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Valley Need to knows > Cardiac Electrophysiology > Flashcards

Cardiac Electrophysiology Flashcards

1
Q

What are the 7 conduction pathways through the heart?

A

1) SA node (normal pacemaker)
2) Intranodal tracts (controversial)
- AV nodal tract
- Bachmann’s bundle to LA
3) AV node
4) Bundle of His
5) Bundle Branches
6) Purkinje fibers
7) Ventricular muscle

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2
Q

what is the relationship of the component of the ECG w/ the mechanical events in the heart?
P-Wave

A

Atrial depolarization

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3
Q

what is the relationship of the component of the ECG w/ the mechanical events in the heart?
PR interval

A

Atrial Systole and AV nodal delay

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4
Q

what is the relationship of the component of the ECG w/ the mechanical events in the heart?
QRS complex

A

ventricular depolarization (atrial depolarization)

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5
Q

what is the relationship of the component of the ECG w/ the mechanical events in the heart?
QT interval

A

Ventricular systole

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6
Q

what is the relationship of the component of the ECG w/ the mechanical events in the heart?
T wave

A

Ventricular repolarization

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7
Q

Action potential with a PLATEAU phase are found where?

A

Atrial muscle cells

Ventricular muscle cells

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8
Q

Action potentials arising om the SA node and AV node are biphasic. what does that mean?

A

they have a depolarization and depolarization phase with no plateau phase.

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9
Q

what is the RMP of the cardiac ventricular cell?

A

-90 mV

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10
Q

What are the phases of the ventricular action potential.

Phase 4

A

Resting membrane potential (diastole)

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11
Q

What are the phases of the ventricular action potential.

Phase 0

A

Rapid depolarization
Na+ diffuses into cell
AKA the upstroke of the potential

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12
Q

What are the phases of the ventricular action potential.

Phase 1

A

Transient (breif) repolarization
Cl- influx
K+ Efflux

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13
Q

What are the phases of the ventricular action potential.

Phase 2

A

Plateau
Ca+ influx
(as always K+ efflux)

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14
Q

What are the phases of the ventricular action potential.

Phase 3

A

Repolarization

K+ Efflux

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15
Q 
What are the phases of the ventricular action potential. 
Phase 4 (last phase 4)
A

RMP
(diastole)
Na+ / K+ pump operates to restore intracellular Na+ and K+ to appropriate levels

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16
Q

See page 103 in sweat book for diagram

A

pg 103 sweat book

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17
Q

What are the phases of the SA or AV nodal action potential?

Phase 4

A 
RMP (Diastole)
Spontaneous depolarization to threshold
K+ efflux
Na+ influx
Ca++ influx (during last 1/3 of phase)
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18
Q

What are the phases of the SA or AV nodal action potential?

Phase 0

A

SLOW depolarization
Ca++ and Na+ diffuse into cell
(side note it is the L-type Ca+ channels aka slow Ca++ channels thus the reason it is slow depolarization)

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19
Q

What are the phases of the SA or AV nodal action potential?

Phase 1

A

Gotcha there is no phase 1

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20
Q

What are the phases of the SA or AV nodal action potential?

Phase 2

A

Gotcha again with nodal action potential there is no phase 1 and phase 2

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21
Q

What are the phases of the SA or AV nodal action potential?

Phase 3

A

Repolarization

K+ Efflux

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22
Q

What are the phases of the SA or AV nodal action potential?

back to phase 4

A

RMP (diastole)

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23
Q

R/T the action potential of the SA node….. changing the rate of what phase leads to a change in HR?

A

Phase 4

24
Q

R/T the action potential of the SA node prolonging the phase 4 does what?

A

slows HR

25
Q

R/T the action potential of the SA node shortening the Phase 4 dose what?

A

increases HR

26
Q

then next questions teach you to read the question closely…. pay attention to nodal action or ventricular action potentionals.

A

read carefully

27
Q

on what phase of the NODAL ACTION potential does digitalis work to SLOW the HR?

A

Phase 4

- Dig slows the HR by slowing phase 4 depolarization of cells in the SA and AV node

28
Q

on what phase of the NODAL ACTION potential do CCB’s work to SLOW the HR

A

Phase 4

- CCB slow HR by slowing phase 4 depolarization of cells in the SA and AV node

29
Q

on what phase of the NODAL ACTION potential does Lidocaine or phenytoin work to control VENTRICULAR dysrhythmias?

A

Phase 4

30
Q

to recap why these drugs work on phase 4

A

in the NODAL action potential Ca++ is in phase 4 there is no plateau phase as with the ventricular action potential

31
Q

on what phase of the VENTRICULAR ACTION POTENTIAL do CCB’s work?

A

Phase 2

Plateau phase

32
Q

The resting membrane potential of the cardiac ventricular cell is what?

A

-90 mV

33
Q

What ion is responsible for establishing the transmembrane resting potential

A

K+

34
Q

When the gated Na+ channel is in the inactive state ( phase 2), the cardiac cell is in the ____ _____ period?

A

absolute refractory period

35
Q

an influx of what ion causes the ventricular cell to produce a plateau in phase 2 of the action potential?

A

Ca++

36
Q

Ca++ ions influence the opening of the gated K+ channel, with Hypocalcemia what happens to the duration of the plateau phase?

A

prolong

37
Q

Ca++ ions influence the opening of the gated K+ channel, with Hypercalcemia what happens to the duration of the plateau phase?

A

shortened

38
Q

on an ECG tracing each mm corresponds to how many seconds?

A

0.04 seconds

39
Q

The QRS complex results from what and what phase?

A

Ventricular depolarization

Phase 0

40
Q

The T wave results from what? and what phase?

A

Ventricular repolarization

phase 3

41
Q

the QT interval reflects the duration of what phase of the action potential?

A

Plateau phase (2)

42
Q

with HYPOcalcemia what happens to the QT interval?

A

it is prolonged

43
Q

with HYPERcalcemia what happens to the QT interval?

A

it is shortened

44
Q

peaked or tented T waves reflect what K+ problem?

A

Hyperkalemia

45
Q

U waves reflect what K+ problem

A

Hypokalemia

46
Q

what leads indicate Posterior inferior MI and what coronary artery supplies it?

A

II, III, aVF

Right (RCA)

47
Q

which leads indicate septal, anterior wall MI? and what coronary artery supplies it?

A

V2-V5

Left Anterior Descending (LAD)

48
Q

which leads indicates a lateral wall MI? and what coronary artery supplies it?

A

I, aVL, V4 - V6

Left Circ

49
Q

MAP is determined by what 2 factors?

A

CO

SVR

50
Q

CO is determined by what 2 factors?

A

HR

SV

51
Q

SV is determined by what 3 factors?

A

Preload
Afterload
Contractility

52
Q

Preload is determined by what 2 factors?

A 
IV volume
Venous tone ( when veins constrict blood is diverted to the heart, and vice versa)
53
Q

The major determinant of IV volume is the amount of what in the body?

A

Sodium

54
Q

what hormone is most important for controlling vascular volume

A

Aldosterone

55
Q

Compared with the normal heart, the size of the left ventricle chamber is NOT changed what what type of hypertrophied heart?

A

concentric

56
Q

Compared with the normal heart, the size of the left ventricle chamber IS substantially increased what what type of hypertrophied heart?

A

Eccentric

Valley Need to knows (25 decks)

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