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Chapter 18 - Cardiovascular System: The Heart Part B

front 1

Cardiac muscle contraction: What opens voltage-gated fast Na+ channels in the sarcolemma?

back 1

depolarization

front 2

Depolarization wave in T tubules causes the SR to release what?

back 2

Ca2+

front 3

Depolarization also opens slow _____ channels in the sarcolemma

back 3

Ca2+

front 4

In cardiac muscle contraction, there is a reversal of membrane potential from _____ mV to _____ mV

back 4

-90, +30

front 5

Repolarization results from inactivation of _____ channels and opening of voltage-gated ____ channels

back 5

Ca2+, K+

front 6

A network of noncontractile cells that initiate and distribute impulses to coordinate the depolarization and contraction of the heart

back 6

intrinsic cardiac conduction system

front 7

What has unstable resting potentials (pacemaker potentials) due to open slow Na+ channels?

back 7

autorhythmic cells

front 8

Sequence of excitation: What is present in the right atrium and generates impulses about 75 times/minute?

back 8

sinoatrial (SA) node (pacemaker)

front 9

Sequence of excitation: what depolarizes faster than any other part of the myocardium?

back 9

SA node

front 10

Sequence of excitation: What has smaller diameter fibers, fewer gap junctions, and delays impulses approximately 0.1 second?

back 10

atrioventricular (AV) node

front 11

What depolarizes 50 times per minute in the absence of SA node input?

back 11

AV node

front 12

Sequence of excitation: What is the only electrical connection between the atria and ventricles - divides into the left and right bundle branches?

back 12

atrioventricular (AV) bundle (bundle of His)

front 13

What are the two pathways in the inter-ventricular septum that carry the impulses toward the apex of the heart?

back 13

right and left bundle branches

front 14

What completes the pathway into the apex and ventricular walls?

back 14

purkinje fibers

front 15

What depolarize only 30 times per minute in the absence of AV node output?

back 15

AV bundle and Purkinje fibers

front 16

What are irregular heart rhythms?

back 16

arrhythmias

front 17

What are rapid, irregular contractions, useless for pumping blood?

back 17

fibrillation

front 18

A defective SA node may result in?

back 18

ectopic focus (abnormal pacemaker takes over) or if AV node takes over, a junctional rhythm (40-60 bpm)

front 19

A defective AV node may result in?

back 19

partial or total heart block; few or no impulses from SA node reach the ventricle

front 20

Intrinsic innvervation of the heart involves:

back 20

SA node generating impulse, which pauses at AV node; AV bundle connects atria to ventricles; bundle branches conduct impulses through interventricular septum; Purkinje fibers depolarize contractile cells of both ventricles

front 21

Defects in the intrinsic conduction system may result in?

back 21

arrhythmias; uncoordinate atrial and ventricular contractions; fibrillations

front 22

Extrinsic innervation of the heart: heartbeat is modified by the?

back 22

ANS

front 23

Extrinsic innervation of heart: what center innervates SA and AV nodes, heart muscle, and coronary arteries through sympathetic neurons?

back 23

cardio-acceleratory center

front 24

Extrinsic innervation of the heart: What center inhibits SA and AV nodes through parasympathetic fibers in vagus nerves?

back 24

cardio-inhibitory center

front 25

What part of the ANS increases heart rate?

back 25

sympathetic

front 26

Which part of the ANS slows heart rate?

back 26

parasympathetic

front 27

What is a composite of all the action potentials generated by nodal and contractile cells at a given time?

back 27

electrocardiogram (EKG/ECG)

front 28

What are the three waves of an EKG?

back 28

P wave, QRS complex, T wave

front 29

Which EKG wave is the depolarization of the SA node?

back 29

P wave

front 30

Which EKG wave is ventricular depolarization (activation of muscle fibers, contraction, blood pumped out)?

back 30

QRS complex

front 31

Which EKG wave is ventricular repolarization (coming back to the original state, heart filled with blood)?

back 31

T wave

front 32

When atrials contract, what do ventricles do?

back 32

relax

front 33

What is low oxygen tension in the blood called?

back 33

hypoxemia

front 34

What is low oxygen tension called?

back 34

hypoxia

front 35

An EKG that shows no irregularites is called?

back 35

normal sinus rhythm

front 36

An EKG that shows the SA node is nonfunctional, P waves are absent, and the heart is paced by the AV node at 40-60bpm is called?

back 36

junctional rhythm

front 37

An EKG that shows some P waves are not conducted through the AV node, resulting in more P waves than QRS complexes (ratio 2 to 1) is called?

back 37

second-degree heart block

front 38

Chaotic, grossly irregular EKG deflections are seen in acute heart attack and electrical shock. They are called?

back 38

ventricular fibrillation

front 39

Hearts sounds are caused by what?

back 39

closing heart valves

front 40

Which heart sound occurs as AV valves close, signifying the beginning of systole/ blood pumping away from the heart?

back 40

the first sound (lub)

front 41

Which heart sound occurs when SL valves close at the beginning of ventricular diastole/blood going back into the heart?

back 41

the second sound (dup)

front 42

What are abnormal heart sounds most often indicative of valve problems

back 42

heart murmurs

front 43

Which heart sound is the closing of the mitral and tricuspid valves?

back 43

the first sound

front 44

Which heart sound is the closure of semilunar walls of aorta and pulmonary trunk?

back 44

the second sound

front 45

All events associated with blood flow through the heart during a complete heartbeat is called?

back 45

cardiac cycle

front 46

What are the phases of the cardiac cycle?

back 46

ventriuclar filling, ventricular systole, isovolumetric relaxation

front 47

What is the volume of blood in each ventricle at the end of ventricular diastole?

back 47

End diastolic volume (EDV)

front 48

What is the volume of blood remaining in each ventricle after the end of systole?

back 48

End systolic volume (ESV)

front 49

When does isovolumetric relaxation occur?

back 49

in early diastole

front 50

What is a brief rise in aortic pressure that leads to the closure of the semilunar valves?

back 50

dicrotic notch

front 51

What is the volume of blood pumped by each ventricle in one minute?

back 51

cardiac output (CO)

front 52

How do you determine cardiac output?

back 52

heart rate (HR) x stroke volume (SV)

front 53

Heart rate is?

back 53

number of beats per minute

front 54

Stroke volume is ?

back 54

volume of blood pumped out by a ventricle with each beat

front 55

What is the difference between resting and maximum cardiac output?

back 55

cardiac reserve

front 56

What are the three main factors affecting stroke volume (SV)?

back 56

preload, contractibility, after load

front 57

What is the degree of stretch cardiac muscle cells have before they contract ?

back 57

preload

front 58

What is the Frank-Starling law of the heart?

back 58

the shorter the fiber, the shorter the power of contractibility

front 59

What is the contractile strength at a given muscle length, independent of muscle stretch and EDV?

back 59

contractibility

front 60

What is the pressure that must be overcome for ventricles to eject blood?

back 60

afterload

front 61

Hypertension increases afterload, resulting in ?

back 61

increased ESV and reduced SV

front 62

What hormones are involved with regulation of heart rate?

back 62

epinephrine and thyroxine

front 63

What is an abnormally fast heart rate called?

back 63

tachycardia

front 64

What is the bpm of tachycardia?

back 64

>100 bpm

front 65

What is a heart rate slower than 60 bpm called?

back 65

bradycardia

front 66

What is a progressive condition where the cardiac output is so low that blood circulation is inadequate to meet tissue needs?

back 66

congestive heart failure

front 67

What is dilated cardiomyopathy?

back 67

muscle fibers elongate and stretch - heart enlarges/bursts

front 68

Why do you see swelling/edema in the ankles of someone with congestive heart failure?

back 68

there is no venous return, blood pools to lower extremeties

front 69

Blood travels into the right atrium via what?

back 69

superior and inferior vena cava

front 70

Blood travels from the right atrium to the right ventricle via?

back 70

tricuspid valve

front 71

Blood travels from the right ventricle through _____ to the lungs

back 71

pulmonary valve

front 72

Blood travels from the left atrium to the left ventricle through what?

back 72

mitral valve

front 73

What is the final valve blood travels though to get to the rest of the body?

back 73

the aortic valve (through the aorta)