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Heart: Cardiac Function & ECGs

Adapted From: Textbook Of Medical Physiology, 11 Ed. Arthur C. Guyton, John E. Hall Chapters 9, 10, 11, 12, & 13 John P. Fisher
th

Copyright 2012, John P. Fisher, All Rights Reserved

The Heart and Circulatory System


Introduction

pumps

The heart is two separate

A right heart that


pumps blood through the lungs A left heart that pumps blood through the peripheral organs

Each heart pump is a pulsatile


two-chamber pump composed of an atrium and a ventricle The atrium is a weak primer pump, to move blood into the ventricle The ventricle then
supplies the main pumping force that propels the blood

circulatio n by the right ventricle Through the peripher al circulati on by the left ventricle

Upp er bod y

aorta pulmonary artery superior vena cava

lungs

right atrium pulmonary vein pulmonary valve

left atrium mitral valve

tricuspid valve

aortic valve

Through the
pulmonary

right ventricle

inferior vena cava

bo dy

lower

Guyton & Hall. Textbook of Medical Physiology, 11


th

Edition
Copyright 2012, John P. Fisher, All Rights Reserved

Physiologic Anatomy of Cardiac Muscle


Introduction

The heart is composed of three major types of cardiac muscle

Atrial muscle and ventricular muscle contract in a manner similar to skeletal muscle,
except that the duration of contraction is much longer

Specialized excitatory and conductive fibers contract only feebly because they contain
few contractile fibrils However, they exhibit automatic rhythmical electrical discharge in the form of action potentials, providing an excitatory system that controls the rhythmical beating of the heart

Copyright 2012, John P. Fisher, All Rights Reserved

Physiologic Anatomy of Cardiac Muscle


Cardiac Muscle as a Syncytium

Cardiac muscle is striated in the same


manner as in typical skeletal muscle Cardiac muscle has typical myofibrils that contain actin and myosin filaments

that separate individual cardiac muscle cells from one another

Cardiac muscle
fibers are made up of many individual cells connected in series and in parallel with one another
Guyton & Hall. Textbook of Medical Physiology, 11
th

The dark areas crossing the cardiac


muscle fibers are called intercalated discs

These discs are actually cell membranes

Edition

Reserved

Copyright 2012, John P. Fisher, All Rights

Physiologic Anatomy of Cardiac Muscle


the next Cardiac Muscle as a Syncytium At each intercalated disc the
cell membranes fuse with one another, forming gap junctions

Thus, when one


cardiomyocyte becomes excited, the action potential spreads to all of them, spreading from cell to cell throughout the latticework interconnections
Guyton & Hall. Textbook of Medical Physiology, 11 Edition
th

Ions move with ease in the intracellular

fluid along the longitudinal axes of the cardiac muscle fibers Action potentials travel easily from one cardiac muscle cell to

Copyright 2012, John P. Fisher, All Rights Reserved

Cell Junctions

Most notable
type of communicatin g junction is the gap junction

cell lumen

Communicating Junctions

Gap junctions
provide a mechanism for regulated exchange of molecules between adjacent cells

Formed by the
coordinated assembly of transmembran e proteins Gap
junctions in the liver, two adjacent cells each contribute 6

cell lumen

proteins (connexins) to form a 12 transmemb rane protein complex (connexon) that allows small molecules (< 1.2 kDa) to move from one cell to another

Copyright 2012, John P. Fisher, All Rights

Reserved

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