Myocardial Excitation-Contraction Coupling
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Questions and Answers

What initiates the depolarization in contractile cells?

  • Depolarization from gap junctions of adjacent cells (correct)
  • Pacemaker potential from iF channels
  • Hyperpolarization from external stimuli
  • Sodium influx through NCX antiporter

Which protein does calcium bind to during myocardial contraction?

  • Actin
  • Myosin
  • Calmodulin
  • Troponin (correct)

What role does the sodium-potassium ATPase pump play in myocardial relaxation?

  • Moves sodium into the contractile cell
  • Helps transport potassium into the extracellular fluid
  • Pumps calcium out of the contractile cell (correct)
  • Retains calcium in the contractile cell

What characterizes the membrane potential of autorhythmic cells?

<p>Unstable with continuous depolarization (A)</p> Signup and view all the answers

What is the average cardiac output in a healthy adult?

<p>5 L/min (C)</p> Signup and view all the answers

How is stroke volume calculated?

<p>EDV - ESV (B)</p> Signup and view all the answers

What prevents tetanus in myocardial contractile cells?

<p>Longer refractory periods (B)</p> Signup and view all the answers

What mechanism contributes to the long contraction duration in contractile cells?

<p>Extended plateau phase from calcium entry (C)</p> Signup and view all the answers

In smooth muscle, what mechanism is similar to the calcium process in cardiac muscle?

<p>Calcium-induced calcium release (D)</p> Signup and view all the answers

Which of the following describes the primary function of the NCX antiporter in myocardial relaxation?

<p>Moves sodium into the cell while transporting calcium out (B)</p> Signup and view all the answers

What is the formula for calculating ejection fraction?

<p>Stroke volume / EDV (D)</p> Signup and view all the answers

Which neurotransmitter is primarily involved in increasing heart rate through sympathetic stimulation?

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

How does parasympathetic stimulation affect heart rate?

<p>It decreases heart rate by increasing potassium permeability. (D)</p> Signup and view all the answers

What effect does increased afterload have on stroke volume?

<p>Decreases stroke volume (A)</p> Signup and view all the answers

Which factor determines venous return?

<p>Skeletal muscle pump and respiratory pump (D)</p> Signup and view all the answers

What term describes the load placed on a ventricle during contraction?

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

Which of the following is a positive inotropic agent?

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

What relationship does length-tension have with stroke volume?

<p>Longer length = greater tension = greater force (A)</p> Signup and view all the answers

What is true about catecholamines like norepinephrine regarding contractility?

<p>They increase contractility without changing stretch. (B)</p> Signup and view all the answers

What is primarily responsible for maintaining tonic control of heart rate?

<p>Parasympathetic nervous system (C)</p> Signup and view all the answers

Flashcards

Myocardial Excitation-Contraction Coupling (EC) - Contraction

The process of converting an electrical signal (action potential) into a mechanical force (contraction) in heart muscle cells. It involves calcium entering the cell from the extracellular fluid (ECF) through L-type calcium channels, triggering the release of more calcium from the sarcoplasmic reticulum (SR) through ryanodine receptors (RYR) - calcium-induced calcium release. This calcium binds to troponin, initiating the cross-bridge cycle, leading to muscle contraction.

Myocardial Excitation-Contraction Coupling (EC) - Relaxation

The process of reversing muscle contraction in heart muscle cells. After contraction, calcium is actively pumped back into the SR for storage by ATPase pumps. Additionally, a sodium-calcium exchanger (NCX) moves calcium out of the cell by exchanging it for sodium. The sodium that enters the cell is then pumped back out by the sodium-potassium ATPase pump.

How is Myocardial EC Coupling similar to Skeletal Muscle?

Both myocardial and skeletal muscle use troponin as a calcium-binding protein to initiate contraction. Calcium binding to troponin causes a conformational change that allows actin and myosin to interact and generate force.

How is Myocardial EC Coupling similar to Smooth Muscle?

Both myocardial and smooth muscle utilize calcium-induced calcium release (CICR). In CICR, initial calcium influx triggers the release of a larger amount of calcium from internal stores, amplifying the signal.

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What are Autorhythmic Cells?

Specialized heart muscle cells that are self-excitable and responsible for initiating and maintaining the heart's rhythmic contractions. These cells have an unstable membrane potential, known as the "pacemaker potential", which continuously depolarizes, leading to spontaneous action potentials that set the pace of the heart.

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What are Contractile Cells?

The majority of heart muscle cells, responsible for generating force and pumping blood. These cells have stable membrane potentials and are triggered to contract by action potentials generated by autorhythmic cells via gap junctions. They have a plateau phase in their action potential due to calcium entry, resulting in longer contraction times. Their longer refractory period prevents tetanus.

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What is Cardiac Output (CO)?

The volume of blood pumped by the heart per minute. It is calculated by multiplying heart rate (HR) by stroke volume (SV).

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What is Stroke Volume (SV)?

The amount of blood ejected from the left ventricle with each beat. It is calculated by subtracting end-systolic volume (ESV) from end-diastolic volume (EDV).

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What is Ejection Fraction (EF)?

The percentage of end-diastolic volume (EDV) that is ejected from the ventricle during each beat. It reflects the efficiency of the heart.

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Ejection Fraction

A measure of how much blood is pumped out of the left ventricle with each heartbeat. It's calculated by dividing stroke volume by end-diastolic volume.

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Sympathetic Nervous System & Heart Rate

The sympathetic nervous system releases norepinephrine and epinephrine, which act on beta-1 receptors in the heart. This increases sodium and calcium permeability, speeding up depolarization and leading to a faster heart rate.

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Parasympathetic Nervous System & Heart Rate

The parasympathetic nervous system releases acetylcholine, which activates muscarinic receptors in the heart. This increases potassium permeability, leading to hyperpolarization and a slower heart rate.

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Stroke Volume (SV)

The amount of blood pumped out of the left ventricle with each heartbeat.

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End-Diastolic Volume (EDV)

The amount of blood in the left ventricle at the end of diastole (heart relaxation).

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Preload

The degree of stretch on the heart muscle fibers at the end of diastole. It's directly related to EDV.

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Venous Return

The amount of blood returning to the heart from the veins. It's a major factor determining EDV and preload.

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Afterload

The resistance the ventricle must overcome to eject blood. It includes the arterial blood pressure and EDV.

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Contractility

The force of contraction of the heart muscle. It's influenced by factors like catecholamines.

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Study Notes

Myocardial Excitation-Contraction Coupling and Relaxation

  • Myocardial contraction begins with an action potential in a pacemaker cell that propagates to adjacent cells.
  • L-type calcium channels open, allowing calcium to enter from the extracellular fluid (ECF).
  • Calcium triggers the release of more calcium from the sarcoplasmic reticulum (SR), a process called calcium-induced calcium release.
  • This combined calcium influx creates a calcium spark, and the summation of these sparks forms a calcium signal.
  • Calcium binds to troponin, initiating the cross-bridge cycle, similar to skeletal muscle contraction.
  • Relaxation occurs when calcium is pumped back into the SR by ATPase pumps.
  • The sodium-calcium exchanger (NCX) antiporter moves calcium out of the cell and sodium into the cell.
  • The sodium is then pumped out by the sodium-potassium ATPase pump, maintaining the sodium gradient.

Autorhythmic vs. Contractile Cells

  • Autorhythmic cells (pacemakers) are responsible for initiating the heartbeat, have unstable membrane potentials (pacemaker potentials), and are small in number.
  • Pacemaker potentials arise from the inward "funny" current (If) through If channels.
  • This allows the cells to continuously depolarize and set the heart beat.
  • Contractile cells have stable membrane potentials
  • Depolarization in contractile cells is initiated via gap junctions from adjacent cells.
  • The prolonged plateau phase of the action potential in contractile cells is due to calcium entry, resulting in a longer contraction.
  • The long refractory period in contractile cells prevents tetany.

Cardiac Output, Stroke Volume, and Heart Rate

  • Cardiac output (CO) is the amount of blood pumped by the heart per minute
  • CO = Heart Rate (HR) × Stroke Volume (SV)
  • Stroke volume (SV) is the amount of blood ejected per ventricular contraction.
  • SV = End-diastolic volume (EDV) - End-systolic volume (ESV)
  • EDV is affected by venous return and preload (the degree of stretch of the heart).
  • Venous return is affected by skeletal muscle pump, respiratory pump, and sympathetic innervation of the veins.
  • SV is affected by contractility (the force of ventricular contraction).

Autonomic Nervous System and Heart Rate

  • Sympathetic neurons release norepinephrine and epinephrine, binding to β1 receptors to increase heart rate by increasing sodium and calcium permeability.
  • Norepinephrine and epinephrine also increase contractility.
  • Parasympathetic neurons release acetylcholine, binding to muscarinic receptors to decrease heart rate by increasing potassium permeability and hyperpolarizing the cells.

Factors Influencing Stroke Volume

  • Venous return: dictates end-diastolic volume (EDV), which affects stroke volume.
  • Preload: degree of stretch on the heart, influenced by EDV.
  • Contractility: the force of ventricular contraction, affected by catecholamines and inotropic agents.
  • Afterload: the pressure the ventricles must overcome to eject blood.

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Description

This quiz covers the fundamental concepts of myocardial excitation-contraction coupling and relaxation. It explores the role of calcium in heart muscle contraction, including the mechanisms of pacemaker cells and the processes that lead to relaxation. Test your understanding of the electrical and chemical signals that regulate heart function.

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