[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-109-2-basic-medicine-018":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":37,"lastmod":65},"基礎醫學","basic-medicine","基礎醫學(包括解剖學、生理學、病理學、藥理學、微生物學與免疫學)",{"id":8,"webId":9,"year":10,"session":11,"subject":4,"number":12,"stem":13,"options":14,"answer":19,"answerNote":20,"images":21,"explanation":22,"explanationDeep":23,"topics":24,"freq":27},"nurse-109-2-基礎醫學-018","nurse-109-2-basic-medicine-018",109,2,18,"心肌不會發生收縮力加成作用（summation）的原因，主要是下列何者？",{"A":15,"B":16,"C":17,"D":18},"心肌沒有橫小管（transverse tubule）","心肌的不反應期時間幾乎與其收縮時間重疊","心肌的動作電位不會加成","心肌肌漿網（sarcoplasmic reticulum）不發達","B",null,[],"本題考點是心肌無法產生收縮加成(summation)與強直收縮的生理機制。依心肌電生理，心肌動作電位有很長的絕對不反應期(約250-300毫秒)，幾乎涵蓋整個收縮期,在此期間細胞無法被再次興奮,故新刺激無法在前次收縮尚未鬆弛前疊加上去,因而不會發生加成或強直,正解B。A橫小管(T-tubule)心肌其實有,且較粗大,並非缺乏。C「動作電位不會加成」說法本末倒置:重點是不反應期長,而非電位本身,且此敘述並未指出真正機轉。D心肌的肌漿網雖較骨骼肌不發達,但這關係到鈣供應而非防止加成,並非主因。故防止加成的關鍵在超長不反應期。","心肌動作電位的平台期(phase 2)由L型鈣通道緩慢內流維持,使不反應期延長至與機械收縮幾乎等長,這是心臟無法強直收縮的保命機制——若心肌能像骨骼肌一樣強直,將無法交替充盈與射血。對比骨骼肌:不反應期僅約1-2毫秒,遠短於收縮時間,故可經頻率加成達到強直收縮。心肌另有「全或無」與功能性合胞體(閏盤縫隙連接)特性。記憶:心肌「長不反應期=不能強直=永保節律射血」。",[25,28,30,33,35],{"term":26,"count":27},"L型鈣通道",3,{"term":29,"count":11},"強直收縮",{"term":31,"count":32},"心肌不反應期",1,{"term":34,"count":32},"動作電位平台期",{"term":36,"count":32},"心肌與骨骼肌對比",[38,42,47,51,56,61],{"webId":39,"stem":40,"number":41,"year":10,"session":11},"nurse-109-2-basic-medicine-019","下列那個腦區受損會造成表達性的失語症？",19,{"webId":43,"stem":44,"number":45,"year":46,"session":32},"nurse-110-1-basic-medicine-035","堵塞性血栓血管炎（thromboangiitis obliterans）最常侵犯身體何處的血管？",35,110,{"webId":48,"stem":49,"number":50,"year":46,"session":11},"nurse-110-2-basic-medicine-049","治療青光眼的藥物中，下列何者是藉由直接作用於膽鹼性受體（cholinergic receptor）而降低眼壓？",49,{"webId":52,"stem":53,"number":54,"year":55,"session":32},"nurse-112-1-basic-medicine-037","治療高血脂症時，能同時降低膽固醇及三酸甘油酯的藥物，下列何者最佳？",37,112,{"webId":57,"stem":58,"number":59,"year":60,"session":11},"nurse-113-2-basic-medicine-041","有關細菌內毒素（endotoxin），下列敘述何者最不適當？",41,113,{"webId":62,"stem":63,"number":45,"year":64,"session":27},"nurse-114-3-basic-medicine-035","關於秋水仙素（colchicine），下列敘述何者錯誤？",114,"2026-09-04",1788510714890]