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CPR Exam 1 > Cardiac Conduction And Action Potentials > Flashcards

Cardiac Conduction And Action Potentials Flashcards

1
Q

Bradycardia

A

RR is < 60/min

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2
Q

Tachycardia

A

RR > 100/min

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3
Q

First Degree AV Block

A

PR interval > 0.2

P is far from QRS complex

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4
Q

Long QT Syndrome

A

Q—> T is too far from

T wave is far from QRS complex

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5
Q

SA node

A

Major pacemaker

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6
Q

AV node passes to

A

through septa to Purkinjie Fibers

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7
Q

what makes A contract and V contract

A

A : SA node

V : AV node

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8
Q

which A contracts first

A

RA

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9
Q

What contracts first Endocardium or epicardium

A

Endocardium

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10
Q

which epicardium contracts first

A

RV epicardium

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11
Q

How are the AP speeds different

A 
HIGHEST (largest D)
Purkinje fibers 
Atrial and ventricular muscle fibers
AV node
SLOWEST
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12
Q

AP frequency in heart

A 
HIGHEST 
SA node
AV node
Purkinje fibers
LOWEST 
* to —I overdrive
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13
Q

What 2 places have spontaneous AP

A
  1. SA node : if it never gets signal to contract (40/min)

2. Purkinje fibers : if they dont get signal from AV node (20/min)

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14
Q

What happens in the primary AV block

A

The SA node sends signal to AV node and AV node holds on to it for too long

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15
Q

Secondary AV block

A

The SA node sends signal to AV node and it drops it and then SA node sends a second signal that causes AV node to send signal
= 2 p-waves , pretty spaced apart

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16
Q

AP Phases 0-4

For Ventricels and Atria and Purkfibers

A

Phase 0 : depolarization
Phase 1+ 2: keep Depolarization longer
Phase 3: Repolarization
Phase 4 : RMP (resting)

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17
Q

Phases of AP in SA node and AV node

A

More like
Slow APs and
Phase 4 : is at RMP——> rising slowly on its own
* no Phase 1 or 2

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18
Q

Phase 0

A

Na+ quick influx

19
Q

Phase 1

A

NA+ channels close by inactivation gate
K+ channels open and K+efflux
*rapid small dip

20
Q

Phase 2

A

Ca+2 channels then open = CA+ influx
= common always open (rectifying) K+ channels close
= closure of phase 1 K + channels
*MP stays + for a while

21
Q

Phase 3

A

CA+2 closure
Rectifying K + channels open
Voltage K+ channels from phase 1 open (FULLY, started during phase 2)

22
Q

What happens in Long OT syndrome

A

long time from phase 2 to phase 3
* Ikr(rapid K channels opening) and Iks (Slow K channels opening) channels don’t function right
= long QT interval (T wave is far from QRS)

23
Q

Ik1
Ikr
Iks
Ito

A

Rectifying K+ channel (close phase 2)
Rapid voltage gated K + channel (O phase 3)
Slow voltage gated K + channels (O phase 3)
The voltage gated K + channels (O in phase 1)

24
Q

When does ICa open

A

Phase 2

25
Q

Phase 4 on slow AP

A

Gradual depolarization until threshold (spontaneous pacemaker)
= slow Na+ influx (If or INaf) funny voltage channels (closes at threshold and open during complete repolarization)

26
Q

Phase 0 during slow AP

A

Ca+ channels open

K+ channels close

27
Q

Phase 3 during slow AP

A

K+ channels open (rectifying)

Closure of Ca+ channels ——> opens Na+ funny voltage channels for phase 4

28
Q

Parasympathetic stimulation by what N goes to

A

Vagus N —> ACH (M2/M3 receptors + special K+ ach channels)

SA node and AV node, and only very few to atrial myocytes

29
Q

Slowing of heart rate has no influence on

A

Contractility (inotrophic)

30
Q

Parasympathetic innervation on HR and how

A 
Slows it (- chronotropic effect)
Phase 4 : funny Na+ channels are slower = slow NA+ entry (decrease slope)
Phase 3 : ACH causes K+ ACh receptors to keep K+ channels open longer = hyperpolarization
31
Q

What does the sympathetic N innervates and what R and NT

A

The SA node, AV node, and ventricular myocytes

Norepinephrine——> B1 adrenergic Receptors

32
Q

Sympathetic effect of HR and how

A

Increase it (+ chronotropic effect)

  1. Rapid influx of funny NA+ channels (phase 4)
  2. Increases CA+ into myocytes (phase 0) = increased contractility + slope
    * + inotropic effect due to more Ca available for muscles
33
Q

What does sympathetic n do to velocity and relaxation velocity on AP

A

Increases both
+ dromotropic : fast contraction
+ lusitropic : fast relaxation after contraction

34
Q

Refractory period in heart

A

Are longer to allow all blood to get into A and V

35
Q

ARP (Absolute Refractory Period)

A

X AP can be made no matter what

=All Na+ channels are inactive

36
Q

RRP (Relative Refractory Period)

A

AP can be if the stimulus is great enough
= many of Na+ channels have reset
= makes an AP that’s not as big

37
Q

Supranormal Period (SNP)

A

Cell is more excitable then normal (anything will)
= AP here will be abnormal and small
= close to threshold and mostNA+ channels are reset

38
Q

Biggest reasons you get arrhythmia

A

ion concentrations aren’t right

39
Q

Hyperkalemia

A

Excess K+ in ECM = RMP will get higher
SLOWS phase 0 + less steep slope
SPEEDS UP phase 3 + doesn’t go all the way back down to normal RMP = not normal refractory period

40
Q

Hypokalemia

A

Low K+ in ECM = RMP gets lower

Need higher stimulus for AP (phase 0)

41
Q

Hyperkalemia and Hypokalemia on HR

A

Makes some myocytes fire at different times - not normal rhythmic contractions

42
Q

Isoelectrial point

A

When all myocytes are depolarized and contracting either in A or V

43
Q

Ventricular AP happens at what point

Atrial AP happens at what point

A

End of T wave

End of P wave

44
Q 
Cardiac sounds: means what on the ECG
S1
S2
S3
S4
A

S1 : Q wave starts when mitral valve closes
S2 : End of t wave, when the aortic valve closes
S3 : Mitral Valve opens and blood enters V
S4 : PR segment (atrial repolarization) blood fills the A

CPR Exam 1 (20 decks)

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