BY DR. MUDASSAR ALI ROOMI (MBBS, M.

PHIL)

April 18, 2012

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

April 18, 2012

Frank-Starling mechanism of the heart cotraction: greater the heart muscle is stretched during diastolic filling (more initial or end diastolic length), the greater is the force of contraction and the greater is the quantity of blood pumped into the aorta(within Physiologic limits). Frank starling Law is applied to each individual skeletal muscle fiber but on heart as a whole.
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April 18, 2012

ventricular function curves is a way of expressing the FrankStarling mechanism of the heart. That is, as the ventricles fill in response to higher atrial pressures, each ventricular volume and strength of cardiac muscle contraction increase, causing the heart to pump increased quantities of blood into the arteries. MECHANISM: (as actin myosin move apart by stretching to an optimum length contract more powerfully.
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Excitability is the property to respond to stimuli. Stimuli: nervous, chemical, mechanical, electrical. This property enables the heart muscles to respond to artificial pacemaker.*** The Nerves, drugs, ions and ischemia affect the excitability of cardiac muscles.

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Each fiber contracts to its maximum or not at all in response to a threshold stimulus. Obeyed by each skeletal muscle fiber individually but by heart muscle as a whole because heart is a functional syncitium. ***

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DEFINITION: it is the interval during which a normal cardiac impulse cannot re-excite an already excited area of cardiac muscle. (0.30-0.35 sec) Absolute refractory period: It is the period during which already excited cardiac muscle does not respond to a second stimulus. (0.25-0.30 sec)** Relative refractory period: It is the period during which already excited cardiac muscle gives response to a powerful excitatory stimulus. (0.05 sec)**
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The normal refractory period of the ventricle is almost equal to the duration of plateau phase of action potential. **** The refractory period of atrial muscle (0.15 sec) is much shorter than that of the ventricles (0.25 to 0.30 sec).

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During relative refractory period early premature contraction may occur if heart is stimulated by a strong stimulus.

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It is due to plateau in action potential of cardiac muscle because plateau increases the refractory period.

TETANIZATION SEEN IN SKELETAL MUSCLE

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Ventricular Muscle Action Potential

++ K+ Channels Ca Channels K+ Channels Open More Open Open More

Slow Ca++ Channels Open

+20

1 2

Membrane Potential (mV)

0 -20 -40 -60 -80 -100 0

Fast Na+ Channels Open 4 0 3

phase 0- Fast Na+ channels open then slow Ca++ channels phase 1- K+ channels open Seconds phase 2- Ca++ channels open more phase 3- K+ channels open more phase 4- Resting membrane potential
Copyright 2006 by Elsevier, Inc.

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Resting membrane potential of the SA nodal fiber is -55 to -60 mvolts. The cause of this lesser negativity is that the cell membranes of the sinus fibers are naturally leaky to Na+ and Ca++ ions and entry of these ions neutralize much of the intracellular negativity.
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April 18, 2012

Rhythmical Discharge of Sinus Nodal Fiber

Sinus Nodal Fiber Slow Ca++ Channels Open Ventricular Muscle fiber

+20

K+ Channels Open more

Threshold

Membrane Potential (mV)

0 -20 -40 -60 -80 -100 0

Na+ Leak

2 Seconds

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At -55 mvolts, the fast Na+ channels become inactivated. Therefore, only the slow sodium-calcium channels can open and cause the action potential. As a result, the SA nodal action potential is slower to develop than the that of the ventricular muscle. Therefore, the inherent leakiness of the sinusnodal fibers to Na+ and Ca++ ions April 18, 2012 causes their self-

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