Anatomy & Physiology of the Heart
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Questions and Answers

What is the primary purpose of antibiotic prophylaxis in dental procedures?

  • To prevent transient bacteremia during dental work.
  • To reduce pain during dental treatments.
  • To protect prosthetic valves in high-risk patients. (correct)
  • To enhance recovery from dental procedures.
  • Which junctions in cardiac muscle facilitate electrical coupling for synchronous contraction?

  • Desmosomes
  • Adherens junctions
  • Gap junctions (correct)
  • Tight junctions
  • What characterizes the absolute refractory period in cardiac muscle contractions?

  • New action potentials can be generated.
  • No new action potential is possible. (correct)
  • The muscle can respond to a very weak stimulus.
  • The muscle is fully excitable.
  • How does sympathetic nervous system stimulation affect heart rate and contractility?

    <p>It increases heart rate and contractility. (D)</p> Signup and view all the answers

    In comparison to skeletal muscle, how does cardiac muscle's excitation-contraction coupling differ?

    <p>Cardiac muscle uses both extracellular and SR Ca²⁺. (A)</p> Signup and view all the answers

    What does the ECG identify in a 12-lead setup that a 3-lead system cannot?

    <p>Electrical activity from multiple angles. (B)</p> Signup and view all the answers

    Which structure acts as the primary pacemaker in the cardiac conduction system?

    <p>SA Node (B)</p> Signup and view all the answers

    How is troponin used as a diagnostic marker in myocardial infarction compared to angina?

    <p>Troponin is elevated only in myocardial injury, indicating necrosis. (B)</p> Signup and view all the answers

    What does the QT interval reflect in an electrocardiogram?

    <p>Total ventricular depolarization and repolarization (C)</p> Signup and view all the answers

    Which abnormality is indicated by peaked T waves on an ECG?

    <p>Hyperkalemia (A)</p> Signup and view all the answers

    What condition is characterized by a 'sawtooth' pattern of atrial waves on an ECG?

    <p>Atrial Flutter (D)</p> Signup and view all the answers

    What is the consequence of prolonged PR intervals in an electrocardiogram?

    <p>AV block indication (A)</p> Signup and view all the answers

    Which part of the ECG represents ventricular depolarization?

    <p>QRS Complex (B)</p> Signup and view all the answers

    What does the phenomenon of overdrive suppression ensure in cardiac physiology?

    <p>A single dominant pacemaker controls heart rhythm (D)</p> Signup and view all the answers

    What does ST segment elevation on an ECG typically indicate?

    <p>Acute myocardial injury (B)</p> Signup and view all the answers

    Which condition is indicated by chaotic rhythm and the absence of QRS complexes in an ECG?

    <p>Ventricular Fibrillation (D)</p> Signup and view all the answers

    What is a common symptom associated with pericarditis?

    <p>Sharp chest pain (C)</p> Signup and view all the answers

    Which condition is characterized by inflammation of the myocardium?

    <p>Myocarditis (D)</p> Signup and view all the answers

    Which of the following best describes the contraction pattern of cardiac muscle?

    <p>Involuntary, rhythmic contractions (A)</p> Signup and view all the answers

    What does cardiac tamponade refer to?

    <p>Fluid accumulation under pressure around the heart (A)</p> Signup and view all the answers

    Which type of cardiomyopathy is noted for weakened and stretched heart muscles?

    <p>Dilated cardiomyopathy (B)</p> Signup and view all the answers

    What composes the cardiac conduction system?

    <p>Nodes and specialized conducting fibers (A)</p> Signup and view all the answers

    Which layer of the heart wall is responsible for the contraction necessary for pumping blood?

    <p>Myocardium (C)</p> Signup and view all the answers

    Which valvular closure is associated with the S2 heart sound?

    <p>Closure of the semilunar valves (D)</p> Signup and view all the answers

    Flashcards

    Antibiotic Prophylaxis in Dental Procedures

    Using antibiotics to prevent infective endocarditis in high-risk patients before dental procedures that can cause transient bacteremia to protect valves

    Cardiac Muscle Contraction

    Muscle contraction in the heart driven by calcium, sarcomeres & t-tubules/SR for Ca+ influx → contraction then Ca+ reuptake for relaxation

    Intercalated Disks in Cardiac Muscle

    Gap junctions and desmosomes that electrically couple cardiac muscle cells for synchronous contraction, and provide mechanical support for a coordinated heartbeat.

    Cardiac vs Skeletal Muscle Excitation-Contraction Coupling

    Cardiac muscle relies on both extracellular and SR Ca²⁺ for excitation-contraction Coupling; skeletal muscle uses only SR Ca²⁺. Cardiac muscle is involuntary and synchronized by gap junctions, while skeletal muscle is voluntary and independent.

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    Troponin Changes in Angina vs. MI

    Troponin levels remain normal in angina (chest pain), but increase significantly in a heart attack (myocardial infarction). Elevated troponin indicates myocardial injury due to tissue death.

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    Cardiac Conduction System

    A series of specialized cardiac cells (SA node, AV node, Bundle of His, bundle branches, Purkinje fibers) that ensure electrical signals are conducted smoothly, leading orderly depolarization and contraction.

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    Cardiac vs Neuronal Action Potentials

    Cardiac action potentials are much longer (200-400ms) than neuronal action potentials (1-2ms), with a unique plateau phase from Ca²⁺ influx, while neuronal APs lack a plateau.

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    Autonomic Effects on Cardiac Conduction

    Sympathetic (norepinephrine) increases heart rate, AV conduction, and contractility; parasympathetic (acetylcholine) decreases heart rate and AV conduction, with little effect on contractility.

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    P wave

    Represents atrial depolarization (contraction).

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    PR interval

    Time from start of P wave to QRS complex; reflects AV node delay.

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    QRS complex

    Represents ventricular depolarization (contraction).

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    ST segment

    Early ventricular repolarization phase.

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    Atrial fibrillation (AFib)

    Irregularly irregular rhythm, no distinct P waves. High risk of stroke.

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    Ventricular tachycardia (VT)

    Rapid, wide QRS complexes.

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    ST elevation

    Indicates acute heart attack (transmural infarction).

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    Overdrive suppression

    Faster pacemaker (SA node) suppresses slower pacemakers (AV node etc).

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    ASD vs. VSD

    ASD (Atrial Septal Defect) is a heart defect affecting the atria, generally less severe, while VSD (Ventricular Septal Defect) impacts the ventricles, leading to more significant hemodynamic changes.

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    Cardiac Muscle

    Striated, branched muscle tissue with intercalated discs, responsible for involuntary and rhythmic contractions of the heart, aided by gap junctions for synchronized beating.

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    Heart Sound S1

    The "lub" sound, caused by the closing of the AV valves at the start of ventricular contraction (systole).

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    Heart Sound S2

    The "dub" sound, caused by the closing of the semilunar valves at the end of ventricular contraction (systole).

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    Cardiac Tamponade

    Life-threatening condition caused by fluid buildup in the pericardial space, putting pressure on the heart.

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    Pericardial Layers

    The pericardium has two layers: visceral (epicardium) which is part of the heart wall, and parietal (fibrous sac) which surrounds the heart, anchoring it and preventing overexpansion.

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    Pericarditis

    Inflammation of the pericardium, often causing sharp chest pain and a friction rub.

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    Blood Flow (Deoxygenated)

    Deoxygenated blood flows from the body to the right atrium (RA) through the superior/inferior vena cava and coronary sinus, then to the right ventricle through the tricuspid valve, and finally to the lungs via the pulmonary valve and arteries.

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    Study Notes

    Anatomy & Physiology of the Heart

    • Apex: The pointed tip of the heart, located at the 5th intercostal space near the midclavicular line. It's formed by the left ventricle and acts as a landmark for auscultating heart sounds.
    • Base: The broad, flat upper portion of the heart, located near the 2nd rib, opposite the apex. It's the entry/exit point for major blood vessels (aorta and pulmonary trunk).
    • Atria: The upper chambers of the heart receiving blood.
      • Right Atrium: Receives deoxygenated blood from the superior vena cava, inferior vena cava, and coronary sinus.
      • Left Atrium: Receives oxygenated blood from pulmonary veins.
    • Ventricles: The lower chambers of the heart pumping blood out.
      • Right Ventricle: Pumps deoxygenated blood to the pulmonary arteries.
      • Left Ventricle: Pumps oxygenated blood to the aorta.
    • Septum: A wall dividing chambers within the heart.
      • Interatrial Septum: Separates the right and left atria. The fossa ovalis is a remnant of a fetal opening.
      • Interventricular Septum: Separates the right and left ventricles.
    • Atrioventricular (AV) Valves: Regulate blood flow between atria and ventricles.
      • Tricuspid: Between the right atrium and the right ventricle.
      • Mitral (Bicuspid): Between the left atrium and the left ventricle.
    • Semilunar Valves: Prevent backflow from the arteries into the ventricles.
      • Pulmonary Valve: Between the right ventricle and the pulmonary trunk.
      • Aortic Valve: Between the left ventricle and the aorta.
    • Major Vessels:
      • Aorta: The largest artery, carrying oxygenated blood from the left ventricle to the body.
      • Pulmonary Trunk & Arteries: Carry deoxygenated blood from the right ventricle to the lungs.
      • Pulmonary Veins: Return oxygenated blood from the lungs to the left atrium.
      • Superior Vena Cava (SVC): Drains deoxygenated blood from the upper body into the right atrium.
      • Inferior Vena Cava (IVC): Drains deoxygenated blood from the lower body into the right atrium.
      • Coronary Sinus: Collects venous blood from the heart muscle (myocardium) and empties it into the right atrium.

    Heart Wall Layers

    • Endocardium: The inner lining, providing a smooth surface to prevent clots.
    • Myocardium: The middle, muscular layer responsible for heart contractions.
    • Epicardium (Visceral Pericardium): The outer layer, containing fat and blood vessels for protection and reducing friction.
    • Parietal Pericardium (Fibrous Sac): Surrounds the heart, anchoring it and preventing overexpansion.

    Cardiac Muscle

    • Cardiac Muscle: Striated, branched, and interconnected by intercalated disks.
    • Skeletal Muscle: Striated, long cylindrical fibers, controlled voluntarily.
    • Smooth Muscle: Non-striated, spindle-shaped, found in organ walls, and involved in involuntary, slower contractions.

    Heart Sounds

    • S1 ("lub"): The sound of AV valves closing at the start of systole (ventricular contraction).
    • S2 ("dub"): The sound of semilunar valves closing at the end of systole.
    • S3 and S4: Additional sounds that can indicate potential heart problems.

    Heart Defects

    • Atrial Septal Defect (ASD): A hole in the interatrial septum, causing a left-to-right shunt and increased blood flow to the lungs.
    • Ventricular Septal Defect (VSD): A hole in the interventricular septum leading to a left-to-right shunt and potentially more significant hemodynamic changes.

    Other Important Concepts

    • Cardiac Conduction System: The SA node (pacemaker), AV node, Bundle of His, bundle branches, and Purkinje fibers coordinate the heart's rhythm.
    • ECG (Electrocardiogram): A recording of the electrical activity of the heart. Different waves (P, QRS, T) correspond to specific stages of the cardiac cycle.
    • Antibiotic Prophylaxis: Prevention of infective endocarditis before dental procedures in high-risk patients.

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    Description

    Test your knowledge on the anatomy and physiology of the heart with this quiz. It covers key structures such as the apex, base, atria, ventricles, and septum. Understand how each part contributes to the heart's function in the circulatory system.

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