what are the steps of the conducting system in the heart?
SA Node → AV Node → AV bundle→ Bundle fibers → purkinje fibers (Sam Actually Ate Banana Pancakes)
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how does blood move in the body?
from areas of high pressure and low pressure
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what do conducting cells do?
generate their own AP and stimulate the contractile cells to contract
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why are nodal/conducting cells autorhythmic?
leakiness of the cell membranes control a regular heartbeat
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which part of the conducting system is the pace maker?
SA Node, because it fire faster than any other nodal cell
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how is cardiac muscle AP different from skeletal muscle AP?
Calcium pumps are needed to maintain a gradient because there is much less of it stored in the terminal cisternae
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how many potassium and sodium ions are exchanged at the cell membrane of cardiac muscle cells?
3 sodium ions enter the cell and 2 potassium ions exit the cell, making a negative membrane potential
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what is the first step of conducting cells action potential?
Reaching threshold- slow sodium channels open and membrane potential changes from -60mV → -40mV
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what is the second step of conducting cells action potential?
depolarization- fast calcium channels open and calcium enters the cell changing membrane potential from -40mV → 0mV
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what is the third step of conducting cells action potential?
Repolarization- fast calcium channels close and potassium channels open allowing potassium to leave until the RMP of -60 mV is reached again and potassium channels close
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what is the first step of contractile cells action potential?
depolarization- fast sodium channels open changing polarity -90mV → +30mV, then they close
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what is the second step of contractile cells action potential?
plateau- both potassium and slow calcium channels open so there is no electrical change and depolarization plateaus
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what is the third step of contractile cells action potential?
repolarization- calcium channels close and potassium stay open reversing the polarity back from +30mV → -90mV
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what happens during a P wave
SA node depolarizes, atria contract, blood moves to the ventricles
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what happens during a PR interval?
AV node delay, atria complete contraction, ventricles fill all the way with blood
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QRS complex
HIS bundle and purkinje fibers depolarize, ventricles contract, blood begins to move towards the great vessels
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ST segment
HIS bundle and purkinje fibers completely depolarize, ventricles completely contract, blood completely moves into great vessels
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T wave
HIS bundle/purkinje fibers repolarize, ventricles relax, blood moves from atrium to ventricles
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what atria systole called?
primer pump, occurs when ventricles are in diastole
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what is ventricle diastole called?
power pump, occurs when the atria are in diastole
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as volume increases…
pressure decreases
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what is the first stage of the cardiac cycle?
atrial contraction and ventricular filling- atria contract and increase in pressure, AV valves open
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what is the second stage of the cardiac cycle?
isovolumetric contraction- ventricles now contract causing artery pressure to increase, so all valves are closed
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what is the third stage of the cardiac cycle?
ventricular ejection- ventricles contract fully so atrial pressure decreases and semilunar valves open
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what is the fourth stage of the cardiac cycle?
isovolumetric relaxation- atria and ventricles relax, artery pressure builds again but all valves are closed
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what is the fifth step of cardiac cycle?
atrial relaxation and ventricular filling- atria contract increasing pressure in atria and opening AV valves
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what is end diastolic volume (EDV)?
volume of blood in the ventricles at the start of systole
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what is end systolic volume (ESV)?
volume of blood that remains in the ventricles at the very end of systole
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what is stroke volume (SV)?
volume of blood ejected during systole
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what are the two formulas for ventricular ejection?
1. EDV - ESV= SV
1. SV / EDV = ejection fraction
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what is a healthy ejection fraction about?
50%-65% at rest, 41%-49% is considered borderline low
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what is cardiac output (CO)?
the volume of blood pumped by the heart per minute
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what is the formula for cardiac output (CO)?
HR x SV = CO
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what is an average cardiac output (CO)?
4-8 mL/min at rest
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what is cardiac reserve?
the difference between resting CO and maximal CO
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how do you find your cardiac reserve?
calculate the cardiac output (CO) and subtract 5L, because there is always about 5L of blood circulating the body regularly
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what are some positive chronotropic factors?
* epinephrine/norepinephrine * causes SA node to reach threshold quicker * nicotine * cocaine * caffeine * thyroid hormone
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what are some factors the cause negative chronotropic?
* parasympathetic nervous system stimulation * through the vagus nerve, it will release Ach at the SA and hyperpolarize the cells * beta-blocker drugs