marieb chapter 18 part b: the heart
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Marieb Chapter 18 Part B: The Heart. Cardiac Muscle Contraction. Depolarization of the heart is rhythmic and spontaneous (autorhythmic) About 1% of cardiac cells have automaticity— (are self-excitable) Gap junctions ensure the heart contracts as a unit - PowerPoint PPT PresentationTRANSCRIPT
Copyright © 2010 Pearson Education, Inc.
Marieb Chapter 18 Part B: The Heart
Copyright © 2010 Pearson Education, Inc.
Cardiac Muscle Contraction• Depolarization of the heart is rhythmic and
spontaneous (autorhythmic)
• About 1% of cardiac cells have automaticity— (are self-excitable)
• Gap junctions ensure the heart contracts as a unit
• Long absolute refractory period (250 ms); muscle fibers can’t go into sustained contraction with no relaxation
Copyright © 2010 Pearson Education, Inc. Figure 18.12
Absoluterefractoryperiod
Tensiondevelopment(contraction)
Plateau
Actionpotential
Time (ms)
1
2
3
Depolarization isdue to Na+ influx throughfast voltage-gated Na+
channels. A positivefeedback cycle rapidlyopens many Na+
channels, reversing themembrane potential.Channel inactivation endsthis phase. Plateau phase isdue to Ca2+ influx throughslow Ca2+ channels. Thiskeeps the cell depolarizedbecause few K+ channelsare open.
Repolarization is due to Ca2+ channels inactivating and K+
channels opening. This allows K+ efflux, which brings the membranepotential back to itsresting voltage.
1
2
3
Tens
ion
(g)
Mem
bran
e po
tent
ial (
mV)
Action Potential in Myocardium
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Heart Physiology: Electrical Events
• Intrinsic cardiac conduction system
• A network of non-contractile (autorhythmic) cells that initiate and distribute impulses to coordinate the depolarization and contraction of the heart
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Autorhythmic Cells
• Have unstable resting potentials (pacemaker potentials) due to open slow Na+ channels
• At threshold, Ca2+ channels open
• Explosive Ca2+ influx produces the rising phase of the action potential
• Repolarization results from closure of Ca2+ channels and opening of voltage-gated K+ channels
Copyright © 2010 Pearson Education, Inc. Figure 18.13
1 2 3 Pacemaker potentialThis slow depolarization is due to both opening of Na+
channels and closing of K+
channels. Notice that the membrane potential is never a flat line.
Depolarization The action potential begins when the pacemaker potential reaches threshold. Depolarization is due to Ca2+
influx through Ca2+ channels.
Repolarization is due to Ca2+ channels inactivating and K+ channels opening. This allows K+ efflux, which brings the membrane potential back to its most negative voltage.
Actionpotential
Threshold
Pacemakerpotential
1 1
2 2
3
Action Potential in Conduction System Cells
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Heart Physiology: Sequence of Excitation
1. Sinoatrial (SA) node (pacemaker)
• Generates impulses about 75 times/minute (sinus rhythm)
• Depolarizes faster than any other part of the myocardium
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Heart Physiology: Sequence of Excitation
2. Atrioventricular (AV) node
• Delays impulses approximately 0.1 second; gives the atria
• Depolarizes at 50 times per minute in absence of SA node input
• Is this fast enough to stay alive?
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Heart Physiology: Sequence of Excitation
3. Atrioventricular (AV) bundle (bundle of His)
• Only electrical connection between the atria and ventricles
• Fibrous skeleton (fibrous trigone)
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Heart Physiology: Sequence of Excitation
4. Right and left bundle branches
• Two pathways in the interventricular septum that carry the impulses toward the apex of the heart
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Heart Physiology: Sequence of Excitation
5. Purkinje fibers
• Complete the pathway into the apex and ventricular walls
• AV bundle and Purkinje fibers depolarize only 30 times per minute in absence of AV node input
• Is this fast enough to keep you alive?
Copyright © 2010 Pearson Education, Inc. Figure 18.14a
(a) Anatomy of the intrinsic conduction system showing the sequence of electrical excitation
Internodal pathway
Superior vena cavaRight atrium
Left atrium
Purkinje fibers
Inter-ventricularseptum
1 The sinoatrial (SA) node (pacemaker)generates impulses.
2 The impulsespause (0.1 s) at theatrioventricular(AV) node. The atrioventricular(AV) bundleconnects the atriato the ventricles.4 The bundle branches conduct the impulses through the interventricular septum.
3
The Purkinje fibersdepolarize the contractilecells of both ventricles.
5
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Homeostatic Imbalances
• Defects in the intrinsic conduction system may result in
1. Arrhythmias/dysrhythmias: irregular heart rhythms
2. Uncoordinated atrial and ventricular contractions
3. Fibrillation: rapid, irregular contractions; useless for pumping blood
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Homeostatic Imbalances• Defective SA node may result in• Ectopic focus: abnormal pacemaker
somewhere else takes over
• If the AV node takes over, there will be a junctional rhythm (40–60 bpm)
• Defective AV node may result in• Partial or total heart block
• Few or no impulses from SA node reach the ventricles
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Extrinsic Innervation of the Heart and Blood Vessels
• Heartbeat is modified by the ANS
• Cardiac centers are located in the medulla oblongata
• Cardioacceleratory center (CAC) innervates SA and AV nodes, heart muscle, and coronary arteries through sympathetic neurons
• Cardioinhibitory center (CIC) inhibits SA and AV nodes through parasympathetic fibers in the vagus nerves
• A vasomotor center (VMC;) is also in the medulla; it sends sympathetic fibers to blood vessels
Copyright © 2010 Pearson Education, Inc. Figure 18.15
Thoracic spinal cord
The vagus nerve (parasympathetic) decreases heart rate.
Cardioinhibitory center
Cardio-acceleratorycenter
Sympathetic cardiacnerves increase heart rateand force of contraction.
Medulla oblongata
Sympathetic trunk ganglion
Dorsal motor nucleus of vagus
Sympathetic trunk
AV nodeSA node
Parasympathetic fibersSympathetic fibersInterneurons
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ANS Effects on HR
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Electrocardiography• Electrocardiogram (ECG or EKG): a composite of
all the action potentials generated by all cardiac cells at a given time
• THIS IS NOT AN OSCILLOSCOPE TRACING!!!!!
• Three waves
1. P wave: depolarization of SA node
2. QRS complex: ventricular depolarization
3. T wave: ventricular repolarization
See the next two figures…
Copyright © 2010 Pearson Education, Inc. Figure 18.16
Sinoatrialnode
Atrioventricularnode
Atrialdepolarization
QRS complex
Ventriculardepolarization
Ventricularrepolarization
P-QInterval
S-TSegment
Q-TInterval
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ECG
Copyright © 2010 Pearson Education, Inc. Figure 18.17
Atrial depolarization, initiatedby the SA node, causes theP wave.
P
R
T
QS
SA node
AV node
With atrial depolarizationcomplete, the impulse isdelayed at the AV node.
Ventricular depolarizationbegins at apex, causing theQRS complex. Atrialrepolarization occurs.
P
R
T
QS
P
R
T
QS
Ventricular depolarizationis complete.
Ventricular repolarizationbegins at apex, causing theT wave.
Ventricular repolarizationis complete.
P
R
T
QS
P
R
T
QS
P
R
T
QS
Depolarization Repolarization
1
2
3
4
5
6
Copyright © 2010 Pearson Education, Inc. Figure 18.17, step 1
Atrial depolarization, initiated bythe SA node, causes the P wave.
P
R
T
QS
SA node DepolarizationRepolarization
1
Copyright © 2010 Pearson Education, Inc. Figure 18.17, step 2
Atrial depolarization, initiated bythe SA node, causes the P wave.
P
R
T
QS
SA node
AV node
With atrial depolarization complete,the impulse is delayed at the AV node.
P
R
T
QS
DepolarizationRepolarization
1
2
Copyright © 2010 Pearson Education, Inc. Figure 18.17, step 3
Atrial depolarization, initiated bythe SA node, causes the P wave.
P
R
T
QS
SA node
AV node
With atrial depolarization complete,the impulse is delayed at the AV node.
Ventricular depolarization beginsat apex, causing the QRS complex.Atrial repolarization occurs.
P
R
T
QS
P
R
T
QS
DepolarizationRepolarization
1
2
3
Copyright © 2010 Pearson Education, Inc. Figure 18.17, step 4
Ventricular depolarization iscomplete.
P
R
T
QS
DepolarizationRepolarization
4
Copyright © 2010 Pearson Education, Inc. Figure 18.17, step 5
Ventricular depolarization iscomplete.
Ventricular repolarization beginsat apex, causing the T wave.
P
R
T
QS
P
R
T
QS
DepolarizationRepolarization
4
5
Copyright © 2010 Pearson Education, Inc. Figure 18.17, step 6
Ventricular depolarization iscomplete.
Ventricular repolarization beginsat apex, causing the T wave.
Ventricular repolarization iscomplete.
P
R
T
QS
P
R
T
QS
P
R
T
QS
DepolarizationRepolarization
4
5
6
Copyright © 2010 Pearson Education, Inc. Figure 18.17
Atrial depolarization, initiatedby the SA node, causes theP wave.
P
R
T
QS
SA node
AV node
With atrial depolarizationcomplete, the impulse isdelayed at the AV node.
Ventricular depolarizationbegins at apex, causing theQRS complex. Atrialrepolarization occurs.
P
R
T
QS
P
R
T
QS
Ventricular depolarizationis complete.
Ventricular repolarizationbegins at apex, causing theT wave.
Ventricular repolarizationis complete.
P
R
T
QS
P
R
T
QS
P
R
T
QS
Depolarization Repolarization
1
2
3
4
5
6
Copyright © 2010 Pearson Education, Inc. Figure 18.18
(a) Normal sinus rhythm.
(c) Second-degree heart block. Some P waves are not conducted through the AV node; hence more P than QRS waves are seen. In this tracing, the ratio of P waves to QRS waves is mostly 2:1.
(d) Ventricular fibrillation. These chaotic, grossly irregular ECG deflections are seen in acute heart attack and electrical shock.
(b) Junctional rhythm. The SA node is nonfunctional, P waves are absent, and heart is paced by the AV node at 40 - 60 beats/min.
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Pacemakers
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Heart Sounds
• Two sounds (lub-dup) associated with closing of heart valves
• First sound occurs as AV valves close and signifies beginning of systole
• Second sound occurs when SL valves close at the beginning of ventricular diastole
• Heart murmurs: abnormal heart sounds most often occur because of valve problems
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Mechanical Events: The Cardiac Cycle• Cardiac cycle: all events associated with
blood flow through the heart during one complete heartbeat
• Systole—contraction
• Diastole—relaxation
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Phases of the Cardiac Cycle1. Ventricular filling—takes place in mid-to-late
diastole
• AV valves are open; SL valves are closed
• 80% of blood passively flows into ventricles (Drips!)
• Atrial systole occurs, delivering the remaining 20%
• End diastolic volume (EDV): volume of blood in each ventricle at the end of ventricular diastole
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Phases of the Cardiac Cycle2. Ventricular systole• Atria relax and ventricles begin to contract
• Rising ventricular pressure results in closing of AV valves
• Isovolumetric contraction phase (all valves are closed)
• In ejection phase, ventricular pressure exceeds pressure in the large arteries, forcing the SL valves open
• End systolic volume (ESV): volume of blood remaining in each ventricle
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Phases of the Cardiac Cycle3. Isovolumetric relaxation occurs in early
diastole
• Ventricles relax
• Backflow of blood in aorta and pulmonary trunk closes SL valves and recoil causes the dicrotic notch (a brief rise in aortic pressure)
Copyright © 2010 Pearson Education, Inc. Figure 18.20
1 2a 2b 3
Atrioventricular valvesAortic and pulmonary valves
Open OpenClosed
Closed ClosedOpenPhase
ESV
Left atriumRight atriumLeft ventricleRight ventricle
Ventricularfilling
Atrialcontraction
Ventricular filling(mid-to-late diastole)
Ventricular systole(atria in diastole)
Isovolumetriccontraction phase
Ventricularejection phase
Early diastole
Isovolumetricrelaxation
Ventricularfilling
11 2a 2b 3
Electrocardiogram
Left heart
P
1st 2nd
QRSP
Heart sounds
Atrial systole
Dicrotic notch
Left ventricle
Left atrium
EDV
SV
Aorta
T
Vent
ricul
arvo
lum
e (m
l)Pr
essu
re (m
m H
g)
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Cardiac Output (CO)
• Volume of blood pumped by each ventricle in one minute
• CO = heart rate (HR) x stroke volume (SV)
• HR = number of beats per minute
• SV = volume of blood pumped out by a ventricle with each beat
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Cardiac Output (CO)• At rest• CO (ml/min) = HR (75 beats/min) SV (70
ml/beat)
= 5.25 L/min
• Maximal CO is 4–5 times resting CO in nonathletic people
• Maximal CO may reach 35 L/min in trained athletes
• What’s the resting CO in athletes?
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Cardiac Output (CO)
•Why do athletes have a low HR? (bradycardia)
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Regulation of Stroke Volume
• SV = EDV – ESV
• Three main factors affect SV
• Preload
• Contractility
• Afterload
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Regulation of Stroke Volume
• Preload: degree of stretch of cardiac muscle cells before they contract (Frank-Starling law of the heart)
• Cardiac muscle exhibits a length-tension relationship
• At rest, cardiac muscle cells are shorter than optimal length
• Slow heartbeat and exercise increase venous return
• Increased venous return ( ) stretches the ventricles and increases contraction force (SNAP!)
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Regulation of Stroke Volume• Contractility: contractile strength at a given muscle
length, independent of muscle stretch and EDV
• Dependent on the activity of the sympathetic NS
• Positive inotropic agents increase contractility• Increased Ca2+ influx due to sympathetic stimulation
• Hormones (thyroxine, glucagon, and epinephrine)
• Negative inotropic agents decrease contractility• Acidosis
• Increased extracellular K+
• Calcium channel blockers
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Regulation of Stroke Volume
• Afterload: pressure that must be overcome for ventricles to eject blood
• Hypertension increases afterload, resulting in increased ESV and reduced SV
• What else could increase afterload?
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Autonomic Nervous System Regulation
• Sympathetic nervous system is activated by emotional or physical stressors
• Norepinephrine causes the pacemaker to fire more rapidly (and at the same time increases contractility)
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Autonomic Nervous System Regulation
• The parasympathetic nervous system opposes sympathetic effects
• Acetylcholine hyperpolarizes pacemaker cells by opening K+ channels
• The heart at rest exhibits parasympathetic tone; it is slowed down to 70-80 bpm from 100 bpm.
Copyright © 2010 Pearson Education, Inc. Figure 18.22
Venousreturn Contractility Sympathetic
activityParasympathetic
activity
EDV(preload)
Strokevolume
Heartrate
Cardiacoutput
ESV
Exercise (byskeletal muscle andrespiratory pumps;
see Chapter 19)
Heart rate(allows more
time forventricular
filling)
Bloodborneepinephrine,
thyroxine,excess Ca2+
Exercise,fright, anxiety
Initial stimulus
ResultPhysiological response
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Chemical Regulation of Heart Rate
1. Hormones
• Epinephrine from adrenal medulla enhances heart rate and contractility
• Thyroxine increases heart rate and enhances the effects of norepinephrine and epinephrine
2. Intra- and extracellular ion concentrations (e.g., Ca2+ and K+) must be maintained for normal heart function
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Other Factors that Influence Heart Rate
• Age
• Gender
• Exercise
• Body temperature
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Homeostatic Imbalances
• Tachycardia: abnormally fast heart rate (>100 bpm)
• If persistent, may lead to fibrillation
• Bradycardia: heart rate < 60 bpm
• May result in grossly inadequate blood circulation
• May be a desirable result of endurance training
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Congestive Heart Failure (CHF)
• Progressive condition where the CO is so low that blood circulation is inadequate to meet tissue needs
• Some possible causes of this condition:
• Coronary atherosclerosis
• Persistent high blood pressure
• Multiple myocardial infarcts