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Cardiovascular System > Physiology > Flashcards

Physiology Flashcards

1
Q

What is the functional unit for Cardiac muscle?

A

Sacromere

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2
Q

How is the nucleus located in cardiac muscle fibers?

A

Centrally located

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3
Q

True or False ? The refractory period is long in skeletal muscle but short in Cardiac muscle .

A

FALSE!!!! It is LONG in Cardiac muscle but short in skeletal muscle.
S for shirt as for skeletal.

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4
Q

What are the structures that make up the Cardiac conduction system ?

A
  1. Purkinje System
  2. Atrioventricular node(AV node)
  3. Bundle of His
  4. Internodal Atrial pathways
  5. Sinoatrial node (SA node )
    PABIS
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5
Q

Where is Bachman’s Bundle located?

A

In the left atrium

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6
Q

What are the two types of Cardiac Muscle cells?

A

Contractile cells
Auto-rythmic cells

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7
Q

What activates the contractile cells?

A

A change in the membrane potential

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8
Q

True or False? The action potential in cardiac muscle cells are ________ than that of skeletal muscle and the contraction phase is also _____.

A

Wider action potential
Longer contraction phase

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8
Q

True or False? In Cardiac muscle cells ,fibers are not anchored at ends which allows for greater sarcomere shortening and lengthening.

A

TRUE!!

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9
Q

Through what structure does current from autorythmic cells spread to contractile cells?

A

Through Gap Junctions

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10
Q

True or False? The refractory period is long in skeletal muscle but short in cardiac muscles.

A

FALSE!! The refractory period is short in skeletal muscle but very LONG in cardiac muscle.

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11
Q

True or False? Cardiac muscle CANNOT sum action potentials or contractions and cannot be tetanized.

A

TRUE!!

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12
Q

Where are autorhythmic cells found?

A

Through the conduction system ( SA node, AV node, Bundle of His, Pukrinje fibres)

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13
Q

What is the Pacemaker potential?

A

It is slow depolarisation due to both OPENING of Na+ channels and the CLOSING of K+ channels.

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14
Q

Where is the SA node located?

A

At the junction of the superior vena cava with the right atrium.

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15
Q

Fill in the blanks. “ The SA node develops structures from the _____ side of the embryo while the AV node develops structures from the _____ side of the embryo?

A

SA node- RIGHT
AV node- LEFT

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16
Q

What are the two types of voltage-gated Calcium channels in the heart?

A

T (for transient) channels and the L (for long-lasting) channels.

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17
Q

Fill in the blanks. “ The Ca2+ current ( due to opening of T channels completes the _________, and the Ca2+ current due to opening of L channels produces _____.

A

T channels - completes the pacemaker potential
L channels - produces the impulse.

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18
Q

What is the time period for AV-nodal delay?

A

0.1 seconds

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19
Q

What is the number of action potentials per minute procuced at the SA node?

A

70-80

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20
Q

What is the number of action potentials per minute produced at the AV node?

A

40-60

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21
Q

What is the number of action potentials per minute produced at the Purkinje fibres?

A

20-40

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22
Q

Why does the AV nodal delay take place?

A

There is a delay in the action potential from reaching the ventricles, in order to allow the atria to empty blood into ventricles before the ventricles contract.

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23
Q

What structure in the heart allows for the AV nodal delay?

A

Bundle Branches

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24
Q

What happens during the plateau phase?

A

Sodium channels close and there is a SLOW INFLUX of calcium channels through L- type calcium channels.

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25
Q

What happens during the Absolute refractory period of the myocyte?

A

The myocyte is unexcitable to stimulation as all sodium channels are inactivated following the open (depolarized) state.

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26
Q

What happens during the relative refractory period of the myocyte?

A

Stimulation produces a weak action potential that propagates, because some of the Na channels have moved from inactivated to closed, making them able to reopen in response to electrical stimulus.

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27
Q

Where is the AV node located?

A

The AV node is located in the right posterior portion of the interatrial septum

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28
Q

What causes the P-wave in an ECG?

A

Atrial depolarisation, initiated by the SA node.

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29
Q

Where does Ventricular depolarisation begin?

A

At the apex of heart

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30
Q

What causes the QRS complex?

A

Ventricular depolarisation

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31
Q

Fill in the blanks. “ Ventricular repolarisation begins at apex causing the ______ wave?

A

T wave

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32
Q

True or False? Unipolar leads are leads I,II and III.

A

FALSE!! Bipolar leads uses those.

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33
Q

Which Lead uses a third ground (RL) electrode ?

A

Bipolar leads

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34
Q

What leads are unipolar limb leads?

A

aVR, aVL , aVF

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35
Q

Which leads are unipolar chest leads?

A

V1 through to V6

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36
Q

Where is the RA electrode positioned?

A

It is positioned anywhere on the right arm or below the right clavicle in the midclavicular line.

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37
Q

Which electrode is positioned positioned anywhere on the left leg or left midclavicular line below the last palpable rib?

A

LL electrode

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38
Q

Where is La electrode positioned?

A

It is positioned anywhere on the left arm or below
the left clavicle in the midclavicular line

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39
Q

True or False? The RL electrode is ositioned anywhere on the left arm or below the left clavicle in the midclavicular line?

A

TRUE!!

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40
Q

Where should V1 be placed?

A

Fourth intercostal space to the RIGHT of the sternum.

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41
Q

Which chest lead is positioned at the Fifth intercostal space at midclavicular line?

A

V4

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42
Q

Where is V2 located?

A

Fourth intercostal space to
the Left of the sternum.

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43
Q

Which lead is located between leads V2
and V4?

A

V3

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44
Q

True or False? V5 is level with V4 at left anterior
axillary line.

A

TRUE!

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45
Q

Where is V6 located?

A

Level with V5 at left midaxillary line.

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46
Q

What leads provide an inferior, superior, and lateral views of heart (Frontal Plane)?

A

I, II, III, aVR, aVL and aVF

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47
Q

What leads provide anterior, and lateral views of heart (Horizontal Plane)?

A

Include leads V1- V6

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48
Q

What is the normal duration for the PR interval?

A

0.12-2.0 seconds

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49
Q

What is the difference between bipolar leads and unipolar leads?

A

Bipolar leads - Record the difference in electrical potential between a positive and negative electrode.

Unipolar Leads- Uses only one positive electrode and a reference point calculated by the ECG machine.

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50
Q

Which leads provide an anterior view of the heart?

A

V1-V4

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51
Q

Fill in the blanks. “ Leads II, III and aVF provide a what view of the heart ?

A

Inferior View

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52
Q

What leads provide a view of the entire lateral heart wall?

A

Leads I, aVL, V5 and V6

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53
Q

What is an artifact?

A

This is markings on an ECG tracing that are not a product of the heart’s electrical activity.
- Patient movement is among its many causes
- Can mimic life threatening dysrhythmias

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54
Q

Which lead is most often chosen as the Rhythm strip?

A

Lead II

55
Q

What is the normal amplitude of a P- wave?

A

0.05- 0.25mV

56
Q

What is the normal duration of a P-wave?

A

0.06-0.10 seconds

57
Q

What is the normal duration of the PR interval ?

A

0.12- 0.20 seconds

58
Q

What is the normal amplitude of the QRS complex?

A

0.5- 3.0 mV

59
Q

What is the normal duration for the QRS complex?

A

0.06- 0.10 seconds

60
Q

What is the name of the starting point of the ST segment ?

A

J- point

61
Q

What does the QT interval measure?

A

It measures the time and ventricular depolarisation and repolarization.

62
Q

What is the normal duration of the QT interval?

A

0.36 - 0.44 seconds

63
Q

What is the purpose of the U wave?

A

It measures depolarisation of the papillary muscles/ Purkinje fibres

64
Q

What is a T-wave Inversion usually an indication of?

A

Ischaemia

65
Q

What is the name of the three bundles of atrial fibres that contain Purkinje-typpe of fibres and connect SA node to AV nodes?

A

The Anterior fibres ( Buchman Bundle)
Middle fibres ( tract of Wenckebach)
Posterior fibres ( Tract of Thorel)

66
Q

True or False? The bundle of His is found in the left ventricle.

A

FALSE!! It is found in the Intraventricular septum where it gives off a left bundle brand and continues as a right bundle branch.

67
Q

Fill in the blanks, In Lead I the electrodes are connected so that an upward deflection is inscribed when the _______ arm becomes ______.

A

Left arm becomes positive!!!

68
Q

In Lead II , where are the electrodes placed and what is positive?

A

On the right arm and left leg
Left leg is positive

69
Q

In Lead III where are the electrodes placed?

A

The electrodes are on the left arm and left leg with the leg being positive

70
Q

What does Einthoven’s law state?

A

Lead I + Lead III = Lead II

71
Q

How is the Electrical axis of the heart calculated?

A

It is the mean QRS vector

72
Q

Fill in the blanks. “Right axis deviation normally represents _______”

A

Right ventricular hypertrophy

73
Q

An inverted T wave can be an indication of what condition?

A

Ischaemia

74
Q

Fill in the blanks. “ An elevated ST segment can be an indication of ______.”

A

Myocardial Infarction

75
Q

In which degree of heart block does the the atria and ventricle beat independently of each other and is usually treated with an artificial pacemaker?

A

Third degree AV block ( Complete block)

76
Q

In which degree of heart block has a progressive lengthening of PR interval until a P wave is not followed by a QRS complex ( dropped) ?

A

Second degree Av block Morbitz Type I ( Wenckebach )

77
Q

When the PR interval is fixed and prolonged > .20 seconds it is described as a ?

A

First degree heart block

78
Q

Fill in the blanks. _________ is randomly dropped beats without progressive PR prolongation and at risk for degenerating to third-degree block .

A

Second degree type II ( Morbtz II)

79
Q

Which degree heart block can be as a result of Lyme disease?

A

Third degree heart block

80
Q

Which condition has no discernible P waves?

A

Atrial fibrillation

81
Q

True or False? Hypoxia increases intracellular ATP.

A

FALSE!! It DECREASES intracellular ATP

82
Q

Why is a inverted T wave usually an indication for Ischaemia?

A

This is because ischaemic tissue does not depolarise normally .

83
Q

What are the causes of Myocardial Ischemia?

A

Atherosclerosis
Vasospasm
Thrombosis and Embolism
Decreased ventricular filling time - tachycardia
Decreased filling pressure in coronary arteries
- severe hypotension or aortic valve disease

84
Q

Fill in the blanks.” Myocardial injury is usually represented by _____.”

A

ST elevation

85
Q

When the Q wave changes it is normally an indication of what condition?

A

Myocardial infarction

86
Q

What is the electrical axis of a normal QRS complex?

A

Between 0 and +90 degrees

87
Q

The first heart sound S1 is produced by ?

A

Closure of Mitral and Tricuspid valves

88
Q

What does the A wave represent?

A

Atrial contraction

89
Q

What does the C wave represent?

A

The c wave is the next upward deflection in pressure, corresponding to con- traction of the right ventricle, causing the tricuspid to bow inward toward the right atrium, transiently increasing pressure.

90
Q

What does the V wave represent?

A

I occurs during venous filling (v for “villing”

91
Q

When is the second heart sound S2 produced?

A

In isovolumetric ventricular relaxation - ( pulmonary and aortic valve closes)

92
Q

True or False? In skeletal muscle, ATP is not stored in any appreciable quantity.

A

TRUE

93
Q

Fill in the blanks. A rise in metabolism depends on ________.

A
  1. The cross- bridge cycling rate of myosin and actin
  2. Substrate availability
  3. Accumulation of metabolic byproducts
94
Q

What percentage of ATP is produced by Aerobic metabolism at rest?

A

100%

95
Q

Fill in the blanks. At rest “ 2/3 of fuel is contributed by _____ by ______ while 1/3 of fuel is contributed by ______ by ________.

A

2/3 - Fats by Beta Oxidation
1/3 - CHO by aerobic glycolysis

96
Q

True or False? At rest your blood lactate levels are high .

A

FALSE!! They are low

97
Q

What is Oxygen Deficit / Debt?

A

This is the period of exercise during which level of oxygen consumption is below necessary to supply all ATP required.

98
Q

True or False? Trained individuals have a lower oxygen deficit.

A

TRUE!!

99
Q

ATP and creatine phosphate ( CP) is what kind of energy source?

A

Alactic anaerobic source

100
Q

Glucose from stored glycogen in the absence of oxygen is what kind of energy source ?

A

Lactic anaerobic source

101
Q

Glucose, lipids and proteins in the presence of oxygen is what kind of source?

A

Aerobic source

102
Q

How long is Alactic anaerobic sources maintained for?

A

8-10 seconds

103
Q

What type of physical activities utilizes Alactic anaerobic sources?

A

‘Explosive sports’ - weightlifting, jumping , throwing, 100m running , shot put and 50m swimming

104
Q

What type of physical activities utilises lactic anaerobic sources?

A

” Short intense sport ( less than 2 mins) Gymnastics, 200 to 1000 m running, 100 to 300 m swimming

105
Q

What is the recovery time for lactic anaerobic sources?

A

1 to 2 h

106
Q

What are the effects of lactic acid on the skeletal muscles?

A

↓ the rate of ATP hydrolysis
↓ efficiency of glycolytic enzymes
↓Ca2+ binding to troponin
↓ interaction between actin and myosin (muscle fatigue)

107
Q

Where does lactate change back into pyruvate and by what process ?

A

In the liver - Gluconeogenesis

108
Q

Fill in the blanks. During rest , Lactic acid is converted back to _____ and oxidised by _____.

A

Pyruvic acid and oxidised by skeletal muscles

109
Q

What is the recovery time for activities that utilised that Aerobic source?

A

24-48 hours

110
Q

What type of activities utilises the aerobic source?

A

Long sports - available after 2-4 mins of exercise

111
Q

What organs are fuel aerobic sources stored in?

A

Muscles, Adipose tissue and liver

112
Q

When is Aerobic respiration used?

A

After 2-4 minutes of exercise

113
Q

When is Glycolysis used during exercise ?

A

After 8-10 seconds

114
Q

What is Vo2 max?

A

It is the peak oxygen consumption that is influenced by age, sex and training level of person performing exercise.

115
Q

What is the name of the plateau in peak oxygen consumption, reached during exercise involving a sufficiently large muscle mass ?

A

Maximal oxygen consumption

116
Q

What is maximal oxygen consumption limited by?

A

The ability to deliver Oxygen to skeletal muscles and muscle oxidative capacity .

117
Q

During Oxygen Deficit/Debt, What is the primary fuel source initially?

A

Anaerobic systems

118
Q

What is Oxygen Deficit?

A

It is the volume difference between an ideal and real oxygen uptake.

119
Q

What is Oxygen debt?

A

It is the extra volume that is needed to store all energetic systems .

120
Q

True or false? Untrained individuals have a higher oxygen deficit while trained individuals have a lower oxygen deficit.

A

TRUE!!

121
Q

What is the unit for VO2 max?

A

mL/kg/min - VO2 max is measured in milliliters of oxygen used in one minute per kilogram of body weight (mL/kg/min).

122
Q

What is Cardiac Output?

A

Cardiac Output is Strove Volume x Heart Rate
CO = SV x HR

123
Q

What is the unit for Cardia Output?

A

mL/min

124
Q

Which leads provide a view of the anterior heart wall?

A

Leads V3, V4

125
Q

Which leads provide a view of the septal heart wall?

A

Leads V1 & V2

126
Q

Ischemia is represented on an ECG via?

A

ST depression or T inversion ( because ischemic tissue does not depolarise properly

127
Q

An ST elevation on ECG can indicate what condition?

A

Myocardial Injury

128
Q

Myocardial injury can as a result of ?

A

Prolonged ischemia

129
Q

Which wave of an ECG can a myocardial infarct be detected on?

A

Q wave ( it may get shorter )

130
Q

Fill in the blanks. “ The left bundle branch divides into _____, _______ &________.”

A

Septal, Anterior and Posterior fascicles

131
Q

What is the norm duration of the QRS complex

A

0.06-0.10 seconds

132
Q

What happens during a bundle branch block?

A

It leads to one or both bundle branches failing to conduct impulses, produces delay in depolarisation of the ventricle it supplies .

133
Q

What are the key characteristics of a bundle branch block?

A
  • Widened QRS complex (0.12 seconds greater in duration)
  • ‘M’ shaped chest leads.
134
Q

What is the ECG readings for a Right Bundle branch block(RBBB)?

A

wide, tall, notched QRS complex in leads V1 & V2 .

Look for slurred S waves in leads I , V5 & V6.

135
Q

What are the causes of a right bundle branch block?

A
  • Anterior wall MI
  • Coronary artery disease
    *Hypertension
  • Scar Tissue that develops after heart surgery
  • Viral or bacterial myocarditis
  • Pulmonary embolism
  • Drug toxicity
  • Congenital defect ( atrial septal defect)
136
Q
A

Cardiovascular System (10 decks)

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