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Physio Ch. 12 B
| Question | Answer |
|---|---|
| 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), branching...gap 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.. | open..closed...closed..open |
| 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 ventricle...final 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... | dub...sl 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 = ...at 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? | increases...beats 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 |
| EF = | SV/EDV |
| 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...sl 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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