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PBCI Summary

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Summary of the course PBCI on cardiovascular & respiratory system. Based on all lectures given during this course (including learning objectives)

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Cardiovascular & respiratory
system


Thema A: Cardiac electrophysiology

CO2: Cardiac anatomy
Learning objectives

To be able to recognise the various structures that constitute the
tissues of the cardiac conduction system

Integration of anatomy with electrophysiology of the heart, that can
be recognised by the surface ECG

Study basic cardiac anatomy and orientation of the heart in the
thorax

Study the morphological structure and functional aspects of the
atria and ventricles, in relation to functional aspects

Learn the function of the 4 cardiac valves

Learn how the cardiac muscle provides itself from blood (coronary
arterial system)

Cardiac muscle
Muscle fiber > myofibrils > sarcromere
Cardiac muscle:




Cardiovascular & respiratory system 1

, Large T-tubules, located at the level of Z-disk

One T-tubule per sarcomere

Large mitochondria, densely packed between myofibrils

Skeletal muscle cell vs. cardiac muscle cell

Skeletal Cardiac

Peripheral nucleus
(beneath the plasma Central nucleus
membrane)
single multinucleated
Intercalated disks
protoplasmic unit (fiber

juxtanucleur
cytoplasma
(+mitochorndria)

Intercalated disk
Cardiac muscle cells are mechanically, chemically and electrically connected to
one anther so that single myocytes function as a whole > functional
syncytium.
Due to this stimulation of an individual muscle cell results in the contraction of
all the muscle cells

Fascia adherens

the site at which the thin filaments in the terminal sarcromere anchor onto
the plasma membrane

Maculae adherens (desmosomes)

help prevent the cells from pulling apart under contraction strain.

Gap junctions
Ionic continuity between adjacent cardiac muscle cells

Electrical and metabolic coupling between adjacent cells
2 Connexons (hemichannels) > Connexins




Cardiovascular & respiratory system 2

, Cardiac muscle fibers are surrounded by a thin layer of endomysium that
contains a rich network of blood capillaries

Contraction

Purkinje fibers exhibit spontaneous rhythmic contraction that leads to
depolarization in cardiac myocytes

Voltage-sensor proteins (DHSRs) > gated ca2+ release channels

calcium triggered calcium release mechanism > delay of start depolarization




Cardiovascular & respiratory system 3

, Cardiac conduction system

progenitor cells of cardiac conduction system are cardiomyocytes. Cardiac
conduncting cells accumulate locally form nodes


Cardiovascular & respiratory system 4

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