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Chapter: Medical Physiology: Rhythmical Excitation of the Heart

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Atrioventricular Node, and Delay of Impulse Conduction from the Atria to the Ventricles

The atrial conductive system is organized so that the cardiac impulse does not travel from the atria into the ventricles too rapidly; this delay allows time for the atria to empty their blood into the ventricles before ventricular contraction begins.

Atrioventricular Node, and Delay of Impulse Conduction from the Atria to the Ventricles

The atrial conductive system is organized so that the cardiac impulse does not travel from the atria into the ventricles too rapidly; this delay allows time for the atria to empty their blood into the ventricles before ventricular contraction begins. It is primarily the A-Vnode and its adjacent conductive fibers that delay thistransmission into the ventricles.

The A-V node is located in the posterior wall of the right atrium immediately behind the tricuspid valve, as shown in Figure 10–1. And Figure 10–3 shows dia-grammatically the different parts of this node, plus its connections with the entering atrial internodal pathway fibers and the exiting A-V bundle. The figure also shows the approximate intervals of time in fractions of a second between initial onset of the cardiac impulse in the sinus node and its subsequent appearance in the A-V nodal system. Note that the impulse, after traveling through the internodal path-ways, reaches the A-V node about 0.03 second after its origin in the sinus node. Then there is a delay of another 0.09 second in the A-V node itself before the impulse enters the penetrating portion of the A-V bundle, where it passes into the ventricles.A final delayof another 0.04 second occurs mainly in this penetrat-ing A-V bundle, which is composed of multiple small fascicles passing through the fibrous tissue separating the atria from the ventricles.


Thus, the total delay in the A-V nodal and A-V bundle system is about 0.13 second. This, in addition to the initial conduction delay of 0.03 second from the sinus node to the A-V node, makes a total delay of 0.16 second before the excitatory signal finally reaches the contracting muscle of the ventricles.

Cause of the Slow Conduction. The slow conduction in thetransitional, nodal, and penetrating A-V bundle fibers is caused mainly by diminished numbers of gap junc-tions between successive cells in the conducting path-ways, so that there is great resistance to conduction of excitatory ions from one conducting fiber to the next. Therefore, it is easy to see why each succeeding cell is slow to be excited.


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