fisiologi KV_fkg.pptx

8/19/2019 fisiologi KV_fkg.pptx

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FISIOLOGIKARDIOVASKULAR

dr. Fransisca Chondro, M.Biomed


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The circua!or" s"s!em has !hree #asic com$onen!s%&.The hear!

◦ as !he $um$ '' #ood (o)s do)n a $ressure *radien!+rom an area o+ hi*her $ressure !o an area o+ o)er$ressure.

.The #ood -esses

◦ as !he $assa*e)a"s !hrou*h )hich #ood is direc!edand dis!ri#u!ed +rom !he hear! !o a $ar!s o+ !he #od"and su#seuen!" re!urned !o !he hear!.

0. Bood

◦ !rans$or! medium


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hear! %◦ hoo), muscuar or*an a#ou! !he

si1e o+ a cenched 2s!.

◦ ies in !he !horacic ca-i!" s!ernum3#reas!#one4 an!erior" and !he-er!e#rae 3#ac5#one4 $os!erior".

◦ +unc!ion as !)o se$ara!e $um$s.

◦ di-ided in!o ri*h! and e+! ha-es andhas +our cham#ers a!ria and-en!rices


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COM6ARISO7 OF T89 RIG8T A7D L9FT6UM6S

◦ Bo!h sides simu!aneous" $um$ euaamoun!s o+ #ood.

◦ The -oume o+ O in #ood

◦ $umonar" circua!ion a o)'$ressure,o)' resis!ance s"s!em

◦ s"s!emic circua!ion is a hi*h' $ressure,

hi*h'resis!ance s"s!em.

◦ 6ressure :: Resis!ance ::

◦ VALV9S B9T;997 T89 ATRIA A7D V9I7S :::


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The hear! )a has !hree dis!inc!a"ers%

◦ A !hin inner a"er endo!heium

◦ A midde a"er m"ocardium◦ A !hin e


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hear! con!rac!s '' rh"!hmica" au!o'rh"!hmici!"

There are !)o s$eciai1ed !"$es o+cardiac musce ces%

◦ &. Con!rac!ie ces, )hich are ==> o+ !hecardiac musce ces

◦. !he au!orh"!hmic ces

do no! con!rac!#u! ini!ia!in* and conduc!in* !he ac!ion$o!en!ias


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6AC9MAK9R 6OT97TIAL A7D ACTIO76OT97TIAL I7 AUTO' R8?T8MIC C9LLS

The mos! im$or!an! chan*es !ha! *i-erise !o !he $acema5er $o!en!ia are

3&4 an increased in)ard 7a curren!,

34 a decreased ou!)ard K curren!,and

304 an increased in)ard Ca curren!.


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The s$eciai1ed noncon!rac!iecardiac ces %

◦ &. The sinoa!ria node 3SA node4

a sma, s$eciai1ed re*ion in !he ri*h!a!ria )a near !he o$enin* o+ !he su$erior-ena ca-a.

◦ . The a!rio-en!ricuar node 3AV node4 oca!ed a! !he #ase o+ !he ri*h! a!rium near

!he se$!um, @us! a#o-e !he @unc!ion o+ !hea!ria and -en!rices.


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◦ 0. The #unde o+ 8is 3a!rio-en!ricuar#unde4 a !rac! o+ s$eciai1ed ces !ha! ori*ina!es

a! !he AV node and en!ers !he

in!er-en!ricuar se$!um.

◦ . 6ur5in@e 2#ers

sma !ermina 2#ers !ha! e


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A!ria e


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CO7DUCTIO7 B9T;997 T89 ATRIAA7D T89 V97TRICL9S

im$use is dea"ed a#ou! &msec 3!he AV noda dea"4 a!ria com$e!e" de$oari1ed and

!o con!rac!


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Cardiac ou!$u! 3CO4 -oume o+ #ood$um$ed #" each -en!rice $er minu!e

The !)o de!erminan!s o+ cardiac ou!$u! are

hear! ra!e 3#ea!s $er minu!e4 and s!ro5e-oume 3-oume o+ #ood $um$ed $er #ea!or s!ro5e4. The a-era*e res!in* hear! ra!e is #ea!s $er minu!e, es!a#ished #" SA

node rh"!hmici!"E !he a-era*e res!in* s!ro5e-oume is m $er #ea!, $roducin* ana-era*e cardiac ou!$u! o+ = mmin, orcose !o i!ersmin


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Durin* e


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ACh so)s hear! ra!e increasin* K$ermea#ii!" o+ !he $acema5er ces in !he SAnode #" #indin* )i!h muscarinic choiner*icrece$!ors !ha! are cou$ed direc!" !o ACh'

re*ua!ed K channes #" a G $ro!ein.

The enhanced K $ermea#ii!" o$$oses !heau!oma!ic reduc!ion in K $ermea#ii!" !ha!con!ri#u!es !o de-eo$men! o+ !he $acema5er$o!en!ia decreases !he ra!e o+s$on!aneous de$oari1a!ion, $roon*in* !he

!ime reuired !o dri+! !o !hreshod.


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de$resses #o!h !he in)ard mo-emen! o+ 7aand Ca !hrou*h !he I+ and T'!"$e channes,res$ec!i-e", +ur!her so)in* !hede$oari1a!ion reaches !hreshod and 2res

ess +reuen!", decreasin* !he hear! ra!e.

increasin* K $ermea#ii!" h"$er$oari1es!he mem#rane '' re!ardin* !he ini!ia!ion o+

e


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S"m$a!he!ic s!imua!ion *rea!er in(u< o+ Ca in!o !hece !hrou*h L'!"$e Ca channe

enhancin* !he ac!i-e Ca $um$ in!he sarco$asmicre!icu' um !ha!remo-es Ca +rom !he c"!oso


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in!rinsic con!ro

FRA7KSTARLI7G LA; OF T89 89ART

◦ !he *rea!er !he dias!oic 2in* ar*er !he end'dias!oic -oume 39DV4 hear! is s!re!ched on*er !he ini!ia cardiac 2#er en*!h #e+ore

con!rac!ion *rea!er +orce on cardiac con!rac!ion *rea!er s!ro5e -oume.

◦ in!rinsic rea!ionshi$ #e!)een 9DV and s!ro5e-oume Fran5 S!arin* a) o+ !he hear!.


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e

s"m$a!he!ic ner-es and

e$ine$hrine◦ s"m$a!he!ic s!imua!ion !he hear!

con!rac!s more +orce+u" and

suee1es ou! a *rea!er $ercen!a*eo+ !he #ood i! con!ains, eadin* !omore com$e!e e@ec!ion


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The e@ec!ion +rac!ion is !he ra!io o+ s!ro5e-oume !o end'dias!oic -oume3SV9DV4

o+!en used cinica" as an indica!ion o+con!rac!ii!". A hea!h" hear! norma"has an e@ec!ion +rac!ion o+ > !o >

under res!in* condi!ions and ma" *o ashi*h as => durin* s!renuous e


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COM697SATOR? M9ASUR9S FOR 89ARTFAILUR9

In !he ear" s!a*es o+ hear! +aiure %

◦ s"m$a!he!ic ac!i-i!" !o !he hear! is re(e


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D9COM697SAT9D 89ART FAILUR9◦ can no on*er $um$ ou! a norma

s!ro5e -oume

◦ (uid accumua!ion in un*, 5idne"res$onse )orse :::


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Bood (o) !o !he hear! musceces is su#s!an!ia" reduceddurin* s"s!oe %

◦ con!rac!in* m"ocardium com$resses !he ma@or #ranches o+!he coronar" ar!eries

◦ o$en aor!ic -a-e $ar!ia" #oc5s !heen!rance !o !he coronar" -esses.


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T9RIMAKASI8

fisiologi KV_fkg.pptx

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