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BIO 304 · Human Anatomy & Physiology

Cardiac Conduction System

Cardiovascular System · Module 11

A reference for the Cardiac Conduction video. The heart generates its own rhythm. A network of specialized myocardial cells fires impulses from atria to ventricles in a precise sequence that an ECG can read from outside.

How to use this sheet Toggle the toolbar above. Notes prints the full reference for review. Study prints as a fill-in-the-blank worksheet , print it, then write each definition while you watch the video or read your book. Quiz me is on-screen typing practice; type the term, click Reveal to check yourself.

Open spaced recall

By the end
  1. Trace the conduction pathway from SA node to ventricular myocardium.
  2. Compare pacemaker action potentials with contractile action potentials.
  3. Identify the P wave, QRS complex, T wave, and intervals on a normal ECG.
Anterior view of the body and face labeled with upper-body regions: cranial, frontal, orbital, nasal, buccal, oris, mental, cervical, acromial, deltoid, axillary, brachial, antecubital, antebrachial, carpal, digital, mammary, sternal, abdominal, umbilical.
Anterior · upper body & face
Anterior view of the body labeled with lower-body regions: pelvic, inguinal, pubic, coxal, pollex, femoral, patellar, fibular, crural, tarsal, plantar, digital toes, and hallux.
Anterior · lower body
Posterior view labeled occipital, cervical, scapular, vertebral, lumbar, sacral, glu#0B1530, femoral, popli#0B1530, sural, tarsal, calcaneal; lateral head view labeled otic, buccal, occipital, cervical.
Posterior & lateral head

Click any image to enlarge.


Conduction Pathway

Specialized conducting cells

  • SA noderight atrium near SVC; intrinsic rate 60-100; primary pacemaker
  • Internodal pathwayscarry signal across atria to AV node
  • AV nodeinteratrial septum; intrinsic rate 40-60; delays signal ~0.1s
  • Bundle of His (AV bundle)penetrates into interventricular septum
  • Right & left bundle branchesdown either side of septum
  • Purkinje fibersspread through ventricular myocardium; intrinsic rate 20-40; fastest conduction

Why the AV delay matters

  • ~100 ms pauseallows atrial systole to finish before ventricular contraction begins
  • Bottom-up contractionPurkinje delivers signal to apex first; contraction pushes blood up toward valves

Pacemaker action potential

  • No true resting potentialmembrane drifts upward toward threshold
  • Funny current (If)slow Na+ leak in; "funny" because it opens at hyperpolarization
  • Threshold reachedL-type Ca²⁺ channels open; depolarization upstroke (Ca²⁺, not Na+)
  • RepolarizationK+ channels open
  • Auto-rhythmicitycycle repeats; pacemaker rate controlled by ANS

Action Potentials & ECG

Contractile cell AP

  • Phase 0 (upstroke)fast Na+ channels open; rapid depolarization
  • Phase 1brief K+ efflux; small dip
  • Phase 2 (plateau)Ca²⁺ influx balances K+ efflux; sustained depolarization — this is unique to cardiac muscle
  • Phase 3Ca²⁺ channels close; K+ continues out; repolarization
  • Phase 4resting potential restored; ready to fire again

Why the plateau matters

  • Long refractory periodprevents tetanus — the heart can't sustain contraction
  • Allows proper fillingeach beat is followed by relaxation and refilling

ECG basics

  • P waveatrial depolarization
  • QRS complexventricular depolarization (also masks atrial repolarization)
  • T waveventricular repolarization
  • PR intervalstart of P to start of QRS; AV node delay; ~0.12-0.20 s
  • QRS durationnormally < 0.12 s; widened in bundle branch block
  • QT intervalstart of QRS to end of T; ventricular electrical cycle; longer = arrhythmia risk

Autonomic control

  • Sympatheticnorepinephrine on beta-1 receptors → speeds SA, increases contractility
  • Parasympathetic (vagus)ACh on muscarinic → slows SA and AV nodes
  • Resting toneparasympathetic dominates; intrinsic SA rate without ANS is ~100/min

When conduction fails

  • AV block (1st degree)PR interval > 0.20 s; signal slow but reaches
  • AV block (2nd degree)some atrial beats not conducted
  • AV block (3rd degree, complete)no atrial-to-ventricular conduction; ventricles use junctional or ventricular pacemaker
  • Bundle branch blockone ventricle activates late; widens QRS
Dr. Sharilyn Rennie BIO 304 · Module 11 · Cardiac Conduction