Ex 3: Regulation of the Heart Flashcards

1
Q

Where is the cardiac control center?

A

Tractus solitarius in the Medulla Oblongata

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2
Q

The heart is composed by which two opposing divisions of the autonomic nervous system?

A

sympathetic and parasympathetic nervous systems

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3
Q

In the sympathetic pathway, the sensory fibers from baroreceptors travel via ____ to _____?

A

CN IX (glossopharyngeal) to Tractus Solitarius

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4
Q

In the sympathetic pathway, name the flow from Tractus solitarius to the heart?

A

Tractus solitarius -> paramedian reticular nucleus-> cervical and thoracic segments of spinal cord -> pregranglionic fibers from the lower to upper thoracic segment-> sympathetic chain ganglia->postganglionic fibers from cervical ganglia-> cardiac plexus (mediastinum) -> cardiac nerve -> heart

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5
Q

During the sympathetic pathway, where does the sensory fiber terminate on the heart?

A

SA node, AV node, myocardium, aorta, pulmonary trunk, coronary arteries

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6
Q

Describe the flow of the parasympathetic pathway from the sensory fibers of baroreceptors on CN IX to the heart?

A

baroreceptors via CN IX -> Tractus Solitarius-> vagal nucleus -> vagus nerve fibers -> cardiac plexus -> cardiac nerve (mix with sympathetic fibers) -> synapse on epicardium. Post ganglionic fibers from right vagus nerve -> SA node. Post ganglionic fibers from the left vagus nerve -> AV node

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7
Q

Where do the postganglionic fibers of right vagus nerve within the parasympathetic pathway travel to?

A

SA node

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8
Q

Where do the Postganglionic fibers of the Left vagus nerve within the parasympathetic pathway travel to?

A

AV node

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9
Q

During stressful situations, which nervous system dominates?

A

sympathetic

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10
Q

What results from the activation of the sympathetic nervous system?

A

tachycardia, increased CO, increased oxygen demand of the heart

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11
Q

Which nervous system is activated during relaxed states?

A

parasympathetic nervous system

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12
Q

What happens to the heart during parasympathetic nervous system?

A

(during sleep) resting heart rate, baseline cardiac output, decreased oxygen demand of the heart

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13
Q

For sympathetic effects, increased contractility would be what kind of effect?

A

primary

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14
Q

For sympathetic effects, increased heart rate would be what kind of effect?

A

associated

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15
Q

Describe the sympathetic effect to increase contractility?

A

Catecholamine binding to B1 receptor which increases cAMP. Results in increased Ca++ which increases contractility

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16
Q

Describe the sympathetic effect of increased heart rate?

A

increased inward Ca++, faster phase 4 “slow” phase and faster depolarization.

17
Q

What usually affects contractility?
A. intracellular Calcium levels
B. preload
C. Moving to a higher point on the starling curve
D. all of the above

A

D. all of the above

18
Q

How does the parasympathetic effect decrease heart rate?

A

SA node. Ach activate K+ channels, the increased K+ conductance (out)= fast repolarization or slows depolarization of pacemaker cells

19
Q

What is Sinus Arrhythmia?

A

fluctuation in vagal tone, associated with phases of respiration

20
Q

What drugs could be used to increase HR?
A. Beta 1 agonists
B. Parasympathetic blocking agents
C. A and B
D. None of the above

A

C. A and B

21
Q

What drugs could be used to increase HR?
A. YES- epinephrine
B. YES- Atropine blocks vagal activity
C. A and B
D. none of the above

A

C. A and B

22
Q

What are chronotropic agents?

A

agents that influence or change heart rate such as hormones, electrolytes, drugs

23
Q

What are positive chronotropic agents?

A

increase heart rate via sympathetic stimulation (EPI/NE, thryoid hormone, hypercalcemia, herpcapnia, acidoses)

24
Q

What are negative chronotropic agents?

A

decrease heart rate via parasympathetic stimulation. Ach, hypocalcemia, hypoxia

25
Q

What are Inotropic agents?

A

increase contractility or increase contraction strength of the heart

26
Q

What are positive inotropic agents?

A

stimulated by sympathetic NS, Ca++, NE/EPI, Digitalis, caffeine

27
Q

What are negative inotropic agents?

A

stimulated by parasympathetic. hypocalcemia, beta blockers

28
Q

Cardiac glycosides is what type of inotrope?

A

positive

29
Q

What is Frank-Starling Law of the Heart Ventricular Function Curve?

A

2 ways to pump blood

30
Q

How to pump more blood via increasing preload?

A

fill ventricle with more blood. increase force of contraction

31
Q

How to pump more blood via increasing contractility?

A

increase force at given preload. Extrinsic via hormones or pharmacologic treatment (increase intracellular calcium)

32
Q

What is Fractional Shortening?

A

(LVDd-LVDs) / LVDd x 100