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The document summarizes key aspects of cardiac electrical function and the cardiac action potential. It describes two main types of action potentials that occur in the heart:
1) The fast response action potential found in normal atrial and ventricular cells, which has five phases - a rapid upstroke, early repolarization, plateau, final repolarization, and resting state.
2) The slow response action potential found in the sinoatrial and atrioventricular nodes, which lacks the early repolarization phase.
It then provides details on the molecular mechanisms underlying each phase of the fast response action potential, including the role of sodium, potassium, and calcium ion channels in generating and regulating the upstroke, repolarization phases,
Descrizione originale:
Physiology Notes Berne and Levy chapter 16 respiratory system useful for med students
The document summarizes key aspects of cardiac electrical function and the cardiac action potential. It describes two main types of action potentials that occur in the heart:
1) The fast response action potential found in normal atrial and ventricular cells, which has five phases - a rapid upstroke, early repolarization, plateau, final repolarization, and resting state.
2) The slow response action potential found in the sinoatrial and atrioventricular nodes, which lacks the early repolarization phase.
It then provides details on the molecular mechanisms underlying each phase of the fast response action potential, including the role of sodium, potassium, and calcium ion channels in generating and regulating the upstroke, repolarization phases,
The document summarizes key aspects of cardiac electrical function and the cardiac action potential. It describes two main types of action potentials that occur in the heart:
1) The fast response action potential found in normal atrial and ventricular cells, which has five phases - a rapid upstroke, early repolarization, plateau, final repolarization, and resting state.
2) The slow response action potential found in the sinoatrial and atrioventricular nodes, which lacks the early repolarization phase.
It then provides details on the molecular mechanisms underlying each phase of the fast response action potential, including the role of sodium, potassium, and calcium ion channels in generating and regulating the upstroke, repolarization phases,
Cells of the heart are excitable and generate action potential that initiate contraction and determine heart rate. The Cardiac Action Potential The heart consists of two kinds of muscle cells o Contractile cells o Conducting cells Two main types of action potentials occur in the heart o The fast response Occurs in normal atrial and ventricular myocytes and in the specialized conducting fibers (Purkinje fibers of the heart) Divided into five phases: 1. Rapid upstroke of action potential 2. Early repolarization 3. Plateau that persists 0.1-0.2 sec 4. Membrane then repolarizes 5. The resting state of polarization Phase 3 or final repolarization develops more slowly than depolarization or phase 0 Resting membrane potential (phase 4) of fastresponse cells is more negative Upstroke, amplitude, and overshoot are greater in fast-response cells o The slow response Occurs in SA node (natural pacemaker of heart and AV node (specialized tissue that conducts the cardiac impulse from the atria to the ventricles) No phase 1 Action potential is propagated more slowly and conduction is more likely to be blocked Rapid depolarization precedes the development of force, and completion of repolarization occurs at peak force Relaxation of the muscle takes place mainly during phase 4 of action potential The various phases of the cardiac action potential are associated with changes in cell membrane permeability, mainly to Na+, K+, and Ca++ Permeability is changed by the opening and closing of ion channels that are specific for individual ions. These changes of membrane permeability alter the rate of movement of these ions across the membrane and change the membrane voltage.
Resting Membrane Voltage
Resting cell membrane has relatively high permeability to K+; permeability to Na+ and Ca++ is much less K+ diffuses from inside to outside of cell Potassium channels take potassium out. There are several types of K+ channels in cardiac cell membranes; soe are controlled by a chemical signal and others are regulated the membrane voltage o Inwardly rectifying K+ Voltage-regulated channel open at rest when K+ conductance is high and are closed by depolarization K+ passes through during phase 4 o In a resting cardiac cell conductance to K+ is 100 times greater than conductance to Na+ o Alterations in extracellular [K+] can change membrane voltage Hypokalemia= hyperpolarization Hyperkalemia = depolarization Fast-Response Action Potentials Genesis of the Upstroke (Phase 0)
Any stimulus that abruptly depolarizes membrane voltage (Vm) to
threshold elicits an action potential Upstroke is a phase of rapid depolarization that commences the action potential The upstroke is caused by a transient increase in Na+ conductance produced by depolarization-induced opening of activation gates on the Na+ channels o Na+ enters the myocyte through specific fast voltageactivated Na+ that exist in the membrane. Na+ channels open briefly and the close (slower than they open) o Na+ channels activate (open) very rapidly, causing an abrupt increase Na+ conductance, which drives the membrane potential toward Na+ equilibrium. o The membrane does not quite reach Na+ equilibrium because the inactivation gates close on Na+ channels close in response to depolarization (but slower than the when the gates open) In graph, action potential amplitude is dependent on [Na+]o o When [Na+]o is decreased, amplitude of action potential decreases
o When [Na+]o is reduced from its normal value the cell is no
longer excitable Na+ channels remain inactivated until membrane begins to repolarize o With repolarization, the channel transitions to the closed state, form which it can then be reopend by another depolarization for membrane voltage to threshold Effective refractory period or absolute refractory period: When Na+ channels are in the inactivated state, they cannot be reopen, and another action potential cannot be generated o Prevents tetanic contraction of cardiac muscle Relative refractory period: As cell repolarizes (phase 3), the inactivated channels begin to transition to the closed state. Another action potential can be generated during this period, but it requires a larger than normal depolarization Only when membrane voltage has returned to the resting level (phase 4) are all the Na+ channels closed and thus able to be reactivated by normal depolarization
Genesis of Early Repolarization (Phase 1)
Repolarization is brief becasuse of activation of a transient
outward current carried mainly by K+ Activation of K+ channels during phase 1 causes a brief efflux of K+ from the cell because the cell interior is positively charged and [K+] greatly exceeds [K+]0. This causes the cell to be briefly and partially repolarized Size of phase 1 notch between the end of upstroke and beginning of plateau varies among cardiac cells o Prominent in myocytes in the epicardial and midmyocardial regions of the left ventricular wall and in ventricular Purkinje fibers o Notch is negligible in myocytes from the endocardial region of the left ventricle
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