Physiology Flashcards
What is meant by autorhythmicity of the heart?
It is able to generate its own electrical impulses without external stimuli
Where does excitation of the heart normally originate?
SA node
What are the specialised cells within the SA node that initiate the heart beat called?
Pacemaker cells
What is meant by sinus rhythm?
Describes the heart’s pace being controlled by the SA node
SA node cells have a stable resting membrane potential. True/False?
False
They exhibit spontaneous pacemaker potential
What is the function of the spontaneous pacemaker potential?
Takes the membrane potential to threshold (depolarisation) to generate an action potential
What gives rise to pacemaker potential?
Decrease in K+ efflux
Slow Na+ influx
What causes the rising phase of the action potential (depolarisation) in SA node cells?
Opening of Ca++ channels, resulting in Ca++ influx
What causes the falling phase of the action potential (repolarisation) in SA node cells?
Opening of K+ channels, resulting in K+ efflux
Summarise the phases of the SA node action potential
Pacemaker potential: decreased K+ efflux, slow Na+ influx
Rising phase: Ca++ influx
Falling phase: K+ efflux
Which junctions allow cell-to-cell spread of excitation?
Gap junctions
The AV node is the only point of electrical contact between atria and ventricles. True/False?
True
AV node cells are large and slow to conduct. True/False?
False
They are small and slow to conduct
Why is AV nodal delay present?
To allow time for atrial systole to precede ventricular systole
Which fibres enable the excitation to spread to the ventricles?
Bundle of His and Purkinje fibres
What gives rise to the rising phase of the action potential in ventricular contractile cells?
Fast Na+ influx
Describe Phase 0 of the cardiac action potential
Fast Na+ influx causes reversal of the resting membrane potential from -90mV to +30mV
Describe Phase 1 of the cardiac action potential
Closure of Na+ channels + transient K+ efflux causes some repolarisation
What gives rise to the plateau phase (phase 2) of the cardiac action potential?
Ca++ influx
What gives rise to the falling phase (phase 3) of the cardiac action potential?
K+ efflux
Describe Phase 3 of the cardiac action potential
Closure of Ca++ channels and opening of K+ channels allows K+ efflux which causes repolarisation of the membrane potential back to -90mV
Sympathetic stimulation causes increased heart rate. True/False?
True
What is meant by vagal tone?
Parasympathetic stimulation to the heart dominating in resting conditions
The vagus nerve supplies only the SA node. True/False?
False
Supplies both SA and AV nodes
What does parasympathetic stimulation do to the AV node?
Increases AV nodal delay
Which neurotransmitter acts on which receptor in parasympathetic control of the heart?
ACh on M2 receptors
Name a competitive inhibitor of ACh that is used in bradycardia
Atropine
Vagal stimulation causes the slope of the pacemaker potential to increase. True/False?
False Slope decreases (increased AV node delay)
What is meant by negative chronotropic effect?
Decreased contraction of the heart due to less frequent action potentials
Which areas of the heart does the sympathetic system supply?
SA node
AV node
Myocardium
Which neurotransmitter acts on which receptor in sympathetic control of the heart?
Noradrenaline on B1 receptors
Sympathetic stimulation does what to the slope of the action potential?
Increases it
What is meant by positive chronotropic effect?
Increased contraction of the heart due to more frequent action potentials
Where does Lead I of an ECG connect?
Right arm - Left arm
Where does Lead II of an ECG connect?
Right arm - Left leg
Where does Lead III of an ECG connect?
Left arm - Left leg
Cardiac muscle is striated. True/False?
True
What creates the striated appearance of cardiac muscle?
Contractile protein elements (actin and myosin)
Give the name of protein channels that which form electrical communication between neighbouring myocytes
Gap junctions
What do desmosomes do in the heart?
Provide mechanical adhesion between adjacent cardiac cells
Ensure tension is developed
What is contained within muscle fibres?
Myofibrils (contractile protein elements of muscle)
Actin filaments are thick and appear light. True/False?
False
They appear light but are thin
Myosin filaments are thick and appear dark. True/False?
True
What is the arrangement of of actin and myosin within each myofibril called?
Sarcomere
Myosin filaments slide over actin filaments to produce muscle tension. True/False?
False
Actin slides over myosin!
What is required to generate the force by which sliding of filaments can occur?
ATP
Calcium
What is the role of calcium in sliding of filaments?
Required to ‘switch on’ cross-bridge formation
- binds to troponin complex on myosin
- causes conform change which exposes actin binding site
- cross-bridge forms via site and myosin binding site
What is the role of ATP in sliding of filaments?
Binds to myosin head to either energise it or break down the cross-bridge between myofibrils (that is created by calcium)
Where does the calcium that activates contractile machinery come from (where is it stored)?
Sarcoplasmic reticulum
What is meant by calcium-induced calcium release?
Ca++ influx during the plateau phase of the AP causes Ca++ to be released from the sarcoplasmic reticulum to cause contraction
What is meant by the refractory period?
Period following action potential where it is not possible to generate another action potential
What are the two moments where a new action potential cannot be generated?
Plateau phase (Na channels in closed state) Falling phase (K channels open, thus membrane cannot depolarise)
What is the clinical benefit of the refractory period?
Prevents tetanic contractions of the heart
Define stroke volume
Volume of blood ejected by each ventricle per heart beat
EDV - ESV
What is meant by end diastolic volume (EDV)?
Volume of blood remaining in each ventricle following diastole
What determines EDV?
Venous return
Describe the Frank-Starling Law of the Heart
The greater the EDV (as a result of more venous return), the greater the stroke volume will be during systole
Optimal skeletal muscle fibre length (for contraction) is achieved by stretching the muscle. True/False?
False
Optimal length is at rest
What is meant by preload?
Volume of blood in each ventricle before contraction
What is meant by afterload?
The resistance against which the heart has to pump after contraction
How does the Frank-Starling law compensate partially for decreased stroke volume?
EDV increases (due to failure to pump full SV) so force of contraction increases
What is meant by positive inotropic effect?
Force of contraction increases (due to sympathetic stimulation)
Parasympathetic system has a negative chronotropic and inotropic effect. True/False?
False
No inotropic effect
What does sympathetic stimulation do to the Frank-Starling curve?
Shifts it to the left (increased SV)
What is meant by cardiac output?
Volume of blood pumped out by each ventricle per minute
SV x HR
Cardiac valves produce a sound when they open and close. True/False?
False
Only produce a sound when they close (normally)
What is the cardiac cycle?
Encompasses all the events from one heartbeat to the next
What happens in Passive Filling?
AV valves open and blood flows into ventricles
80% of ventricular filling is done by atrial contraction. True/False?
False
80% is contributed to by passive filling
In Passive Filling, what are the pressures in the atria and ventricles?
Close to zero
What happens in Atrial Contraction?
Remaining atrial volume fills ventricles by atrial systole, completing the EDV