Cardiac SEE

Question 1

What is

Inotropy
Chronotropy
Dromotropy
Lusitropy

Answer 1

Inotropy - Contractility
Chronotropy - HR
Dromotropy - Conduction velocity
Lusitropy - Myocardial relaxation during diastole

Question 2

What is the RMP and TP of the cardiac myocyte?

Answer 2

TP, -55
RMP, -70

Question 3

What happens to the RMP when potassium is increased or decreased

Answer 3

Decreased K - Decreases RMP
Increased K - Increases RMP

Question 4

What is the primary determinant of TP? How does hyper/hypo affect it?

Answer 4

Ca

Increased Ca - TP becomes positive
Decreased Ca - TP becomes more negative

Question 5

What happens when RMP becomes closer to TP? What about further away?

Answer 5

Closer - more easily depolarized
Further - Harder to depolarize

Question 6

What is the sodium-potassium ATPase pump?

Answer 6

Restores balance towards RMP

For every 3 Na lost, 2 K enters the cell

Question 7

What drug inhibits the Sodium-potassium ATPase pump?

Answer 7

Digoxin

Question 8

Cardiac Conduction

Answer 8

Question 9

What happens in phase 0 of the myocyte action potential

Answer 9

Sodium enters the ICF

(depolarization)

Question 10

What happens in phase 1 of the myocyte action potential

Answer 10

Cl- enters the ICF
K+ leaves the ICF

(Initial repolarization)

Question 11

What happens in phase 2 of the myocyte action potential

Answer 11

Ca+ enters and K+ leaves

(Plateau)

Question 12

What happens in phase 3 of the myocyte action potential

Answer 12

K leaves the ICF

(Final repolarization)

Question 13

What happens in phase 4 of the myocyte action potential

Answer 13

Resting phase

K out

Na/K/ATPase pump working

Question 14

Between what phases is the absolute refractory period?

Answer 14

End of phase 1 to middle of phase 3

Question 15

When is the relative refractory period?

Answer 15

End of phase 3

Question 16

What is the conduction pathway through the heart?

Answer 16

SA node
Internodal Tracts
AV node
Bundle of HIS
Bundle branches
Purkinje fibers

Question 17

Cardiac conduction potential

Answer 17

Question 18

What is phase 4 of the cardiac conduction potential?

Answer 18

Spontaneous depolarization

Na in through leaky channels

Ca channels open (T type)

Question 19

What is phase 0 of the cardiac conduction potential?

Answer 19

Depolarization

Ca enters through L channels

Question 20

What is phase 3 of the cardiac conduction potential?

Answer 20

Repolarization

K out

Question 21

What are the RMP and TP of cardiac conduction?

Answer 21

RMP, -60
TP, -45

Question 22

What is Reynolds number? What does it signify?

Answer 22

Can predict flow

<2,000 laminar
2000-4000 transitional
>4000 turbulent

Question 23

How much does atrial kick contribute to Cardiac output?

Answer 23

20-30%

Question 24

Wiggers Diagram

Answer 24

Question 25

On the wiggers diagram when do the aortic and mitral valves open and close?

Answer 25

Opposite corners

Question 26

On the wiggers diagram when does isovolumetric contraction and relaxation occur?

Answer 26

When the valves are closed

Question 27

Cardiac Cycle

Answer 27

Question 28

Normal EF? Severe?

Answer 28

Normal >50% Mild > 41-49% Moderate > 26 - 40% Severe < 25%

Question 29

Increased Preload on diagram

Answer 29

Question 30

Decreased Preload on diagram

Answer 30

Question 31

Increased contractility on diagram

Answer 31

Question 32

Decreased contractility on diagram

Answer 32

Question 33

Increased afterload on diagram

Answer 33

Question 34

Decreased afterload on diagram

Answer 34

Question 35

What does the Left coronary artery divide to?

Answer 35

Left anterior Descending and the circumflex

Question 36

What does the LAD perfuse? What leads?

Answer 36

anterolateral and apical walls of the LV and the anterior two thirds of the septum V1 V2 V3 V4

Question 37

What does the circumflex artery perfuse? What leads?

Answer 37

Left atrium and posterior walls of LV Lead I aVL V5 V5

Question 38

What does the RCA perfuse? What leads?

Answer 38

R atrium R ventricle II III aVF

Question 39

What does the PDA perfuse? Where does it arise from?

Answer 39

inferior wall RCA

Question 40

What does the Great Cardiac Vein drain?

Answer 40

LAD

Question 41

What does the middle cardiac vein drain?

Answer 41

PDA

Question 42

What does the anterior cardiac vein drain?

Answer 42

RCA

Question 43

Where does almost the blood return to?

Answer 43

Coronary sinus

Question 44

Cardiac Leads

Answer 44

Question 45

What is the best TEE view for LV ischemia?

Answer 45

Midpapillary muscle level short axis

Question 46

How much cardiac output does the coronaries get?

Answer 46

5%

Question 47

What does the coronary blood flow autoregulate to?

Answer 47

MAP 60-140

Question 48

What is a potent coronary vasodilator?

Answer 48

Adenosine (by product of ATP metabolism)