2008 Kaplan USMLE Step 1 Home Study Program-Brand New Volume by Kaplan

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Shapeof the pressurecurve is alteredin certain pathologic states(Figure I-4-18). The shapeis a function of: 56 Physiology ( 1) Rate of rise of ventricular pressure. The faster the ventricle contracts, the steeper the rise in arterial pressure. (2) Stroke volume. The larger the stroke volume, the larger the increment of arterial volume and the larger and steeperthe rise in arterial pressure. (3) Arterial elasticity. The lesscompliant the arteries,the larger and steeperthe rise in arterial pressure for a given stroke volume; this is one of the reasonsblood pressurerises with age.

The phospholipid bilayer of the myocardial cell membrane, particularly its hydrophobic core' servesasan insulator that allows the cell to maintain a potential differencebetweenits interior and its exterior. This potential differenceis generatedby: t2 Physiology a. , electrical current) across the cell membrane through transmembrane protein "openings" in the phospholipid bilayer, called channels. Channelsare usually selectivefor a specific ion (Na*, K*, Ca2*,or Cl-) and are controlled by protein gates,whose conformation (open or closed) may depend on the potential difference acrossthe cell membrane.

The RBB is a relatively thin bundle that travels along the endocardial surface of the right side of the interventricular septum. b. The LBB is a thicker bundle that travelsalong the endocardialsurfaceof the left side of the interventricular septum. After approximately I to 2 cm, the LBB divides into a thin left anterior division and a broad left posterior division. 6. The RBB and the divisions of the LBB arborize into a fine network of Purkinje fibers, which also conduct rapidly. The Purkinje fibers penetrate the ventricular myocardium and function to depolarize the ventricular muscle cells.

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