Cardiac Rhythm & Cardiac Cycle Flashcards

1
Q

Describe the special features of cardiac myocytes

A
  • striated & branching with centrally located nuclei
  • no terminal cisterna
  • almost exclusively aerobic metabolism
  • intercalated discs (made up of desmosomes and gap junctions) connect myocytes
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2
Q

Describe the anatomy of intercalated discs, desmosomes and gap junctions in cardiac myocytes

A

Intercalated discs:

  • connect adjacent myocytes
  • made up of desmosomes and gap junctions

Desmosomes:

  • intercellular junctions
  • create strong adhesions between cells to maintain tissue integrity and resist mechanical stress

Gap junctions:

  • protein lined tunnels
  • allow direct transmission of action potential from cell to cell
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3
Q

Describe the importance of calcium for generating action potentials in cardiac myocytes

A

Stage 1:
- depolarization of cardiac myocytes opens calcium channels in plasma membrane (10-20% of calcium needed for contraction)

Stage 2:
- influx of calcium triggers the opening of calcium channels in sarcoplasmic reticulum (80-90% of calcium needed for contraction)

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4
Q

What are the two circuits in the cardiovascular system?

A

Pulmonary - between heart and lungs

Systemic - between heart and the rest of the body

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5
Q

What is the intrinsic conduction system and the direction of conduction?

A

Intrinsic conduction = wave of depolarization / contractions that is generated by pacemaker cells and spreads through gap junctions in the heart

  1. SA node (pacemaker cells) - in right atrial wall inferior to SVC
  2. AV node
    - in inferior interatrial septum superior to tricuspid valve
  3. AV bundle
    - superior interventricular septum
  4. AV bundle branches
    - interventricular septum
  5. Purkinje Fibres
    - from apex of heart superiorly along ventricular walls
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6
Q

Describe the main events of the cardiac ECG and what they correlate to.

A

P: atrial systole / atrial depolarization

QRS: ventricular systole / ventricular depolarization

T: ventricular diastole / ventricular repolarization begins at apex

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7
Q

Describe the events of the cardiac cycle

A
  1. Atrial systole / ventricular diastole
    - atria contract (early phase)
    - atria relax (mid-late)
    - ventricles relaxed & filling with blood through open AV valve
  2. Ventricular systole
    - atria relaxed
    - ventricles contract and empty (isometric contraction)
    - AV valves close (S1 beat)
    - semilunar valves open
  3. Early ventricular diastole
    - atria & ventricles relaxed
    - atria passively filling (isovolumetric relaxation)
    - semilunar valves closed (S2 beat)
    - AV valves open
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8
Q

Describe what is happening in (mid-late) ventricular diastole

A
  • atria in systole: contracting & pumping blood to ventricle
  • AV valves open & semilunar valves closed
  • ventricle in diastole & filling with blood
  • P wave
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9
Q

Describe what is happening in ventricular systole

A
  • atria in diastole
  • AV valves close (S1 beat)
  • ventricles in systole & pumping blood through open semilunar valves
  • QRS wave
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10
Q

Describe what is happening in (early) ventricular diastole

A
  • atria in diastole & filling with blood passively
  • ventricles in diastole
  • semilunar valves close (S2 beat)
  • AV valves open
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11
Q

What is the difference between an electrocardiograph and an elecrogardiogram?

A
Graph = machine
Gram = image produced
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12
Q

What are the locations of the SA node and AV node?

A

SA node:
in right atrial wall
(inferior to SVC)

AV node:
inferior interatrial septum (above tricuspid valve)

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13
Q

What does the QRS complex represent?

A

Electrical event:
ventricular depolarization

Mechanical event:
ventricular contraction

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14
Q

What does the P wave represent?

A

Electrical event:
atrial depolarization

Mechanical event
atrial contraction

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15
Q

What does the T wave represent?

A

Electrical event:
ventricular repolarization

Mechanical event
ventricular relaxation

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