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b) Nodal tissue - RMP & AP

0. I Ca L. I K. mV. -40. -60. Pacemaker potential. i. Voltage gated -. Cardiac ion channels:. ii. Ligand gated -. b) Nodal tissue - RMP & AP. Action potential. I Ca T. 0. mV. -60. 0. mV. Sympathetic stimulation. -60. Vagal stimulation. SYMPATHETIC STIMULATION:.

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b) Nodal tissue - RMP & AP

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  1. 0 ICaL IK mV -40 -60 Pacemaker potential i. Voltage gated - Cardiac ion channels: ii. Ligand gated - b) Nodal tissue- RMP & AP Action potential ICaT

  2. 0 mV -60 0 mV Sympathetic stimulation -60 Vagal stimulation SYMPATHETIC STIMULATION: PARASYMPATHETIC STIMULATION:

  3. 3) CONDUCTIVITY: • SA node: ii. Internodal pathways: iii. AV node: iv. Bundle of HIS: v. Purkinje fibres:

  4. Transtitional cells P - cells i. SA (SINO-ATRIAL) NODE:

  5. SA node

  6. ii. INTERNODAL PATHWAYS: • Anterior internodal tract: • Middle internodal tract: • Posterior internodal tract:

  7. SA node Internodal pathways Anterior Middle Posterior

  8. SA node AV node Internodal pathways Anterior Middle Posterior

  9. HIS bundle iii. AV (ATRIO-VENTRICULAR) NODE: N AN NH

  10. iv. BUNDLE OF HIS: • Left bundle branch: • Right bundle branch:

  11. SA node AV node HIS bundle Internodal pathways Rt. branch Lt. branch Anterior Middle Posterior

  12. SA node AV node HIS bundle v. PURKINJE FIBRES: Internodal pathways Rt. branch Lt. branch Anterior Middle Posterior Purkinje fibres

  13. Conduction speeds of different parts (m/sec) Rate of discharge of impulses (impulses/sec) Time taken for impulse to travel different tissues: 0.03sec 0.13sec 0.03sec 0.03sec SA node AV node Bundle branches Purkinje fibers Ventricular endocardial & epicardial surfaces

  14. STEPS IN SPREAD OF ELECTRICAL ACTIVITY: 1. Atrial activation: 2. Septal activation: 3. Activation of: Ventricular myocardium- anteroseptal portion Ventricular myocardium-major portion 4. Late activation of: Left ventricle-posterobasal portion Pulmonary conus Uppermost portion of septum

  15. SA node AV node 1. Atrial activation:

  16. A-V nodal delay- • Duration – • Cause for the delay – • Significance of the delay – • Effect of drugs- • Regulation of A-V conduction: Vagal stimulation Sympathetic stimulation

  17. AV node 2. Septal activation: SA node

  18. AV node 3 (a) Activation of anteroseptal region of ventricular myocardium SA node

  19. AV node 3 (b). Activation of major portion of ventricular myocardium SA node

  20. AV node 4. Late activation of : Posterobasal portion of left ventricle Pulmonary conus & septal uppermost portion SA node

  21. SA AV

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