List the elements of the intrinsic conduction system in order, starting from the SA node.

First - SA (sinoatrial) node

Second - AV (atrioventricular) node

Third - Bundle of His (AV bundle)

Fourth - Bundle branches (right and left)

At what structure in the transmission sequence is the impulse temporarily delayed and why?

The impulse is temporarily delayed at the AV (atrioventricular) node. This delay allows the atria to
contract and pump blood into the ventricles before the ventricles contract. The delay ensures
coordinated and efficient pumping of blood through the heart.

Even though cardiac muscle has an inherent ability to beat, the intrinsic conduction system plays a
critical role in heart physiology. What is that role?

The intrinsic conduction system of the heart coordinates and regulates the heartbeat. It controls the
timing and sequence of electrical impulses that stimulate the cardiac muscle to contract and pump blood
effectively. The role of the intrinsic conduction system is to ensure that the atria and ventricles contract
in a coordinated manner, allowing efficient blood flow through the heart and maintaining an appropriate
heart rate. It helps synchronize the contraction of the heart chambers, optimizing the pumping action
and ensuring an adequate supply of oxygenated blood to the body's tissues.

ECG (Electrocardiogram) is a diagnostic test that measures the electrical activity of the heart. It involves
placing electrodes on the skin to detect and record the electrical signals produced by the heart during
each heartbeat.

Heart rate increases during running due to several factors. Firstly, physical activity requires increased
oxygen supply to the muscles, and the heart responds by pumping more blood. Additionally, running
stimulates the sympathetic nervous system, leading to the release of adrenaline, which further enhances
heart rate. Increased heart rate ensures that oxygen and nutrients are delivered efficiently to the
working muscles.

e. SA node: the intrinsic conduction system structure that initiates atrial depolarization.

f. segment: a region on an ECG tracing that is between two waves but doesn’t include a wave.

c. P wave: the deflection on the ECG that is a result of atrial depolarization.

d. QRS complex: the deflection on the ECG that is a result of ventricular depolarization.
g. T wave: the deflection on the ECG that is a result of ventricular repolarization.

b. interval: a region on an ECG tracing that includes a segment and at least one wave.

a. AV node: the intrinsic conduction system structure where the conduction of the impulse is delayed.

Tachycardia: A condition characterized by an abnormally rapid heart rate, usually above 100 beats per
minute.

Bradycardia: A condition characterized by an abnormally slow heart rate, usually below 60 beats per
minute.

Fibrillation: A chaotic, irregular, and ineffective contraction of the heart muscle, impairing its ability to
pump blood efficiently.

Abnormalities of heart valves are better detected by auscultation than by electrocardiography because
auscultation allows direct assessment of the heart sounds and murmurs produced by abnormal blood
flow through the valves. Electrocardiography primarily measures the electrical activity of the heart,
providing information about the rhythm and electrical conduction, but it does not directly assess the
physical changes or abnormalities in the heart valves. Auscultation provides valuable information about
the functioning of the valves, including the presence of abnormal sounds that can indicate valve
disorders

The maze procedure creates scar tissue in the atria, whichh is electrically inert and does not conduct
electrical impulses. This scar tissue acts as a barrier that redirects the abnormal electrical impulses
generated in atrial fibrillation. By channeling these impulses through specific pathways and preventing
them from circulating randomly, the maze procedure restores the normal electrical conduction pattern in
the atria. This allows the atria to contract in a coordinated manner, preventing the spasms seen in atrial
fibrillation.

During the Q-T interval, several electrical events occur in the heart. The QRS complex represents
ventricular depolarization, which corresponds to the initiation of ventricular contraction. Following the
QRS complex, the ventricles enter the plateau phase, maintaining a depolarized state. Finally, the T wave
represents ventricular repolarization, corresponding to the restoration of the ventricles to their resting
state. In long Q-T syndrome (LQTS), there is a delay in ventricular repolarization, leading to a prolonged
Q-T interval on the electrocardiogram. This delay increases the risk of dangerous arrhythmias, such as
torsades de pointes, resulting in episodes of fainting and arrhythmia in symptomatic LQTS patients.