lecture 2: 9/10 guyton Flashcards

1
Q

what happens to Aortic pressure during systole after the aortic valve opens.

A

aortic pressure increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

when does aortic pressure decrease

A

towards the end of the ejection phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what devlops after the aortic valve closes and why

A

insura develops due to a sudden back flow towards the left ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

why does aortic pressure decrease slowly during diastole

A

because of the elasticity of the aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

why do we get heart sounds

A

because of the closing of heart values

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

when does the first hear sound occur

A

First sound occurs as the atrioventricular (Tricuspid and Mitral) valves close and signifies beginning of systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

when does the second heart sound occur

A

Second sound occurs when the semilunar (Pulmonary & Aortic) valves close at the beginning of ventricular diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the atrioventricular valves

A

tricuspid and mitral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the semilunar valvues

A

pulmonary and aortic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

why is there a backflow of blood that develops the insura

A

blood bounces off of the peripheral ressitance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

whatt is the prupose of the valves

A

to prevent backflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

why do we sometimes hear a 3rd heart sound and who do we hear it in

A

sometimes when the blood flowing back into the ventricles is so rapid it produces a third sound

can happen in childrena nd highly trained individuals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

true or false: during the period of filling the ventricles, pressure increases significantly?

A

false, no it stays oretty constant because the heart is elastic and expanding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is another name for preload

A

end diastolic volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

when the end diastolic volume is reached, what happens

A

isovolumic contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

when is the blood from the ventricles ejected

A

when the pressure in the ventricle is equal or greater than the systemic pressure so that the valve can open

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the minimum blood pressure needed to eject blood called

A

diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what do hypertensive indidualss hearts need to work harder

A

since they have a higher systemic pressure, the heart must have a higher pressure in the ventricles to combat that which means thte heart needs to work harder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

true or false: end sytolic volume is the systolic bp

A

false, systlic BP is highest pressure in the ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is another name for afterload

A

end systolic volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

when all the blood has been ejected (end systlic volume), what happens to the ventricles

A

isovolumic relaxation and pressure starts to decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

why would an indivual get an incrased preload

A

because of an increase venous retrun (more blood comes into the heart)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are 2 ways to increase venous return

A

slow heart rate

make better posture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what happens ifIf cardiac muscle sarcomeres are stretched, within limits,

A

they contract more forcibly without increase in heart work

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

why do cardiac muscles contract more forcefully if the sarcomers are stretched

A

there are more sites available for cross bridge interacteion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what happens if sarcomeres are stretched too much

A

there will no longer be optimal crossbirdged, pressure will will plateau, decrease in stroke volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

explain why the frank starlic mecahism is good

A

beacuse if you get an icnrease venous return, the heart will be able to eject the blood more forcefully (rubber band mecahnist) without extra heart work and that will increase the stroke volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

if you increase preload, you get a larger or smaller stroke volume

A

larger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what happens if there is an increased after load>

A

increase afterload measn there is more blood left in the ventricles, which will decrase storke volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

if you increase afterload, you increase or decrease stroke volume

A

stroke volume decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

wnhat happens to BP with an increased afterload

A

if there is an icnreaase afterload that measn there is more blood left in the heart which means the ventricle must build higher pressure to which makes it harder for the hear to eject the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

if you have an increased contractility what happens to the stroke volume (increase or decrease)

A

increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what happens to BP if there is an icnrease contractility

A

causes an increase in pressure since there heart needs to contract more forcefully

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what happens to end systolic volume with an icnreased contractility

A

it will decrease

less blood left in the haart since more was ejectred due to incrase contractility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

how can you icnrease contractlity (2 ways)

A

1) hormones

2) sympathetic activation (epinephrine )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

The concentrations of K+ (and organic anions) are BLANK inside a myocyte but very BLANK outside the sarcolemma.

A

high inside

low outisde the sarcolemma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Na+ (and Ca2+ & Cl-) are more concentrated outside or inside the cell

A

outside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what is the potential difference between the inside and outside is called

A

diffusion potention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what gives the resting membrame potential

A

The electro-chemical equilibrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what are the 3 factors that affect permeability to diff ions of the mebrane

A

1) Polarity of the electrical charge of each ion (compare Na+ to Ca2+)
2) Permeability of the membrane
3) Concentrations of the respective ions on the inside and outside of the membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

membrane potential is a potential?

A

false, it is the difference between two potentials so it is a voltage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what does SA node stand for

A

sinoatrial node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what is the SA node made of

A

Specialized cardiac muscle

44
Q

what is the SA node and where is it

A

flattened ellipsoid strip of cells in the right atrium.

45
Q

true or false: there are no contractile filaments in the sinus node

A

true

46
Q

what are sinus nodal fibers are electrically connected to

A

atrial muscle fibers through syncitum

47
Q

since the SA node has no contractile filalnets, it is not excitable?

A

false, there are highly excitable

48
Q

what is the inherent rate of the SA node

A

100 bpm

49
Q

true or false: The SA node sets the rate and rhythm of your heartbeat

A

true

50
Q

since the SA node controls HR and has a rate of 100 bpm, that means something is BLANK these cells to get it to resting HR

A

dampening

51
Q

if the SA node has no cotnractile filaments, how are they self excibtable

A

because of the inherent leakiness of the SA node to sodium and calcium

52
Q

what is the resting membrane potentation of the sinus nodal fiber

A

-55 to -60 mV

53
Q

what is the resting membrane potential for the ventricular mucle fiber

A

-85 to -90 mV

54
Q

which ap develps slower, the atrial nodal or the ventricular muscle

A

atrial nodal

55
Q

true or false: there is a slow depolarization for sinus nodal

A

true

56
Q

why does the Sinus Node Controls Heart Rhythmicity

A

because of its more postiive resting membrane potential and leakyiness, it is the first to be depolarized and spread because of the syncitum

57
Q

true or false The discharge rate of the sinus node is considerably slow than the natural self-excitatory discharge rate of either the A-V node or the Purkinje fibers.

A

false, it is much faster

58
Q

can other parts of the heart ever control heart rhytm

A

yes, Under abnormal conditions, few other parts of the heart can exhibit intrinsic rhythmical excitation in the same way like the sinus nodal fibers (A-V node and Purkinje fibers).

59
Q

what other types of parts of the hear can exhibit rhythmical excitation?

A

av node and purkinje fibers

60
Q

what is a pacemaker elsewhere than the sinus node is called …

A

an ectopic pacemaker/abnomral pacemake

61
Q

where do Action potentials originating in the sinus node travel

A

outward into the atrial muscle fibers and to the A-V node.

62
Q

what happens to the impluse (AP) afrter it travels through the internodal pathways

A

it reaches the A-V node about 0.03 second after its origin in the sinus node.

63
Q

true or false: the impulse/AP syaus the same speed travelling from the SA node to the AV node

A

false, it gets delayed

64
Q

what is the reason for the delay of action portteial from reaching the ventricles

A

allowing the atria to empty blood into the ventricles before the ventricles contract.

65
Q

why does the delay happen at the AV noe

A

This happens because the A-V node has less gap junctions

66
Q

what is the only fiber that connects the atrial to the ventrical

A

the av bundle

67
Q

true or false: the Ap only delays at the AV node

A

false The impulse is delayed more than 0.1 second in the A-V nodal region before appearing in the ventricular septal A-V bundle.

68
Q

the AV bundle has one way or 2 way conduction

A

one way

69
Q

where do the right bundle branch and left bundle branch carry the impuse

A

towards the apex of the heart

70
Q

was is another name for the AV bundle

A

this His nundle

71
Q

how does the impulse transmit to the ventricular

A

Purkinje System

72
Q

where do the special purkinje fibers lead

A

lead from the A-V node through the A-V bundle into the ventricles.

73
Q

what is the effect of the Diminished numbers of gap junctions between successive cells in the conducting pathways within the A-V node

A

induce resistance to conduction of excitatory ions from one conducting fiber to the next.

74
Q

what happens to the impluse at the termination of the purkine fibers

A

the impulse rapidly travels through the ventricle muscle fibers via gap junctions, from the inside (endocardium) to the outside (epicardium).

75
Q

why is it necessary for rapid proparge of the cardac impulse through the purkinje fibers and ventricles

A

importtant for an effect contraction

76
Q

true or false: the impulse rapidly travels through the ventricle muscle fibers via gap junctions, from the inside (endocardium) to the outside (epicardium).

A

true

77
Q

why does the signal/impulse go to the apex of the heartt

A

because it allows max blood to be ejected

78
Q

why is the The SA and AV node action potential is slower to develop than the action potential of the atrial or ventricular muscles.

A

because of the leaky channels

since the atrial/ventricular muscles are already at their resting membrane potential, when the impulse is sense the ap gets sent fast

79
Q

can fast responses (like in the atria and ventricles) ever be converted to the slow responses ?

A

yes
Fast responses may be converted to slow responses either spontaneously or under certain experimental conditions (lack of blood supply)

80
Q

what does ERP stand for and what does it mean

A

effective refractory period

The effective refractory period (ERP) is the amount of time in which the cell cannot respond to a new conducted stimulus. This period is how the heart stays in rhythm and prevents arrhythmias

81
Q

what is the RRp

A

relative refractory period

period where under certain circumstances, it can be depolarixed

82
Q

the refrcatory period is short in BLANK muscles but long is BLANK MUSCLE

A

shoet in skeletal

long in cardiac

83
Q

what does it mean for the sketal muscle to have short refractory periods and cardiac muscle to have long refractory periods.

A

This means that skeletal muscle can undergo summation and tetanus, via repeated stimulation

Cardiac muscle CAN NOT sum action potentials or contractions and CAN NOT be tetanized

84
Q

why is it imporatnt for the heart muscle to have a long refractory periof

A

allows the atrium anf ventricle to refill with blood

prevent artyhmias

85
Q

what are 2 ways to change the frequence of pacemaker firing

A

1) increase HR (increase sodium in the cell)
you will reach the threshold soonwer and generate the AP faster

2) change the normal resting potential so you can reach the AP faster

86
Q

what neurotranmitter to parasympathetic nerves release

A

acetylcholine

87
Q

true or false, the parasympatheic increases or decrease the heart rhythem and excitability

A

decreases

88
Q

what nerves make it so the excitatory signals are no longer transmitted into the ventricles

A

parasympahtetic

89
Q

expalin how parasympathetic nerves decrease heart rhythem and excitability

A

because of Increased permeability of the fiber membranes to potassium ions

(longer to reach threshold)

90
Q

what NT do sympathtic nerves release

A

noreipineprhine

91
Q

true or false: sympathetic nerves increase or decrease the rate of sinus nodal discharge

A

increase

92
Q

what happens to the heart activity when sympathttic nevres are stimulated

A

increases overall heart activity

93
Q

explain how sympathetic nerves effect basic rhythem

A

increases the permibility to the NA and Ca ions, faster to reacher AP tthreshold

94
Q

what modulates the frquence of depolizsaation of pacemaker

A

autonomic nervous system

95
Q

where does the noepinephrine bind for sympathetic stimulation

A

binds to beta1 receptors on the SA nodal membranes

96
Q

where does acetylcholine bind for parasymtphathic stimulation and what does that do

A

binds to muscarinic receptors on nodal membranes; increases conductivity of K+ and decreases conductivity of Ca2+

97
Q

sympathetic stimulation meass there is a HIGHER OR LOWER resting membrane potential

A

higher (more postive) easier to reach threshold

98
Q

parasympathetic stimulation meass there is a HIGHER OR LOWER resting membrane potential

A

lower (more negative0

harder to reach threshold

99
Q

what does atrial fibrilation mean

A

not just one cell initiating the signal causing irregular beat

100
Q

what are 4 examples of abnormal heart rhytmes

A

atrial fibrilation
supraventrical tachycardia
ventricular tachycardia
bradycardia

101
Q

what does supraventricular tahycardia mean

A

electic impulses travel from ventricle to atria

102
Q

what is ventricular tachycardia

A

ventricles do not have enough time to fill up properly

103
Q

what is the effect on stroke volume and cardiac output of ventricular tachycardia

A

decreased stroke volume and decreased cardiac putput

104
Q

what is brady cardia

A

slow heart beat

105
Q

where do they implant the pacemaker

A

connected to the SA node and apex

106
Q

what do artificual pacemakers do

A

generate electrical signal when SA node doesnt work