Physiology Flashcards
Pacemaker potential in SAN/AVN(slow depolarisation to threshold) is from ___ to ___ mV
It is due to ___ + ___
-60 to -40mV
slow Na+ influx - If and Ib - funny current and background Na current
ICaT - transient Ca2+ influx
decreased Ik - less K+ efflux
The action potential in SAN/AVN(rapid depolarisation) is from ___ to ___ mV
It is due to ___
-40 to +10mV
Voltage-gated Ca2+ channels open for rapid influx of Ca2+ - ICaL
Repolarisation in SAN/AVN is from ___ to ___mV
It is due to ____ + ____
+10mV to -60mV
K+ channels open (efflux - increase Ik) and Ca2+ channels close
Electrical impulse travels between myocytes through ____
gap junctions
3 stages of SAN/AVN electrical activity
pacemaker potential - spontaneous slow depolarisation
action potential - rapid depolarisation
Repolarisation
____ and ____ allow rapid conduction of AP to ventricles
Bundle of His, its branches and the Purkinje fibres
Resting potential in cardiac myocytes is
-90mV
Phase 0 of cardiac myocyte AP is from __ to __mV
Due to ___
-90 to +30mV - depolarisation
Fast Na+ influx
Phase 1 of cardiac myocyte AP is due to ___
transient K+ efflux (Ito)
closure of Na+ channels
Phase 2 of cardiac myocyte AP =___
Due to ___
Plateau phase
Opening of voltage-gated Ca2+ (influx - ICaL)
INaL (late Na influx) w. NCX1 (1Ca in:3Na out)
Phase 3 of cardiac myocyte AP = ___
Due to ___
Repolarisation
K+ channels open (efflux) Ik
closure of Ca2+ channels
Phase 4 of cardiac myocyte AP =
maintained at -90mV
______ is the dominating ennervation of the SAN at rest
Vagal tone (parasympathetic)
Normal HR at rest =
60-100bpm
Vagal nerve causes release of __ to ___ receptor in the _____
ACh to M2 receptor
SAN and AVN
Parasympathetic effect on pacemaker potential in SAN
hyperpolarisation, threshold increases = -ve chronotropic
Increases perm. to K+ and decreases perm. to Na+ & Ca2+
Parasympathetic NS has a chronotropic+/ionotropic effect on the heart
-ve chronotropic
NO IONOTROPIC
Sympathetic nerves supply _____ in the heart
SAN, AVN and myocardium
Parasympathetic effect on the AVN
increases delay
Sympathetic nerves causes release of __ to __ receptors in the heart
noradrenaline beta1 adrenoceptor
Effect of sympathetic NS on SAN
threshold decreases, decreased perm to K+ increased perm to Na+ and Ca2+ - increases slope of pacemaker potential
=> +ve chronotropic effect
Sympathetic NS has a chronotropic+/ionotropic effect on the heart
+ve chronotropic and ionotropic effect
QRS complex =
ventricular depol.
masked atrial repol.
T wave =
ventricular repol.
PR interval =
mainly AVN delay
ST interval =
ventricular systole
TP interval =
diastole
P wave =
atrial depolarisation
Desmosomes are located in ___ and provide ___ allowing ___
the intercalated discs
mechanical adhesion
tension development between myocytes
In the heart: Myosin + ___ -> + ___ = ____ formation allowing for binding to _____
ATP ; Ca2+ ; cross-bridge ; actin
In the heart: actin + myosin -> ___ + _______ -> ____
ADP, Pi + energy released ; powerstroke as myosin bends ; A + M detach
Excitation-contraction coupling in cardiac myocytes
systolic Ca2+ influx at Phase 2 stimulates CICR from SR so binding site on actin available for myosin
location of SR
covers myofibrils in muscle cells
effect of increased intracellular Ca2+ in actin myosin binding
Ca2+ binds to troponin on tropomyosin and pulls it away from the binding site on actin
Long refractory period in cardiac myocytes is from ___ to ___
depolarisation to repolarisation
Stroke volume definition =
blood vol ejected from each ventricle per heart beat
EDV-ESV
Intrinsic control of stroke volume =
change in diastolic length of myofibrils (EDV/preload determined by venous return)
Staling’s law of the heart
increased EDV/venous return => increased stroke volume
stretch in cardiac myocytes ____ troponin affinity for Ca2+
Stretch increases troponin affinity for Ca2+
Optimal fibre length in cardiac myocytes =
stretched
Starling’s law partially compensates for a decreased SV as ____
heart doesn’t eject full volume so EDV increases => SV increases by Starling’s law
Extrinsic control of stroke volume =
sympathetic NS to ventricular myocytes
Hormones - adrenaline and noradrenaline
How does the symp. NS cause +ve ionotropic effect on ventricular myocytes?
cAMP mediated Ca2+ channels activated = increase force
Shifts Starling curve to the left (contractility at a given EDV is greater)
Aortic area on the chest =
2nd intercostal space
R of sternum
Pulmonary area on the chest =
2nd intercostal space
L of sternum
Tricuspid area on the chest
4th intercostal space
L of sternum
Mitral area on chest
5th intercostal space
Mid-clavicular line
a wave in JVP =
atrial contraction
c wave in JVP =
tricuspid valve bulges into R atrium as ventricles contract
v wave in JVP =
atrial filling
The dicrotic notch in aortic pressure occurs at ____ due to ____
the end of ventricular systole
closure of the aortic valve
isovolumetric ventricular contraction and relaxation occur when
the AV valves and the aortic/pulmonary valves are shut
Ib background Na current in the pacemaker potential is due to ___
“leaky cells” = influx of Na
If (funny current) is mediated by _____
HCN channels
hyperpolarisation-activated cyclic nucleotide gated channels (influx Na and efflux K)
beta 1 stimulation in AVN causes _____ by increasing ____
increased conduction velocity
If and ICa
beta 1 stimulation in SAN causes ____ by ____
increased HR
steeper pacemaker potential slope by If+ ICa increase
lowers threshold by increasing ICa
beta 1 stimulation causes +ve ionotropic effect by ____
increase Ca2+ influx and sensitise tropomyosin to Ca2+
beta 1 stimulation causes an increase in _____ activity which speeds up ___
NaKATPase
repolarisation
Sympathetic enervation of the heart causes the length of systole + diastole to _____
Both shorten
ACh to M2 receptors in SAN+AVN cause ____ subunits to open ____ causing ______
βγ ; GIRK (K+ channels) hyperpolarisation
Parasympathetic NS increases SAN threshold by ____
decreasing ICa
Parasympathetic NS does not supply the _____ in the heart
ventricular myocytes
AVN delay is increased by the parasympathetic NS by ___
decreased Ca2+ channel activity and GIRK hyperpolarisation
Parasympathetic NS ____ atrial refractory period and may => ____
shortens
atrial arrhythmias
HCN channels are activated by
hyperpolarisation
cAMP
SERCA =
Its role is to ____
SR Ca2+ATPase
sequestration of Ca2+ into the SR so cardiac myocytes relax
CICR is caused by Ca2+ activating ____ receptors
ryanodine type 2 (RyR2 receptors)
greatest p.d. detected when lead is _____ to dipole
parallel
Limb lead I goes from ___ to ___
R arm (-ve) to L arm (+ve)