Physiology of the Heart

Histology of the Cardiac Muscle

Cardiac Muscle Cells

o Are branched, elongated cells with a centrally located nucleus o Actin and myosin are organized to form sarcomeres (striated) o T tubules and sarcoplasmic reticulum are not as organized as in skeletal muscle o Normal contraction depends on extracellular Ca2+ o Rely on aerobic respiration for ATP production They have many mitochondria and are well supplied with blood vessels o Joined by intercalated disks Specialized gap junctions that allow action potentials to move from one cell to the next, thus cardiac muscle cells function as a unit

Histology of the Heart

Fig. 17.11

Cardiac Conduction System

Sinus node (SA) AV node Bundle of His Purkinji fibers

Conduction System

(Bundle of His)

SA node vs. AV node

SA node is located in the

right atria, medial to the opening of SVC and has the highest rate of depolarization It starts each heart beat and sets the pace for the whole heart. It is called the pacemaker. From SA node, the impulse spreads through the atria to AV node, and then the atria contract.

AV node is located at the

lower portion of the right atrium. The impulse is delayed briefly at the AV node to give the atria time to finish contracting. Then impulse stimulate the ventricle to contract.

Impulse Conduction
Step 1 SA node activity and atrial activation begins Time= 0

Step 2 Stimulus spreads across the atrial surfaces and reaches the AV node Time= 50 msec

Impulse Conduction

Step 3 There is a 100-msec delay at the AV node. Atrial contraction begins Time= 150 msec

Impulse Conduction
Step 4
The impulse travels along the interventricular septum within the AV bundle (Bundle of His) and the bundle branches to the Purkinje fibers to the papillary muscles of the right ventricle

Time= 175 msec

Impulse Conduction
Step 5 The impulse is distributed by Purkinje fibers and relayed throughout the ventricular myocardium. Atrial contraction is completed, and ventricular contraction begins

Time= 225 msec

Electrical (Conductive) System

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Pacemaker
A pacemaker is a small,
battery-operated electronic device which is inserted under the skin to help the heart beat regularly and at an appropriate rate. The pacemaker has leads that travel through a large vein to the heart, where the wires are anchored. The leads send the electrical impulses to the heart to tell it to beat.

Electrical Activity of the Heart

Autorhythmicity of Cardiac Muscle

o Some cardiac muscle cells are autorhythmic because of the spontaneous development of a prepotential
Prepotential: slowly developing local action potential

o The sinoatrial (SA) node is the pacemaker of the heart

Collection of cardiac muscle cells capable of spontaneously generating action potentials

o The prepotential results from the movement of Na+ and Ca2+ into the SA node cells o The duration of the prepotential determines heart rate

Electrical Activity of the Heart

Electrocardiogram (ECG)
Based on the magnitude of the ECG
oRecords only the electrical activities of the heart

waves and the time between waves, ECGs can be used to diagnose heart abnormalities

EKG

P wave- shows how QRS complexT wave- shows how

ventricle relax shows how ventricles contract

atria contract

EKG or ECG

Cardiac Cycle

Cardiac Cycle: Each complete Systole: The contraction of the heart Diastole: The relaxation of the heart
muscle. muscle, especially the ventricle heartbeat consisting of systole and diastole of both atria plus systole and diastole of both ventricles.

Cardiac Cycle

Repetitive contraction and relaxation of the Overview of Systole and Diastole

Atrial systole is contraction of the atria

heart chambers

Systole is contraction of the ventricles

Atrial diastole is relaxation of the atria Diastole is relaxation of the ventricles

Cardiac Cycle

 Abnormal heart

Location of the Heart Valves in the Thorax

sounds called murmurs are usually a result of faulty valves. Incompetent valves increase the workload of the heart Ex: an incompetent bicuspid valve causes pulmonary edema

Terminology
Mean arterial pressure (MAP) is the average blood pressure in
the aorta o Adequate blood pressure is necessary to ensure delivery of blood to the tissues o MAP= CO x PR Stroke volume (SV) is the volume of blood pumped during each heart beat. Cardiac output (CO) is the amount of blood pumped out by each ventricle in 1minute. o CO= HR x SV (5 L/min) Peripheral resistance is the total resistance against which blood must be pumped. o Changes in CO and PR can alter MAP

Terminology
Heart rate is the number of times the heart beats (contracts)
per minute.

Venous return is the amount of blood returning to the heart for

Cardiac reserve is the difference between maximum cardiac
output and the cardiac output when person is at rest.
o The greater a persons cardiac reserve, the greater his or her capacity for exercises.

o At rest 72 beats/min

the peripheral circulation.

Regulation of the Heart

Intrinsic Regulation
o Modifies stroke volume (SV) through the functional characteristics of cardiac muscle cells o According to Starlings law of the heart, a critical factor controlling the SV is how much the cardiac cells are stretched just before they contract. The important factor stretching the heart muscle is the venous return.
Anything that will increase the venous return will increase the SV. (ex. a slow heart beat allows more time for the ventricles to fill)

Regulation of the Heart

Extrinsic Regulation
oModifies heart rate and stroke volume through nervous and hormonal mechanisms
The cardioregulatory center in the medulla oblongata regulates the parasympathetic and sympathetic nervous control of the heart Epinephrine and norepinephrine are released into the blood from the adrenal medulla as a result of sympathetic stimulation. They increase the rate and force of heart contraction

Regulation of the Heart

Parasympathetic stimulation is supplied by the vagus nerve
o Decreases heart rate. o Giving more time heart to rest during noncrisis time o Postganglionic neurons secrete acetylcholine, which increases membrane permeability to K+. Sympathetic stimulation is supplied by the cardiac nerves o Increases heart rate and the force of contraction (stroke volume) o Postganglionic neurons secrete norepinephrine, which increases membrane permeability to Ca2+. o More oxygen and glucose are made available to the cells during stress.

Regulation of the Heart

Various hormones and ions have a dramatic effect on heart
Epinephrine and thyroxin mimic the effect of the sympathetic Age, gender, and exercise influence the heart rate.
o Resting heart rate is fastest in the fetus (140-160 bpm) o Average heart rate is faster in females (72-80 bpm) than in males (64-72 bpm).

activity

nerves and increase the heart rate.

Regulation of the Heart

Effect of Ions and Body Temperature

o A deficit of potassium ion K+ in the blood, causes the heart to beat feebly, and abnormal heart rhythms appear. o Reduced level of Ca2+ in the blood depressed the heart, whereas hypercalcemia causes such as prolonged contractions that the heart may stop entirely.

o Heart rate increases when body temperature increases, and it decreases when body temperature decreases

The Heart and Homeostasis

Effect of pH, Carbon
Dioxide, and Oxygen
o Carotid body and aortic chemoreceptor receptors monitor blood oxygen levels o Chemoreceptors monitor blood pH and carbon dioxide levels o Chemoreceptors are not important for the normal regulation of the heart, but are important in the regulation of respiration and blood vessel constriction

The Heart and Homeostasis

Effect of Blood Pressure

o Baroreceptors monitor blood pressure and the cardioregulatory center modifies heart rate and stroke volume o In response to a decrease in blood pressure, the baroreceptor reflexes increase heart rate and stroke volume o When blood pressure increases, the baroreceptor reflexes decrease heart rate and stroke volume

Effects of Aging on the Heart

Aging results in gradual changes in the function of the heart,
which are minor under resting conditions but are more significant during exercise Some age-related changes to the heart are the following o Decreased cardiac output and heart rate o Increased cardiac arrhythmias o Hypertrophy of the left ventricle o Development of stenoses or incompetent valves o Development of coronary artery disease and heart failure Exercise improves the functional capacity of the heart at all ages.