Cardiovascular Physiology Flashcards

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1
Q

What is a heart contraction?

A

Electrical impulse that triggers contractile cells

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2
Q

Is a heart contraction intrinsic or extrinsic?

A

intrinsic (arises from within the heart)

nervous system NOT required

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3
Q

What are the nodes?

A

clusters of conducting ells that initiate AP in the heart

they have an unstable resting potential (leaky to Na+)

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4
Q

What is the name for the gradual depolarization of nodal cells

A

prepotential

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5
Q

what happens when threshold is met in the nodal cells?

A

the voltage gated Ca2+ channels open and a spontaneous AP occurs

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6
Q

List the steps of a conducting cell AP

A

1) Na+ enters through leak ch. (slow influx)
2) cell develops a prepotential
3) v. gated ca2+ channels open @ threshold
4) rapid influx of ca2+ causes depolarization which causes an AP
5) ca2+ channels close and voltage gated K+ channels open
6) depolarization occurs

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7
Q

How do the AP’s spread beyond the nodal cells to the contractile cells?

A

gap junctions @ intercalated discs

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8
Q

How are the cells connected?

A

via desmosomes an anchoring protein which prevents separation

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9
Q

explain and list the electrical pathway that the impulse spreads

A

1) Sinoatrial (SA) node -In posterior wall of R. Atrium
* goes across internal pathway
2) Atrioventricular (AV) node - floor of R. Atrium
* AP delayed here to allow time for atria to contract
* impuse transmitted to…
3) AV bundle (in the intertribal septum)
4) L + R Bundle branches (in the inter ventricular septum)
5) Purkinje fibers (walls of ventricles)
* Ventricles contract

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10
Q

what is the contraction rate established by the SA node?

A

100 bpm

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11
Q

so if the SA node wants the heart to beet 100bpm… why doesn’t it?

A

the parasympathetic system innervates the node - Acetylcholine slows the heart

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12
Q

what happens if the sympathetic system innervates the nodes?

A

norepinephrine speeds the heart

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13
Q

What would happen if the SA node stopped working

A

the AV node would fire on its own 40-60bpm

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14
Q

Special aspects of cardiac cell anatomy

A
  • Gap junctions: allow ions to move from cell to cell
  • Desmosomes: prevent separation
  • Mitochondria: are very fatigue resistant
  • Myofibrils: Branch
  • NO Terminal cisternae: T tubules release Ca2+ from sarcoplasmic reticulum
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15
Q

Describe the spread of AP to contractile cells

A

1) Na+ leaks in
2) V. Gated ca2+ ch. open in nodal cells
3) Action potential across nodal cells
4) Cations (+) diffuse into adjacent contractile cells via intercalated discs which house gap junctions
5) this depolarization causes fast v. gated na+ Ch and slow ca2+ channels to open in contractile cells

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16
Q

why are AP slower and more prolonged than in skeletal muscle

A

-V. gated Na+ channels close quickly
-V. Gated K+ Ch = open
**Repolarization is delayed because voltage gated ca2+ channels in the cell membrane are still open and Ca2+ comes in from the ECF
**
This influx also opens ca2+ gated ca2+ channels (like a ligand) in the sarcoplasmic reticulum
**So there is a plateau in membrane potential as ca2+ moves in while K+ moves out
(AP is 30x slower)

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17
Q

Explain the steps of the cardiac muscle cell AP

A

1) Na+ & ca2+ influx through voltage gated ch.
2) na+ ch. close, k+ ch. open
3) ca2+ influx from ECF & SR and K+ influx -plateau
4) Ca2+ ch. close
5) K+ outflow continues
6) v. Gated K+ ch close (repolarized)

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18
Q

What does it mean that contraction of cardiac muscle cells is coupled to excitation

A
  • Ca2+ enters from SR + ECF
  • Ca2+ binds troponin causing tropomyosin to shift
  • This allows the cross bridge to form (Myosin binds actin)
  • the filaments slide which causes a contraction
  • The ca2+ ch are slow to close so the contraction is prolonged
  • eventually the ca2+ pumps will put all the Ca2+ back where it came from and outflux of K+ will repolarize the cell
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19
Q

What is meant by a cardiac cycle?

A

1 complete contraction & relaxation

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20
Q

What is systole

A

contraction phase (blood pushed out of chamber)

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21
Q

what is diastole

A

Relaxation phase (chamber fills with blood)

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22
Q

What does an electrocardiogram do?

A

Records electrical currents (AP’s) during the cardiac cycle

DOES NOT measure muscle contractions: just the electrical events that trigger it

23
Q

what causes the p wave

A

atria depolarization then atrial systole occurs in space after

24
Q

What causes QRS Complex

A

Ventricles depolarize then after the ventricular systole occurs
(@ same time atria is repolarizing and atrial diastole)

25
Q

What is causes the T wave

A

ventricles repolarize then ventricular diastole occurs

26
Q

What is happening at atrial systole

A

SA node depolarizes to AV node
both atria contract
both AV valves are forced open
the blood is pushed into the ventricles

27
Q

What is happening at ventricular systole

A

The electrical impulse to AV bundle to R +L Bundle branches to purkinje fibers
-The isovolumetric contraction phase occurs
as pressure rises the SL valves open
the ejection phase

28
Q

What is the isovolumetric contraction phase

A

both ventricles contract but blood has not been ejected yet

29
Q

what is the stroke volume

A

amount ejected from left ventricle

30
Q

what is the end systolic volume

A

the amount of blood remaining in ventricles after systole

31
Q

What is happening at ventricular diastole

A
  • Semilunar valves close
  • isovolumentric relaxation phase (only the ESV is in ventricle)
  • passive filling
  • active filling
32
Q

What is passive filling

A

low pressure pulls blood from atria through av valve
the ventricles fill 70%
w/o the atria even contracting

33
Q

What is active filling

A

The atria contract and push 30% more blood in

the av valves close

34
Q

What is end diastolic volume

A

blood in ventricles @ max

35
Q

what is happening during atrial diastole

A
  • Passive filling of atrial as the relax

- occurs during ventricular systole and diastole

36
Q

What are the muscles doing @ P wave

A

passive ventricular filling & atrial contraction

37
Q

what are the muscles doing @QRS complex

A

isovolumetric contraction

38
Q

What happens just after QRS complex

A

ventricular ejection phase

39
Q

what happens in muscles at T wave

A

isovolumetric relaxation

40
Q

What is the equation for cardiac output

A

HR X SV

41
Q

Explain the regulation of heart rate

A

Intrinsic contraction rate is altered by the ANS

ANS fibers innervate nodal cells (adjust pacemaker activity) by altering ion permeability

42
Q

Explain what the cardio accelerator centers do

A
  • Sympathetic
  • Increase heart rate
  • Norepinephrine binds to beta 1 receptors
43
Q

Explain what the cardio inhibitory enters do

A
  • parasympathetic
  • vagus nerve
  • decrease heart rate
  • Acetylcholine binds to M2 recepters
44
Q

What is the dominant influence on regulation of heart rate

A

Parasympathetic

The vagus nerve fibers release ACH which opens K+ ch in conducting cells to decrease HR

45
Q

Steps of parasympathetic regulation of HR

A

1) cardio inhibitory center
2) Vagus nerve
3) ach. decrease hr on SA+AV node

46
Q

steps of sympathetic regulation of HR

A

1) cardioacceleratory center
2) sympathetic chain ganglion
3) sympathetic cardiac nerve
- NE increase HR & Contractile force
4) can go to the nodes and the muscle cells

47
Q

Equation for stroke volume

A

SV = EDV - ESV

48
Q

what is ejection fraction

A

fraction of blood ejected from ventricles with each contraction

49
Q

equation for ejection fraction

A

SV / EDV x 100

50
Q

What are the 3 factors affecting stoke volume

A

1) Preload
2) Contractility
3) Afterload

51
Q

Explain preload

A

Amount the ventricles are stretched by contained blood
Increased preload causes harder heart contractions
*Increased stretch increases sarcomere length, more cross bridges can form between actin & Myosin
*Factor that increase venous return will increase preload
*Hr will also increase in response to venous return (atrial reflex)

52
Q

Explain the atrial reflex

A

Strech receptors in all or right atrium detect pressure and increase HR to get blood out of the heart

53
Q

Explain contractility

A

Increase in contractile force

  • Decreased ESV and increased SV
  • regulated by hormones
  • NE, THYROXINE, EPINEPHRINE
  • increase Ca2+ entry into cardiac cells
54
Q

Explain after load

A

pressure exerted bu arterial blood on SL valves
must overcome to eject blood into systemic circulation
ventricles must over come this resistance to circulate blood