The Conduction System Flashcards
describe the electrical activity of the heart
inherent and rhythmical (heart beat)
describe the heart’s network of specialized cardiac muscle fibers (3)
- autorhythmic fibers
- self-excitable
- repeatedly generate AP’s that trigger heart contractions
what percentage of cardiac muscle fibers become autorhythmic?
about 1%
what are the 2 functions of autorhythmic cardiac muscle fibers? describe these functions
- act as a pacemaker: the set rhythm of electrical excitation causes contraction of the heart
- form conduction system: the network of specialized cardiac muscle fibers provide a path for each cycel of cardiac excitation and ensures that the cardiac chambers become stimulated to contract in a coordinated manner
where does cardiac excitation begin?
SA node
where is the SA node located?
in the right atrial wall just inferior to the opening of the superior vena cava
what do SA node cells do?
repeatedly depolarize to threshold spontaneously
what is the pacemaker potential due to?
spontaneous depolarization
what is the SA node also called?
the pacemaker of the heart
what happens when the pacemaker potential of the SA node reaches threshold?
triggers an action potential
what do sinus nodal fibers connect directly with?
atrial muscle fibers
what happens to each action potential from the SA node? what is the result of this?
propogates directly through both atria via gap junctions in intercalated disks of atrial muscle fibers; result in atrial contraction
give the conduction system sequence(6)
- action potential (AP) initiated in SA node and travels through internodal pathays to make atria contract
- AP reaches AV node
- AP enters the AV bundle/bundle of His
- after propogating along AV bundle, AP enters R and L bundle branches
- AP then travels to purkinjie fibers, which rapidly conduct AP from apex of heart upward to remainder of ventricular myocardium
- ventricles contract
where is the AV node located?
in the septum between the 2 atria, just anterior to the opening of the coronary sinus
what is the only site where APs can conduct from atria to ventricles?
the AV bundle/bundle of His
why is the AV bundle the only site where APs can conduct fron atria to ventricles?
everywhere else, the fibrous skeleton of the heart electrically insulates from atria to ventricles
where do the L and R bundle branches extend?
through the interventricular septum toward the apex of the heart
how often do the autorhythmic fibers in the SA node node initiate an AP?
every 0.6 seconds (100x/min)
describe how nerve impulses from the ANS and hormones like epinephrine influend the heart beat
they modify timing and strength of the heartbeat but DO NOT establish the fundamental rhythm
what happens if the SA node is damaged?
the slower AV node can pick up pacemaking tasks
what happens if both the SA node and the AV node are suppressed?
the distal fibers can maintain the heartbeat but their pace is too slow to maintain adequate blood flow to the brain
what are automaticity foci? (2)
focal areas of automaticity in the heart; potential pacemakers capable of pacing in emergency situations
describe automaticity foci under normal circumstances; what does this mean in terms of what they are referred to as?
electrically silent; is why they are referred to as “potential pacemakers”
what are the 3 ion channels that are important in causing action potential in cardiac muscle? which is the leaky one?
- fast sodium channels
- slow sodium-calcium channels (leaky)
- potassium channels
describe the resting potential of sinus nodal fibers and what this results in
high resting potential, results in inactivation of fast sodium channe;s
what kind of cell membranes do sinus fibers have and what does this result in?
have cell membranes that naturally leak Na+ and Ca2+ that results in the slow rise in membrane potential between heartbeats
what channels become activated when the SAnodepotential reaches threshold voltage?
sodium-calcium (slow and leaky)
what does the inherent leakiness of sinus nodal fibers to sodium and calcium result in?
self-excitation of the sinus nodal fibers
why doesn’t leakiness result in permanent depolarization of sinus nodal fibers? (2)
- sodium-calcium channels become inactivated
- potassium channels move K+ out of the cell, resulting in hyperpolarization of the cell which carries the membrane potential to “resting” potential
what is the resting membrane potential?
-55 to -60mV
what happens when the membrane potential reaches 0mV? (3)
- Na+/Ca2+ channels inactivate/close so ions are not flowing in anymore
- K+ channels open to move K+ out of the cell, againt concentration gradient
- this results in hyperpolarization and the membrane resturns to resting potential
when are artificial pacemakers needed?
when there is an issue with the conduction system of the heart (arrythmia); usually bradychardia
how are artifical pacemakers implanted? what are they? what do they consist of?
implanted surgically; devices that send out small electrical currents to ST heart to contract; consist of a battery and an impulse generator
where are artifical pacemakers usually implanted? what are they connected to?
implanted beneath skin just inferior to the clavicle; connected to 1 or 2 flexible leads that are threaded through the superior vena cava, then pass into the right atrium and right ventricle
whata re activity adjusted pacemakers?
a new upgrade that automatically speeds up the heartbeat during exercise
describe the anatomy that allows for transmission of the cardia impulse through the atria
sinus nodal fibers connect directly with atrial muscle fibers; small bands of atrial fibers also carry the impulse at a more rapid rate