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Physio II > cardiac physiology and conduction disorders > Flashcards

cardiac physiology and conduction disorders Flashcards

1
Q

three types of cardiac cells

A

pacemaker
conducting
contracting

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2
Q

conducting cells

A

carry signals to the muscle wall

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3
Q

contracting cells

A

do the contracting

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4
Q

where are pacemaker cells found (5)

A

SA node –> superior part of the R atrium

AV node–> in the atrioventricular septum

bundle of his

left and right branches

purkinje fibers

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5
Q

what specific subset of pacemakers cells set the rhythm of the heart

A

SA node in the superior part of the right atrium

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6
Q

pacemaker cells in the AV node respond to

A

signals sent from the SA node and then fire impulses that are conducted in the ventricle

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7
Q

what is the bundle of his

A

bundle of fibers that rub within the ventricular septum and when they get to the apex of the heart the fibers loop around and extend up the wall of the ventricles as the L and R bb

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8
Q

describe the three types of channel states

A

open allows for the flow of ions

closed inhibits the flow of ions and

inactivated is where the flux is inhibited by a gate function of a part of the protein called the inactivation gate

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9
Q

describe how the inactivation gate works

A

when the voltage gets to a certain point the flux of ions is so great that the inactivation gate closes which inhibits the flow of ions then the membrane has to reset that electrical charge back to normal so that the channel can reset to normal posture

close–>open–>inactivated–>closed

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10
Q

what does the term threshold mean with respects to voltage gating

A

the membrane potential where predominance of a given channel is open

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11
Q

three types of channels in cardiac cells

A

fast
slow
and
potassium

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12
Q

how do pacemakers cells differ from regular muscle

A

closer to the threshold because of more positive resting potential

and have a innate permeability to sodium which pushes the cell charge up

this permeability is what give the cell it’s rhymic nature because it is always climbing toward threshold

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13
Q

falling phase of pacemaker cells happens as a result of what

A

K channels opening

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14
Q

phases of pacemaker cells

A

0 - upstroke d/t opening of voltage gated sodium/calcium channels

3- repolarization d/t inactivation of sodium/calcium channels and opening of potassium channels

4 - resting, d/t slow leak of sodium into cell

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15
Q

how do contracting cells differ from pacemaker cells physiologically speaking

A 
0 = fast Na+ channels (as opposed to slow acting) 
1 = K+

Potassium channels starting to open and membrane potential starting to reset but then calcium channels start to open

2 = Ca++

3 = K+

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16
Q

60-100 bpm pace is seen where

A

a. SA node

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17
Q

40-55 bpm seen at what pacemakers

A

AV node

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18
Q

25-40 bpm seen in what pacemakers

A

Purkinje cells

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19
Q

which area of pacemakers set the heart rate usually?

A

SA node unless there is an issue in which case you might see a much lower heart rate

20
Q

what is normal sinus rhthym

A

Normal basically means that the contraction or electrical spike is generated from the atrium. If it is not generated in the atrium, then it is not normal

  1. If b/w 60-100bpm and there is a p wave for every QRS complex, then you can call it NSR
21
Q

45 yo man w/ chest pain. If he is shown to have a block at the SA node due to infarction, what would his HR be if all other areas are normal?

A

The AV node provides the next faster pace; that is probably going to give you the heart rate of 40-55 bpm

22
Q

P wave

A

= atrial contraction

depolarization of atria

23
Q

Q wave

A

= ventricular contraction

24
Q

Gap b/w p wave and QRS complex is represented by what in a EKG

A

delay in AV node

25
Q

Atrial repolarization results in what EKG marker

A

loss in QRS spike

26
Q

sinus bradycardia

A

coming from the sinus node seen as P waves but less than 60 bpm

27
Q

what is a respiratory sinus arrhythmia

A

Arrhythmia (first 2 spikes are farther apart, next 3 are closer together and last 2 are further apart í so pace is speeding up and slowing down which corresponds with respiration

28
Q

i. Atrial flutter

A

flutter waves which occur at a very rapid rate (>200 bpm) but ventricular rate remains regular b/c only so many atrial contractions get transmitted to the ventricle

29
Q

atrial flutter is characterized by what in EKG

A

flutter waves

30
Q

Atrial fibrillation

A

í disco-ordinated contraction; wave but not as crisp as you would see in flutter

31
Q

Atrial fibrillation seen as

A

Disorganized atrial activity

32
Q

PAT

A

rapid rate, P for every QRS but at the onset you see it accelerate dramatically

Sudden onset, occurs in phases of very rapid rate triggered by the atria

33
Q

Premature atrial contractions

A

abnormally short interval between contractions before the atrium fires another P wave

34
Q

First-degree block

A

elongation of normal interval b/w P wave and R wave.

Two parties are growing apart

35
Q

what are heart blocks

A

disorders at the AV node

36
Q

Second degree block

A

sometimes you have a P wave w/ no QRST complex

One of the parties doesn’t come home

37
Q

third degree block

A

total disconnect; no real relationship between atrial activity (p wave) and the ventricular activity

38
Q

PVC

A

ventricle spontaneously contracts (sometimes electrical abnormality and sometimes a volume problem)

39
Q

Ventricular tachycardia

A

rapid rate triggered by ventricle; the spike gets very wide

40
Q

Ventricular fibrillation

A

disorganized electrical activity

41
Q

polarization is when there are more ____ ions on the outside of the cell than are on the inside

A

positive ions on the outside=polarization

42
Q

what is the membrane potential

A

it is the difference between the positive charge we see outside the cell and the less positive charge we see in side the cell

43
Q

membrane potential decreasing in multiple cells is known as a

A

depolarization wave

auto iirrhytmic pacemaker cells

self generate ap and trigger each other

44
Q

describe the depolarization wave seen in pacemaker and myocytes

A

fast in pacemaker connects atria through bundle branches and will be see traveling slow in myoctes leads to the contraction of the atria

45
Q

depolarization wave will travel from the SA node to the AV node and conduction velocity will change here because

A

the AV node cells have very small diameters which increases resistance to electrical flow

and they use slower opening Ca ion channels rather than the faster opening Na channels

46
Q

pacemaker cell phases

A

4 0 3 4

Physio II (18 decks)

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