Autonomic Nervous System (ANS): While the heart is myogenic, the medulla oblongata in the brain regulates the heart rate via the ANS to meet the body's metabolic demands.
Sympathetic Nervous System: Sends impulses via the accelerator nerve to the SAN to increase the heart rate and force of contraction during exercise or stress.
Parasympathetic Nervous System: Sends impulses via the vagus nerve to the SAN to decrease the heart rate during rest and recovery.
Hormonal Control: Adrenaline (epinephrine) released from the adrenal glands can also directly stimulate the SAN to increase heart rate as part of the 'fight or flight' response.
| Feature | Sinoatrial Node (SAN) | Atrioventricular Node (AVN) |
|---|---|---|
| Location | Right Atrium wall | Junction of atria and ventricles |
| Primary Function | Initiates the heartbeat (Pacemaker) | Delays the impulse |
| Effect | Causes Atrial Systole | Allows Ventricular Filling |
| Pathway | Spreads across atria | Passes to Bundle of His |
Sequence is Vital: Always describe the pathway in order: SAN Atria AVN Bundle of His Purkyne fibers. Missing a step usually loses marks.
Explain the 'Why': When asked about the AVN, don't just say it 'delays the impulse'; explain that this allows the atria to empty and the ventricles to fill.
Direction Matters: Emphasize that ventricles contract from the apex upwards. This is a common specific point in marking schemes regarding the efficiency of blood ejection.
Terminology Precision: Use 'wave of depolarization' or 'wave of excitation' rather than 'message' or 'signal' to demonstrate technical accuracy.