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Patho > CVS 1 > Flashcards

CVS 1 Flashcards

1
Q

Ventricle AP Phase 0

A

Rapid upstroke- fast Na channels open, inward Na flow

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2
Q

Ventricle AP Phase 1

A

Initial repolarization- K channels open, outward K flow

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3
Q

Ventricle AP Phase 2

A

Plateau- Ca channels open (L-type), inward Ca flow

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4
Q

Ventricle AP Phase 3

A

Rapid repolarization- K channels open more, massive outward K flow

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5
Q

Ventricle AP Phase 4

A

Resting membrane potential- high K permeability through leaky K channels

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6
Q

SA node AP Phase 0

A

Depolarization- inward Ca current

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7
Q

SA node AP Phase 3

A

Outward K current

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8
Q

SA node AP Phase 4

A

Slow depolarization- inward Na current

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9
Q

How does sympathetic stimulation affect SA node AP?

A

Increases rate of phase 4 depolarization & frequency of APs d/t increased permeability to Na & Ca

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10
Q

How does parasympathetic stimulation affect SA node AP

A

Decreases rate of phase 4 depolarization & hyperpolarizes the max diastolic potential to decrease frequency of APs d/t increased K permeability

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11
Q

_______ has stable RMP, while ____ has unstable RMP

A

Ventricular AP; SA node AP

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12
Q

Accounts for the pacemaker activity of the SA and AV nodes (automaticity)

A

Phase 4 depolarization (Na)

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13
Q

CCB effect on vascular smooth muscles (greatest to least)

A

Nifedipine > diltiazem > verapamil

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14
Q

CCB affect on Heart (greatest to least)

A

Verapamil > diltiazem > nifedipine

Verapamil = Ventricle

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15
Q

Adverse effects of CCB:

A

Flushing, dizziness, fatigue, constipation, headache, hypotension

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16
Q

Drug of choice for prevention of SVT

A

Digoxin

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17
Q

Reflects the time required for excitation to spread throughout cardiac tissues

A

Conduction velocity

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18
Q

Conduction velocity is fastest in ______; slowest in ______

A

Purkinje Fibers; AV node

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19
Q

Why is conduction velocity slowest in AV node?

A

Few gap junctions allowing time for ventricular filling

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20
Q

The ability of cardiac cells to initiate AP in response to inward depolarizing current

A

Excitability

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21
Q

Begins with upstroke of AP & ends after plateau;
NO AP can be initiated;
250 msec

A

Absolute refractory period

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22
Q

Slightly longer than ARP;

No AP can be generated

A

Effective refractory period

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23
Q

Period immediately after ARP;

AP can be elicited but more than usual inward current is required

A

Relative Refractory period

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24
Q

+ dromotropic effect

A

Increases conduction velocity through AV node, speeding conduction of AP from atria to ventricles and decreasing the PR interval

25
Q

Sympathetic receptor on heart & parasympathetic receptor on heart

A

B1; muscarinic

26
Q

S4 (atrial kick) is associated with?

A

A hypertrophic ventricle

27
Q

‘a’ wave on venous pulse curve

A

Increase in atrial pressure caused by atrial systole

28
Q

P-wave

A

Represents electric activation of the atria

29
Q

7 phases of cardiac cycle

A
  1. Atrial systole;
  2. Isovolumetric ventricular contraction;
  3. Rapid ventricular ejection;
  4. Reduced ventricular ejection;
  5. Isovolumetric ventricular relaxation;
  6. Rapid ventricular filling;
  7. Reduced ventricular filling (diastasis)
30
Q

What causes the fourth heart sound?

A

Filling of the ventricle by atrial systole

31
Q

Closure of AV valve represents

A

First heart sound

32
Q

Marks the end of both ventricular contraction and rapid ventricular ejection.
Represents repolarization of ventricles

A

Onset of T wave

33
Q

Second heart sound is created by closure of?

A

Semilunar valves (aortic & pulmonic)

34
Q

What happens when ventricular pressure becomes less than atrial pressure?

A

Mitral valve opens

35
Q

Rapid blood flow from atria into ventricle cause? This is normal in ____ but is associated with _____

A

Third heart sound; children; CHF in adults

36
Q

stroke volume=?

A

End-diastolic volume - end systolic volume (nl = 75 ml)

37
Q

stroke index=?

A

Stroke volume / body surface area

38
Q

MAP = ?

A

DBP + 1/3 pulse pressure

Pulse pressure = SBP- DBP

39
Q

Contractility (and SV) increase with:

A

Catecholamines (increased activity of Ca pump in SR);
Increased intracellular Ca;
Decreased extracellular Na;
Digitalis (increased intracellular Na, resulting in increased Ca)

40
Q

Contractility (and SV) decrease with:

A

B1 blockade;
Heart failure;
Acidosis;
Hypoxia/hypercapnia

41
Q

Ejection fraction =

A

SV / end diastolic volume

42
Q

Sympathetic stimulation via B1 receptor increases _________ current during the plateau of AP

A

Inward Ca

43
Q

Period of highest O2 consumption in pressure-volume loop

A

B to C (Isovolumetric contraction)

44
Q

What happens from C to D on pressure-volume loop

A

Ventricular ejection

45
Q

D to A on pressure-volume loop

A

Isovolumetric relaxation

46
Q

A to B on pressure-volume loop

A

Ventricular filling + atrial kick

47
Q

Atrial kick accounts for ____% filling

A

20

48
Q

Refers to an increase in ventricular end-diastolic volume (filling)

A

Increased preload

49
Q

Preload (ventricular) increases with

A

Exercise;
Increased blood volume (pregnancy or over transfusion);
Excitement (sympathetic)

50
Q

stroke volume is affected by?

A

Contractility, Afterload, Preload

51
Q

Order of excitation of heart

A

SA node > internodal tracts > AV node > Bundle of His > Bundle branches > Purkinje fibers > Ventricular muscle

52
Q

P-R interval

A

Conduction through AV node (<200 msec)

53
Q

AV node is bypassed making PR interval < 0.12 sec and leads to early depolarization of ventricle.
Most commonly seen as?

A

Pre-excitation syndrome; Wolf-Parkinson-White syndrome

54
Q

Cessation of P waves

A

Sinoatrial block

55
Q

Occurs with inferior wall MI

A

2nd degree Type 1

56
Q

Occurs with anterior wall MI

A

2nd degree Type 2

57
Q

Complete AV block comes & goes;
Ventricles stop contracting for 5-30 sec b/c of overdrive suppression (used to atrial drive) then ventricle escape occurs with AV nodal or AV bundle rhythm (15-40 bmp)

A

Stokes-Adams Syndrome

58
Q

Impulse is sometimes blocked and sometimes not in peripheral portions of Purkinje system resulting in abnormal QRS waves

A

Incomplete Intraventricular Block (electrical alternans)

Patho (13 decks)

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