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A/P lecture 1 > exam 4 > Flashcards

exam 4 Flashcards

1
Q

term to describe the cardiac muscle

A

syncytium

atrial and ventricular

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2
Q

cell membranes that separate individual cardiac muscle cells from one another

A

intercalated discs

curvy cell boarders allows for more surface area/gap junctions

cardiac centric term

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3
Q

sagital

A

left vs right

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4
Q

vertical

A

front vs back
limb leads

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5
Q

axial

A

top vs bottom
unipolar leads
precordial

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6
Q

what muscle is multinucliated

A

skeletal muscle

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7
Q

another name for smooth muscle

how it contracts

A

visceral (unitary) contractions

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8
Q

what lays down scar tissue in the the heart

A

fibroblasts
- controlled rate
- occurs in CHF

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9
Q

what medication slows down fibroblast activity

A

ACEi

  • angiotensin 2 is a growth hormone
  • no ACEi or ARB in pregnancy
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10
Q

whats majority of the heart muscle

A

myofibrils

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11
Q

what does conduction tissue not have

A

myofibrils

need to send action potentials quickly

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12
Q

layers of the heart

A

endocardium
- deep one layer thick

myocardium
- bulk of muscle

epicardium
- superficial
major blood vessels on top

pericardial space
- low mucus, little water

pericardium
- connective tissue sac
- visceral: thin/stretchy/clear
- parietal: physically attached to fibrous pericardium. partial pain = tissue
- fibrous… similar to dura in CNS

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13
Q

what term normally describes the LV

A

subendocardium

  • deep within the endocardium and myocardium
  • MI
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14
Q

how to heart muscle squeeze

A

2 layers
perpendicular

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15
Q

what does the heart look like when relaxed

A

a little under strectched

actin filaments overlap
no H band

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16
Q

how does muscle contract

A

myosin moves to Z disk

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17
Q

purkinje
RMP and threshold

A

threshold -70
RMP -90

don’t contract, just send action potentials

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18
Q

ventricle
RMP and threshold

A

threshold -70
RMP -80

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19
Q

how long does it take for the first action potential for AV block

A

30+ seconds

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20
Q

CHB reflex for eye procedures

A

five and dime
- cranial nerve 5 (trigeminal)
- vagus
- prevents action potential transmission at the AV node

21
Q

fast action potential phases

A

4: slight slope
- not many HCN, Na/Ca leak channels

0: fast Na+
-via gap junctions coming from upstream

1: fast T-type Ca+

2: slow L-type Ca+

K+ closes end phase 0 -> end phase 2
K+ opens end phase 2 -> 3

22
Q

how many milliseconds of a fast action potential

A

200 milliseconds

23
Q

ohms law

A

voltage= ionic current x resistance

24
Q

slow action potential phases

A

4: HCN, Ca+ and Na+ leak channels

0: L-type Ca+

3: L-type Ca+ close
voltage gated K+ close

threshold: -40
VRM: -55

25
Q

AV node VRM compared to SA

A

less HCAN, leaky Na+ and Ca+

lower VRM
lower HR

26
Q

what does HCN stand for

ions

A

hyperpolarized and cyclic nucleotide medicated channels

open when VRM reached (repol. or hyperpol)

Na, Ca, K

27
Q

calcium effects on threshold

A

high calcium
- increase threshold
- decrease HR

only works in cardiac tissue

28
Q

what phase do some books say the slow act potentials have

A

phase 2 “platue”

29
Q

beta agonist

A

increase adenyl cyclase
increase CAMP

more HCN channels open, same VRM

30
Q

Beta antagonist

A

atenolol

less HCN channels open
reduced phase 4

31
Q

MACh-R

A

inhibitory alpha subunit
lower adenyl cyclase
lower CAMP

more K open
lower VRM
lower HR

32
Q

potassium effects

A

increase VRM
increase HR

REALLY HIGH
- reduces conduction speed
- loose Na+ and Ca++

33
Q

refractory period

A

stimulation before cell is rest

can see or not see an action potential

34
Q

relative refractory period

A

cell reset enough to produce a weaker action potential

35
Q

absolute refractory period

A

can’t regenerate an action potential

36
Q

HR if no vagus/SNS

A

110

37
Q

HR if SNS

A

120

38
Q

HR if vagus

A

60-62

39
Q

AV node HR

A

40-60

40
Q

Perkinji HR

A

15-30

41
Q

pathway from SA to AV

A

internal pathway

anterior
middle
posterior

42
Q

pathway of SA to LA

A

interatrial
Bachmens bundle

  • comes off the anterior internodal pathway
43
Q

p wave time

A

0.09 seconds

44
Q

SA to AV time

A

0.03 seconds

45
Q

SA to posterior lateral RA

A

0.07 seconds

46
Q

SA to bottom LA

A

0.09 seconds

47
Q

what causes the AV node delay

A

decreased gap junctions
fat

48
Q

PR interval

A

0.16
SA -> bundle branches

49
Q
A

A/P lecture 1 (7 decks)

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