Chapter 18 The heart (Part 2)

Microscopic Anatomy of Cardiac Muscle

Heart cells
Electrocardiography (ECG)
Stroke volume and cardiac output

Microscopic Anatomy of Cardiac Muscle:

Characteristics

Intercalateddiscs(unique)
Branches
Striation
Uninucleate

Microscopic Anatomy of Cardiac Muscle:

Characteristics

Intercalateddiscs(unique)
Branches
Striation
Uninucleate

Muscle
Microscopic Anatomy of Cardiac Muscle:
Intercalated discs

Gap
junctions

Desmosomes

Microscopic Anatomy of Cardiac Muscle:

Intercalated discs
Junctions between cells
Gap junctions: allow ions to pass from cell to
cell, which makes heart to be functional
syncytium

Microscopic Anatomy of Cardiac Muscle:

Intercalated discs
Junctions between cells
Gap junctions: allow ions to pass from cell to
cell, which makes heart to be functional
syncytium
Desmosomes: prevent cells from separating
during contraction

Microscopic Anatomy of Cardiac Muscle:

Characteristics

Intercalateddiscs(unique)
Branches
Striation
Uninucleate

Microscopic Anatomy of Cardiac Muscle:

Striation

A band

Chapter 18 The heart (Part 2)

Microscopic Anatomy of Cardiac Muscle

Heart cells
Electrocardiography (ECG)
Stroke volume and cardiac output

Heart cells

Heart cells
Pace maker cells (1%)
Cardiac muscle cells (99%)

Heart cells
Pace maker cells (1%)
Cardiac muscle cells (99%)

Pace maker cells

Sinoatrial (SA)
node

Pace maker cells: SA node

1% of cells: modified cardiomyocytes
Only exist in right atrium of heart
Automaticity (sinus rythm):
Do not need nervous system stimulation
Can depolarize entire heart

Intrinsic cardiac conduction system

Intrinsic cardiac conduction system

1,SAnodeinrightatrium
2,AVnode
3,AVbundle
4,BundleofHis
5,Purkinjefibers
Modifiedcardiomyocytes
Arrhythmia

Intrinsic cardiac conduction system

Chapter 18 The heart (Part 2)

Microscopic Anatomy of Cardiac Muscle

Heart cells
Electrocardiography (ECG)
Stroke volume and cardiac output

ECG

Electrocardiography (ECG)

Electrocardiography (ECG)
QRS
complex

ECG waves
P wave Atrial depolarization
QRS complex - ventricular depolarization
and atrial repolarization
T wave - ventricular repolarization

ECG intervals and segments

P-R interval
S-T segment
Q-T interval

ECG intervals and segments

P-R interval
S-T segment
Q-T interval

ECG intervals: P-R interval

Beginning of atrial excitation to beginning
of ventricular excitation

P-R

ECG intervals and segments

P-R interval
S-T segment
Q-T interval

ECG intervals: S-T segment

Entire ventricular myocardium
depolarized

S-T

ECG intervals and segments

P-R interval
S-T segment
Q-T interval

ECG intervals: Q-T interval

Beginning of ventricular depolarization
through ventricular repolarization

Q -

ECG
Normal sinus rhythm.

Junctional rhythm. The SA node is nonfunctional, P waves are

absent, and the AV node paces the heart at 4060 beats/min.

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.

Ventricular fibrillation. These chaotic, grossly irregular ECG

deflections are seen in acute heart attack and electrical shock.

31

Chapter 18 The heart (Part 2)

Microscopic Anatomy of Cardiac Muscle

Heart cells
Electrocardiography (ECG)
Stroke volume and cardiac output

Stroke volume (SV)

volume of blood pumped out by one
ventricle with each beat.
70ml/beat

Cardiac Output (CO)

Volume of blood pumped by each ventricle
in one minute
CO (ml/min) = HR (75 beats/min) SV (70
ml/beat) = 5.25 L/min
Normal 5.25 L/min

Regulation of SV and CO
Parasympathetic

Sympathetic
SAnode

Regulation of SV and CO
By autonomic nervous system via medulla
oblongata
Sympathetic rate and force
Parasympathetic rate and force