HEART SMART Q&A

Your name: Michael Wakefield

Date: 1/20/06

Use this interview sheet to keep track of the people to whom you speak and what they
say. Use a new sheet for each interview.

■ 1. WHAT IS THE FUNCTION OF THE RIGHT SIDE OF THE HEART?

■ Answer:
• Pump blood through the pulmonary circuit (to the lungs) to
pickup oxygen and drop off carbon dioxide

■ 2. WHAT IS THE FUNCTION OF THE LEFT SIDE OF THE HEART?

o Answer:
• Pump blood through the systemic circuit (to the body
tissues) to exchange gases and nutrients with body
tissues.

■ 3. IN A NORMAL HEART, WHERE, EXACTLY, IS THE PACEMAKER

OF THE HEART LOCATED (NOT THE NAME OF THE
PACEMAKER, THE LOCATION)?

o Answer:
• Right atrial wall, just inferior to the entrance of the superior
vena cava

■ 4. WHAT “CLUSTER OF CELLS” (RECEIVES IMPULSES FROM

THE PACEMAKER AND) SENDS IMPULSES INTO THE
VENTRICLES?

o Answer:
• AV (atrioventricular node)

■ 5. WHERE, EXACTLY, (CLASS) IS THIS “CLUSTER OF CELLS”

LOCATED?

o Answer:
• Inferior portion of the interatrial septum immediately above
the tricuspid valve.
■ 6. FROM THE SPECIAL “CLUSTER OF CELLS”. “THE SIGNAL
STRENGTH SPREADS DOWN SPECIALIZED TRUNK CABLES
(NOTE THE WORD IS PLURAL) CALLED PURKINJE FIBERS…”.
CORRECT THIS STATEMENT.

o Answer:
• The signal streaks down (Bundle of His) atrioventricular
bundle which then split into right and left bundle branches
along the interventricular septum to Purkinje fibers.

■ 7. WHERE DO YOU FIND PURKINJE FIBERS AND WHAT IS THEIR

FUNCTION?

o Answer
• Heart apex turned superiorly into ventricular walls, excite
the septal cells & papillary muscles to contract before the
rest of the ventricle muscles.

■ 8. FROM CLASS NOTES, DESCRIBE WHAT IS HAPPENING

DURING AN ATRIAL FIBRILLATION.

o Answer:
• 1) Rapid uncoordinated beat
• 2) Small areas of myocardium beat independently
• 3) The atria cannot pump blood effectively
• 4) Rapid & erratic impulses are sent to AV node resulting
in reduced cardiac output by the ventricles.

■ 9. FROM THE ARTICLE, WHAT ARE TWO OF THE MANY THINGS

THAT CAN CAUSE FIBRILLATION?

o Answer:
• 1) Electrical impulses cannot travel from cell-to-cell
• 2) AV node is unable to dampen irregular or fast heartbeat
• 3) Aberrant conduction into Purkinje fibers

■ 10. WHAT DOES THE ATRIOVENTRICULAR NODE DO THAT

HELPS DAMPEN THE EFFECTS OF ATRIAL FIBRILLATION?

o Answer:
• Delays depolarization wave spread gap junctions from
atria by 0.1secs allowing atria to respond & complete
contraction before ventricles contract. Conducts impulses
slowly.
■ 11. WHAT IS IT CALLED WHEN THE VENTRICLES BEAT TOO
FAST? (OVER 100 BEATS/MINUTE)?

o Answer:
• Ventricular tachycardia

■ 12. WHY DOES YOUR BLOOD PRESSURE DROP WHEN THE

VENTRICLES BEAT TOO FAST?

o Answer:
• Atrials don’t have time to complete a contraction into
ventricles, no blood to pump (or less blood to pump).

■ 13.

 A. HOW DOES DIGITALIS (DIGOXIN) HELP REDUCE THE

NUMBER OF VENTRICULAR CONTRACTIONS

o Answer A:
• It is a calcium-channel blocker which boosts the AV
dampening mode rate which slows ventricular contractions
by slowing impulses to the ventricle muscles.

 B. WHY DID THE DOCTOR NOT WISH TO USE IT ON MRS. WU

(LOOK AHEAD IN THE ARTICLE)?

o Answer B:
 To slow to respond (3 hours)

■ 14.

 A. HOW WOULD A CALCIUM CHANNEL BLOCKER REDUCE

THE NUMBER OF VENTRICULAR CONTRACTIONS? (CLASS)

o Answer A:
 Enhance AV node dampening abilities thus slowing
impulses to the ventricles

 B. WHY DID THE DOCTOR NOT WANT TO USE A CALCIUM

CHANNEL BLOCKER WITH MRS. WU? (LOOK AHEAD IN THE
ARTICLE).

o Answer B:
 Would lower blood pressure & Mrs. Wu was already at
100 which is considered borderline.

■ 15. “…CERTAIN IO CHANNELS IN THE CELL MEMBRANE OPEN,

 ALLOWING SODIUM IONS TO POUR IN. WHEN THE INFLUX OF
SODIUM REACHES A THRESHOLD. IT TRIGGERS THE RELEASE
OF ELECTRONS FROM THE CELL --- THIS IS THE ELECTRICAL
IMPULSE”. CORRECT THE PORTION OF THIS QUOTE THAT IS IN
BLOD TYPE.

o Answer:
 Plasma membranes of adjacent cardiac cells interlock
at junctions called intercalated discs, they contain
desosomes, which prevent adjacent cells from
separating during a contraction, and gap junctions
allow ions to pass from cell-to-cell transmitting a
depolarization wave across the cardiac muscle.
(cardiac cells are electrically coupled by gap junctions).

■ 16. DEPOLARIZATION OF PACEMAKER CELLS DEPENDS UPON

WHAT TWO IONS? (CLASS, CD)

o Answer:
 Calcium & Sodium

■ 17. WHAT WAS ULTIMATELY GIVEN TO MRS. WU TO SLOW HER

HEARTBEAT?

o Answer:
 Magnesium Sulfate (Epsom salts)