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M. Djauhari Widjajakusumah
Departemen Fisiologi
Fakultas Kedokteran Universitas Indonesia
Mohrman, Heller:
Cardiovascular
Physiology, 6th
Edition 2006
Figure 12.
Cardiovascular circuitry
indicating the percentage
distribution of cardiac
output to various organ
systems in a resting
individual.
Physiology:
From Cells to Systems,
Major body fluid compartments with average volumes indicated for a 70-kg human. Total
body water is about 60% of body weight.
Mohrman, Heller:
Cardiovascular
Physiology, 6th Edition
2006
Physiology:
From Cells to Systems,
Lauralee Sherwood,
FIGURE 9-6 Organization of cardiac muscle fibers. Bundles of cardiac muscle fibers are
arranged spirally around the ventricle. Adjacent cardiac muscle cells are joined end to end by
intercalated discs, which contain two types of specialized junctions: desmosomes, which act as
spot rivets mechanically holding the cells together; and gap junctions, which permit action
potentials to spread from one cell to adjacent cells.
Lauralee Sherwood,
FIGURE 9-6 Organization of cardiac muscle fibers. Bundles of cardiac muscle fibers are
arranged spirally around the ventricle. Adjacent cardiac muscle cells are joined end to end by
intercalated discs, which contain two types of specialized junctions: desmosomes, which act as
spot rivets mechanically holding the cells together; and gap junctions, which permit action
potentials to spread from one cell to adjacent cells.
FIGURE 9-6 Organization of cardiac muscle fibers. Bundles of cardiac muscle fibers are
arranged spirally around the ventricle. Adjacent cardiac muscle cells are joined end to end by
intercalated discs, which contain two types of specialized junctions: desmosomes, which act as
spot rivets mechanically holding the cells together; and gap junctions, which permit action
potentials to spread from one cell to adjacent cells.
Gap Junction
Structure in plasma membranes of cells that are in direct physical contact
with one another
The two opposing plasma membranes come within 2 to 4 nm of each
other, which allows specific proteins from the two membranes to join,
forming small, protein-lined channels linking the two cells, linking the
cytosols of adjacent cells
Allows cells to have direct communication by allowing small molecules to
pass directly from the cytosol of one cell to the cytosol of an adjacent cell
Gap junctions coordinate the activities of adjacent cells by allowing
chemical messengers to move from one cell to another
The small diameter of the channels (about 1.5 nm) limits what can pass
between the cytosols of the connected cells to small molecules and ions,
such as sodium and potassium, and excludes the exchange of large
proteins
Heart muscle cells and smooth-muscle cells possess gap junctions, play a
very important role in the transmission of electrical activity between the
cells.
Human Physiology:
From Cells to Systems,
Seventh Edition,
Lauralee Sherwood, 2010
FIGURE 9-8 Specialized conduction system of the heart and spread of cardiac excitation.
Human Physiology:
From Cells to Systems,
Seventh Edition,
Lauralee Sherwood, 2010
FIGURE 9-8 Specialized conduction system of the heart and spread of cardiac excitation.
Impulse Transmission
AV delay
AV node conduction:
Penetrating portion of AV bundle:
0.09 sec
0.04 sec
------------------------------------
PR segment
Atrial impulse conduction
SA node Internodes AV node:
0.13 sec
0.03 sec
------------------------------------
PR interval
0.16 sec
Conduction Velocity
Myocardium
Atrium:
0.3 m/sec
Ventricle:
0.5 m/sec
Special Conducting System
Internodal pathways:
Transitional fibers:
AV Node:
Purkinje fibers
(Bundles of His, terminal fibers):
1
m/sec
0.02 m/sec
0.05 m/sec
1.5 - 4.0 m/sec
Purkinje Fiber
Figure 22.
Action potentials from these cell types are referred to as "fast response"
and "slow response" action potentials, respectively.
potential.
FIGURE 2.5
Changes in ion conductances associated
with a ventricular myocyte action
potential.
Phase 0 (depolarization) primarily is due
to the rapid increase in sodium
conductance (gNa+) accompanied by a
fall in potassium conductance (gK+)
The initial repolarization of phase 1 is
due to opening of special potassium
channels (Ito)
Phase 2 (plateau) primarily is due to an
increase in slow inward calcium
conductance (gCa++) through L-type
Ca++ channels
Phase 3 (repolarization) results from an
increase in gK+ and a decrease in gCa++
Phase 4 is a true resting potential that
primarily reflects a high gK+. ERP,
effective refractory period.
Changes in Na+ and K+ conductance during the action potential in giant squid axon. The dashed
line represents the action potential superimposed on the same time coordinate. Note that the initial
electrotonic depolarization initiates the change in Na+ conductance, which in turn adds to the
depolarization. (Modified from Hodgkin AL: Ionic movements and electrical activity in giant nerve
fibers. Proc R Soc Lond Ser B 1958;143:1.)
Figure 102
Rhythmical discharge of a sinus nodal fiber. Also, the sinus nodal action potential is compared
with that of a ventricular muscle fiber.
Physiology:
From Cells to Systems,
Figure 15-2 Time relationships between the developed force and the changes in
transmembrane potential in a thin strip of ventricular muscle. (Redrawn from Kavaler
F, Fisher VJ, Stuckey JH: Bull NY Acad Med 41:592, 1965.)
Physiology:
From Cells to Systems,
Refractory Period
Atrium
Ventricle
0.15 sec
0.03 sec
0.05 sec
------------------------------------
--------------------------------------------------------------
0.18 sec
Human Physiology:
From Cells to Systems,
Seventh Edition,
Lauralee Sherwood, 2010
Human Physiology:
From Cells to Systems,
Seventh Edition,
Lauralee Sherwood, 2010
Ganong Review of
Med Physiol 22nd ed,
2005
Diagram of the changes in pressure and velocity as blood flows through the systemic circulation.
TA, total cross-sectional area of the vessels, which increases from 4.5 cm2 in the aorta to 4500
cm2 in the capillaries (Table 301). RR, relative resistance, which is highest in the arterioles.
Human Physiology:
From Cells to Systems,
Seventh Edition,
Lauralee Sherwood, 2010
Human Physiology:
From Cells to Systems,
Seventh Edition,
Lauralee Sherwood, 2010
Human Physiology:
From Cells to Systems,
Seventh Edition,
Lauralee Sherwood, 2010
Human Physiology:
From Cells to Systems,
Seventh Edition,
Lauralee Sherwood, 2010
Human Physiology:
From Cells to Systems,
Seventh Edition
Lauralee Sherwood, 2010
Human Physiology:
From Cells to Systems,
Seventh Edition
Lauralee Sherwood, 2010
Physiology:
From Cells to Systems,
7th Ed, 2010
Human Physiology:
From Cells to Systems,
Seventh Edition
Lauralee Sherwood,
2010
Human Physiology:
From Cells to Systems,
Seventh Edition
Lauralee Sherwood, 2010
Cardiac output
+
vasoconstriction
arterioles
+
Heart rate
_
+
Extrinsic
control
Stroke volume
Contractility
Intrinsic control
Parasympathetic
activity
Sympathetic activity
(and epinephrine)
End-diastolic
volume
+
Human Physiology:
From Cells to Systems,
Extrinsic
control
Intrinsic control
+
Venous return
SA Node
Cardiac muscle
End-Diastolic Volume
Heart Rate
Acetylcholine
Venous return
Adrenal Med
& Sympathetic
Nerve Activity
Parasympathetic
Nerve Activity
Cardio-Accelerator &
Vasomotor Centers
(Medulla)
Cardio-Inhibitory
Center (Medulla)
Exercise
Stress
Human Physiology:
From Cells to Systems,
Seventh Edition
Lauralee Sherwood, 2010
Cardiovascular Centers
sympathetic output
Blood Vessels
vasoconstriction
parasympathetic output
Heart
Heart Rate
(SA Node)
Stroke volume
Blood Pressure
Heart
Heart Rate
(SA Node)
Blood pressure
Baroreceptors
In arch of aorta &
carotid sinuses.
Output
In kidneys
Secretion of renin
Blood
Angiotensin II
activated
Adrenal Cortex
Aldosterone
released
Posterior pituitary
ADH released
Blood Vessels
vasoconstriction
Kidneys
water
reabsorption
Kidneys
water
reabsorption
Blood Vessels
vasoconstriction
Blood pressure
CV Center
sympathetic output
Adrenal Medulla
Epinephrine
released
Heart
Heart rate
(SA node)
Stroke volume
(Cardiac muscle)
Human Physiology:
From Cells to Systems,
Seventh Edition
Lauralee Sherwood, 2010
Physiology:
From Cells to Systems,
7th Ed, 2010
Human Physiology:
From Cells to Systems,
Seventh Edition
Lauralee Sherwood, 2010
Figure 317.
+
+
Nucleus ambiguus:
The nucleus of origin of
motor fibers of the vagus,
glossopharyngeal, and
aaccessory nerves that suplay
the striated muscles of the
larynx and pharynx.
(Dorlands Illustrated Medical
Dictionary 27th ed, 1988
W.B.Saunders Company)
Human Physiology:
From Cells to Systems,
Seventh Edition
Lauralee Sherwood, 2010
Physiology:
Lange Cardiovascular
Physiology, 2006 The McGrawHill Companies
Physiology:
Physiology:
From Cells to Systems, 7th Ed, 2010
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