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Cardio > Lecture #1 - Part 2 > Flashcards

Lecture #1 - Part 2 Flashcards

1
Q

What does Excitation-Contraction coupling refer to?

A

Connection leading from electrical changes in the PM to initiation of contraction.

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2
Q

Cause of cardiac muscle contraction?

A

Increase in intracellular Ca+

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3
Q

Talk through the steps of muscular contraction

A

Depolarization along Sarcolema into T Tubules
Trigger Ca enters via L-Type Voltage-sensitive channels
Trigger Ca opens Calcium release channels
Calcium leaves SR –> Calcium “spark”
Calcium Binds Troponin subunit C

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4
Q

Another name for L-type voltage sensitive channels?

A

DHP receptors

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5
Q

Another name for calcium release channels?

A

Ryanodyne Receptors

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6
Q

Two proteins associated with Ryanodine receptors?

A

Junctin

Triadin

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7
Q

How are heart contractile activities dysregulated in heart failure?

A

SR Calcium Stores Depleted

Weakened Contractility

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8
Q

How does cardiac muscle relax?

A

cAMP dependent protein kinase P’s troponin I
Tropomyosin can now reblock the binding site
Calcium removed from sarcoplasm by SERCA

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9
Q

What causes SERCA activation?

A

phospholamban

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10
Q

How do catecholamines affect the heart?

A

Speeding the phosphorylation rate of Troponin I and Phospholamban

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11
Q

What is lusitropy?

A

Relaxation of the heart

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12
Q

What happens to Ca after it is pumped into the SR?

A

Binding to calsequestrin

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13
Q

Other than SERCA, where else might Ca go?

A

Pumped out in NA-Ca exchange pump (Coupled with Na/K)

(much less important) Ca ATP-ase

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14
Q

Increasing available intracellular calcium has what effect on the heart?

A

More vigorous contraction

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15
Q

What is the Cardiac Inotropic State?

A

Myocardial Contractility, The Force Developed by the Heart Muscle at a given length.

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16
Q

Ca influence on the heart’s ionotropic state?

A

Higher with increased intracellular calcium

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17
Q

Four primary influences on intracellular calcium?

A

Extracellular Calcium
Positive Inotropic Agents
Heart Rate
Negative Inotropic Agents (Ca channel blockers)

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18
Q

Effects of increased and decreased extracellular calcium?

A

Increased – Initial inc. in contractility, eventually arrest in systole

Decrease – Initial dec in contractility, eventual arrest in diastole

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19
Q

Give two examples of positive inotropic agents.

A

Catecholamines (Inc. P of Ca channels to let Ca in)

Digitalis (inhibits Na/K pump, less Ca pumped out)

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20
Q

Why would increasing the heart rate increase calcium levels?

A

Not enough time to return it all to the SR between contractions.

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21
Q

What does the force-frequency relationship refer to?

A

Increase in contractility with the increase in the HR due to remnant Ca

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22
Q

Two ways Calcium channel blockers influence the CV system

A

Contractility reduced, as less Ca gets in

No Ca for smooth muscle –> Vasodilation and lost Per. Resistance.

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23
Q

Four types of Cardiomyopathy?

A

Dilated cardiomyopathy
Hypertrophic Cardiomyopathy
Restrictive Cardiomyopathy
Arrhythmogenic RV Dysplasia

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24
Q

Six Steps in Heart Contraction

A 
Filling
Atrial Systole
Isovolumetric Ventricular Contraction
Ejection (Rapid, then reduced)
Isovolumetric Relaxation
Filling Again
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25
Q

Define End Diastolic Volume

A

Volume in the Ventricle following Atrial Systole

26
Q

Role of papillary muscles?

A

Pull on chordae tendinae to prevent AV values from inversion

27
Q

Define End Systolic Volume

A

Blood volume remaining in the ventricle following Systolic Contraction in the isovolumetric relaxation phase

28
Q

How does end diastolic volume relate to heart rate?

A

Higher heart rate means that diastolic filling time is reduced

29
Q

Approx. fractions for blood movement in a healthy heart?

A

1/3 End Systolic Volume

2/3 Pumped Out

30
Q

Relationship of SV, End Diastolic, and End Systolic Volumes

A

SV=EDV-ESV

31
Q

Equation for Ejection Fraction.

A

(SV/EDV) x 100 (for percentage)

32
Q

What does the incisura reflect?

A

Closure of the aortic semilunar valves

33
Q

Memorize pg 8 figure

A

plz.

34
Q

What is the Pulse Pressure?

A

The difference between the systolic and diastolic pressure.

35
Q

Difference in pressure between R and L Heart?

A

Much lower systolic pressure

36
Q

Why does the drop in pressure in reduced ejection occur?

A

Onset on physiological systole

37
Q

Equation for CO

A

CO = HR x SV

38
Q

Low ejection fraction may indicate…

A

Heart Failure

39
Q

Relationship of SV, EDV, and Ejection Fraction

A

SV= (EF) (EDV)

40
Q

Equation for Cardiac Index.

A

Cardiac Output/Body Area

41
Q

Equation for Stroke Index.

A

Stroke Volume/Body Area

42
Q

Equation for Stroke Work

A

(SV) (Mean Arterial Pressure)

43
Q

Equation for Pulse Pressure

A

Systolic Pressure - Diastolic Pressure

44
Q

Equation for MAP (with Diastolic)

A

Diastolic + 1/3 (Pulse Pressure)

45
Q

Equation for MAP (with CO)

A

CO X Systemic Vascular Resistance

46
Q

Equation for MAP (with HR)

A

(HR)(SV)(Systemic Vascular Resistance)

47
Q

What is compliance? (concept)

A

A measure of wall stiffness

48
Q

What is compliance (equation)?

A

Change in V / Change in P

SV/PP (for full system)

49
Q

Increasing compliance will have what affect on pulse pressure.

A

Inc Stiffness will cause inc. pressure

50
Q

Non-Compliant arteries will have _______ pulse wave velocity

A

Higher

51
Q

Source of reflected waves

A

Bifurcations and diameter changes

52
Q

Relationship of Diastolic Run Off to SVR (Total Peripheral Resistance)

A

Inverse

53
Q

Central Venous Pressure is equal to (for all intents and purposes)

A

RA Pressure

54
Q

How can Central Venous Pressure be determined?

A

Measurement of Jugular Vein Filling

Direct catheterization of the right internal jugular

55
Q

Name the five venous waves

A

Positive - a,c,v

Negative - x,y

56
Q

Cause of A-Wave

A

R Atrial Systole

57
Q

Cause of C-Wave

A

Tricuspid Closes

58
Q

Cause of X-wave

A

Atrial Relaxation, Early Ventricular Ejection

59
Q

Cause of V-Wave

A

Increased Pressure from Passive Atrial Filling

60
Q

Cause of Y-Wave

A

Tricuspid Opens

Cardio (10 decks)

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