HEART RATE

It is called as NORMAL SINUS RHYTHM

At resting condition, in adults, it ranges between 60 100 beats per minute When HR increases >100, it is called TACHYCARDIA When HR decreases < 60, it is called BRADYCARDIA

BRADYCARDIA

TACHYCARDIA
PARASYMP.-decrease HR & rhythm

-decrease excitability of
nodal tissue

SYMP.- increase HR,nodal rhythm -increase excitability -increase force of contraction

TACHYCARDIA
It is due to decreased activity of BARORECEPTORS They are present in artery, left ventricle and Pulmonary circulation It is seen in : Inspiration Fever Excitement Anger Exercise Pain Hypoxia Thyroxine Nor epinephrine Epinephrine

BRADYCARDIA
It is due to increased activity of BARORECEPTORS It is seen in : Expiration Sleep Fear Grief Intracranial Pressure

SINUS ARRHYTHMIA
There is a change in HR seen during respiratory cycle In inspiration, there is increase in HR In expiration, there is decrease in HR It is commonly seen in children and young adults It is due to change in rate of impulse generated by SA Node

CAUSES OF SINUS ARRHYTHMIA

During inspiration,ITP decreases which causes engorgement of great veins This sets up BAINBRIDGE REFLEX BB-Reflex raised pressure in vena cava and right atrium causes tachycardia Irradiation of impulses occur from respiratory centers to cardio-regulatory centers Stretching of lungs influences cardiac centers

VARIATIONS IN HR
Heart rate metabolism Heart rate 1 body size Birds 1000 b/min Rabbit 250/min Child 180/min Man 80/min Elephant 25/min

VARIATIONS ( contd. )
Age : Fetus Child Adults Middle age Old age Posture : standing lying 140b/min 100b/min 75b/min 60b/min 100b/min increases HR decreases HR

VARIATIONS ( contd.)

Athletes have low heart rate due to vagal hypertonia Exercise increases HR During meals, HR increases Emotions- rage and fear, increases HR In pregnancy, HR increases In sleep, HR decreases

PATHOLOGICAL HR
INCREASED HR: Fever thyrotoxicosis Circulatory Shock Congestive heart failure Paroxysmal Tachycardia DECREASED HR: Heart Block Myxoedema RELATIVE BRADYCARDIA: Viral infection Enteric fever

APPLIED VARIATIONS
HR can be regulated by some people voluntarily, by discharge of impulses along the sympathetic nerves Some YOGIS claim to stop their heart beat, by tensing their thoracic and abdominal muscles This reduces VR , heart sounds and pulse But by ECG, electrical changes are seen confirming heart beat

REGULATION OF HR
1. 2. 3. 4. 5. 6. 7. Reflex regulation Oxygen lack hypoxia Temperature Endocrines Muscular exercise ANS Serum control

REFLEX REGULATION
1. Higher centers in brain 2. Respiratory centers

3. Baro-receptors
4. Bainbridge reflex 5. Other afferents

HIGHER CENTERS
It is due to : 1. Frontal lobe of cortex stimulation of Area 13 raises HR 2. Posterior hypothalamic nucleus stimulation increases HR 3. Vagal dorso-medial nucleus stimulation causes bradycardia

RESPIRATORY CENTER
It is seen in sinus arrhythmia, deep breathing in children and in quiet breathing It is due to alteration in vagal tone It occurs due to : Inflation of lungs,when stretch receptors get reflexly excited Excessive activity of respiratory center,irradiates to cardiac center

BARO-RECEPTORS
These receptors are situated in aortic arch and carotid sinus Raised pressures in them causes bradycardia and hypotension It is due to increased discharges from BR resulting in reflex vagal tone There is an inverse relationship between HR and BP, called as MAREYS LAW It does not apply during exercise, as BP and HR, both increase as VR sets up BB-Reflex

BAINBRIDGE REFLEX
Raised pressure in vena cava and right atrium, increases HR The degree of tachycardia is related to initial HR and vagal tone, which if increased will cause cardiac acceleration This reflex is initiated by receptors present in walls of atrium and vena cava which increase HR

ANREP PHENOMENON
BB-Reflex is initiated by receptors present in walls of vena cava and right atrium They transmit impulses to VMC by vagal afferents These impulses mainly inhibit the vagal efferents to the heart, raising HR It is called ANREP PHENOMENON

VMC

___ +++

ANREP PHENOMENON

OTHER AFFERENTS

1. 2. 3. 4. 5. 6.

Stimulation of V nerve (central end) Irritation of nasal mucosa Abdominal surgery (visceral stimuli) Occulo-cardiac reflex Stimulation of Sciatic nerve(central end) Painful stimuli

HR HR HR HR HR HR

OXYGEN LACK - HYPOXIA

Anoxia or Hypoxia increases HR
It occurs due to two reasons : 1. Direct effect on SA Node 2. Reflex secretions of Adrenaline from adrenal medulla during anoxia

TEMPERATURE
Raised temperature increases HR It occurs due to two reasons : 1. Directly acts on SA Node 2. By temperature regulating centres in hypothalamus It relays excitatory impulses to cardio-accelerator center

ENDOCRINES
1. Adrenaline increases HR
It directly acts on heart 2. Thyroxin increases HR by increasing action of catacholamines

MUSCULAR EXERCISE
HR increases in anticipation and at the onset of exercise It is due to : 1. Cortical impulses relayed via hypothalamus to CIC and VMC 2. Increased sympathetic and decreased vagal tone on heart Cortico-hypothalamic centers discharge excitatory impulses to medullary cardio-accelerating center and inhibit activity of DMN of vagus

ANS
PARASYMPATHETICS
cholinergic

SYMPATHETICS

adrenergic

HR

HR