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5222: Advanced Physiology > Module 10 - Cardiovascular > Flashcards

Module 10 - Cardiovascular Flashcards

Exam 4

1
Q

What are the 3 linings of the heart?

A

Endocardium
Myocardium
Epicardium

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2
Q

Which is the innermost layer of the heart? Which is the outermost?

A

Innermost - Endocardium
Outermost - Epicardium

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3
Q

In the epicardium, there are 2 important membranes called…

A

visceral and parietal

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4
Q

What are DHP receptors?

A

Specialized voltage receptors that are sensitive to changes in Ca and somewhat to changes in Na

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5
Q

What other receptor is related to the DHP?

A

RyR receptor

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6
Q

What is the purpose of the RyR receptor?

A

This is where the Ca moves out from the sarcoplasmic reticulum

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7
Q

Automaticity

A

Nodal cells can spontaneously depolarize when they reach RMP; this happens b/c of Na/K leak, which allows the cell to reach threshold

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8
Q

Rhythmicity

A

The consistency of the automaticity (is it regular?)

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9
Q

The pacemaker of the heart is what?

A

SA Node

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10
Q

If the SA node is not working, what is the next in line pacemaker?

A

AV Node

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11
Q

If the AV node AND the SA node are not working, what is the next pacemaker for the heart?

A

Purkinje Fibers

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12
Q

How many times per minute does the SA node depolarize?

A

60-100 (which is a normal RHR)

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13
Q

The AV node depolarizes ___ times per minute

A

40-60

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14
Q

The Purkinje Fibers depolarize ____ times per minute

A

20-30

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15
Q

What connects the SA and AV nodes?

A

Wenckebach’s Tract / middle tract AND the Thorel’s Tract / posterior tract

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16
Q

What connects the SA node to the L Atrium?

A

Bachmann’s Bundle / anterior tract

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17
Q

What is the main function of the AV node (when SA node is working)?

A

Pause the action potential for ~100 ms to allow for the ventricles to fill with blood

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18
Q

When the ___ ___ depolarize, the ventricles contract

A

Purkinje fibers

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19
Q

Semilunar valves

A

aortic, pulmonary

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20
Q

Atrioventricular (AV) valves

A

tricuspid and mitral / bicuspid

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21
Q

Tricuspid valve is on which side of the heart?

A

Right

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22
Q

Bicuspid / mitral valve is on which side of the heart?

A

Left

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23
Q

T/F: We should not have retrograde blood flow (from ventricles back to atria)

A

True

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24
Q

What is retrograde blood flow called?

A

Regurgitation

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25
Q

When we reach RMP, what happens to the nodal cell?

A

It becomes more permeable for cations to enter

26
Q

What causes depolarization of the nodal cell?

A

The movement of Ca INTO the cell, particularly when Ca moves through the L-type Ca channel

27
Q

Why are gap junctions important in the nodal cell AP?

A

They allow the ions to move through diffusion

28
Q

What triggers myocyte action potential?

A

all the positive cations that are moving through the gap junctions

29
Q

Which voltage-gated channel is fast vs. slow - Na and K?

A

Na is fast
K is slow

30
Q

What happens with all the Ca that moves into the myocyte?

A

it triggers the calcium-triggered calcium release from the RYR receptors of the sarcoplasmic reticulum

31
Q

What is the function of Ca in the cytoplasm of a muscle cell?

A

Muscle contraction

32
Q

Repolarization of the nodal cell and myocyte is always due to what?

A

Movement of K+ OUT of the cell
(Slow voltage-gated K channels)

33
Q

Chronotropic factors are related to ____ _____

A

Heart rate

34
Q

Inotropic factors are related to _____

A

the heart’s ability to contract

35
Q

Dromotropic factors are related to what?

A

the conduction speed

36
Q

Epi/NE will generally cause the Nodal Cell curve to what?

A

Steepen - more APs, higher HR

37
Q

ACh will generally ____ the depolarization curve.

A

Flatten; fewer APs, lower HR

38
Q

During the P wave, what is happening in the heart?

A

Atrial depolarization

39
Q

What is the PR interval?

A

Time from onset of the P wave to the QRS complex

40
Q

What is happening during the PR interval?

A

AP at the AV node

41
Q

T/F: There is NO electrical activity in the PR interval.

A

True.

42
Q

What is happening in the heart during the QRS complex?

A

Ventricular depolarization
Atrial repolarization

43
Q

What is happening during the T wave in the heart?

A

Ventricular repolarization

44
Q

What ion is leaving the ICF of the myocyte during the T wave?

A

K

45
Q

If P(atria) > P(ventricles), the ____ valves open.

A

AV

46
Q

at the end of the atrium draining out of blood, what happens?

A

Atrial kick - actively contracts to get the remaining blood into the ventricles

47
Q

After the atrial kick, what would you expect to see on the ECG?

A

P wave

48
Q

If P(ventricles) < P(aorta / pulmonary), what happens to the semilunar valves?

A

They stay closed

49
Q

If P(ventricles) > P(atria), the ____ valves _____.

A

AV, close.

50
Q

The first heart sound - LUB - comes from what?

A

The closing of the AV valves

51
Q

If P(ventricles) > P(aorta/pulmonary) what happens the semilunar valves?

A

They open

52
Q

End-Systolic Volume

A

The amount of blood remaining in the ventricles at the end of systole

53
Q

End-Diastolic Volume

A

The amount of blood in the ventricles at the end of diastole

54
Q

What causes the semilunar valves to close in isovolumetric relaxation?

A

The contraction of the arteries (Retrograde / Pulse wave)

55
Q

The second DUB heart sound comes from what?

A

The closing of the semilunar valves

56
Q

Preload

A

amount of sarcomere stretch experienced by cardiac myocytes at the end of diastole

57
Q

Contractility

A

Force of contraction at any given EDV (independent of Frank Starling Mechanism)

58
Q

Afterload

A

The pressure that the LV must work against to eject blood during systole

59
Q

What are positive influencer(s) of SV?

A

Preload and contractility

60
Q

What is the negative influencer for SV?

A

Afterload

61
Q

If we generate a greater P1 and P2 and Resistance stay constant, what happens to F?

A

Flow will increase

62
Q

Chronic afterload is associated with what clinical condition?

A

LV hypertrophy

5222: Advanced Physiology (5 decks)

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