Cardiovascular System - Cardiac Action Potential & Electrocardiogram Flashcards
cardiac cycle
alternating contraction and relaxation of cardiac muscle (myocardium)
cardiac muscle fibers
- smaller/shorter
- branched ends (connect to each other)
- one or two nuclei
cardiac muscle tissue (2 components)
- syncytium
- gap junctions
syncytium
multinucleate mass of cytoplasm resulting from fusion of cells
gap junctions
conduct the action potential to neighbouring cells
cardiac vs skeletal muscle cells
- both striated
- involuntary vs voluntarily
- 10-20um diameter vs 20-100um
- 50-100um in length vs mm to cm in length
- 1-2 nuclei vs hundreds
- often branch vs do not branch
- connect to neighbouring cells vs fuse with tendons
- many mitochondria vs few
3 types of muscle tissue in myocardium
- atrial muscle
- ventricular muscle
- specialized muscle tissue coordinates electrical signals (conduction system of heart)
conduction system of heart
“an automatic electrical system controls contraction of heart”
- sinoatrial (SA) node
- atrioventricular (AV) node
- bundle of His
- bundle branches (right and left)
- Purkinje fibers
SA node
pacemaker
AV node
delays transmission of signal
bundle of His and ramifications
conducts signal to ventricles
main phases of action potential **
- resting membrane potential
- threshold potential
- depolarization
- depolarization
- hyperpolarization
- refractory period
- inward and outward currents
heterogeneity of cardiac action potential **
- heart is heterogeneous with respect to cell type
- these different cells have different versions of their action potential
(slide 14)
phases of action potential in SA node
“SA nodal cells spontaneously generate action potential
0. upstroke/depolarization
1/2. absent
3. pacemaker potential
characteristics of action potential in SA node
- automaticity (spontaneously generate action potentials without neural inputs)
- unstable resting membrane potential
- no sustained plateau
effect of ANS stimulation on SA node action potential
autonomic nerves affect the heart rate by affecting the pacemaker potential
conductance changes and currents in the myocyte and action potential
- upstroke of action potential is due to inward Na+ current
- phase 1 repolarization is due to an outward K+ current, while Na+ channel inactivates
- Ca2+ inward current maintains the Plateau of Phase 2
- Ca2+ channel closure and increased gk repolarize the cell during Phase 3
phases of action potential in the atria and ventricles
- rapid depolarization
- partial repolarization
- plateau
- repolarization
- pacemaker potential
characteristics of action potential in atria and ventricles
- stable resting membrane potential
- longer action potential
- sustained plateau
“contractile cells do not spontaneously generate action potentials
basic principle of ECG
- equivalent electric dipole is produced by heart muscle during repolarization
- heart muscle fibres act as electric dipoles
Einthoven’s triangle
- 3 bipolar leads
- voltage in each lead is the projection of the heart vector onto that lead
Normal ECG configuration components
- P wave, PR interval, QRS complex, ST segment, T wave, U wave, QT interval
origin of P wave of the ECG
- heart electric dipole varies with time and so does the recording on leads I, II, and III
- atrial depolarization causes the P wave
origin of QRS complex of ECG
- the depolarization of the ventricles occur in a sequential manner
- ventricular depolarization causes the QRS complex
P wave
atrial depolarization
P-R interval
total atrial activity prior to activation of the bundle of His
QRS complex
ventricular depolarization
ST segment
time between ventricular depolarization and repolarization
T wave
ventricular repolarization
U wave
usually flat or not seen
occurs in electrolyte disturbances, heart diseases
QT interval
total ventricular activity (QRS complex, ST segment, and T wave)
augmented limb leads
augmented unipolar limb leads use combinations of only two electrodes for the indifferent electrode
sympathetic stimulation of SA node
- shorter time, higher slope of pacemaker potential
parasympathetic stimulation of SA node
- longer time, lower slope of pacemaker potential