Cardiology Week 1

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What are the three layers of the left ventricle and their functions: subendocardium - move apex toward base 2. midmyocardium -- move lateral walls toward septum 3. sbepicardium -- squeeze ventricle at the end of systole
what are the layers of the right ventricle: subendo and subepicardium
describe the layers of the epicardium: parietal and visceral (v. is attached to the heart muscle)
what type of fiber is prominent in epicardium: elastic
where does pericardial fluid come from: mesothelial cells on the surface of epicardium
which layer of heart muscle is purkinje fiber found: endocardial
what proteins are found in the interstitium: collagen is the most important
how do you increase the collagen amount in the interstitium, increase pressure or vol?: pressure
volume overload like microregurtitation decreases or increases interstitial collage?: decreases
what are some other proteins found in the interstitium?: laminin, fibronectin and other proteins and cells like adipocytes lumphocites fibroblasts
wat line demarcates where the sarcomes occur?: z line
which part of the sarcomere is always stable?: a band
what is i the center of the a band?: m line/band whatever
when does the i band contract?: systole gets wider in diastole
what are the three components of the intercalated disk? and what proteins involved with each: fascia adherens -- actin filaments desmosomes -- desmin gap junctions -- connexin
match letters and numbers: a. connexin 43 b. connexin 40 1. myocardium 2. pukinje fiber: 2.b 1.a
withough enough oxygen muscle will stop contracting, but does that mean that it will die?: no it can survive without contracting. p2 of jan 4 9 am lecture
what is different about purkinje fiber intercalated discs compared to myocytes: no fascia adherens
what are two fuel sources for cardiac muscle?: glucose and lipid
what hormone does the heart release?: atrial naturitic factor (ANF) involved in BP
what happens to the arteries during systole and diastole?: expansion during sys, recoil during diastole
match letters and numbers a. elastic b. musclular 1. aorta 2. coronary artery and renal: 1. a 2. b
where is most of the resistance to arterial flow: arterioles
which types of vessels are most often targets for drugs: muscular... for bp meds that is
what are the three layers of the vesssels?: tunica intima tunica media tunica adventitia
where would you find the vasa vasorum, tunica media or adventitia: adventitia
changes to arteries with age?: replace elastic tiss ue with collagen and reduce elsaticicty
which problem causes the tunica intima to get wider?: atherosclerosis
is the iel or eel more prominent?: iel
with decreasing artery size the iel or eel disappears?: iel
where do nutrients cross into tissue?: capillaries
where are fenestrated endothelium: gut kidney
where are weibel palade bodies and what is their significance: storage of von willebrand factor needed for coagulation ... found in the endothelal cells
what are the most important functions of endothelial cells: antithrombotic effect
why is the adventitia in veins very important?: protects if the muscular layer is damaged
what part of the veins allow for capacity of blood vol change: smooth muscle in the media
when the heart is relaxed the chordae tendinae are slack or taut?: slack
when valve disease causes regurgitation the cardiac output is increased or decreased?: decreased?
cardiac hypertrophy can be a result of what valve disease?: stenosis
describe what vessel delivers o2 to the back of the heart: circumflex artery
what artery supplies 02 to the front and bottom surfaces of the left ventricle: LAD
the right coronary artery supplies what heart muscle with blood?: right atrim and and right ventricle
describe what angina pectoris is: chest pain behind sterum from partial artery blockage
complete blockage of an artery result sin what?: acute myocardial infarction
veins contian more or less adventitial and elastic tissue than arteries?: less
the smooth muscle layer is larger in arteries or veins?: arteries
what is tone?: there is always some level of sympathetic tone or stimulation in the vessels. decreaseing stimulation will cause the vessel to dialate
where you find sinusoid capillaries?: liver spleen bone marrow
where is 2/3 of the total blood supply?: veins
what the is average pressure in the left ventricle?: 120/0 mmhg
whta is the average pressure in the rigt ventricle?: 25/0 mmhg
what is the relationship between velocity and blood flow and cross sectional area?: v = flow / x area
where does the greatest pressure drop occur?: arterioles
what is compliance?: amnt of blood that can be stored in a unit of circulation/ unit of pressure.... compliance refers to the distensibility of vessels
the pulmonary circuit is inseries or in parallel with the systemic circuit?: series
most of the systemic organs and in parallel or series arrangements?: parallel
how do you calculate resistance if you are given systemic vascular and total peripheral resistancE?: resistance = systemic vascular / total peripheral resistance
given flow and resistance how do you calc pressure difference?: flow * resistance = pressure difference
if resistance increases fllow goes up or down?: down
if the pressure drop increases does flow increase or decrease?: increase
the most important factor in determining resistance to blood flow is?: the radius
if hematocrit increases, viscosity increases or decreases? and resistance increases or decreases?: both increase
where is the max velocity of flow in a blood vessel: the center
calcium from where initiates contraction in muscle cell?: Sarcoplasmic Reticulum
calcium binds to troponin or tropomyosin to initiate muscle cell contraction?: troponin
agents like norepi and epi increase or decrease cAmp levels? what does cAMP do to the membrane?: atp is hydrolyzed to form cAMP which opens the l type calcium channels in the membrane
adenosine and ach causes formation or blocks formation of cAMP in the pathways regulating cardiace myocyte contraction?: block cAMP formation
norepi works through which pathway to cause release of calcium from the SR?: IP3 pathway
diastole is the filling or ejection pahse?: filling
during diastole the AV valves are open or closed? systole?: av valves open in diastole closed in systole
the p wave comes before or after atrial contraction?: before. the electrical events preceed the mechanical events
what does the t wave represent: repol of ventricles
what is the end diastolic vol?: vol in ventricle at the end of diastole before contraction norm is 120 ml
what is end sysolic vol?: vol in the ventricl after contraction
what is an intrinisc factor that determines cardiac pump performance?: inotropy
what are two extrinsic pump performance determinants?: preload and afterload
if you increase afterload do u increase or decrease esv?: increase
if you increase venous return you increase or decrease preload?: increase
what is the ejection fractoin: the percent of edv ejected = sv/edv
in the wiggers diagram there are 7 phases. which belong to systole?: pahse 2 - isovolumetric contractoin, phase 3 rapid ejection, phase 4 reduced ejection
diastole has 4 phases in the wiggers diagram. what are they: phas e5 isovol. filling phase 6 rapid filling, phase 7 reduced filling, phase 1 atrial systole
during atrial contraction are the AV valves open or closed. is this systole or diastole?: open diastole
what is the fourth heart sound. when can it be heard, what are you hearing?: during phase 1 ventricular wall vibration
during phase 2 what valves are open?: none. they are all closed. this is isovolumetric contraction
when do u hear the first heart sound and what is it?: during phase 2, isovol contraction, mitral valve closing
during phase 3 what valves are open: aortic and pulmonic
what does the c wave represent: phase 3, decrease in vol in the ventricle as blood is ejected
during phase 4 which valves are open: aortic and pulmonic
what valves are open in phase 5: none. this is isovol relaxation
when do u hear the 2nd heart sound?: during phase 5 isovol relaxation. you have reached ESV. aortic valve closing
phase 6 which valves are open: AV valves this is rapid filling
what is the 3rd heart sound and when do u hear it?: mitral valve opens during phase 6 rapid filling. this is only normal in kids
what valves open in phase 7: av valves
what are the three major pressure changes in the atria?: a waves by atrial contraction at the beginning of atrial systole, c wave when ventricals contract, v wave at the end of ventric contraction from slow build up of blood while av valves are closed
in mitral valve stenosis, describe the pressure of the left atria as compared to left ventricle: left atria pressure greater
what pump maintains the resting membrane potential in a myocyte?: na/k-atpase
is a myocyte at rest very hyperpolarized?: yes. this is bolded and underlined in the script
are inward rectifying K channels voltage dependent or gated/: dependent
during the resting potential phase of the cardiac myocyte, why is there a leak of k?: the equillib ptential is slightly more neg than the resting membrane potential. slide 9 of jan 5 10 am lecture
as soon as threshold is reached, durin gthe upstroke of the action potential, what lets in the sodium?: m gate (fast activation) allows na
what gate closes during fast inactivation during th ap upstroke that is important for refractori ness: h gate
fast na channel at rest which gate open which closed? inactive?: m gate closed h open at rest. m gate open h closed inactive
what creates early repolarization?: Ito1 - transient outward current 1 : voltage gated ca independent k channels and Ito2: calcium activated cl- channel. this creates the repolarization notch.
what ions are doing where during the myocyte AP plateau phase? describe the two ca channels: inwared ca and outward k. L type ca channel and T type
when do the l type ca channels open: after depolarization
why can san and avn fire without electrical input?: If - funny current channels
during phase 4 the nodal cells are undulating bc of what?: activity of If current
is the activation of the SA notte action ptoential carried by na or ca?: ca
are fast na channels present in SAN/AVN cells?: no only in ventricular/atrial myocytes
general function of If channel in myocyte AP?: conducts an inward current that depolarizes the cell to threshold
T type Ca channel general function in myocyte AP: activate at low potentials and contribute to early depolarization
L type ca channel general function in myocyte AP: enhance depol and continue upstroke and phase 0 of the action potential
what would the heart rate be if the sa node failed?: 40-60 bpm the rate of the AVN
if cAMP levels decrease due to Ach, the If channel activity increases or decreases? upstroke of AP increased or decreased?: decreases both.
what is the effect of ach on the avn?: slows the conduction velocity not the heart rate

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Created By swimaline