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Echocardiography > Innervation > Flashcards

Innervation Flashcards

1
Q

During ventricular depolarization, does the electrical stimulation occur from the endocardium outwards or the epicardium inwards?

A

endocardium outwards

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2
Q

During ventricular repolarization, does the electrical stimulation occur from the endocardium outwards or the epicardium inwards?

A

epicardium inwards

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3
Q

During ventricular depolarization, does the electrical stimulation occur from the base to the apex, or the apex to the base?

A

apex to base

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4
Q

During ventricular repolarization, does the electrical stimulation occur from the base to the apex, or the apex to the base?

A

base to apex

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5
Q

Which part of the nervous system controls the HR?

A

autonomic

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6
Q

Which part of the nervous system causes an increase in HR?

A

sympathetic

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7
Q

Which part of the nervous system causes a decrease in HR?

A

parasympathetic

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8
Q

conduction path immediately following the AV node

A

Bundle of His

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9
Q

conduction path immediately following the SA node

A

interatrial tract/Bachmann’s bundle

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10
Q

conduction path immediately following the Bundle of His

A

R and L bundle branches

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11
Q

conduction path immediately following either bundle branch

A

Purkinje fibres

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12
Q

excitation coupling

A

process of an electrical stimulus causing a mechanical event

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13
Q

name and number the phases of an action potential

A 
0 - depolarization
1 - early repolarization
2 - plateau
3 - repolarization
4 - resting state
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14
Q

phase 3 of an action potential

A

plateau

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15
Q

phase 2 of an action potential

A

early repolarization

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16
Q

phase 4 of an action potential

A

resting state

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17
Q

phase 0 of an action potential

A

depolarization

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18
Q

phase 1 of an action potential

A

repolarization

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19
Q

time for one action potential to complete

A

200 ms

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20
Q

change in voltage inside a cardiac cell during depolarization

A

-90 mV to +40-50 mV

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21
Q

events during depolarization: voltage and ions

A

change in voltage inside a cardiac cell from -90 mV to +40-50 mV
influx of Na+ and Ca2+
efflux of K+

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22
Q

depolarization: excitable or refractory?

A

refractory

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23
Q

early repolarization: excitable or refractory?

A

refractory

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24
Q

events of early repolarization

A

cardiac cell begins returning to a negative state

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25
events during plateau
sarcomere contracts
26
plateau: excitable or refractory?
refractory | only excitable by a VERY strong stimulus, and only towards the end of this phase/beginning of Phase 3
27
repolarization: excitable or refractory?
excitable, but by a strong stimulus only
28
resting state: excitable or refractory?
excitable
29
events during repolarization
cardiac cell returns to -90 mV state
30
events during resting state
polarity approaches ideal depolarization threshold
31
What affect does the slope of Phase 4/resting state have on the action potential?
steeper slope: reaches threshold for depolarization faster = higher HR flatter slope: reaches threshold for depolarization slower = slower HR
32
structures involved in intrinsic conduction
SA node, atrial sarcomeres, AV node, Bundle of His/AV bundle, right and left bundle branches, Purkinje fibres
33
role of the SA node
primary pacemaker
34
heart rate, as stimulated by the SA node
60-100 bpm
35
What structure in the intrinsic conduction stimulates a heart rate of 60-100 bpm?
SA node
36
What structure in the intrinsic conduction stimulates a heart rate of 60-80 bpm?
interatrial tract/Bachmann's bundle
37
What structure in the intrinsic conduction stimulates a heart rate of 40-60 bpm?
either of AV node or Bundle of His/AV bundle
38
primary pacemaker
SA node
39
secondary pacemaker
interatrial tract/Bachmann's bundle
40
3rd pacemaker
AV node
41
4th pacemaker
AV bundle/Bundle of His
42
Bundle of His, aka
AV bundle
43
AV bundle, aka
Bundle of His
44
role of AV node
slows action potential from reaching the ventricular conduction system to allow the atria to fully contract first
45
role of Bundle of His
stoplight: delays action potential from depolarizing ventricles to allow appropriate ventricular filling time
46
role of AV bundle
stoplight: delays action potential from depolarizing ventricles to allow appropriate ventricular filling time
47
role of bundle branches
accelerate impulse to prepare for efficient systolic contraction (QRS on ECG)
48
intrinsic conduction structure that accelerates impulse for efficient systolic contraction
right and left bundle branches
49
intrinsic conduction structure that slows action potential from reaching the ventricular conduction system to allow the atria to fully contract first
AV node
50
intrinsic conduction structure that acts as a stoplight: delays action potential from depolarizing ventricles to allow appropriate ventricular filling time
Bundle of His/AV bundle
51
segment of ECG associated with bundle branch stimulation
QRS complex
52
electrical event associated with the QRS complex of the ECG
bundle branch stimulation
53
What is indicated by a wide QRS complex, and why?
bundle branch block - impulse must travel along slower path to initiate contraction, through muscle instead of nerves
54
What would you see on the ECG with a bundle branch block?
wide QRS complex
55
role of Purkinje fibres
stimulate ventricular wall and pap muscle contraction
56
intrinsic conduction structure that stimulates depolarization of the pap muscles
Purkinje fibres
57
intrinsic conduction structure that stimulates depolarization of the ventricles
Purkinje fibres
58
What structure in the intrinsic conduction stimulates a heart rate of 20-40 bpm?
Purkinje fibres
59
5th pacemaker
Purkinje fibres
60
Why does the RV contract slightly before the LV?
impulse short cuts across the moderator band within the RV apex, instead of all the way to the apex and up the outer walls, as in the LV
61
role of Vagus nerve
stimulates the SA & AV nodes via extrinsic conduction
62
factors affecting the sympathetic nervous system, and causing increased HR
Stress: fear, anger, excitement, fever, trauma, exercise
63
effect of sympathetic nervous system on cardiac output
increases both the HR and the force of contraction (stroke volume)

Echocardiography (11 decks)

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