最新Cardiac physiology（医学课件）.pptVIP

Cardiac Muscle and Heart Function Cardiac muscle fibers are striated – sarcomere is the functional unit Fibers are branched; connect to one another at intercalated discs. The discs contain several gap junctions Nuclei are centrally located Abundant mitochondria SR is less abundant than in skeletal muscle, but greater in density than smooth muscle Sarcolemma has specialized ion channels that skeletal muscle does not – voltage-gated Ca2+ channels Fibers are not anchored at ends; allows for greater sarcomere shortening and lengthening How are cardiac contractions started? Cardiac conduction system Specialized muscle cells “pace” the rest of the heart; cells contain less actin and myosin, are thin and pale microscopically Sinoatrial (SA) node; pace of about 65 bpm Internodal pathways connect SA node to atrioventricular (AV) node AV node could act as a secondary pacemaker; autorhythmic at about 55 bpm Bundle of His Left and right bundle branches Purkinje fibers; also autorhythmic at about 45 bpm ALL CONDUCTION FIBERS CONNECTED TO MUSCLE FIBERS THROUGH GAP JUNCTIONS IN THE INTERCALATED DISCS Why are fibers of the conducting system autorhythmic? Membrane potential of SA nodal cells If channels How does the depolarization in these cells affect cardiac muscle cells? Superimpose changes in the muscle cell’s membrane potential on this graph Changes in ion concentrations in a cardiac muscle fiber following depolarization What causes the muscle resting membrane potential to change initially? What would be happening with a skeletal muscle at this point? The refractory period is short in skeletal muscle, but very long in cardiac muscle. This means that skeletal muscle can undergo summation and tetanus, via repeated stimulation Cardiac muscle CAN NOT sum action potentials or contractions and can’t be tetanized Autonomic nervous system modulates the frequency of depolarization of pacemaker Sympathetic stimulation (neurotransmitter = ); binds to b1 recepto