Physiology - Cardiovascular I - Physiology

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myocardium

____ - muscle of the heart which forms the heart walls.

cardiac, spirally

The heart is made up of interlacing bundles of ___ muscle fibers arranged ___ around the circumference of the heart.

intercalated discs

Individual cardiac muscle cells are interconnected at junctions called ___ ___.

gap junctions

Within the intercalated discs there are bridges called ___ ___, where opposing membranes approach each other.

low, A.P.

Gap junctions have ___ electrical resistance and allow ___ to travel through them.

skeletal

Cardiac muscle cells shrink to contract just like ___ muscle cells.

arteries, veins

___ (s) (what kind of vessel) go away from the heart and ___(s) go to the heart.

thick, thin

Cardiac m. includes most of the structures seen in skeletal m. including ___ and ___ filaments.

does not , CNS

Unlike skeletal muscle, cardiac muscle ___ ___ require command from ___ for the heart to beat.

within

Signals originate from ___ the heart muscle.

Autorhythmicity

___ - the ability of the heart to generate signals that trigger its contractions on a periodic basis.

contractile

99% of cardiac muscle are made up of ___ cells (those that do the work).

shrink

Contractile cells ___ (action) and act as a pump.

autorhythmic

1% of cardiac muscle is made up of ___ cells (make conduction system)

pacemaker

Contractions of the heart are initiated (triggered) by specialized muscle cells called ___ cells. (also called autorhythmic and conduction system cells)

autorhythmic

___ cells of the heart that do not contract --- they're purpose is to send out the signals.

pacemaker

___ cells of the heart, spontaneously generate A.P.'s.

pacemaker

___ cells are concentrated (primarily) in a specific region of the myocardium (SA node)

sino atrial

SA node stands for ___ ___.

SA

___ node is located in the wall of the upper right atrium (near superior vena cava)

heart rate

SA node is the normal pacemaker of the heart. It determines the ___ ___.

SA, gap junctions

A.P. is initiated in the ___ node and spreads through the myocardium passing through ___ ___ (electrical bridges).

left atrium, fast

The A.P. spreads from the right atrium to the ___ ___ and is very ___.

simultaneous

When the A.P. spreads, contraction of both chambers is ___.

electrical

When the A.P. spreads, there is no ___ connection between the atria and ventricles.

connective

What causes the electrical resistance between the atria and ventricles - ___ tissue there.

AV node

How does the A.P. spread from the atrium to the ventricle? The ___ ___ is the pathway

atrioventricular

___ node - located near tricuspid valve in the base of the right atrium.

Depolarization

___ of AV node is caused when A.P. spreads through muscle cells of the right atrium.

slow

Propogation of A.P. through AV node is relatively ___ (speed).

finishing, starting

The atrial contractions are ___ before ventricular contractions are ___.

bundle of his

Impulse leaves AV node and enters the wall between the ventricles (interventricular septum) through the ___ of ___.

ventricles

Bundle of His splits to the right and left and follows up the walls of the ___.

purkinje fibers

The Bundle of His fibers make contact with ___ ___ which make contact with ventricular myocardium cells (contractile cells of the heart)

ventricles

Once there is contact with the purkenje fibers the impulse then spreads through the rest of the ___. Both sides simultaneously.

sinoatrial node

The ___ ___ is the heart's pacemaker because it initiates each wave of excitation with atrial contraction.

ventricular

The bundle of His and other parts of the conducting system deliver the excitation to the apex of the heart so that ___ contraction occurs in an upward sweep.

contractile, pacemaker

The two types of cells in the heart are: ___ and ___.

depolarization

___ is still the mechanism which the heart cells initiate and propagate A.P.

ion

Different types of heart cells have different combinations of ___ channels that can produce different "looking" A.P.'s.

electrical

These different A.P.'s have different jobs in spreadig ___ currents through the heart muscle. (Fmi -we are not going to get into each one).

ion

___ channels drive the cardiac action potential.

K+, Na+, -90

Cardiac (contractile) cell (like neurons) have greater resting permeability to ___ than to ___. Resting membrane potential favors -___mV.

Na+, Na+

With contractile cells, depolarization is still mainly due to ___ flooding into the cell via voltage-gated ___ channels.

positive, K+, depolarization

(Contractile cells) As ___ feedback system is causing the opening of additional Na+ channels, ___ channels start to close, adding to the ___ effect.

Na+, inactivate

At peak of depolarization (of contractile cells), ___ channels quickly ___.

straight up

Due to the sudden influx of Na+ in the depolarizing contractile muscle cell, the graph looks like a line that is ___-___

plateau

(Contractile cell) When the membrane remains depolarized this is called the "___ phase"

K+, Ca++

(contractile cell) Membrane remains depolarized during the "plateau phase" because: ___ is still below the resting value (still closed) and permeability to ___ increases substantially.

Ca++

(contractile cell) These ___ channels open when Na+ depolarizes the cell and remain open for a long time.

Na+, L-type

(contractile cell) These Ca++ channels open when ___ depolarizes the cell and remain open for a long time (called ___ calcium channels)

depolarized

(contractile cell) The flow of Ca++ cations in the cells balances the flow of K+ cations out of the cell and keeps the membrane ___

Ca++, K+

(contractile cell) The flow of ___ cations in the cells balances the flow of ___ cations out of the cell and keeps the membrane depolarized.

repolarization

(contractile cell) ___ occurs when permeability of Ca++ and K+ return to original state.

one to one

(contractile cell) During the "plateau phase" there is a ___ to ___ exchange of Ca++ coming in and K+ going out.

A.P.

If the axis of a graph are "time" and "mV" we are looking at an ___

Ca++, K+

(contractile cell) Repolarization occurs when permeability of ___ and ___ return to original state.

voltage, Na+

(contractile cell) The rapid opening of ___-gated ___ channels is responsible for the rapid depolarizaiton phase.

voltage, Ca++, K+

The prolonged "plateau" of depolarization is due to the slow but prolonged opening of ___-gated ___ channels PLUS closure of ___ channels

opening, repolarization

(contractile cells) ___ of K+ channels results in the ___ phase.

Na+

(contractile cells) At rest ___ channels are closed...almost zero permeability.

working, pumping

What are the two other names used for "contractile" cells, ___ and ___

pacemaker, autorhythmic, conduction system

What are the three other names used for "SA node" cells, ___, ___, and ___ ___.

no

(pacemaker cells) Is there a steady "resting" membrane potential?

does not

Membrane potential ___ ___ remain constant between A.P.s in the autorhythmic cells.

depolarizes, threshold

Pacemaker potential - following an A.P., the membrane slowly ___ (drifts) to ___

pacemaker

___ potential - following an A.P., the membrane slowly depolarizes (drifts) to threshold.

pacemaker

Which cardiac cells have NO steady resting membrane potential? ___ cells.

depolarization

(autorhythmic cell) Gradual ___ eventually bring membrane potential to threshold --> A.P. occurs.

A.P., A.P., cycle

(conduction system cells) The tail end of one ___ is the trigger for the next ___ --> stuck in a ___.

itself

With a pacemaker cell, what triggers the A.P.....___.

K+, funny

The slow depolarization that occurs in early stages of the pacemaker potential is due to: 1) closing of ___ channels 2) and opening of ___ channels.

depolarize, pacemaker, a.p.

An autorhythmic cell has the unique ability to ___ spontaneously, resulting in a ___ potential. Once threshold is reached an ___ is initiated which begins with further depolarization and leads to reversal to the membrane potential.

repolarization, close

(pacemaker cells) K+ channels open during ___ of the A.P. and then ___ when the membrane returns to its polarized state.

open, negative

pacemaker cells) "Funny channels" - termed because of their unusual gating behavior. They ___ when membrane potential is ___ value.

Na+

"Funny channels" are mostly made up of ___ channels.

after, Na+

"Funny channels" open ___ the cell repolarizes and allow ___ to cross the plasma membrane.

K+, funny, decreases, increases

With __ channels closed and __ channels open during the early stages of the pacemaker potential, K+ movement out of the cell __, where Na+ into the cell __ --> causes initial depolarization

nerve

With ___ cells, after it repolarized, that was it, it stayed resting until something triggered it again. (opposite is true of autorhythmic cells)

quickly, short, A.P.

The funny channels are only open very __, closing about 5mV __ of the threshold needed to generate an __.

depolarization, Na+, voltage, Ca++

(pacemaker cells) The initial __ by __ triggers opening of __-gated __ channels --> depolarizing cell even more.

5, Na+

The "funny" channels are only open very quickly, closing about __mV short of the threshold needed to generate an A.P. This is where this cell differs. In every other cell, it's been __ that has gotten us all the way through depolarization.

T-type, short, second, Ca++, L-type

These channels (__ channels) stay open for a __ time before inactivating, but the resulting depolarization triggers the opening of a __ set of voltag-gated __ channels (__ channels) which stay open longer and inactivate slowly.

pacemaker potential

The SA node cell does not have a steady resting potential, but instead undergoes a slow depolarizaiton. This gradual depolarization is known as a __ __; it brings the membrane potential to threshold, at which point an A.P. occurs.

funny, T-type, L-type

Three ion channel mechanismis contribute to the pacemaker potential: ___-type sodium channels, __ calcium channels, and __ calcium channels.

T-type

This pacemaker channel is a type of Ca++ channel that opens only briefly but contributes an inward Ca++ current and an important final depolarizing boost to the pacemaker potential. These channels are called __ calcium channels.

L-type

Once the pacemaker mechanisms have brought the nodal cell to threshold, an AP occurs. The depolarizing phase is caused by Ca++ influx through the __ calcium channels.

L-type

These channels open much more slowly than do sodium channels, and, because of the fact that they remain open for a prolonged period, they are often referred to as __ calcium channels.

Ca++

After the second set of (L-type channels) opens the result is a large increase of __, that produces the rapid upswing of depolarization.

K+, K+

(pacemaker cells) The rapid upswing of depolarization (caused by the L-type channels) triggers the opening of __ channels and rise in __ pulls membrane potential back down.

Ca++

Fall in membrane potential (repolarization) causes __ to close.

Na+

In pacemaker cells, __ only triggers the first initial depolarizing climb.

negative, pacemaker

(autorhythmic cells) The return to __ potential activates the __ mechanisms again and the cycle continues !!!

electrical, depolarization, repolarization

___ currents generated during ___ and ___ spread into the tissue surrounding the heart and are conducted through the bodily fluids.

recorded

A small portion of the electrical currents, traveling through the bodily fluids, reaches the bodies surface where it can be ___

ECG, heart

___ is a recording of that portion of electrical activity induced in the body fluids that reaches the surface of the body --> NOT a direct recording of the ___.

spread, depolarization, repolarization

EKG is a complex recording of the overall __ of activity throughout the heart during __ and __.

NOT

ECG is __ a recording of a single A.P. of a single cell at a single point in time.

P-wave

In an EKG reading, __ represents atrial depolarization

QRS complex

In an EKG reading, __ __ represents ventricular depolarization.

T-wave

In an EKG reading, __ represents ventricular repolarization.

systole

___ - ventricular contraction, blood ejects.

systole, closed, get out, tension, shorten

During ___, ventricles are contracting but all valves are __ so no blood can __ __ --> muscle has __ but cannot __.

pressure, aorta, ventricular

Once rising __ in ventricles exceeds that in __, aortic and pulmonary valves open and __ ejection occurs.

stroke, ejected, systole

__ volume - volume of blood __ from each ventricle during __.

diastole

___ - ventricular relaxation (blood fills)

close, closed, no

During diastole, ventricles begin to relax, aortic and pulmonary valves __. Atrialventricular (AV) valves are also __--> __ blood is going in or out.

not

During diastole, blood volume is __ changing.

atrial, ventricular

Eventually __ pressure becomes slightly higher than __ pressure --> AV valve opens

ventricular filling

When AV valves open __ __ occurs as blood comes in from atria

atrial, before

Once ventricle is mostly filled, __ contraction takes place (most of the blood fills into the ventricles __ the atriums even contract)

pressure

During diastole, when the ventricles begin to relax, the aortic and pulmonary valves close because of __

higher

During diastole, aortic valve is closed because aortic pressure is __ than the ventricular pressure.

arteries, rising

Throughout diastole, aortic pressure is falling (due to blood moving out of __) and ventricular pressure is __ (blood from atrium in).

SA, contracts

Near end of diastole, __ node fires and atrium depolarizes and __.

end-diastolic

Amount of blood in the ventricle at the end of diastole is called __-__ volume.

contraction

Wave of depolarization passes into ventricles triggering __.

rises, shuts, atrium

As ventricle contracts, pressure __ and __ AV valve preventing backflow into __

exceeds, aortic

Eventually ventricular pressure __ aortic pressure and __ valve will open and ejection can occur.

end-systolic

__-__ volume : amount of blood remaining in ventricle after ejection.

AV valves

The first heart sound is due to the closing of the __ __.

aortic, pulmonary valves

The second heart sound is due to the closing of the __ and __ __

BPM, Liters/min

Cardiac output measured 2 ways: 1) __ (how fast heart is beating) and 2)__/__ (how much of the fluid you are putting out)

100

Heart rate: In absence of any nervous or hormonal influence heart will beat at approx. __ bpm (inherent rate of SA node)

hormones

SA node is normally under constant influence of nerves and __.

parasympathetic, 70

At resting state, __ activity dominates activity to heart --> normal bpm=__.

threshold, Na+, T-type

Sympathetic system causes SA node to reach __ quicker (by increasing permeability to __ and __ Ca+ channels)

slower, K+

Stimulation of parasympathetic causes threshold to be reached __ (hyperpolarizes by increasing permeability to __+)

70, 100

Because we are normally under parasympathetic control our bpm is __ not __.

stroke, force

__ volume also determines cardiac output. The volume of blood ejected by ventricle during contraction is going to change with how much __ you are putting down on it.

preload, sympathetic, afterload

When determining cardiac output, changes in force can be achieved by: 1. changes in end-diastolic volume (or called __) 2. magnitude of __ input to ventricles 3. __ - the aterial pressure against which the ventricle pumps.

Frank Starling

Stroke volume increases as the end-diastolic volume increases: this is called the __ __ mechanism.

volume, stretch, Frank Starling

Greater the end-diastolic __, greater the __ -->more forceful the contraction. (also known as the __ __ mechanism)

stretch, myosin

To increase the hearts stroke volume, fill it more fully with blood. The increased __ of the ventricle will align its actin & __ in a more pattern of overlap.

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