D4 The heart

Essential Idea: Internal and external factors influence heart function

Understandings
Statement Guidance
D.4.U1 Structure of cardiac muscles cells allows propagation of
stimuli through the heart wall

D.4.U2 Signals from the sinoatrial node that cause contraction cannot
pass directly from atria to ventricles

D.4.U3 There is a delay between the arrival and passing on of a

stimulus at the atrioventricular node

D.4.U4 This delay allows time for atrial systole before the
atrioventricular valve closes

D.4.U5 Conducting fibres ensure coordinated contraction of the entire

ventricle wall

D.4.U6 Normal heart sounds are caused by the atrioventricular valves

and semi lunar valves closing causing changes in blood flow
Applications and Skills
D.2.A1 Statement Guidance
D.4.A1 Use of artificial pacemakers to regulate the
heart beat
D.4.A2 Use of defibrillation to treat life-threatening
cardiac conditions

D.4.A3 Causes and consequences of hypertension and

thrombosis
D.4.S4 Measurement and interpretation of the heart
rate under different conditions

D.2.S2 Interpretation of systolic and diastolic blood

pressure measurements

D.4.S3 Mapping of the cardiac cycle to a normal ECG

trace

D.2.S4 Analysis of epidemiological data relating to the

incidence of coronary heart disease.
 Myocardium

Myocardium is the name for the The Intercalated discs allow nerve impulses ‘ the
special muscle tissue (cardiac) wave of electrical excitation’ to pass and,
found in the heart. coupled with the branching of the cells, give a
toughness to the tissue
This photomicrograph of cardiac muscle tissue shows the
branching nature
of the fibres, the intercalated discs and the nuclei
Heart muscle is myogenic
Contraction does not have
to be stimulated
(innervated) to occur

But beats origin is from

tissue called the
pacemaker or sino – atrial
node (SA )

It can speed up the

contractions

Sends wave of contraction

to atria causing the atrial
walls to contract

Wave of ‘excitation’ sent to

Atrio-ventricular node (AV)
Moves down the septum
of heart and contraction
occurs from apex upwards
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 An electrocardiogram (EKG or ECG) is done to:
•Find the cause of unexplained chest pain, such as a heart attack,
inflammation of the sac surrounding the heart or reduced blood flow to the
heart muscle
•Find the cause of symptoms of heart disease, such as unexplained chest pain,
shortness of breath, dizziness, fainting, or rapid, irregular heartbeats
(palpitations).
•Check the heart's electrical activity.
•Find out if the walls of the heart chambers are too thick
•Check how well medicines are working and whether they are causing side
effects that affect the heart.
•Check how well mechanical devices, such as pacemakers or defibrillators
implanted in the heart, are working to control a normal heartbeat.
•Check the health of the heart when other diseases or conditions are present,
such as high blood pressureCheck the health of the heart when other
diseases or conditions are present, such as high blood pressure, high
cholesterolCheck the health of the heart when other diseases or conditions
http://www.youtube.com/watch?v=v3b-YhZ
mQu8
So what is happening
at
P

PR

Q R S complex

T
http://www.youtube.com/watch?v=v3b-YhZ So what is happening at:
mQu8
P wave – SA node spreads
action potential through both
atria causing
DEPOLARISATION of heart
muscle and muscle
contraction

PR – repolarisation of cells
in atria (ready for next heart
beat)

Q R S complex- AV node
sends a wave of
depolarisation down Bundle
of His and Purkinje fibres to
apex of, heart.
Depolarisation of ventricular
walls occurs quickly

T – ventricular repolarisation
in preparation for next heart
beat.
 Component of the electrical sequence in the heart.
P Wave - Firing of the SA node and depolarization of the atria.
PR Interval - Delay of the electrical impulse at the AV node and the
depolarization of the atrium.
QRS Complex - Ventricular depolarization
•Q-wave = first negative deflection
•R-wave = first positive deflection
•S-wave = second negative deflecton
ST Segment- The beginning of ventricular repolarization. Should be
isoelectric (flat at baseline).
T Wave - Ventricular repolarization.
1)Late Diastole 2)Ventricular
& SystoleAV valves close
Atrial Systole AV valves at the end of
open, atrial systole - this causes
semi-lunar the LUB sound!
valves
Passive
closedfilling All valves
of the closed
ventricles as the
followed by ventricle
atrial systole Pressure
muscles
builds
contract
up in the
ventricles
4) Ventricular 3)Ventricular
Relaxation, Systole
diastoleSemi-lunar (aortic valves) Semi-lunar
valves valves
close as the ventricles open and blood
begin to relax and pressure is ejected into
in the aorta is now greater the aorta and
pulmonary
Pressure in the Muscles
artery
ventricles falls and shorten
the as they
AV valves open contract
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