origin + conduction of cardiac impulse Flashcards
what is the heart
electrically controlled muscular pump which sucks and pumps blood
where are electrical signals which control the heart generated
within the heart
the heart is capable of beating rhythmically in the absence of external stimuli (T/F)
True
what is autorhythmicity
heart is capable of beating rhythmically in the absence of external stimuli
excitation originates
pacemaker cells in sino-atrial node
what initiates heart beat
cluster of specialised pacemaker cell in SA node
where is the SA node located
Upper right atrium
SA node does not drive entire heart (T/F)
False - does drive entire heart
What is sinus rhythm?
Heart controlled by sino-atrial node
How does cardiac excitation originate?
- cells in SA node = no stable resting membrane potential
- cells in SA node = generate regular spontaneous pacemaker potentials
- spontaneous membrane potential takes membrane potential to threshold
- every time threshold reached = action potential
- –> regular spontaneous action potentials in SA node
define pacemaker potential
slow depolarisation of membrane potential to a threshold
pacemaker potential due to
- decrease in K+ efflux
- Na+ and K+ influx
- transient Ca++ influx
explain rising phase of action potential
- depolarisation
- activation of long lasting L-type Ca++ channels
- Ca++ influx
explain falling phase of action potential
- repolarisation
- activation of K+ channels
- K+ efflux
Cell-to-cell current flow moves via
Gap junctions
Give characteristics of the AV node
- small bundle of specialised cells
- located at base of right atrium just above junction of atria and ventricles
- only point of electrical contact between A + V
- smal in diameter
- slow conduction velocity
Spread of Excitiation
-across atria = cell-to-cell conduction via gap junctions
-SA to AV node = cell-to-cell conduction via gap junctions
AV node = conduction delayed (atrial systole to proceed ventricular diastole
-Bundle of His, Purkinjie Fibres = rapid spread of action potentials to ventricles
-ventricular muscle = cell-to-cell conduction
Phase 0 of ventricular muscle action potential
fast Na+ influx
Phase 1 of ventricular muscle action potential
closure of Na+ channels
transient K+ efflux
Phase 2 of ventricular muscle action potential
mainly Ca++ influx
AKA plateau phase
Phase 3 of ventricular muscle action potential
Closure of Ca++ channels and K+ efflux
Phase 4 of ventricular muscle action potential
Resting membrane potential
sympathetic stimulation
increases HR
parasympathetic stimulation
decreases HR
Heart rate is mainly controlled by what system?
Autonomic nervous system
Explain vagus nerve
- parasympathetic supply to heart
- continuous influence on SA under normal resting conditions
Explain vagus tone
- dominates under normal resting conditions
- slows intrinsic heart rate
- 100 to 70bpm
Normal resting heart rate values
60-100 bpm
Resting heart rate less than 60bpm =
bradycardia
resting heart rate more than 100bpm =
tachycardia
what does vagus nerve supply?
SA and AV node
Vagal stimulation
slows HR
increases AV nodal delay
what is the neurotransmitter in parasympathetic supply of the heart
acetyl choline acting through muscarinic M2 receptors
what is atropine
-competitive inhibitor of acetylcholine
when is atropine used
extreme bradycardia (speeds up the heart)
outline the effects of vagal stimulation on pacemaker potentias
- cell hyperpoalrises
- longer to reach threshold
- slope of pacemaker potential decreases
- frequency of AP decreases
- negative chronotropic effect
what does cardiac sympathetic nerves supply?
SA node
AV node
Myocardium
what does sympathetic stimulation do
- increase HR
- decrease AV nodal delay
- increases contraction force
what is the sympathetic supply of the heart neurotransmitter
noradrenaline acting through B1 adrenoreceptos
noradrenaline effect on pacemaker cells
- pacemaker potential slope increases
- pacemaker potential reaches threshold quicker
- frequency of action potentials increases (positive chrronotropic effect)
what is an ECG?
record of depolarisation and repolarisation cycle of cardiac muscle obtained from skin surface
P wave
Atrial depolarisation
QRS Complex
Ventricular depolarisation
T wave
Ventricular depolarisation
PR interval
Largely AV node delay
ST segment
Ventricular systo;e
TP interval
Diastole