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Cardiopulmonary pathology > Cardiac Arrhythmias > Flashcards

Cardiac Arrhythmias Flashcards

1
Q

arrhythmias

What is the cause?

A

abnormal heart rhytms

altered impulse formation, impulse conduction or both

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2
Q

bradycardias

It has ______ (increase/decrease) firing rate

A

slow heart rhythms

decreased

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3
Q

tachycaridas

It has _________ (decrease/increase) firing rate

A

fast heart rhytms

increased

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4
Q

What are the factors cause the altered impulse formation in tachycardias?

A

increase automaticity of SA node & of latent pacemakers

automaticity of atrial/ ventricular myocytes

triggered activity

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5
Q

What are the factors cause the altered impulse formation in bradycardias?

A

decrease automaticity of SA node

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6
Q

What are the factors cause the altered impulse conduction in tachycardias?

What are the factors cause the altered impulse formation in bradycardias?

A

unidirectional block & reentry

conduction block

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6
Q

T/F: In normal conditions, only SA node cells are able to depolarize itself to threshold

A

False.

AV node, Bundle of His & Purkinje fibers cells can also depolarize itself

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7
Q

Why does triggered activity lead to the tachycaridas?

A

some action potentials can trigger abnormal depolarizations that result in extra heart beats or rapid arrhythmias

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8
Q

T/F: cardiac tissue damage can cause myocytes outside the specialized conduction system to acquire automaticity

A

True

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8
Q

Which pacemaker cells have the fastest firing rate? 2nd & 3rd?

A

SA node > AV node & Bundle of His > Purkinje fibers

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9
Q

Describe the cells depolarization & repolarization

A

1) phase 4 depolarization: the Na+ channels slowly open
2) phase 0: progressive decline in K+ efflux & Na+ channels is inactive while Ca2+ slowly influx
3) K+ efflux progressively while Ca2+ channels slowly closes

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10
Q

What are factors that determine firing rates?

A

slope of phase 4 depolarization

the maximum negative diastolic potential

the threshold potential

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11
Q

the rate of pacemaker current (If) is equivalent to ___________

What does If depend on?

A

the slope of phase 4 depolarization

the # and kinetics of individual pacemaker channels through the current flows

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12
Q

The more negative MDP (maximum diastolic potential), the _______ firing rate as the slop of phase 4 depolarization _________ (less steeper/ more steeper)

A

longer

less steeper

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13
Q

The less negative threshold potential, the ______ firing rate as the slope of phase 4 depolarization is ________ (longer/shorter)

A

longer

longer

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14
Q

What modulate SA node?

A

sympathetic nervous system

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15
Q

Why do we say that SA node is a native pacemaker?

A

Because it has the highest firing rate -> set the HR

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16
Q

True/False: Automaticity of SA node can increase under exercise or emotional stress

A

True

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17
Q

Through what cells receptors does sympathetic system stimulate SA node?

what are hormones that these receptors react with?

A

ß-adrenergic receptors

epinephrine or norepinephrines

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18
Q

What are two factors of firing rate depends on that sympathetic stimulation affect?

A

steeper the slope of phase 4 depolarization

shift threshold to more negative values

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19
Q

What are the factors of firing rate depends on that parasympathetic system affect?

A

shifts maximum negative diastolic potential (MDP) is more negative

decreases the slope of phase 4 depolarization

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20
Q

How does PNS decrease the slope of phase 4 depolarization?

A

by decreasing the probability of pacemaker channels being open

21
Q

what are the arrhythmias as consequences of decreased SA node?

A

escape rhythm

supraventricular arrhythmias

ventricular arrhythmias

22
Q

escape rhythms

what will happen to impulse formation in escape rhythms

A

SA node is suppressed -> decreased firing rate

impulse formation is shift to latent pacemakers cells

23
Q

What are the types of escape rhythms in heart?

Explain each

A

nodal or junctional escape beat: originate in AV node through His-Purkinje fibers (normal QRS)

ventricular escape beat: originate from Purkinje fibers (abnormal QRS)

24
Q

What is the cause of escape rhythms?

A

strong parasympathetic stimulation

25
Q

Where does supraventricular arrhythmias occur?

Does it have normal or abnormal QRS?

What are types of Supraventricular arrhythmias?

A

above the ventricle

normal

PSVT, Atrial flutter & atrial fibrilation

26
Q

Describe the ECG of atria flutter

A

rapid succession of identical, back to back atrial depolarization waves (P wave)

27
Q

atria flutter

T/F: all atrial impulses are transmitted to ventricles in atria flutter

A

regular rapid arrhythmias

False. Not all because AV node is in refractory period

28
Q

T/F: SA node is more sensitve to parasympathetic stimulation than latent pacemakers cells

A
29
Q

T/F: ventricular escape beat have normal QRS complex

A

False

abnormal

30
Q

atrial fibrilation

Describe the ECG

A

irregular rapid impulses from atrial foci depolarize atria

chaotic & erratic baseline with no discrete P waves & irregular space QRS complex

31
Q

Ventricular arrhythmas has ______ (normal/abnormal) QRS complex

A

abnormal

32
Q

What are the symptoms of ventricular arrhythmias?

A

premature ventricular contraction

ventricular tachycardiacs

ventricular fibrilation

33
Q

premature ventricular contraction (PVC)

A

ectopic beat

34
Q

ectopic beats

What are the causes of ectopic beats?

A

when latent pacemaker develops rate of depolarization faster than of SA node -> disturbance of impulse formation

ischemia, electrolyte disturbance & hypoxemia

35
Q

T/F: The impulse in ectopic beats are premature relative to normal rhythm

A

True

36
Q

What is the cause of ventricle tachycardia?

What can ventricle tachycardia lead to?

A

the re-entry mechanism

ventricular fibrilation

37
Q

ventricular fibrilation

A

rapid, irregular ventricular depolarization due to the impulse generated from ventricular foci

38
Q

early after depolarizations

Why does this happens?

A

changes in membrane potential in the positive direction that interupt normal repolarization

because action potential duration is longer than normal

39
Q

What phase does early after depolarization occur in?

A

phase 2 (plateau) and phase 3 (during repolarization)

40
Q

T/F: early after depolarization can be self-pertuating & lead to repeated depolarizations and tachycaridas

A

True

41
Q

When does delayed after depolarization occur?

A

after repolarization but before another normal action potentials would occur

42
Q

True/False: the impulses can’t be blocked when it enters the region of the heart that is non-conductive

A

false

43
Q

fixed block

A

the block is caused by a barried in which fibrosis or scarring replaces conducting myocytes

44
Q

What does block within the AV node or His/Purkinje system do?

A

prevent the impulse propagation to the more distal sites

45
Q

1st degree of AV block

What are the causes?

A

delayed conduction between atria & ventricle

vagal stimulation, beta-receptor antagonist, amyloidosis, sarcoidosis

46
Q

2nd degree of AV block

3rd ______

A

intermitten or cyclical failure of impulse conduction

failure of impulses conduction

47
Q

What are the causes of 3rd degree of AV block?

A

atria & ventricle beat independently; ventricle escape rhythm (atrial rate is faster than ventricular rate)

48
Q

His/Purkinje block

A

failure of impulse conduction through one of bundle branches -> ventricle depolarize much slowly

49
Q

unidirectional block & re-entry

A

an electrical rhythm circulates repeatedly around a re-entry path & recurrently depolarize a region of cardiac tissue

50
Q

What type of heart diseas is this?

A

Mobitz type 1 - 2nd degree block

51
Q

What type of heart disease is this?

A

mobitz type II - 2nd degree block

no R wave

Cardiopulmonary pathology (12 decks)

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