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Physio 2: Cardiac Muscle Physiology
Dr. Green's Lecture on Cardiac Muscle Physiology
35
Medical
Graduate
02/16/2011

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Cards

Term
How many nuclei does a cardiac cell contain?
Definition
1-2
Term
T/F Cardiac cells contain T-tubules and sarcoplasmic reticulum.
Definition
True
Term
What is the purpose of intercalated discs?
Definition
Intercalated discs are mechanical connections which keep the cardiac cells from pulling apart during contraction. Composed of fascia adherens and desmosomes. Also have electrical connections called gap junctions that allow for the propagation of action potential throughout the heart.
Term
What makes of the sarcomere.
Definition
Myofilaments of actin and myosin.
Term
Draw and label the cardiac action potential cycle.
Definition
See notes pg 4
Term
What happens during phase 4 of cardiac action potential?
Definition
It is the resting potential.
-Sodium and calcium channels are closed
-potassium channels (inward rectifying) are open
-extracellular concentration of Na is greater than intracellular
-extracellular concentration of K is less than intracellular
Term
What takes place during phase 0 of cardiac action potential?
Definition
-fast sodium channels open when the membrane rapidly depolarizes
-sodium channels only open for a brief period of time
-sodium channels close to inactive state
-sodium channels return to closed resting state when membrane repolarizes
Term
What takes place during phase 1 of cardiac action potential?
Definition
Partial repolarization due to:
-efflux of K through transient outward channels
-inactivation of sodium channels
Term
What takes place during phase 2 of cardiac action potential?
Definition
-L-type calcium channels open and remain open for relatively long time
-calcium influx more gradual than sodium
-these calcium ions trigger internal calcium release from SR
-K+ exits through delayed rectifier channels
-plateau caused by balance between influx of calcium and efflux of K+
Term
What takes place during phase 3 of cardiac action potential?
Definition
-K+ exits through delayed rectifier channels
-K+ efflux is greater than Ca2+ influx
-Eventually Ca2+ influx stops and soley K+ efflux
-membrane is depolarized by to resting potential
Term
Which is longer the refractory period of cardiac or skeletal muscle cells?
Definition
Cardiac muscle cells--allows time for ventricles to empty and refill.
Term
Why can't an action potential be generated during the refractory period?
Definition
B/c fast sodium channels are inactive.
Term
What is the difference between the effective and relative refractory period?
Definition
During the effective refractive period an action potential cannot be generated, during the relative refractory period an action potential can be generated with a large enough stimulus-but it is slow and weak.
Term
What is the role of extracellular calcium in the contraction of cardiac muscles?
Definition
Extracellular calcium is not sufficient to induce contraction of cardiac muscles however it signals to release intracellular calcium from the SR which then allows for contraction
Term
How does calcium enter cardiac cells and during which phase?
Definition
Calcium enters cardiac muscle cells via L type channels in the T-tubules and sarcolema during phase 2 of action potential.
Term
Which opens first T-type Calcium channels or L-type calcium channels?
Definition
T-type calcium channels open first during zero phase.
Term
Which calcium channels must be activated for contraction to occur?
Definition
L-type calcium channels
Term
Once calcium enters through L-type channels what does it activate?
Definition
Ryanodine receptor 2 (RyR2) which are calcium gated--calcium causes confirmational change allowing the release of calcium from the SR
Term
How does calcium release result in contraction of cardiac muscle?
Definition
Calcium binds to troponin, cahnging the conformation of troponin/tropomyosin and allowing myosin to bind to actin.
Term
What is the model for cardiac muscle contraction?
Definition
Sliding filament
Term
During what phase do cardiac muscle cells have the greatest force from contraction?
Definition
During phase 2
Term
During what stage does relaxation take place?
Definition
During the end of phase 2 beginning of phase 3.
Term
What events cause relaxation?
Definition
During the end of phase 2 and the beginning of phase 3 SERCA pumps most calcium back into the SR. The remaining calcium is removed by sodium-calcium exchanger and calcium pump.
Term
How is calcium uptake into the SR regulated?
Definition
Phsopholamaban regulated SR calcium reuptake. When phospholamban is phosphorylated it makes SERCA more active--cytoplasmic calcium levels go down and cardiac muscle cells relax.
Term
How does the amount of calcium in the SR effect contraction strength?
Definition
The more calcium that is released the stronger the contraction.
Term
How is the force of contraction regulated?
Definition
All cardiac muscle cells contract, so cannot increase the number of cells to increase contraction strength. Instead calcium levels are regulated by modulating:
-amount of calcium into the cell
-calcium release by SR
-SERCA levels
-calcium efflux
Term
What is the effect of stimulating the sympathetic nervous system on cardiac muscle cells? What is the mechanism for this?
Definition
Increases contraction and relaxation.
Mechanism:
-Stimulation of sympathetic nervous system leads to the release of catecholamines
-Catecholamines bind to beta adrenergic receptors
-B/Adrednergic receptors activate PKA
-leads to phosphorylation of L-type ca channels
-More calcium enters cell
- Increase in release of ca from SR
-Increase in calcium leads to increase in contraction strength
-Increase in PKA leads to phosphorylation of phospholamban which increases SERCA reuptake of ca to SR leading to an increase in relaxation.
Term
What is the effect of beta adrenergic receptor blockers?
Definition
Decrease heart rate
Term
What is the effect of stimulation of the parasympathetic nervous system on heart rate? What is the mechanism for this?
Definition
Lowers heart rate.
Mechanism:
-Acetylcholine released from nerve that binds to muscarinic receptors
-Acetylcholine inhibits kinases by preventing activation
-this slows the contraction rate by reducing intracellular calcium concentration
Term
Which cells are more sensitive to cholinergic stimulation?
Definition
Atrial cells are more sensitive to cholinergic stimulation than ventricular cells
Term
What is one way to treat congestive heart failure involving sodium potassium ATPase?
What is the mechanism for this?
Definition
With cardiac glycosides such as digoxin and ouabain.
-Inhibit ATPase
-Less Na gets pumped
-Increase in intracellular Na inhibits sodium-calcium exchange
-Leads to increased intracellular calcium
-Leads to greater contractions
Term
What is the Frank-Starling Law of the heart?
Definition
Stretching sarcomere increases the force of contraction
Term
Why does the heart have greater passive resistance than skeletal muscle?
Definition
Titin
More extracellular matrix and thus more connective tissue
Term
What are some factors that might allow cardiac muscle to increase its force of contraction with stretching?
Definition
-cardiac muscle has greater passive resistance than skeletal muscle
-actin and myosin filaments closer together during stretch
-increasing sarcomere length increases sensitvity of troponin c to calcium, which increases rate of cross bridge attachment and detachment (stretch takes less calcium to generate same force)
Term
What is the decrease in contraction force due to at high degrees of stretch?
Definition
Decrease is due to disruption of myocardial fibers--cardiac muscles stretch too far they break
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