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Natural Excitation of The Heart. Guyton 2011 pages 115-120 Berne 2008 pages 302-309. Natural Excitation of The Heart. Excitatory and Conductive System of the Heart. To cause rhythmical contraction of the heart muscle. Conducting impulses rapidly through the heart.
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Natural Excitation of The Heart Guyton 2011 pages 115-120 Berne 2008 pages 302-309
Natural Excitation of The Heart Excitatory and Conductive System of the Heart • To cause rhythmical contraction of the heart muscle • Conducting impulses rapidly through the heart. Is susceptible to damage by heart disease, especially by ischemia of the heart tissues
Natural Excitation of The Heart SA Node = normal pacemaker • Pacemaker Cells (Small, round cells having few organelles and myofibril) Have two cell type • Conductor Cells (Slender, elongated cells) RMP is much less negative Lack the iKl, then the ratio of gK to gNa during phase 4 is much less
Natural Excitation of The Heart SA Node = normal pacemaker Change the Heart Rate Change the slope of Phase 4 Change threshold Potential Change the RMP Normal rhythm = 70 – 80 beats/min
Natural Excitation of The Heart SA Node = normal pacemaker Ca K Na , Ca Depolarization and repolarization is slower in slow responses
Natural Excitation of The Heart Internodal Pathways
Natural Excitation of The Heart AV Node Regions • AN region • (transitional zone) • N region • (mid portion) • NH region • Cause of the Slow Conduction • Mainly by diminished numbers of gap junctions Normal rhythm = 40 – 60 beats/min One-way conduction
Natural Excitation of The Heart Purkinje fibers • Cause of the Rapid Conduction • mainly by increased numbers of gap junctions Normal rhythm = 15– 40beats/min
Natural Excitation of The Heart Summary of the Spread of the Cardiac Impulse Through the Heart (second)
Natural Excitation of The Heart Impulse Velocity in Different Part of the Heart
Natural Excitation of The Heart Points Stokes - Adams Syndrome Ectopic Pacemaker Overrdrive Suppression
Natural Excitation of The Heart Effect of ANS of cardiac rhythmicity
Natural Excitation of The Heart Effect of ANS of cardiac rhythmicity • Parasympathetic division • Sympathetic division Mainly innervates nodes Innervates all areas • Acetylcholine • Norepinephrine • Increased permeability to K • Increased permeability to Na and Ca • Decreases Heart Rate • Increases the overall activity of the heart
Natural Excitation of The Heart Reentry Phenomenon
Natural Excitation of The Heart Reentry Mechanisms Pathway around the circle is too long Like cardiac dilation Velocity of conduction becomes decreased Blockage of the Purkinje system, Ischemia of the muscle, High blood potassium levels The refractory period of the muscle shortened in response to various drugs, such as epinephrine or after repetitive electrical stimulation
Natural Excitation of The Heart Global Reentry