Cardiac Physiology and ECG Interpretation
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Questions and Answers

What are the three major waves seen on an electrocardiogram (ECG)?

  • Depolarization, repolarization, hyperpolarization
  • P wave, QRS complex, T wave (correct)
  • Atria, ventricles, septum
  • SA node, AV node, Purkinje fibers
  • What does the P wave on an ECG represent?

  • Repolarization of the ventricles
  • Depolarization of the ventricles
  • Repolarization of the atria
  • Depolarization of the atria (correct)
  • What does the QRS complex on an ECG represent?

  • Depolarization of the ventricles (correct)
  • Repolarization of the ventricles
  • Repolarization of the atria
  • Depolarization of the atria
  • Which of the following is NOT a benefit of using an ECG?

    <p>Requires a trained technician to interpret (D)</p> Signup and view all the answers

    What is the normal range for heart rate, as measured by an ECG?

    <p>60–100 beats per minute (B)</p> Signup and view all the answers

    Which of the following is TRUE regarding the role of the parasympathetic nervous system on the heart?

    <p>Parasympathetic fibers only innervate the SA and AV nodes (B)</p> Signup and view all the answers

    What is the function of the sympathetic nervous system on the heart?

    <p>Increases heart rate and force of contraction (D)</p> Signup and view all the answers

    What is the primary reason that heart cells contract?

    <p>Action potentials generated by specialized autorhythmic cells spread through the heart muscle triggering contraction. (D)</p> Signup and view all the answers

    What is the effect of action potentials on heart muscle cells?

    <p>Action potentials directly cause muscle contraction by triggering the release of calcium ions. (B)</p> Signup and view all the answers

    Which of the following is NOT a method for studying cardiac excitability?

    <p>Echocardiography to visualize heart structure and motion. (C)</p> Signup and view all the answers

    What is the key connection between cardiac excitability and the study of the heart?

    <p>Cardiac excitability allows us to understand the physiological mechanisms behind the heart's ability to pump blood. (D)</p> Signup and view all the answers

    What is the primary function of the SA node in the heart?

    <p>To act as a pacemaker setting the heart rate (C)</p> Signup and view all the answers

    Which structure routes electrical signals and delays their transmission?

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

    What is the heart rate of the AV node under normal conditions?

    <p>50 bpm (D)</p> Signup and view all the answers

    What neurotransmitter is released by the vagus nerve to lower heart rate?

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

    Under what condition can the Purkinje fibers act as a pacemaker?

    <p>Under specific pathological conditions (B)</p> Signup and view all the answers

    Why are there no gap junctions between atrial and ventricular myocytes?

    <p>To prevent electrical interference between chambers (C)</p> Signup and view all the answers

    What is the effect of atropine on heart rate?

    <p>Increases heart rate by 20-40 bpm (C)</p> Signup and view all the answers

    Which nerve activity primarily influences the resting heart rate?

    <p>Parasympathetic nerve activity (B)</p> Signup and view all the answers

    What primarily causes the rapid depolarization phase in non-pacemaker cardiac muscle cells?

    <p>Na+ influx (B)</p> Signup and view all the answers

    Which ions are involved in both the pacemaker potential and action potential of cardiac pacemaker cells?

    <p>Na+ and Ca2+ (A)</p> Signup and view all the answers

    What role do gap junctions play in cardiac conduction?

    <p>They allow rapid spread of depolarizations between cells. (A)</p> Signup and view all the answers

    What phase of the action potential does Ca2+ influx primarily prolong in non-pacemaker cardiac cells?

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

    What is a characteristic feature of the SA node in heart physiology?

    <p>It generates spontaneous action potentials autonomously. (C)</p> Signup and view all the answers

    During which phase do Na+ channels primarily contribute to the cardiac pacemaker potential?

    <p>Slow depolarizing phase (A)</p> Signup and view all the answers

    What happens to the conduction of electrical activity as it passes through the AV node?

    <p>It slows down significantly. (B)</p> Signup and view all the answers

    What initiates the electrical activity in the heart?

    <p>Spontaneous depolarization of the SA node (C)</p> Signup and view all the answers

    What is the primary neurotransmitter released by sympathetic nerves to increase heart rate?

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

    What effect does sympathetic activity have on cAMP in the SA node?

    <p>Increases cAMP levels (D)</p> Signup and view all the answers

    What happens to the membrane potential during sympathetic stimulation of the SA node?

    <p>Depolarizes more rapidly (C)</p> Signup and view all the answers

    Which type of channels are increased in activity due to sympathetic stimulation?

    <p>Calcium (L-type) channels (A)</p> Signup and view all the answers

    What is the effect of vagus nerve activation on the heart rate?

    <p>Decreases heart rate (B)</p> Signup and view all the answers

    Which statement accurately describes the effect of increasing cAMP concentration in autorhythmic cells?

    <p>Increases the rate of depolarization (B)</p> Signup and view all the answers

    What characterizes the membrane potential of autorhythmic cells?

    <p>Drifting between -90mV and -55mV (C)</p> Signup and view all the answers

    What is the role of catecholamines like epinephrine in heart rate modulation?

    <p>Stimulate heart rate increase during stress (C)</p> Signup and view all the answers

    What is the primary role of the funny current channels (If) in cardiac autorhythmic cells?

    <p>They contribute to the slow depolarization of the pacemaker potential. (A)</p> Signup and view all the answers

    What is the primary function of the calcium channels (Ca2+) in cardiac autorhythmic cells?

    <p>They contribute to the slow depolarization of the pacemaker potential. (C)</p> Signup and view all the answers

    What is the role of potassium channels (K+) in cardiac autorhythmic cells?

    <p>They are responsible for repolarization. (D)</p> Signup and view all the answers

    Why is the resting membrane potential of autorhythmic cells described as unstable?

    <p>It is constantly fluctuating due to the activity of the funny current channels (If). (C)</p> Signup and view all the answers

    Which of the following statements accurately describes the relationship between the action potential and the pacemaker potential in autorhythmic cells?

    <p>The pacemaker potential is a gradual depolarization that triggers the action potential. (B)</p> Signup and view all the answers

    What is the primary difference between non-pacemaker cells (myocytes) and pacemaker cells (autorhythmic cells) in the heart?

    <p>Pacemaker cells are responsible for initiating the heartbeat, while non-pacemaker cells carry the electrical signal throughout the heart. (C)</p> Signup and view all the answers

    Which of the following statements accurately describes the role of calcium ions (Ca2+) in cardiac action potentials?

    <p>Calcium ions contribute to both the slow depolarization of the pacemaker potential and the plateau phase of the action potential in non-pacemaker cells. (B)</p> Signup and view all the answers

    Where are pacemaker cells primarily located in the heart?

    <p>The atria, specifically the sinoatrial and atrioventricular nodes. (C)</p> Signup and view all the answers

    Flashcards

    Cardiac Excitability

    The ability of heart cells to respond to stimuli and generate action potentials.

    Heart Contraction

    The process by which heart cells shorten and generate force to pump blood.

    Action Potential

    A rapid change in electrical charge across a cell membrane that leads to contraction.

    Electrocardiogram (ECG)

    A test that records the electrical activity of the heart over time.

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    Heart Rate

    The number of times the heart beats in a minute, indicative of cardiac activity.

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    Na+ Role in Cardiac Action Potentials

    Na+ causes rapid depolarization in non-pacemaker cardiac cells.

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    Pacemaker Potential

    Slow depolarization in pacemaker cells due to Na+ influx.

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    Ca2+ Role in Cardiac Action Potentials

    Ca2+ prolongs action potential duration and creates a plateau phase in cardiac muscle cells.

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    Ca2+ in Pacemaker Cells

    Ca2+ ions initiate the depolarization phase in pacemaker cells.

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    Autorhythmic Cells

    Cells that generate spontaneous action potentials, influencing heart rhythm.

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    SA Node Importance

    The SA node initiates depolarization and sets the heart's pace.

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    Gap Junctions Function

    Gap junctions allow depolarizations to spread rapidly between adjacent heart cells.

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    AV Node Role

    AV node slows conduction of electrical activity between atria and ventricles.

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    SA Node

    The primary pacemaker of the heart, setting the rhythm at ~70 bpm.

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    AV Node

    A secondary pacemaker that routes electrical signals and delays transmission, firing at ~50 bpm.

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    Purkinje Fibers

    Conductive fibers that spread depolarization through the ventricles, allowing synchronized contraction.

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    Heart Rate Regulation

    Controlled by sympathetic and parasympathetic nervous systems, affecting pace of heart beats.

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    Vagal Tone

    The influence of the vagus nerve that usually slows down heart rate at rest.

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    ACh (Acetylcholine) role

    Neurotransmitter released by the vagus nerve that slows heart rate by binding to receptors in SA node.

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    Muscarinic Receptors (M2R)

    Receptors in the SA node that respond to acetylcholine, controlling heart rate.

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    Gap Junctions

    Protein channels that allow communication between myocytes, absent in atrial and ventricular syncytia.

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    Sympathetic Activation

    Increases heart rate through norepinephrine from sympathetic nerves.

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    Norepinephrine (NE)

    A neurotransmitter that increases heart rate at the SA node.

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    Beta-Adrenergic Receptors (bARs)

    Receptors on SA node cells that bind NE to increase heart rate.

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    cAMP

    A molecule that increases PKA activity leading to increased heart cell activity.

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    Heart Rate Modulation

    The control of heart rate by sympathetic and parasympathetic systems.

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    Vagus Nerves

    Parasympathetic nerves that decrease the SA node rate and heart rate.

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    Parasympathetic Fibers

    Nerves that slow heart rate by affecting SA and AV nodes.

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    Sympathetic Fibers

    Nerves that increase heart rate and force of contraction.

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    SA Node Function

    Sinoatrial node initiates heartbeats and regulates heart rate.

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    P Wave in ECG

    Represents atrial depolarization, the electrical activity of atria before contraction.

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    QRS Complex in ECG

    Represents ventricular depolarization, indicating ventricles are preparing to contract.

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    T Wave in ECG

    Represents ventricular repolarization, the heart's recovery phase.

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    ECG Analysis Questions

    Key questions to assess an ECG, including rate, rhythm, and wave presence.

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    Type 1 Action Potentials

    Fast response action potentials in non-pacemaker myocytes, characterized by rapid depolarization.

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    Type 2 Action Potentials

    Pacemaker action potentials from autorhythmic cells, causing spontaneous firing due to unstable resting potential.

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    Funny Current Channels (If)

    Channels that cause unstable resting potential in pacemaker cells, permeable to K+ and Na+.

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    Threshold

    The critical membrane potential that must be reached to trigger an action potential in pacemaker cells.

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    Membrane Potential Changes

    The shifts in cell membrane potential during pacemaker and action potentials due to ion movements.

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    Atrial and Ventricular Myocytes

    Contractile cells that make up most of the muscle wall, transmitting fast response action potentials.

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    Sinoatrial and Atrioventricular Nodes

    Locations in the heart where pacemaker cells are found, responsible for initiating signals.

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    Study Notes

    Cardiac Excitability: Heart Rate and ECG

    • Cardiac cells contract due to specific electrical signals.
    • Understanding these signals helps study the heart's function and identify potential issues.
    • Two main types of cardiac action potentials exist: non-pacemaker (myocyte) cells and pacemaker cells (autorhythmic).

    Two Types of Cardiac Action Potentials

    Type 1: Non-Pacemaker Cells (Myocytes)

    • Characterized as "fast response" action potentials; rapid depolarization upon receiving a signal.
    • Contractile cells need signals to contract.
    • Make up most of the atrial and ventricular muscle walls.

    Type 2: Pacemaker (Autorhythmic) Cells

    • Unstable resting potential leads to spontaneous triggering.
    • Non-contractile cells; "generals" providing signals that other cells follow.
    • Found in the sinoatrial (SA) and atrioventricular (AV) nodes.

    Action Potentials in Cardiac Autorhythmic Cells

    • Funny current channels (If) allow both potassium (K+) and sodium (Na+) to influence the unstable resting potential.
    • The pacemaker potential gradually becomes less negative until it reaches threshold, triggering an action potential.
    • Ion movements are crucial during pacemaker and action potentials.

    Role of Na+ and Ca2+

    Role of Na+

    • Rapid depolarization phase in cardiac muscle (non-pacemaker cells) due to sodium (Na+) channel opening.
    • Gradual depolarization in pacemaker cells results in net sodium (Na+) influx.

    Role of Ca2+

    • Calcium (Ca2+) influx prolongs the duration of action potentials in cardiac muscle (non-pacemaker cells), creating a plateau phase.
    • In pacemaker cells, calcium (Ca2+) is important in initial depolarization.

    Electrical Conduction to Myocardial Cells

    • Autorhythmic signals spread quickly to adjacent contractile cells via gap junctions.
    • Electrical activity originates in the SA node and spreads through the heart.

    All Cells of the Intrinsic Conduction System

    • All intrinsic conduction cells can produce spontaneous action potentials, i.e., are autorhythmic.
    • Structures include the SA node, AV node, bundle of His, bundle branches, and Purkinje fibers.

    Nodes (Control Points)

    • SA node: sets heart rate at roughly 70 bpm.
    • AV node: routes electrical signals and delays their transmission.

    Conductive Fibres

    • Conductive fibres are often sheathed and separated from myocyte connections, except for specialized contact regions of atria and ventricles.
    • Atrial and ventricular myocyte syncytia are separated by inert fibrous tissue; no gap junctions exist.

    Heart Rate is Controlled by Both Sympathetic and Parasympathetic Nerves

    • Parasympathetic activity slows heart rate; vagus nerve stimulates SA node.
    • Sympathetic activity speeds heart rate; norepinephrine (NE) binds to beta-adrenergic receptors (BARs) on SA node cells.

    Heart Rate Regulation - SA Node Action Potential Firing Rate

    • Regulated by both sympathetic and parasympathetic fibers.
    • Acetylcholine (Ach) binds to muscarinic receptors, lowering heart rate.
    • Norepinephrine (NE) binds to beta-adrenergic receptors, raising heart rate.
    • Various receptors and channels are involved at the cellular level.

    Control of Heart Rate

    • To increase heart rate (beyond intrinsic rate), sympathetic nerves need activation.
    • Catecholamines released by the adrenal gland can also stimulate heart rate.

    Modulation of Heart Rate by the Autonomic Nervous System

    • Sympathetic stimulation causes pacemaker potentials to reach threshold quickly.
    • Parasympathetic stimulation causes pacemaker potentials to reach threshold more slowly.

    Review Question – Autorhythmic Cells

    • Statement "c": The membrane potential is unstable, drifting between -90mV and -55 mV, is true.

    Control of Heart Rate vs. Contraction Strength

    • Vagus nerve activity (parasympathetic) influences heart rate, but not contraction force.
    • Sympathetic fibers increase heart rate and contraction force.

    ECG (Electrocardiogram): Normal Waves

    • Three major waves: P wave, QRS complex, and T wave.

    Electrical Activity – Overview

    • The ECG tracing correlates with electrical events in the heart.
    • Each wave represents specific electrical events in the heart.

    Electrical Events of the Cardiac Cycle

    • P wave: atrial depolarization.
    • PQ or PR segment: AV nodal and A-V bundle conduction.
    • QRS complex: ventricular depolarization.
    • ST segment: ventricular depolarization.
    • T wave: ventricular repolarization.

    Comparison of ECG and Myocardial Action Potential

    • ECG reflects summed electrical activity across the whole heart.
    • Myocardial action potentials are recorded intracellularly.

    Tips for ECG Analysis

    • Analyze rate, rhythm, and wave forms.
    • Verify that QRS appears with each P wave.
    • Check both P-R and P-R timings.

    ECG: Normal and Abnormal Electrocardiograms

    • Various abnormal patterns represent different heart conditions.

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    Description

    Test your knowledge on the ECG waves and their significance in cardiac physiology. This quiz covers the P wave, QRS complex, heart rate norms, and the roles of the sympathetic and parasympathetic nervous systems. Assess your understanding of cardiac excitability and the various methods used to study it.

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