Presented by : SSN.

Mariam Al Zeedi SDC/ DHS

The Conduction System

The Conduction System

Depolarization
The impulse causes a discharge of electrical forces within the cell membrane, resulting in myocardial contraction

Repolarization
( recovery process ) muscle cells recover and restore electrical charges

Ions and the Resting Potential

Ions are electrically-charged molecules e.g. sodium (Na+), potassium (K+), chloride (Cl-). The resting potential exists because ions are concentrated on different sides of the membrane.
Na+ and Cl- outside the cell. K+ and organic anions inside the cell.

Na+

Na+

Cl-

Na+

Na+

Cl-

outside

Organic anions (-) K+

K+ Organic anions (-)

inside Organic anions (-)

Before Depolarization

Rapid depolarization
When partial depolarization reaches the activation threshold, voltage-gated sodium ion channels open. Sodium ions rush in. The membrane potential changes from -70mV to +40mV.

Na+

Na+

Na+

Depolarization

Action potentials: Repolarization

Sodium ion channels close and become refractory. Depolarization triggers opening of voltage-gated potassium ion channels. K+ ions rush out of the cell, repolarizing and then hyperpolarizing the membrane.
Na+ K+

K+

+ -

Na+

Na+ K+

Repolarization

Mechanical Action
Generation of impulse in the SA node Atrial activation (P) AV conduction (P-R ) Ventricular activation (QRS) Ventricles full depolarized (S-T ) Ventricular repolarization (T)

The Conduction System

The conduction system consists of the sinoatrial node, atrioventricular node, bundle of His, bundle branches and Purkinje fibers.

Conduction System
Location Function

Structure

Intrinsic Pacemaker

SA node

Right atrial wall just inferior to opening of superior vena cava

Primary pacemaker, 60 100 bpm initiates impulse that is normally conducted throughout the left and right atria

Conduction System
Location Function

Structure

Intrinsic Pacemaker

AV node

Floor of the right atrium immediately behind the tricuspid valve and near the opening of the coronary sinus.

Receives impulse from SA node and delays relay of the impulse to the bundle of His, allowing time for atria to empty their contents into the ventricles before the onset of ventricular contraction.

Conduction System
Location Function

Structure

Intrinsic Pacemaker

Bundle of His

Superior portion of interventricular septum

Receives impulse from AV node, and realys it to the right and left bundle branches

40 60 bpm

Conduction System
Location Function

Structure

Intrinsic Pacemaker

Right and left Interventricular bundle Septum branches

Receives impulse from bundle of His and relays it to Pukinje fibers

Conduction System
Location Function

Structure

Intrinsic Pacemaker

Purkinje fibers

Ventricular Receives impulse from myocardium bundle branches and

20 40 bpm

relays it to ventricular myocardium