Chapter 20 The Heart Flashcards
The heart is ______, meaning it can contract without any stimulation of nerves
Auto-rhythmic
The _____ contains specialized cells in nodes that contain excessive numbers of leaky sodium channels that allow them to slowly drift towards threshold and fire action potentials without any neurotransmitters
Heart
Cardiac muscle cells, called ________, are connected by specialized proteins that form intercalated discs or gaps
Cardiocytes
These gap junctions allow an action potential to spread like a wave from one cell directly to another without synapses
Intercalated discs
Nerves and hormones can alter the cardiac rhythm by increasing or decreasing it, but do not cause the heart to contract.
ACH
Adrenaline
Natural pacemaker of the heart
Located in the posterior area of the right atrial wall near the opening of the SVC
Generates action potentials faster than the AV node
Sets heart rate @ about 70-80 beats
Sinoatrial node
The SA node starts an action potential which spreads throughout the two atria, causing them to contract
From the top down
The _______ is located in the floor of the right atrium near the opening of the coronary sinus
Atrioventricular node
If the SA node is destroyed due to damage and the atria could not contract, the ventricles would still contract and pump blood, but only about
60 bpm
The AV node starts the spread of an AP through the
Bundle of his
The _______ is located in the ventricular septum and carries the action potential from the AV bundle to bundle branches
Atrioventricular Bundle bundle of his
Basic sequence of events of the conducting system
1. SA node automatically depolarizes and spreads an AP through the atria
2. Atria contract, action potential spreads through the internodal pathway
3. AP reaches av node
4. AV node spreads AP to bundle of his and bundle branches
5. Purkinje Fibers spread through ventricles
6. Ventricles contract, blood is pumped to lungs and system
Contraction of a chamber
Relaxation of a chamber
Systole
Daistole
What is the purpose of the fibrous skeleton of the heart ?
Connective tissue wall, stops the AP
Is a recording of the electrical events of the cardiac cycle
Electrocardiogram ECG
Atrial depolarization ➡️ atrial systole AV valves are open/SL valves are closed
P wave
Ventricular depolarization ➡️ ventricular systole
QRS complex
Ventricles are repolarizing 4 chambers are in diastole
T wave
From the beginning of the P wave to the next P wave is called ?
Cardiac cycle
Are not electrically isolated, but have specialized connections called gap junctions intercalated disks that allow an action potential to flow directly from one cardiocyte to the next.
Cardiocytes
Cardiocyte action potentials are very prolonged and last approximately ______
250-300 milliseconds
The resting membrane potential for a cardiocyte is
The threshold potential for a cardiocyte is
-90 MV
-75mv
Steps of cardiocyte AP
- Slow depolarization to threshold
- Rapid depolarization
- Plateau phase
- Repolarization
Leaky sodium channels in nodal cells of the SA node slowly allow NA+ ions to diffuse in and depolarize the cell to threshold
Depolarization to threshold
Once threshold is reached, voltage gated sodium channels rapidly open and extracellaur NA+ flows into cell causing rapid depolarization to +30 mv
Rapid depolarization
As the cardiocyte reaches +30 mv, sodium channels rapidly close.
Potassium channels open, but do so very slowly, allowing potassium to slowly leak out. At the same time, calcium channels in the membrane also open and allow CA to slowly leak into cell to counter balance the outward flow of K+, resulting in the action potential remaining constant near +30mv
Plateau phase
Slowly potassium channels open to repolarization. This closes the CA2+ channels and rapid repolarization occurs .
Repolarization
Beginning of the start of one atrial systole and ending at the start of the next atrial systole
Cardiac cycle
As blood enters the atria the av valves are open as as the ventricles are also in diastole allowing approximately ____ of ventricular filling to occur during atrial diastole.
70%
The atria do not have to contract to get blood into ventricles, atrial systole “tops off” the ventricles, filling that last ______ to get maximum blood flow.
30%
When does blood fill a chamber ?
Blood fills a chamber of the heart during the diastolic phase of the cardiac cycle
What causes blood to flow from one area to another ?
Blood flows from one area to another due to differences in pressure within the blood vessels.
Blood pressure is the driving force
When does blood empty from a chamber ?
Empties during the systolic phase
Ventricular diastole
Av valves open
SL valves closed
Ventricular systole
AV valves are closed
SL valves are open
A period of time during ventricular systole where pressure is rising but is still lower pressure in the aorta
Isovolumteric contraction
When is blood ejected from the left ventricle
When pressure in the left ventricle is greater than the pressure in the aorta
What is elastic rebound
Due to the elasticity the aorta snaps back on itself
Is the process of listening to the sounds of the heart using a stethoscope.
The sounds are created by the closing of the AV and SL valves.
The sounds are described as Lubb dupp
Auscultation
The first heart sound, the Lubb, is produced by the closure of the _____ valves during ________?
AV
Ventricular systole
The second heart sound, the dupp, is produced by the closure of the _____ during ____?
SL
Ventricular diastole
What is regurgitation?
Backward flow of blood
What is a heart murmur
Swishing or whispering sound heard due to improper closure of a valve
Complete failure of mitral vale
Mitral valve prolapse
Although the heart is auto rhythmic and can beat without any hormonal or neural stimulation, the rate of the heartbeat must be sped up or slow down to meet the oxygen demand of the bodies tissues
Cardiodynamics
Is the study of the mechanics and abilities of the heart to alter the volume of blood being pumped to tissues to meet these changing demands
Cardiodynamics
The volume of blood pumped by the heart over a period of time
Cardiac output
Volume of blood pump by the heart in one beat
Stroke volume
The number of heartbeats per minute
Heart rate
Is maximum CO - resting CO, or up to around 24 L for a normal individual
Cardiac reserve
The normal heart rate is called the resting heart rate, which is sent by the natural cardiac pacemaker, the SA node . Resting heart rate for the average adult is between
70-80 bpm
The heart is innervated by the nerves of the
ANS
Innvervation is by way of a few cervical and thoracic nerves which from the cardiac plexus
Sympathetic innervation
Sympathetic neurons synapse on the nodes of the heart and release a hormone
Norepinephrine
A few lumbar nerves synapse on the adrenal medulla and cause it to release high levels of _____ into the bloodstream which result in a sympathetic effect for a prolonged period of time
NE
NE is the flight or fight hormone and it will increase heart rate and force contraction therefore increasing SV, which will increase
Cardiac output
Cardio sites of the essay and AV node will increase their permeability to
Cardiocytes of the SA and AV node will increase their permeability to NA+ when ____ is present, causing them to depolarize more rapidly
NE
NE also increases the permeability of Cardiocytes to
CA2+
Ca2+ will increase the force and duration of the contraction, which increases
SV and CO
Parasympathetic innervation is from cranial nerve
Cranial nerve 10 the vagus nerve
The vagus nerve synapses directly on the SA and AV nodes and releases the neurotransmitter
Acetylcholine ACH
The parasympathetic system is a rest and digest system and heart rate decreasing
Cardiac output
In the presence of ACH, Cardiocytes of the SA and AV nodes will increase their permeability to ______, causing them to depolarize more slowly and with less force.
K+ potassium
The ______ of the brain contains the control centers for cardiac function
Medulla
Cardiac acceleratory
ANS = Sympathetic
Neurotransmitter = NE
Affect on HR = increases
Cardio inhibitory
ANS = PNS
Neurotransmitter = ACH
Affect on HR = slow
There are __________ in the walls of the atria, carotid arteries, and the aortic artery
Pressure and baroreceptors
The ______ adjusts the heart rate in response to increases in venous return
Atrial reflex
Several hormones can affect heart rate, including
Norepinephrine
Epinephrine
Thyroid hormone
Atrial natriuretic peptide ANP