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CC2 > Lesson 1 > Flashcards

Lesson 1 Flashcards

1
Q

Ca++ channels initially open to continue the process of

A

depolarization

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2
Q

The rhythm’s isoelectric line reflects __ of the AP

A

phase 4

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3
Q

Bachman’s bundle is

A

an interatrial tract

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4
Q

The anterior-superior fascicle of the LBB supplies

A

the septum

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5
Q

During ventricular systole

A

The tricuspid and mitral valves close

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6
Q

In the event of low osmolarity imbalances

A

ADH levels decrease

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7
Q

The primary area of infarction after occlusion of the RCA is the

A

inferior wall of the LV

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8
Q

Normal LV musculature is approximately __ in thickness

A

8-15mm

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9
Q

The MP is the electrical voltage of the

A

polarized cell

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10
Q

During phase 2 of the AP

A

K+ leaves the cell

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11
Q

The LAD artery supplies a major portion of the heart’s __surface

A

Anterior

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12
Q

Sinus arrhythmias can be found following Inferior wall MIC because the RCA supplies

A

the SA node

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13
Q

Actin and myosin

A

Are muscle proteins, responsible for cardiac muscle contraction & relaxation

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14
Q

How does the PSNS impact cardio-regulation & what hormones are involved

A

PSNS supplies SA, atrial muscle, AV, some purkinje-fibres- they have a SUPRA-VENTRICULAR effect, acetylcholine is released with vagal stimulation, slows SA & AV node

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15
Q

Polarized ventricular cells

A

Are impermeable (at MP of -90mV)

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16
Q

The posterior-inferior fascicle of the LBB supplies

A

the lateral wall of the LV

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17
Q

Spread of ventricular depolarization occurs from

A

Endocardium to Epicardium (Endo closes to heart, Myocaridum (thick), epicardium)

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18
Q

What are the primary extracellular electrolytes

A

Na+ & Ca++

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19
Q

The main event occurring in phase 0 of the AP is

A

opening of the Na+ channels

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20
Q

The vulnerable period of the AP

A
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21
Q

During RRP (relative refractory period)

A

the ventricular cell’s MP is -60 to -90mV

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22
Q

What does aldosterone do

A

promotes fluid retention by promoting retention of Na+ & H2O, & Cl- - increase plasma volume & BP

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23
Q

Cells in the AV node ..

A

slow impulses

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24
Q

Flow of blood during atrial diastole account for about __% of total ventricular volume

A

80%

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25
Q

Ventricular cells with automaticity cannot generate impulses slower then their intrinsic ability of 20-40 impulses/minute because

A

acetylcholine effects are supra-ventricular

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26
Q

Threshold potential (TP) represents the

A

increased voltage required to depolarize the cell (gets more positive)

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27
Q

The initial part of the R wave reflects __ of the AP

A

phase 0

28
Q

Bundle branches are mostly supplied by

A

the LAD

29
Q

If sarcomeres are to contract they must receive energy from _

A

ATP

30
Q

The first heart sound (S1) indicates

A

the onset of ventricular systole
& the closing of

31
Q

Normal RV musculature is approx __ thick

A

4-5mm

32
Q

What is automaticity, excitability, conductivity & contractility

A

Automaticity- ability to initiate impulse (pacemaker cells)
Excitability - respond to impulse
Conductivity - pass impulse along
Contractility - contraction/shortening of cardiac fibers

33
Q

Rate of SA node

A

60-100
it is the original initiator & SA node has automaticity

34
Q

What are the internodal/interatrial tracts

A

Internodal pathway - through RA to AV node, influence conduction time from SA to AV
Interatrial Tract - Bachmann’s bundle, travels through LA

35
Q

What is the purpose of the AV node & AV junction

A

The AV node slows the conduction of the impulse before it reaches the ventricles, thus giving time fro the atrium to contract before the ventricles - creates the PR interval
The AV junction has automaticity, at a rate of 40-60bpm

36
Q

What is the rate of automaticity of the bundle of HIS

A

20-40

37
Q

What does the R bundle branch supply

A

septum & RV

38
Q

What does the anterior superior fascicle of the LBB supply & posterior inferior fascicle of the LBB supply

A

Anterior - septum, lateral LV & anterior LV
Posterior - septum, lateral LV & posterior LV

39
Q

Path of conduction of caridiac AP

A

SA – internodal trach (&interatrial bachmann bundle) – AV- bundle of HIS - RBB & LBB (posterior & anterior) - purkinje fibres

40
Q

What is important to note about purkinje fibres

A

they have FAST conduction for simultaneous ventricle contraction

41
Q

Direction that coronary arteries supply

A

outside to inside
Pericardium to endocardium

42
Q

What does the RCA supply, common infarct & arrhythmia to anticipate

A

RA, RV, inferior LV, posterior LV & posterior septum
SA, AV, bundle of HIS, LBB
Infarct- 1.inferior wall of LV, 2posterior LV, 3. RV
Arryth- Sinus arryth. Junctional, heart blocks

43
Q

What does the LAD supply, common infarct & arrhythmia to anticipate

A

Anterior LV, anterior RV, anterior septum
RBB & large area of LBB (part posterior & anterior)
Infarct - Anterior LV, anterior septum
arryth- BBB, complete heart block

44
Q

What does the Circ supply, common infarct & arrhythmia to anticipate

A

LA, lateral LV, posterior LV
SA, proximal BB
Infarct- Lateral LV, posterior LV
Arryth - Sinuse arryth, BBB

45
Q

What is the entire cardiac muscle structure & what carries in the impulse

A

T-tubule carry impulse to Sarcoplasmic reticulum (mesh coating around myofibril, stores Ca++) - Myofibril, made up of sarcomeres - made up of A band(actin) I band (myosin) & Z-band

46
Q

What is diastole, what vales are open, what veins/arteries are open(in use)

A

Diastole is the resting state, superior/inferior vena cava bring in un-oxygenated blood from body to RA, oxygenated blood flows into LA from pulmonic veins, MV& TV are open, blood flows passively into ventricles - accounts for 80% of blood volume

47
Q

What happens in atrial systole

A

Blood is ejected from atria into partially filled ventricles, adds 20% of ventricular blood volume “atrial kick”

48
Q

What happens in ventricular systole

A

MV&TV close (d/t pressure in ventricle), PV & AV open, ventricles contract, RV eject out pulmonic artery, LV eject out aorta, PV & AV close

49
Q

What makes S1 & S2 sound

A

S1- closing of MV & TV
S2 - PV & AV

50
Q

What are the two cardio-regulatory mechanisms

A

ANS (SNS & PSNS) & specialized defense mechanism ( receptors, osmo,pressor, chemo)

51
Q

How does the SNS impact cardio-regulation & what hormones are involved

A

SNS supplies atria & ventricles, epinephrine & nor-epinephrine, increase hearts excitability, increase force of contraction, increase HR, increase conduction through AV

52
Q

How does the PSNS impact cardio-regulation & what hormones are involved

A

PSNS supplies SA, atrial muscle, AV, some purkinje-fibres- they have a SUPRA-VENTRICULAR effect, acetylcholine is released with vagal stimulation, slows SA & AV node

53
Q

What is the primary intracellular electrolyte

A

K+

54
Q

What two hormones assist with fluid homeostasis

A

Aldosterone (form adrenal) & ADH (from pituitary)

55
Q

What does ADH do

A

conserves water, stimulates re-absorption of water - urine volume decreases & concentration increases

56
Q

what do osmoreceptors do (l& ow vs high osmolarity response)

A
  • detect changes in concentration or osmolarity - cause hormonal response, ADH
  • LOW - hypotonic, osmorecptors decrease impulse on pituitary gland thus decreasing ADH - cause diuresis
  • HIGH - hypertonic, osmoreceptors increase impulse on pituitary gland to increase ADH, increase water re-absorption in kidneys
57
Q

What do pressoreceptors / baroceptors do (high vs low reaction)

A

they are sensitive to changes in BP, HR & CO - effect BV constriction - ANS & hormonal (aldosterone response)
- Increase HR, BP, CO – ANS (PSNS is stimulated, decrease HR, decrease CO) hormone (aldosterone is inhibited, loss of Na+ & water, BP decrease)
– Decrease in HR, BP, CO - ANS (PSNS is inhibited, decrease HR) hormonal (aldosterone is secreted, retention of Na+ & H2O, fluid volume increase)

58
Q

what do chemoreceptors do

A

Respond to low O2, & severe drops in CO & BP - stimulate ANS response
SNS - stimulated release nor-epi & epi - increase HR, vasoconstriction, increase force of contraction - increase BP
- Also send impulse to respiratory centre, alveolar ventilation improves- increase O2 intake by lungs- increase O2 sat

59
Q

What is polarization or polarized state

A
  • polarization is the resting state of the cell, iso-electrical line, end to T wave to next beat, phase 4
60
Q

What is depolarization

A

Cells state of excitability, cells are stimulated Na+ enters cell
P wave is atrial depolarization & & QRS is ventricular depolarization

61
Q

What is repolarization

A

restoration of cells to resting/polarized state, K+ ions move out
Ta wave is atrial repolarization (inside QRS) T waves is ventricular repolarization

62
Q

What is membrane potential & threshold potential

A

MP - voltage when polarized at rest
TP - voltage needed before it can be activated - at this point depolarization can occur for an AP

63
Q

What is a pacemakers cell MP & TP

A

-since pacemaker cell much less the non-pacemaker cell
MP -40mV to -70mV, TP -35mV to -50mV - they can spontaneously depolarize and initiate an AP

64
Q

What is a non-pacemakers cell MP & TP

A

MP -90mV
TP - 70mV to -80mV
these cells need an impulse to commence depolarization to reach the TP

65
Q

What are the 5 phases of an AP

A

Phase 0 - cell voltage goes up till it reaches TP- depolarization occurs from fast Na+ channels until cell is at -60mV - second wave of Na+ and Ca++ slow channels start to open - creates the R wave
Phase 1 - abrupt closure of Na channels, start of S wave
Phase 2 - slighlt plateau, Ca still open to help with contraction & allow one full contraction to occur before another is initiated, K+ is moving out to balance
Phase 3 - Ca channel close - increase in K+ lea ing - sodium-potassium pump restores cell to MP
Phase 4 - cell at MP, iso-electric line

66
Q

What is the absolute refractory period

A

cells cannot respond to a stimulus, phases 1,2&3. still cell reaches approx -60mV - QRS and initial part of ST segment

67
Q

What is the relative refractory period & vulnerable period

A

corresponds to the -60mV to -90mV in phase 3, where a premature impulse is possible to initiate a cycle
- vulnerable period is the end of phase 3 - highest excitability just prior to MP, -85mV to -90mV, a weaker stimulus then normal can initiate an AP- this can cause R on T phenomena (peak of the T wave - cause VT &N VF

CC2 (1 decks)

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