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General Properties of Cardiac Muscle. Fig Heart. Fig 10-1. Fig Microscopic Structure of Cardiac Muscle. Fig 9-2. Properties of myocardial cells. Automaticity (Chronotropic property) Conductivity (Dromotropic property) Contractivity (Inotropic property) Excitability (Bathmotropic property).
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Fig Heart • Fig 10-1
Properties of myocardial cells • Automaticity (Chronotropic property) • Conductivity (Dromotropic property) • Contractivity (Inotropic property) • Excitability (Bathmotropic property)
Fig automaticity • fig 10-2
Automaticity (Chronotropic property) • Pacemaker cell • SA node, AV node and Purkinje fiber • Slow diastolic depolarization • Follower cell • bundle of His, ventricular muscle, et al. • Ion channels • Fast Na+ channel • Slow Ca2+-Na+ channel • K+ channel • Resting membrane potential (RMP) • Maximal diastolic potential (MDP) • Threshold potential (TP)
Fig Stannius ligature • page 5
Regulation of Automaticity • Maximal diastolic potential • Decreased by acetylcohline • Rate of diastolic depolarization • Decreased by acetylcholine • Increased by norepinephrine • Threshold potential
Fig regulation of automaticity • handbook 167
Conductivity(Dromotropic property) • Sinoatrial (SA) node • Internodal tract • Atrioventricular (AV) node • Bundle of His (AV bundle) • Bundle branches (left and right) • Purkinje fiber • Ventricular muscle
Sinoatrial (SA) node • Junction of superior vena cava and right atrium • 8 x 8 x 2 mm3 • Innervations of sympathetic nerve and parasympathetic nerve
Atrioventricular (AV) node • Interatrial septum, near coronary sinus • 22 x 10 x 3 mm3 • AV conduction delay • AN (upper; atrionodal zone) • N (middle zone of nodal cell) • NH (Lower; nodal-His zone)
Table conduction speed • table Ganong 28-1
AV conduction delay • Allows time for the atria to emty their contents into ventricle • Smaller fiber diameter • Less intercalated disc • Poor differentiation • Regulated by sympathetic and parasympathetic nerves (negative and positive dromotropic effect)
Intercalated Disc • Cell membrane seperate but also connect cardiac muscle cells • Gap junction • Low resistance (5 ohm cm2 vs 2000 ohm cm2) • Functional syncytium
Fig functional syncytium • Fig 11
Contractility (Inotropic property) • Ventricle, Ventricular muscle • Correlated to intracellular concentration of Ca2+ • Sympathetic stimulation • Inotropic drugs
Fig inotropic property • Gan 29-8
Excitability (Bathmotropic property) • Full recovery time (FRT) • Absolute refractory period (ARP) • Inactivation of fast Na+ channels • Relative refractory period (RRP) • Part of fast Na+ channels are recovered to resting stage • Supernormal period (SNP) • Most of fast Na+ channels are recovered • Higher membrane potential
Fig excitability • Page 12+13
Fig extrasystolic contraction • page 14
Extrasystolic contraction • Premature contraction • Compensatory period • Extopic focus • Ischemia • Stimulants (Nicotine, Caffeine) • Lack of sleep • Stress, anxiety
Myocardial cells and autonomic nervous system Sympa. Para. Chronotropism (frequency) + - Dromotropism (conduction) + - Inotropism (contractility) + Bathmotropism (excitability) + -