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Sistem Kardiovaskular
* Prinsip umum faal kardiovaskuler : Sistem kardiovaskulerKomponen-komponen vaskulerSirkuit sistem kardiovaskuler
* Hemodinamika Aliran darah dan kecepatan aliran darahTekanan darah
*Elektrofisiologi : Elektrokardiografi Aksi potensial jantungInervasi jantungKeterlibatan elektrolit dalam aksi potensial jantungCardiac output dan otot jantungSiklus jantung dan elektrokardiogram
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The Cardiovascular System
A closed system of the heart and bloodvessels
The heart pumps bloodBlood vessels allow blood to circulate to allparts of the body
The function of the cardiovascularsystem is to deliver oxygen andnutrients and to remove carbon dioxideand other waste products
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The Heart
Location
Thorax between the lungsPointed apex directed toward left hip
About the size of your fist
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The Heart
Slide
Figure 11.1
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The Heart: Coverings
Pericardium a double serousmembrane
Visceral pericardium
Next to heart
Parietal pericardium
Outside layerSerous fluid fills the space between thelayers of pericardium
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The Heart: Heart WallThree layers
EpicardiumOutside layerThis layer is the parietal pericardiumConnective tissue layer
MyocardiumMiddle layer
Mostly cardiac muscleEndocardium
Inner layerEndothelium
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External Heart Anatomy
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The Heart: Chambers
Right and left side act as separate pumpsFour chambers Atria
Receiving chambersRight atriumLeft atrium
VentriclesDischarging chambersRight ventricleLeft ventricle
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Blood Circulation
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Pathway of Blood Throughthe Heart and Lungs
Right atrium tricuspid valve rightventricleRight ventricle pulmonary semilunarvalve pulmonary arteries lungsLungs pulmonary veins left atriumLeft atrium bicuspid valve leftventricleLeft ventricle aortic semilunar valve aortaAorta s stemic circulation
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The Heart: Valves
Allow blood to flow in only one directionFour valves Atrioventricular valves between atria andventricles
Bicuspid valve (left)Tricuspid valve (right)
Semilunar valves between ventricle andarteryPulmonary semilunar valve
Aortic semilunar valve
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The Heart: Valves
Valves open as blood is pumped
throughHeld in place by chordae tendineae(heart strings)
Close to prevent backflow
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Operation of Heart Valves
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Incompetent valve = backflow and repumpStenosis = stiff= heart workload increasedMay be replacedLup Dub Heart Sound
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The Heart: Associated Great Vessels
AortaLeaves left ventricle
Pulmonary arteriesLeave right ventricle
Vena cava
Enters right atriumPulmonary veins (four)
Enter left atrium
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Rapid heart beat= Inadequate blood= Angina Pectoris
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The Heart: Conduction System
Intrinsic conduction system(nodal system)
Heart muscle cells contract, without nerveimpulses, in a regular, continuous way
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The Heart: Conduction System
Special tissue sets the pace
Sinoatrial node (right atrium)
Pacemaker Atrioventricular node (junction of r&l atriaand ventricles)
Atrioventricular bundle (Bundle of His)
Bundle branches (right and left)
Purkinje fibers
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Heart Contractions
Figure 11.5
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Three formations
P wave: impulse across atria QRS complex: spread of impulse down septum,
around ventricles in Purkinje fibers T wave: end of electrical activity in ventricles
Electrocardiograms (EKG/ECG)
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Electrocardiograms (EKG/ECG)(cont .)
Figure 8.15B, C
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Damage to AV node = release of ventriclesfrom control = slower heart beatSlower heart beat can lead to fibrillation
Fibrillation = lack of blood flow to the heartTachycardia = more than 100 beats/minBradychardia = less than 60 beats/min
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Filling of Heart Chambers the Cardiac Cycle
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CO = HR x SV5250 ml/min = 75 beats/min x 70 mls/beatNorm = 5000 ml/minEntire blood supply passes through body onceper minute.CO varies with demands of the body.
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Cardiac Output Regulation
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Regulation of Heart Rate
Increased heart rateSympathetic nervous systemCrisis
Low blood pressureHormones
Epinephrine
ThyroxineExerciseDecreased blood volume
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The Heart: Regulation of HeartRate
Decreased heart rate
Parasympathetic nervous systemHigh blood pressure or blood volume
Dereased venous return
In Congestive Heart Failure the heart isworn out and pumps weakly. Digitalisworks to provide a slow, steady, butstronger beat.
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Decline in pumping efficiency of heartInadequate circulationProgressive, also coronary atherosclerosis, highblood pressure and history of multipleMyocardial InfarctionsLeft side fails = pulmonary congestion and
suffocationRight side fails = peripheral congestion andedema
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The Vascular System
Figure 11.8b
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Blood Vessels: AnatomyThree layers (tunics)
Tunic intima
Endothelium
Tunic mediaSmooth muscle
Controlled by sympathetic nervous
systemTunic externa
Mostly fibrous connective tissue
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Differences Between Blood VesselTypes
Walls of arteries are the thickest
Lumens of veins are larger
Skeletal muscle milks blood in veinstoward the heart
Walls of capillaries are only one celllayer thick to allow for exchangesbetween blood and tissue
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Movement of Blood ThroughVessels
Most arterial blood is
pumped by the heartVeins use the milkingaction of muscles to
help move blood
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Capillary Beds
Capillary bedsconsist of two
types of vesselsVascular shunt directly connects an
arteriole to a venule
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Capillary Beds
True capillaries exchange vessels
Oxygen andnutrients cross tocells
Carbon dioxide
and metabolicwaste productscross into blood
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Diffusion at Capillary Beds
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Pulse
Pulse pressure waveof blood
Monitored atpressure
points wherepulse is easilypalpated
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Blood Pressure
Measurements by health professionalsare made on the pressure in largearteries
Systolic pressure at the peak ofventricular contraction
Diastolic pressure when ventricles relax
Pressure in blood vessels decreases asthe distance away from the heartincreases
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Blood Pressure: Effects of Factors
Neural factors Autonomic nervous system adjustments
(sympathetic division)Renal factors
Regulation by altering blood volume
Renin hormonal control
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Blood Pressure: Effects of Factors
Temperature
Heat has a vasodilation effect
Cold has a vasoconstricting effectChemicals
Various substances can cause increases ordecreases
Diet
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Variations in Blood PressureHuman normal range is variable
Normal140 110 mm Hg systolic80 75 mm Hg diastolic
HypotensionLow systolic (below 110 mm HG)Often associated with illness
HypertensionHigh systolic (above 140 mm HG)Can be dangerous if it is chronic
