What is a recording of all nodal and myocardial action potentials in the heart?

The functioning of the conduction system of the heart

The components of the cardiac conduction system include (in correct sequence) the sinoatrial (SA) node, the atrioventricular (AV) node, the atrioventricular (AV) bundle, the atrioventricular (AV) bundle branches, and the Purkinje fibers. Cardiac pacemaker cells that form this system do not have a stable resting membrane potential like skeletal muscles or neurons.

  • They spontaneously fire at regular intervals and self-generate an action potential (electrical signal). Their membrane potential starts at about -60 mV and drifts upward. This upward drift is the depolarization phase and it results from a slow inflow of sodium ions without a compensating outflow of potassium ions. In repolarization, the inflow of sodium ions stops and potassium ions exit the cell to return the cell to the original membrane potential (review these electrical changes discussed in API, if needed). It is very important to understand that cardiac pacemaker cells do not need external stimulation by nerve cells to generate action potentials. They will "fire" even if all the nerves to the heart are cut and keep the heart contracting. 

The signal from the pacemaker cells is then transmitted to contractile myocardial cells as these cells are stimulated to generate an action potential. 

  • These cells have a resting membrane potential and the action potentials generated by contractile myocardial cells are similar to those in skeletal muscle and neurons. As these cells depolarize, they contract and pump blood into circulation. As they repolarize, they relax and fill with blood. 

All components of the conduction system of the heart function similarly. However, each individual component has certain unique characteristics. For example, the SA node is considered the pacemaker of the heart because it initiates the heart rhythm known as the sinus rhythm, while the Purkinje fibers have the fastest speed of signal conduction. You can watch Conducting the Signal to see a visual for the conduction of the electric signal. 

The Electrocardiogram (ECG or EKG)
We can detect electrical currents in the heart by means of electrodes (leads) applied to the skin. An instrument called the electrocardiograph amplifies these signals and produces a record, usually on a moving paper chart, called an electrocardiogram (ECG), also commonly abbreviated as EKG (K coming from "kardiology", from the German term for cardiology). To record an ECG, electrodes are typically attached to the wrists, ankles, and six locations on the chest. Simultaneous recordings can be made from electrodes at different distances from the heart; collectively, they provide a comprehensive image of the heart's electrical activity. An ECG is a composite recording of ALL action potentials produced by the nodal and myocardial cells—it should not be construed as a tracing of a single action potential. The EKG has very important diagnostic value: it can help us diagnose problems in the conduction system, heart attacks, heart enlargement and hormone/electrolyte imbalances. In a normal ECG tracing each component, segment, and interval is labeled and corresponds to important electrical events, demonstrating the relationship between these events and the cardiac cycle (contraction and relaxation of the heart).

The ECG is made up of a straight baseline and waves. The waves can either move over or under the baseline. 
A segment is the area between two waves. 
An interval is a straight line and one or more waves. 
A complex is more than one wave appearing in succession of one another. 

ECG ComponentDuration in SecondsCorresponding Significance
P wave 0.06-0.11 Depolarization of atrial fibers at SA node
P-R interval 0.12-0.20 Time from beginning of depolarization of atrial fibers to beginning of depolarization of the ventricles
P-Q segment 0.08 Time for cardiac impulse to pass through the AV node
QRS complex < 0.12 Depolarization of ventricular fibers
S-T segment 0.12 Time for ventricles to contract
Q-T interval 0.36-0.44 Time from ventricular depolarization to end of ventricular repolarization
T wave 0.16 Repolarization of ventricular fibers (ends pattern)
T-P segment <0.50 Time of relaxation and filling of the heart between beats

Which of the following is a recording of all nodal and myocardial?

An ECG is a composite recording of ALL action potentials produced by the nodal and myocardial cells—it should not be construed as a tracing of a single action potential.

What is a composite recording of all cardiac action potentials?

Electrical activities of the heart can be recorded in the form of electrocardiogram, ECG or EKG. An ECG is a composite recording of all the action potentials produced by the nodes and the cells of the myocardium. Each wave or segment of the ECG corresponds to a certain event of the cardiac electrical cycle.

Which structure initiates the action potential in the heart?

The cardiac action potential originates from the sinus node, located high in the right atrium (Fig. 9-1). Its cells depolarize spontaneously and initiate the spontaneous depolarization of action potentials at a regular rate from the sinus node.

Which electrocardiogram ECG finding can be used to measure heart rate?

For regular heart rhythms, heart rate can easily be estimated using the large squares (0.2s) on an ECG. Simply identify two consecutive R waves and count the number of large squares between them. By dividing this number into 300 (remember, this number represents 1 minute) we are able to calculate a person's heart rate.

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