HEART PHYSIOLOGY

BY DR. MUDASSAR ALI ROOMI (MBBS, M. PHIL)

Physiologic anatomy of heart

Hollow muscular pumping organ Weight: 330 grams Size: closed fist Function: is to receive blood from veins and then pump it into arteries

Physiologic anatomy of heart

Heart is considered as two pumps Left and right hearts each having an atrium and a ventricle. Each atrium is a weak primer pump for the ventricle, helping to move blood into the ventricle.

The ventricles then supply the main pumping force that propels the blood either: (1) through the pulmonary circulation by the right ventricle or (2) through the peripheral or systemic or greater circulation by the left ventricle

HISTOLOGY of Cardiac Muscle

Why heart acts as a functional syncytium?????

 At intercalated disc cell membranes form communicating junctions (gap junctions) that allow almost totally free diffusion of ions. action potentials travel easily from one cardiac muscle cell to the next, past the intercalated discs. cardiac cells are so interconnected that when one of these cells becomes excited, the action potential spreads to all of them, spreading from cell to cell throughout the latticework. (Functional syncytium).

The Heart Actually Is Composed Of Two Syncytiums:

the atrial syncytium that constitutes the walls of the two atria, and the ventricular syncytium that constitutes the walls of the two ventricles. The atria are separated from the ventricles by fibrous tissue. Normally, potentials are not conducted from the atrial syncytium into the ventricular syncytium directly through this fibrous tissue. Instead, they are conducted only by way of a specialized conductive system of conductive fibers . importace of having two functional syncytia: This division of the muscle of the heart into two functional syncytiums allows the atria to contract a short time ahead of ventricular contraction, which is important for effectiveness of heart pumping.

2 Functional Syncytia In Heart

Functions of atria
1-Conduit function : Conduct blood from great veins into the ventricles. 2-Reservior function: reservior of blood. 3-Pumping functions: Atria act as Primer Pumps for the ventricles 4-Venous blood drainage 5- Pacemaker and conductivity function ,Genesis and conduction of cardiac impulse: 6-Endocrine function: Atrial natriuretic peptide (ANP) secreted from special endocrine cells of atria

Electrical Properties of cardiac muscle

1-Automaticity and rhythmicity (autorhythmicity): 2:Conductivity 3-Contractility: 4-Excitability 5- All or none Law 6-Reractory period

1-Automaticity and rhythmicity:

Automaticity: ability of a cell to produce electrical impuses spontaneously. Rhythmicity: it means spontaneous depolarization occurs at regular intervals. Sinus (Sinoatrial) Node or S-A node: SA node is the pacemaker of heart.** Pacemaker activity is myogenic and not neurogenic.***** Location of SA node: It is located in the posterolateral wall of the right atrium immediately below and slightly lateral to the opening of the superior vena cava. The fibers of this node have almost no contractile muscle filaments.**

2:Conductivity:(Dromotropic effect)
Ability to propagate an electrical impulse. All heart muscle fibers can conduct impulses but conduction is more rapid through the special conducting tissue: SA node-intra-atrial pathways-AV node AV bundle- rt and Lt bundle branch Purkinje fibers. Normally conduction occurs in one direction and in synchronous way. What is +ve and ve dromotropic effect????

VELOCITY OF CONDUCTION:
0.3-0.5 m/sec in atrial and ventricular muscle fibers. 1/250 of the velocity in large nerve fibers and 1/10 of that in skeletal muscle fibers. (slow!) Velocity in purkinje fibers: 4m/sec

3-Contractility: Inotropic Shortening of myocardial muscles in response to stimulus. 0.2 second in atrial muscle and 0.3 second in ventricular muscle. Contractility is increased by (+ve inotropic effect): sympathetic stimulation, Norepinephrines, catecholamines , Ca ions, digitalis, caeffine etc. decreased by(-ve inotropic effect) : acetylcholine, beta receptors blockers and Ca channels blockers, K+ ions, acidosis.