Tutorial 1a
1. Describe how does the heart obtain its nutrients and oxygen?
The coronary arteries play a crucial role in supplying blood to the heart. Blood rich in oxygen
is transported to the heart via the branches of the coronary arteries.
The left coronary artery supplies blood to the left side of the heart, which includes the left
atrium and ventricle. Conversely, the right coronary artery delivers blood to the right atrium
and portions of both ventricles.
2. State TWO (2) determinants of blood pressure.
- peripheral resistance
- cardiac output
3. Describe electrical conduction system in the heart.
SA node depolarizes. Electrical activity goes rapidly to AV nodes via internodal
pathways. Depolarization spreads across atria. Conduction slows through AV nodes.
Depolarization moves rapidly through the ventricular conducting system to the apex of the
heart. Depolarization wave spreads upward from the apex.
4. The rising phase of action potential in contractile myocardium is due to sodium ion and
Calcium ion entry, respectively.
5. Describe how our body restored its normal blood pressure when there is an increase in
blood pressure?
When blood pressure rises, the body activates several mechanisms to restore normal
levels. The baroreceptor reflex detects changes in pressure. Baroreceptors in the carotid
arteries and aorta sense the increased pressure and send signals to the brainstem. In response,
the brain reduces sympathetic nervous activity, lowering heart rate and causing blood vessels
to dilate which is vasodilation. This would decrease the blood pressure. Additionally, the
renin-angiotensin-aldosterone system (RAAS) is suppressed, which reduces angiotensin II
and aldosterone levels and helps prevent blood vessel constriction and water retention.
6. How to ensure unidirectional blood flow?
- The heart relies on several mechanisms to ensure unidirectional blood flow. One of
the main mechanisms is the heart's valves, which consist of 4 main valves. Next, the
pressure gradient. Other mechanisms include heart contractions and smooth muscle
on the vessels.
7. How to minimise friction in the heart?
The heart is enclosed in a protective, double-layered membranous sac known as the
pericardium. This sac has two main layers whic is the fibrous pericardium and the serous
pericardium. Between these two layers is a small cavity filled with a lubricating fluid called
pericardial fluid. This fluid serves multiple purposes such as reducing friction when the heart
beats, preventing damage to the heart’s surface, and provides a cushion to protect the heart
from physical shocks or impact.
8. How does the heart contract (cellular & molecular)?
At cellular level, the there will be electrical stimulation on the sinoatrial node, which
triggers an action potential in cardiac contractile cells. Then, the calcium ion channel will
open, which allows the calcium ion to enter the cell and stimulate the release of release of a
much larger amount of calcium from the sarcoplasmic reticulum (SR). Then the
troponin-tropomyosin complex in thin filaments is pulled aside, then cross-bridging happens
between the thick and thin filaments of the actin-myosin. These allows the heart to contract.
9. Describe homeostasis of blood pressure.
When blood pressure increases, the body activates mechanisms to lower it and
maintain homeostasis. The baroreceptor reflex is the primary response, with baroreceptors in
the carotid arteries and aortic arch detecting the rise in pressure. These receptors send signals
to the brainstem, which reduces sympathetic nervous activity and increases parasympathetic
activity. This results in a slower heart rate and vasodilation which is the widening of blood
vessels, which together help lower blood pressure. The renin-angiotensin-aldosterone system
(RAAS) is suppressed, reducing the production of angiotensin II and aldosterone, both of
which can increase blood pressure through vasoconstriction and fluid retention.
When blood pressure drops, the body works to raise it back to normal. The baroreceptor
reflex detects the decrease and prompts the brainstem to increase sympathetic activity,
causing the heart to beat faster and blood vessels to constrict which is vasoconstriction. The
RAAS is activated, leading to the release of renin from the kidneys, which triggers the
production of angiotensin II. This hormone constricts blood vessels and stimulates
aldosterone release, promoting sodium and water retention by the kidneys, which increases
blood volume and elevates blood pressure. These combined responses help restore normal
blood pressure levels.
10. Describe ion movements and state of ions channels in the action potentials of
autorhythmic and cardiac cells during depolarization, repolarization and rapid repolarization.
When an action potential is initiated in autorhythmic cells at the threshold level, the
L-type voltage-gated calcium channel opens, permitting calcium ions to enter the cell, which
leads to depolarization. Subsequently, after achieving peak depolarization, the voltage-gated
potassium channels open, while the calcium gates close. This process enables potassium ions
to flow out of the channel and halts the influx of calcium ions. In autorhythmic cells, the
mechanism primarily relies on calcium ions rather than sodium ions.
When a wave of depolarization moves into contractile cell through gap junctions, the
membrane potential becomes more positive. Voltage-gated sodium channels open and allow
sodium ions to enter the cell and rapidly depolarize it. After achieving peak depolarization,
voltage-gated sodium channels close, while the potassium channels open. The cell begins to
depolarize as potassium ions leave through the open potassium channels. The action potential
then flattens into plateau when there is a decrease in potassium ion permeability and an
increase in calcium ion permeability. The combination of calcium ions influx and potassium
ion efflux causes the action potential to flatten out into plateau. Plateau ends when calcium
channels close and potassium permeability increases again.
11. Describe how heart rate can be reduced and increased.
Sympathetic and parasympathetic stimulation responsible for influencing the heart
rate. Catecholamines will increase contractility. Parasympathetic stimulation hyperpolarizes
the membrane potential of the autorhythmic cell and slows depolarization, which slows the
heart rate. Meanwhile, sympathetic stimulation and epinephrine depolarize the autorhythmic
cell and speed up the pacemaker potential which increase the heart rate.
12. Explain how conduction system is physically represented as an ECG.
Every stage of the heart's conduction system is indicated by a unique waveform or
interval on the ECG. The order of the P wave (atrial depolarisation), PR interval (conduction
through AV nodenand AV bundle), QRS complex (ventricular depolarisation), T wave
(ventricular repolarisation) depicts the heart’s electrical activity from atrial depolarization to
ventricular repolarization, illustrating the physical mechanism of cardiac conduction and
contraction.
13. How ECG can be used to detect problems in the conduction system.
ECG provides insight to the heart’s conduction system. When deviation from normal
pattern occurs, this can help to identify and diagnose underlying cause of the heart disorders.