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Physio Ch. 12 B

layers of the heart include pericardium (sac and cavity), epicardium (inner pericardium/outer heart), myocardium (muslce), endocardium (inner lining of heart that is continuous with endothelium of vessels)
atrioventricular valves include tricuspid (right) and bicuspid(left)
what holds the atrioventricular valves in place papillary muscles and chordae tendinae
semilunar valves are between ventricles and arteries
semilunar valves include pulmonary (right side between right vent and pulmonary trunk) and aortic semilunar (left side between left ventricle and aorta)
septa include interatrial and interventricular
cardiac muscle cells are...and they have... striated (sarcomeres), intercalated (desmosomes), junctions
conducting system uses nodal tissues and conduction system fibers
nodal tissue sends AP to conduction system fibers
nodal tissue includes the...which is the... sinoatrial node...pacemaker (sets the heart rhythm)
nodal tissue also includes the atrioventricular node
conduction system fibers include atrioventricular bundle (bundle of His), right and left bundle branches and purkinje fibers (conductin fibers)
purkinje fibers go to individual cardiac muscle cells
cardiac muscle innervation is either sympathetic (atrium and ventricles) or para (atria)
sympathetic innervation uses what neurotransmitter with what receptors NE (fast)...beta adrenergic receptors
symp innervation uses what hormone with what receptors epinephrine (adrenal medulla) with beta adrenergic receptors (longer term)
parasympathetic is what CN...and what is the neurotransmitter and receptor? vagus...ACh and muscarinic receptors
parasymp mainly innervates atria (right atria/SA node)
blood supply coronary circulation (systemic blood flow
heart conduction pathway SA node, AV node, bundle of His, right and left bundle branches and then purkinje fibers
SA node is the...and does... pacemaker...atrial contraction and AV excitation
AV node does what slows propagation to make sure atria is done before ventricles start
bundle of His (also called...) is the bridge between...and is... (atrioventricular bundle)...atria and ventricles...non-conducting CT
right and left bundle branches go from septum to outer walls of ventricles
purkinje fibers go to cardiac cells
p wave atrial depolarization (not an AP)
QRS complex sum of electrical depolarization activity in ventricles and also triggers atrial repolarization
T wave vetnricular repolarization
flat areas mean non electrical activity
cardiac action potentials involve muscle action potentials and pacemaker potentials (initiation of the heartbeat)
electrocardiogram measures electrical activity of the heart through the heartbeat
excitation contraction coupling goes from electrical activyt to mechanical activity
refractory period is the inability of cardiac muscle contractions to sum
cardiac muscle cell action potentials are also called ventricular action potentials
cardiac muscle APs look different than neuron or skeletal muscle action potentials
resting potential of the heart...and there are... -90 mV...very leaky K leak channels
depolarization of the heart involves Na voltage gated channels open, most K leak channels close (doesn't require threshold)
plataue phase of heart is when Na voltage gated channels are inactivated, L-type voltage gated Ca channels open
when the L-type voltage gated Ca channels open.. Ca follows its gradient in, and that means K goes out
repolariztion of cardiac muscle cells happen when L-type voltage gated Ca channels inactivate and voltage gated K channels open
pacemaker potential are also called cardiac conduction system action potentials
pacemaker potentials look different than neuron action potentials
pacemaker potentials DO need threshold
resting potential of the pacemaker is -60 mV (reduced K permeability)
depolarizatin ot threshold of pacemaker cells does not involve graded potentials because they are self stimulated through Ftype and T type voltage gatedchannels that are open before threshold
the depolarization to threshold involves F type voltage gated Na channels opening (f for funny)and t type ca voltage gated channels opening (t for short term)
F type voltage gated Na channels are stimulated by...which then stimulate.. negative membrane potentials...T type voltage gated CA channels
rapid depolarization happens when Ltype voltage gated Ca channels open and Ca follows gradient in
L type stands for latent(takes longer to open)
repolarization involves L-type voltage gated Ca channels inactivating and voltage gated k channels opening
pacemaker potentials undergo automaticitiy
inherent rantes of pacemaker potentials for SA node 100 bpm
inherent rantes for ectopic pacemakers are...and include... other nodal/conduction tissues...AV, bundle fibers and purkinje fibers
inherent rates get slower the lower you go down
AV conduction disorders include AV node disconnected from the SA node, and the artificial pacemaker (SA node doesn't work)
ECG/EKG measures collective electrical changes through the heart
P wave is the electrical component, what is the mechanical? atrial contraction
ECG involves einthoven's triangle(basic shape of the heart)
standard bipolar limb leads Lead 1: right arm(-) to left arm (+)
lead II: right arm (-) to left leg (+)
Lead II follows general electrical axis of the heart
lead III left arm (-) to left leg(+)
augmented leads include aVR, aVl and aVF
aVR left arm and leg (-) to right arm (+)
aVL right arm and left leg (-) to left arm (+)
aVF right and left arm (-) to left foot (+)
precordial or chest leads include combining limb leads as negative reference point, chest lead is + lead
contraction coupling is just like...which means...regulates cross bridge formation skeletal muscle...troponin and tropomyosin
contraction coupling requires ca to shift tropomyosin
calcium sources extracellular (required to open up SR) and intracellular (supplies most - SR)
calcium induced calcium release involves the T tubule voltage gated L-type Ca channel and Ca receptors on SR
t tubule voltage gated L-type ca channels expose extracellular ca
ca receptors on sarcoplasmic reticulum opens...and exposes... ca channels in SR...intracellular ca
ca and the strength of contraction increasing ca increases strength of contraction
refractory period means no fused tetanus with cardiac muscle cells
refractory period leads to long action potential absolute refractory period compared to the development of muscle tension
what is the benefit of no fused tetanus the heart can refill through relaxing
systole is...and diastole is.. contraction...relaxation of the atria and ventricles
valve action and blood flow by the av and sl valves
heartbeat mechanicsinvolve systole, diastole, valve action/blood flow, pressure control of vavles, heart sounds
general sequences atrial systole/ventricular diastole, atrial diastole/ventricular systole, atrial diastole/ventricular diastole
during atrial systole and ventricular diastole the AV valve is...and the SL valve is... open...closed
during atrial diastole/ventricular systole: initially the AV valves are..then...and the SL valves are..then..
during atrial diastole/ventricular diastole AV valves are close and then open, and the SL valves are open then closed
ventricular systole involves the...which means.. isovolumetric contraction..same volume
isovolumetric contractions include...which developes...and there is no... isometric contraction...tension w/o shortening...blood movement
ventricular ejection happens during...and involves ventricular systole...isotonic contraction and blood moving to great arteries
ventricular diastole involves... isovolumetric relaxation and ventricular filling
isovolumetric relaxation does what to tension, and fiber length decreases, same length
isovolumetric contraction does what to tension and fiber length increases a little...same length
in isovolumetric relaxation is ther emovement of blood? no
ventricular filling is blood from...and involves... atrium to ventricle...passive filling(following pressure gradient)
passive filling does 80% of the volume
increasing vollume decreases presure
atrial systole is blood from...and does... atrium to ventricular filling (20%)
passive filling during ventricular and atrial diastole and final filling during atrial systole
atrial diastole does atrial filling
atrial filling is blood from vena cavas to atria (passive filling of atrium)
pressure control of valves means pressure gradients drive blood flow
AV valves open throughout...and what is greater than what passive and active filling..pressure atria > ventricles
AV valves close during...and what is less than what... contraction...pressure atria < ventricles
semilunar valves open during...and what is greater than what contraction...pressure ventricles > great artery
semilunar valves are closed during...and what is less than what... relaxing...pressure ventricles < great artery
how many heart sounds are there? 4
1st heart sound is the...when.. lub...AV valves and ventricular systole
2nd sound is the...characterized by... valves and ventricular diastole
3rd sound is passive filling during AV valves open and ventricular filling
4th sound is final filling during atrial systole and final filling
1st sound QRS
2nd sound T wave
4th sound p wave (after)
where is blood volume crucial? ventricles (equal amounts in both ventricles)
cardiac output is... how much blood is pumped out (volume ejected/time)
control of heart rate is influenced by the parasympathetic and sympathetic systems
control of stroke volume is how much is pumped out with each contraction
blood volumes include stroke volume, end diastolic volume, end systolic volume
stroke volume (SV) is the...and is measured as.. volume of blood ejected by the ventricular systole...mL/beat
during SV not everything is pumped out of the ventricles - about 75% is pumped out
end diastolic volume (EDV) is the volume of blood at the end of ventricular diastole
EDV is determined by...and is measured as... passive filling and atrial systole...mL
EDV is how much you have to work with
end systolic volume (ESV) is the...and is measured as...and overall it is the blood that volume of blood at the end of ventricular systole...mL... wasn't pumped out
SV = rest:... EDV - ESV...70 mL = 135 mL - 65 mL
cardiac output is measured L/min pumped by each ventricle
CO means right vent volume = left vent volume
CO = HR * stroke volume
another way to say stroke volume is edv - esv
avg resting CO is 72 BPM * 0.07 L/beat = 5.0 L/min
^ HR > ^ CO
^ SV > ^ CO
^ HR and decreased SV happens when a lot of blood is lost
decreased HR and ^ SV happens when well conditioned heart gets better contractility
what happens to CO during exercise CO increases because HR ^ (meet oxygen demand in muscles) and SV can either increase or decrease
regulation of HR through SA node and parasymp/symp innervation
inherent SA node pacemaker potential = how many bpm 100
parasympathetic system impacts...through the HR...vagus nerve (CN X) and ACh to muscarinic receptors
parasymp inhibits or excites> inhibits SA node
sa node = how many bpm 70
parasymp increases...and decreases... k permeability (more negative membrane potential)...conduction velocity (^ AV nodal delay)
what effect does the parasymp play on the contractility? none, just less frequent beats
sympathetic system affects the...through... atria and vents...NE and E
symp is inhibitory or excitatory? excitatory
symp causes the SA node to be above inherent rate (get to threshold faster)
sympathetic causes decreased...and... k permeability...increased conduction velocity (faster pace and conduction)
symp also causes increased heart contractility
regulation of stroke volume through 3 things frank-starling mechanism, sympathetic input to vents and afterload
frank-starling mechanism deals with... muscle tissue itself
frank-sterling mechanism involves...which is... preload...end diastolic volume (ventricular return)
frank-starling mechanism increases EDV > ^ sarcomere stretch > ^ force of contraction > ^SV
sympathetic input to ventricles does what to contractility...and why? harder (more ca to bind to tropopin to move tropomyosin to move it and expose myosin and actin)
sympathetic input to vents does what increases ejection fraction > ^ SV
sympathetic input to vents also increases rate of contraction
ejection fraction is the proportion of blood you pumped out (efficiency of ventricular contraction)
afterload = arterial pressure
^ afterload > decreases SV (less effective)
afterload can occur with some cardiovascular diseases
factors affecting CO include EDV, symp and parasymp
parasymp is in control... at rest and is like the base, it varies from there through the activation of the symp which overrides the parasymp
irregular beats are called either arrhythmia or heart block
arrhythmia is either tachycardia > 100 bpm or bradycardia < 60 bpm
heart block is a disruption of the ECG
heart block can either be 2:1 (2 p waves for 1 qrs) or complete heart block (no pattern so there is really no communication between SA AND AV node)
another irregular beat disorder is atrial/vent fibrilation
heart murmers are a disruption of laminar (layers) flow - quiet when normal
heart murmers and the disruption of laminar flow results in 3 things septal defect (hole in ventricular septum) stenosis (high pitch whistling murmer) insufficient valve (low pitched gurgling murmuer)
stenosis occurs when...and insufficient valve occurs when... valve narrows...valves allow backflow
heart murmuers occur because of timing problems. during diastole which valves should be open/closed? av valves, sl valves
during diastole, stenotic...and insufficient... av valves
during systole which valves should be open/closed SL, AV
during systole there is either stenotic...insufficient...or.... SL valves...AV valves...septal defect
hypertrophic (which means...) cardiomyopathy occurs bec of enlargement...thickening of the walls (r/l vents), insufficient beats, decreased coronary blood flow
p-r interval goes from...and it is what... start of p to start of qrs..time between activation of sa and av nodes
p-r seg goes from..and is the time between... end of p to start of qrs...atrial depol and vent depol (depol of av node, bundle and purkinje also)
s-t seg goes from and is... end of s to start of t...vents uniformally excited
q-t int goes from...and is what... start of qrs to end of t...electrical systole when vent beat is generated
Created by: handrzej



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