Thursday, March 14, 2013

Cardiac Muscle



Cardiac Muscle

thin = acTIN

thick = myosin 

cross bridge = myosin globular head + actin - MEDIATED BY TROPONIN C-ACTIN

inside myocyte

  • CICR - CONTRACTION  ryanodine receptor  (blocked by dantrolene in malignant hyperthermia)
  • SERCA - RELAXATION
  • Na - Ca exchanger - relaxation = Ca extrusion from cell
  • Ca atpase = relaxation
  • phase 3 - reduced Ca influx



ca channel blockers affect cardiac muscle but not skeletal - why?


ANS regulates heart rate

actual HR of 60 but intrinsic HR (all ANS receptors blocked) = 110  due mainly to PNS dominance

ANS regulates contractility

SNS increases via Gs 
cAMP PKA 
  • ca influx
  • phosphorylates ryanodine receptors
  • phosphorylates phospholamden = increased serca = faster relaxation
PNS
  • inhibits sns pathways via Gi
  • inc. Kach channel = hyperpolarize
signal transduction pathways in heart

RV cardiac (Qp) output always equals LV cardiac output (Qs) unless there is an intracardiac shunt.  If right to left shunt is present Qs > Qp.  If left to right  shunt is present, Qp > Qs.  more on this to come.



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