Cardiac Function Flashcards

1
Q

What is the function of the SA node + what type of cells is it made up of ?

A
  • pacemaker
  • generates spontaneous action potentials
  • action potentials pass to atrial muscle cells and AV nose
  • made of specialised cardiac muscle cells, continuous with atrial syncytium
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2
Q

Why are action potentials conducted more slowly in the AV node ?

A
  • ensures ventricles contract after atrial has contracted fully and have emptied blood into ventricle
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3
Q

What is the function AV bundle ?

A
  • passes through hole in cardiac skeleton to reach inter ventricular septum
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4
Q

Where so the right and left bundle branches extend ?

A
  • beneath endocardium to apices of right and left ventricles
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5
Q

What is the role of purkinje fibres ?

A
  • has many gap junctions
  • large diameter cardiac muscle with few myofibrils
  • conduct action potential to ventricular muscle cells (myocardium)
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6
Q

Stages of conduction through the heart ?

A
  • SA node initiates impulse
  • stimulates artia to contract
  • impulse is delayed in the AV node so that atria can empty blood into ventricles before ventricular contraction
  • impulse at AV bundle and divides into left and right branches which carry impulse along septum
  • impulse reaches purkinje fibres which distribute impulse to ventricular myocardium
  • this triggers ventricular contraction
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7
Q

Structure of cardiac muscle ?

A
  • mononucleated
  • faintly striated
  • connected by intercalated discs
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8
Q

Why is action potentials conducted propagation slower in cardiac muscle compared to skeletal ?

A
  • slower because of gap junctions + smaller diameter of fibres in cardiac cells
  • faster is skeletal cause of larger diameter fibres
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9
Q

Sliding Filament Theory of Cardiomyocyte contraction ?

A
  • Ca2+ binds to troponin C (TN-C) on thin filaments
  • exposes binding site on actin for myosin head
  • ATP hydrolysis provides energy for actin-myosin conformational change
  • ‘ratcheting’ of actin-myosin and shortening of the sarcomere occurs
    • Ca2+ dissociates from TN-C and myosin unbinds from actin with energy from ATP
    • Cycle ends when ATP binds to myosin and the sarcomere returns to original length.
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10
Q

Stages of cardiomyocyte contraction ?

A
  • Ca2+ enters the cardiomyocyte through L-type channels.
  • CICR (Calcium-Induced Calcium Release) = Ca2+ triggers the release of more Ca2+ from the sarcoplasmic reticulum (SR).
  • Intracellular Ca2+ Rise: Intracellular Ca2+ rises to ~0.5-2 µM.
  • Ca2+ binds to troponin-C, freeing the myosin binding site on actin.
  • Actin moves over myosin, leading to myocyte contraction.
  • Ca2+ is reabsorbed into the SR by the SERCA pump and removed from the cell via the Na+/Ca2+ exchanger and an ATP-dependent Ca2+ pump.
  • Ca2+ dissociates from troponin-C, inhibiting the binding site on actin.
  • ATP is required to unbind myosin from actin and reset the sarcomere to its normal length.
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11
Q

What are the 5 phases of cardiac action potential in contractile cells ?

A
  • phase 0 - rapid depolarisation = rapid influx of Na+ through fast Na+ channels
  • phase 1 - initial repolarisation = K+ begins to leave the cell causing slight dip in potential
  • phase 2 - plateau phase = Ca2+ enters via L-type channels, balances K+ leaving so plateaus also generates contraction
  • phase 3 - repolarisation phase = k + efflux through delayed rectifier, decreased membrane potential
  • phase 4 = resting potential
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12
Q

What are the K+ channels in ventricular cardiac cells + what’s their role in action potential ?

A
  1. Inward Rectifier (IK1):
    • maintains phase 4 resting membrane potential by allowing K+ to flow into the cell, helping to stabilize the negative potential.
  2. Transient Outward (Ito):
    • contributes to phase 1 (initial repolarization) by allowing a brief efflux of K+ from the cell, causing a small dip in the action potential.
  3. Delayed Rectifier (IKr, IKs):
    • important for phase 3 (repolarization) by facilitating K+ efflux, which helps return the membrane potential to its resting state.
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13
Q

What is pacemaker tissue + pacemaker potential ?

A
  • areas of the heart where ‘resting potential is unstable
  • after action potential, membrane becomes more positive until threshold potential reached, triggers new AP
  • pacemaker potential = slow depolarisation of membrane between 2 successive AP
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14
Q

What is automaticity in pacemaker tissue ?

A
  • Ability to spontaneous depolarise and trigger Action potential without external stimulation
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15
Q

Where is packemaker tissue found + not found ?

A
  • active in SA node
  • AV node
  • bundle of His
  • not in ventricular muscle cardiomyocytes
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16
Q

What are the phases of action potential in SA node ?

A

Pacemaker Cells: No true resting potential, generate regular, spontaneous action potentials.

Phase 4: Spontaneous Depolarization
• Mechanism: Inward movement of Na+, outward movement of K+.
• K+ movement decays over time.
• Pacemaker potential depolarizes to -55 mV.
• Ca2+ inward current accelerates from -55 to -40 mV (threshold potential).

Phase 0: Depolarisation
• Ca2+ influx increases due to L-type Ca2+ channels.

Phase 3: Repolarisation
• Voltage-controlled K+ channels open, K+ efflux, repolarizing the cell.
• Ca2+ channels inactivate during this phase.

17
Q

How does the parasympathetic nervous system regulate the cardiac cycle?

A

• The cardioinhibitory centre in the medulla oblongata controls the vagus nerve, which branches to the SA and AV nodes.
Ach is released, causing hyperpolarization of the heart.
• This results in a decreased heart rate (dominant effect).

18
Q

How does the sympathetic nervous system regulate the cardiac cycle?

A

• The cardioaccelerator centre activates sympathetic neurons (cardiac nerves).
• These neuron’s release norepinephrine, which has a minor effect on heart rate
- but increases the force of contraction and contractility.

19
Q

How does parasympathetic + sympathetic nervous system affect action potential ?

A
  • refer to graph
  • parasympathetic = increases hyperpolarisation
  • sympathetic = rapid depolarisation
20
Q

What is a P wave ?

A
  • atrial depolarisation / contraction
21
Q

What is QRS complex ?

A
  • ventricular depolarisation
22
Q

What is T wave ?

A
  • repolarisation of ventricles
23
Q

What is the PR interval ?

A
  • Start of atrial depolarisation to start of ventricular depolarisation
24
Q

What is the Q-T interval ?

A
  • time required for ventricles to undergo single cycle of depolarisation and repolarisation
25
Q

What is Ischaemic heart disease ?

A

• Deprivation of blood supply to cardiac tissue
• Angina Symptoms (chest pain)
• can cause HEART ATTACK
- eg. Coronary heart disease

26
Q

What are Cardiac dysrhythmias ?

A
  • Disruption of contraction control
    • an cause CARDIAC ARREST
27
Q

What is cardiac failure ?

A
  • Inability of heart to distribute blood
    • can cause HEART FAILURE
28
Q

What are beta blockers ?

A
  • block β1 receptors which adrenaline/ noradrenaline binds to
  • so slows down SA-node which initiates heartbeat
  • slows down heart rate + lowers blood pressure
29
Q

What are calcium channel blockers ?

A
  • block L-type Ca2+ channel
  • no influx of Ca2+ ions
  • so slows SA-node
  • so lowers heart rate + blood pressure