physiology of excitation and conduction system of heart by dr. mudassar ali roomi
TRANSCRIPT
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HEART PHYSIOLOGYRHYTHMICAL EXCITATION OF HEART
ByDr. Mudassar Ali Roomi (M.B;B.S, M.PHIL.)
Assistant Professor Physiology
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CONDUCTION SYSTEM OF HEART
• SA node • Internodal pathways• AV node• AV bundle of His• Right and left bundle
branches• Purkinje fibers
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Conduction System of the Heart• SA node: sinoatrial node. The
pacemaker. – Specialized cardiac muscle cells.– Generate spontaneous action
potentials (autorhythmic tissue). – Action potentials pass to atrial muscle
cells and to the AV node
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Conduction System of the Heart
• AV node: atrioventricular node.– Action potentials conducted more
slowly here than in any other part of system.
• Function: Ensures ventricles receive signal to contract after atria have contracted
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Conduction System of the Heart
• AV bundle: passes through hole in cardiac connective tissue skeleton to reach interventricular septum
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Conduction System of the Heart
• Right and left bundle branches: extend beneath endocardium to apices of right and left ventricles
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Conduction System of the Heart
• Purkinje fibers: – Large diameter cardiac muscle cells with
few myofibrils. – Many gap junctions. – Conduct action potential to ventricular
muscle cells (myocardium) very rapidly
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Rate of impulse generation in heart:
• SA NODE: 70-80/min• AV NODE: 40-60/min• AV BUNDLE, BRANCHES & VENTRICLES: 15-40/min SA NODEnormal PACEMAKER OTHERS ECTOPIC FOCI
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AV Node, and Delay of Impulse Conduction from the Atria to the Ventricles
• Location of the A-V node: in the posterior wall of the right atrium immediately behind the tricuspid valve
• there is a delay of 0.09 second in the A-V node
• A delay of another 0.04 second occurs mainly in A-V bundle
• Thus, the total delay in the A-V nodal and A-V bundle system is about 0.13 second.
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AV Node, and Delay of Impulse Conduction from the Atria to the Ventricles
Cause of the Slow Conduction:• caused mainly by decreased
numbers of gap junctions b/w successive cells in the conducting pathways
Importance of AV nodal delay: • this delay allows time for
the atria to empty their blood into the ventricles before ventricular contraction begins.
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Rapid Transmission in the Ventricular
Purkinje System
• They are very large fibers, even larger than the normal ventricular muscle fibers
• and they transmit action potentials at a velocity of 1.5 to 4.0 m/sec, a velocity about 6 times that in the usual ventricular muscle and 150 times that in some of the A-V nodal fibers.
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Rapid Transmission in the Ventricular
Purkinje SystemCause of rapid transmission:• The rapid transmission of action
potentials by Purkinje fibers is believed to be caused by a very high level of permeability of the gap junctions at the intercalated discs between the successive cells that make up the Purkinje fibers.
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Rapid Transmission in the Ventricular
Purkinje SystemFUNCTION: rapid transmission in Purkinje fibers is responsible for synchronous contraction of ventricular muscle.
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Conduction velocities of heart tissues:
• ATRIAL MUSCLE= 0.3m/sec• INTERNODAL PATHWAYS=
1m/sec• AV NODE: slowest
0.05-0.1m/sec• AV BUNDLE &
BRANCHES/PURKINJE SYSTEM: Maximum velocity= 1.5-4m/sec
• VENTRICULAR MUSCLE= 0.5m/sec
SUMMARY OF SPREAD OF THE CARDIAC IMPULSE THROUGH THE HERAT
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ECTOPIC PACEMAKER OF HEART
• Normal pacemaker of heart?
• Ectopic pacemaker?Causes of ectopic
pacemaker of heart?1. Excessive excitability of
some part of the heart other than SA node
2. Heart blocks