CARDIO VASCULAR SYSTEM

HEART
(PART 3)

BY
K.KARPAGAM
B Sc NURSING, MBA, PGDCG
 CONDUCTING SYSTEM OF THE HEART
Othername – Pacemaker tissue of the heart
It is made up of myocardium that is specialized for initiation and
conduction of the cardiac muscle. Its fibers are finer than other
myocardial fibers.
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 PARTS
SA node (Sinoartrial Node)
It is known as pacemaker of heart. It generates an impulse at the rate of
about 70 beats per minute and initiates the heartbeat impulses travel through
the atrial wall to reach AV node
AV node (Atrioventricular node)
It is situated in the dorsal part of atrial septum just above the opening of
coronary sinus. It is smaller than SA node.
AV Bundle ( Atrio Ventricular Bundle or Bundle of His)
It is the muscular connection between arterial and ventricular
musculature. At the ventricular septum it divides into the right and left
branches. Right branch of AV Bundle passes along the right side of
interventricular septum. Left branch descends on left side.
Purkinje fiber
It forms a subendocardial plexus. They are large pale fibers striated only at
their margins
 CARDIAC CYCLE
Cyclical repetition of various changes in the heart from beat to beat.
Contraction of heart is systolic during this blood is ejected from contracting
chamber of heart relaxation of heart is diastolic during which blood collects in
chambers of the heart.

Normal duration of cardiac cycle – 0.8 sec

Ventricular events
Ventricular systole – 0.3 sec
Ventricular diastole – 0.8 sec
The right atrium and left atrium are in diastole at that time. The superior
and inferior vena cava transport deoxygenated blood into the right atrium at the
same time as the four pulmonary veins convey oxygenated blood into the left
atrium. The time taken for diastole 0.7sec.
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 CARDIAC CYCLE
Ventricular events
Ventricular systole – 0.3 sec
Ventricular diastole – 0.8 sec
The right atrium and left atrium are in diastole at that time. The superior
and inferior vena cava transport deoxygenated blood into the right atrium at the
same time as the four pulmonary veins convey oxygenated blood into the left
atrium. The time taken for diastole 0.7sec.
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Isometric contraction period
It is the first phase of ventricular systole. It lasts for 0.05sec. In this
atrioventricular valve are closed due to increase in ventricular pressure. The
semilunar valve are already closed. Due to closure of AV valves first heart sounds
is produced. Due to increase in ventricular pressure semilunar valves open.

Ejection period
Due to opening of semilunar valves and contraction of ventricular blood is
rejected from both the ventricles. The duration of period is 0.2 se. In this blood
is ejected slowly and fastly called slow (0.09) rapid ejection period (0.13 sec)
Prediastolic relaxation period
It is first stage of ventricular diastole duration of 0.04 sec. Due to rejection
of blood the pressure in aorta and pulmonary artery increases and pressure in
ventricles drops. So that semilunar valves closed by producing by second heart
sound(0.08sec)

Rapid filling phase

During isometric relaxation period ventricular pressure decreases so that
AV valves will open so sudden rush of blood from atria and ventricles. This
phases lasts for 0.11seconds and third heart sound is produced
Slow filling phase
After sudden rush of blood ventricular filling becomes slow. It is called
diastasis. It lasts for 0.19sec. Due to slow filling fourth heart sound is produced.
HEART SOUND
The mechanical activities of heart during each cardiac cycle produce some
sounds called “heart sounds” generally sounds are produced due to movements of
heart sounds
- Blood through the chambers of heart
- Cardiac muscles
- Valves of heart
- First and second heart sounds are heard by using stethoscope whereas third and
fourth are heard by phonocardiogram
- Heart sound are heard in mitral, tricusbid, aortic and pulmonary areas.
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Cardiac output
It is the volume of blood ejected from each ventricle. It is about
5.6 lit/ minute
Cardiac output = stroke volume X Heart rate
Stroke volume
It is volume of blood ejected from each ventricle. It is about 70-
80ml.
Features First sound Second sound Third sound Fourth sound

Occurs during Isometric protodiastole Rapid filling phase Atrial systole

contraction
period

Cause Closure of AV Closure of Rushing of blood Contraction of

valves semilunar valve into ventricles atrial muscles

characteristics Long, soft and low Short sharp Mild sound Diastolic sound
pitched resembles resembles dub
lub

Duration sec/ 0.10-0.17 0.10-0.14 0.07-0.10 0.02-0.04

frequency 25-45 50 1-6 1-4
Thank you