allows an influx of Na+
2-Small downstroke, as outwards K+ channels repolarise membrane
3-plateau, as l type voltage gated calcium channels open, influx of ca balanced by K efflux
4-downstroke, repolarisation due to efflux of k through voltage gated k channels

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4
Q

What part of the heart depolarises the fastest?

A

Sinoatrial node

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5
Q

Describe the stages of a SAN action potential

A

1-slight increase over long period, funny current activated, HCN channels allow,influx of Na
2-upstroke, opening of voltage gate l type calcium channels
3-downstroke, voltage gated k channels allow efflux of k, causing repolarisaton

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6
Q

How many action potentials are responsible a single heartbeat

A

1

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7
Q

What happens if action potentials are fired too slowly?

A

Bradycardia

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8
Q

What happens if action potentials fail?

A

Asystole

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9
Q

What happens if action potentials are fired to quickly?

A

Tachycardia

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10
Q

What happens if electrical activity becomes random?

A

Fibrillation

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11
Q

Define hyperkalaemia

A

Plasma potassium concentration above 5.5mmol/l

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12
Q

Define hypokalaemia

A

Plasma potassium concentrations below 3.5mmol/l

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13
Q

Why do variations in potassium concentration have such a large effect on the heart?

A

Cardiac myocytes resting membrane potential is very close to Ek and potassium permeability sets the resting membrane potential

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14
Q

What effect does hyperkalaemia have on cardiac myocyte action potentials?

A

Makes Ek less negative, membrane depolarises a little, inactivating voltage gated sodium channels, slowing the upstroke

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15
Q

What are the risks of hyperkalaemia?

A

Initially, increase in excitation

Asystole

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16
Q

How is hyperkalaemia treated?

A

Insulin and glucose

Calcium gluconate

17
Q

What effect does hypokalaemia have on cardiac myocyte action potentials?

A

Lengthens action potential

Delays repolarisation

18
Q

What are the risks of hypokalaemia?

A

Longer action potential - early after depolarisation - oscillations in membrane potential - ventricular fibrillation - no cardiac output

19
Q

Describe how calcium is made available for contraction in cardiac myocytes

A

Depolarisation opens L type calcium channels in T tubule system
Localised calcium entry opens calcium induced calcium release (CICR) channels in sarcplasmic reticulum

20
Q

How are calcium levels controlled following a contraction in cardiac myocytes?

A

Most calcium pumped back into SR by SERCA, the pumps stimulated by the high intracellular calcium levels
Some is pumped out of the cell by Na/Ca exchanger or SERCA

21
Q

What carrier protein does calcium bind to in the cell?

A

Calmodulin

22
Q

What must be phosphorylated to enable actin myosin interactions?

A

Myosin light chain kinase

23
Q

How is MLCK inhibited?

A

Phosphorylated by PKC