Electrical properties of the heart Flashcards

1
Q

What generates the action potentials that cause contraction of the heart muscle

A

Pacemaker cells

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2
Q

Describe how action potentials reach muscle cells

A

They travel extracellularly in transverse tubules

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3
Q

Describe how an action potential causes contraction of a cardiac muscle cell

A

AP causes voltage gated L type Ca2+ channel to open allowing extracellular Calcium ions to flow into the cell

Ca2+ ions induce RyR channel on Sarcoplasmic reticulum to open causing massive release of more Ca2+ ions from SR

Calcium spark from many different SR’s summate to generate Ca2+ signal

Ca2+ signal causes contraction

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4
Q

Describe the components of the contractile fibre thing in cardiac muscle cells

A

Thick myosin filament
- with cross bridges

Thin actin filament

Troponin binding site for Ca2+

Z lines

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5
Q

What junctions exist between cardiac muscle cells?

What is their purpose?

A

Desmosomes - hold them together

Gap junctions - allow electrical connection between cells

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6
Q

What is the name given to the bit where cells join together, where the junctions are found?

A

The intercalated disc

Easily visible histologically

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7
Q

Why does the AP potential graph of cardiac muscle have a plateau bit on it, whereas skeletal muscle doesnt?

A

Myocardial cells have a longer action potential than skeletal/neurones due to Ca2+ entry

Plateau stage:

  • Increase in Permeability to Ca2+
  • Decrease in Permeability to K+

In skeletal/neurones, the rapid depol is due to Na+ entry and the repol is due to K+ leaving the cell

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8
Q

How long is the AP in cardiac muscle, compared to skeletal muscle?

A

Cardiac muscle - 250 ms

Skeletal muscle - 2 ms

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9
Q

Describe how the prolonged action potential means that cardiac muscle can not exhibit tetanus

A

Long refractory period means AP’s cant re-fire before the muscle has relaxed

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10
Q

Describe why cardiac muscle gives graded contractions

A

Ca2+ release does not fully saturate troponin binding sites

Thus more/less can be released to vary the strength of contraction = graded

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11
Q

What property of pacemaker cell’s resting membrane potential makes them different from the contractile cells?

A

It is unstable

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12
Q

In a non-pacemaker AP:

What causes the initial depolarisation

A

Increase in permeability to Na+

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13
Q

In the non-pacemaker AP:

What causes the plateau

(i know its already been asked but shut up)

A

Increase in Permeability to Ca2+ (VGCCs)

Decrease in permeability to K+

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14
Q

In a non-pacemaker AP:

What causes the repolarisation to RMP?

A

Decrease in perm to Ca2+

Increase in perm to K+

High resting permeability to K+ generates the RMP

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15
Q

In the pacemaker AP:

What causes the pacemaker potential (pre potential)?

A

gradual decrease in PK+

early increase in PNa+ (= PF)

late increase in PCa2+ (T-type)

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16
Q

In the pacemaker AP:

What causes the action potential?

A

increase in PCa2+ (L-type)

17
Q

What are the modulators of electrical activity of the heart?

A

Sympathetic & parasympathetic systems

Drugs

Temperature

Hyperkalemia (high plasma K+)

Hypokalemia (low plasma K+)

Hypercalcemia (high plasma Ca2+)

Hypocalcemia (low plasma Ca2+)

18
Q

How do drugs affect the heart?

A

Ca2+-channel blockers – decrease force of contraction

Cardiac glycocides – increase force of contraction

19
Q

How does temperature affect the heart?

A

increases ~10 beats/min/ºC

20
Q

How does Hyperkalemia affect the heart?

A

Fibrillation & heart block

21
Q

How does hypokalemia affect the heart?

A

fibrillation & heart block

22
Q

How does hypercalcemia affect the heart?

A

Increased HR & increased force of contraction

23
Q

How does hypocalcemia affect the heart?

A

Decreased heart rate & decreased force of contraction

24
Q

What are the components of the conducting system of the heart?

A

Sinoatrial node

Atrioventricular node

Bundle of His + Purkinje fibres

25
Q

Where is the SA node located and what does it do?

A

Superior part of the right atrium

It is the ‘main’ pacemaker

0.5 m/sec

26
Q

Where is the AV node located and what does it do?

A

Inferior part of the right atrium

It is the delay box

0.05 m/sec (slow conducting)

27
Q

What is attached to the AV node?

A

Bundle of His

28
Q

How are the Purkinje fibres attached to the Bundle of His?

What is their function?

A

Left & right bundle branches run down through the interventricular septum and then up the walls of the ventricles

Purkinje fibres attached to the branches when they are running up the walls of the ventricles

Rapid conduction system (5 m/sec)

29
Q

What is the annulus fibrosis of the heart?

A

Non-conducting, Fibrous ring surrounding the atrioventricular orifaces

30
Q

What are the 3 main stages in the cardiac cycle?

A

Atrial excitation

Ventricular excitation (+ AR)

Ventricular relaxation

31
Q

On an ECG, there are the P QRS and T waves

What causes each wave?

A

P - atrial depolarisation

QRS - ventricular depolarisation

T - ventricular repolarisation