CARDIAC CONDUCTION SYSTEM

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CARDIAC CONDUCTION SYSTEM:

CARDIAC CONDUCTION SYSTEM Valentin C. Dones III, MSPT, PTRP, COMT, DMS, IMPT Masters of Science in Orthopedic Physical Therapy Integrated NeuroMuscular Taping Therapist Certified Dorn Teacher Certified Dorn Specialist Certified in Orthopedic Manual Therapy Mulligan Practitioner

Cardiac Conduction System:

Cardiac Conduction System Initiates and coordinates contraction Four basic components Sinu-atrial node Atrioventricular node Atrioventricular bundle with its right and left bundle branches Subendocardial plexus of conduction cells (the Purkinje fibers)

Cardiac Conduction System:

Cardiac Conduction System Insulated by connective tissue Unidirectional wave of contraction Form the papillary muscles and apex of the ventricles to the arterial outflow tracts

Sinu-atrial node:

Sinu-atrial node Cardiac pacemaker Located at the superior end of the crista terminalis at the junction of the SVC and the ® atrium Junction between the embryonic sinus venosus and the atrium proper

Atrioventricular node:

Atrioventricular node Medial to the opening of the coronary sinus Close to the attachment of the septal cusp of the tricuspid valve Within the atrioventricular septum Atrioventricular bundle

Atrioventricular bundle:

Atrioventricular bundle Direct continuation of the atrioventricular node Along the lower border of the membranous part of the interventricular septum before splitting into right and left bundle branches

Right bundle branch:

Right bundle branch ® side of the interventricular septum  apex of the ® ventricle  septomarginal trabecula  base of the anterior papillary muscle  subendocardial plexus or Purkinje fibers

Left bundle branch:

Left bundle branch Left side of the interventricular septum  Apex of the left ventricle  branches that eventually become the subendocardial plexus of conduction cells (Purkinje fibers)

Cardiac Innervation:

Cardiac Innervation Autonomic division Heart rate Force of each contraction Cardiac output

Cardiac plexus:

Cardiac plexus Superficial Between the aortic arch and the pulmonary trunk Deep Between the aortic arch and the tracheal bifurcation

Parasymphatetic innervation:

Parasymphatetic innervation Decreases HR Reduces force of contraction Constricts coronary arteries Preganglionic parasympathetic fibers Right and left vagus nerves

Sympathetic Innervation:

Sympathetic Innervation Increases the heart rate Increases the force of contraction Preganglionic sympathetic fibers Upper four or five segments of the thoracic spinal cord

Visceral Afferents:

Visceral Afferents Vagus nerves are primarily concerned with cardiac reflexes.

THANK YOU!:

THANK YOU!

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