SISTEM VASKULAR DAN

SIRKULASI DARAH
l Sistem vaskular merupakan komponen esensial
pada sistem sirkulasi
l Komponen esensial pada sistem sirkulasi sbb:
l Jantung: merupakan organ jaringan otot
yang menghasilkan gerakan (memompa
darah)
l Arteri: merupakan jalan pengangkutan
darah ke organ-organ dan ke jaringan-
jaraingan
l Kapiler: merupakan saluran-saluran kecil
yang beranastomosis, yang membagi dan
melakukan pertukaran bermacam-macam
substrat antara darah dan cairan jaringan
l Vena: merupakan jalan pengangkutan darah
kembali jantung
Jantung (heart)
Struktur Jantung

Endocardium. Merupakan
lapisan yang paling dalam,
terdiri atas jaringan Endothel

Myocardium. Merupakan
lapisan di tengah, terdiri atas
jaringan otot. Jaringan
ototnya tipis di bagian atrium
dan tebal di bagian ventrikel.

Pericardium. Merupakan
lapisan yang paling luar,
terdiri atas jaringan ikat dan
epithel.
l Jantung dipisahkan dari organ-organ dalam
toraks lainnya oleh pericardium
l Epicardium merupakan jaringan fibrosa yang
menutupi myocardium
l Ruang antara pericardium dengan epicardium
disebut ruang pericardium atau kantung
pericardium
l Ruang pericardium secara normal berisi 5-30
mL cairan jernih, yang melumaskan jantung
dan memungkinkannya berkontraksi tanpa
banyak mengalami gesekan
l Jantung terdiri atas 4 ruang, yaitu 2 atrium
(kiri dan kanan) dan 2 ventrikel (kiri dan
kanan).
Heart Pumping Action

Ø Deoxygenated blood (blood low

in oxygen content) from
various parts of the body first
returns to the right atrium
through the two venae cavae
Ø Blood from the head, neck and
arm goes to anterior (upper)
vena cava and blood from the
lower parts of the body is
brought back by the posterior
(lower) vena cava. From the
venae cavae open into the right
atrium
l The right atrium contracts, blood flows into the right ventricle.
The contraction of the right atrium does not causes the blood to
flow down into the ventricle. The ventricle first relaxes, creating
an empty cavity for blood to flow into the ventricle. The right
atrium then contracts, forcing the remaining blood in it to go
down into the right ventricle.
l As the right ventricle contracts, blood in it is forced out into the
pulmonary artery. There is a valve separating the atrium and
ventricle, that prevents blood from flowing back into the atrium
as ventricle contracts. This valve is known as the Tricuspid
valve, because it has three flaps. These flaps are attached to
cord-like tendons called chordae tendineae. As the ventricle
contracts, the blood pressure forces the flaps to close. The
tendons prevent the flaps from being turned back into the
atrium.
l Similarly, there is a valve in the pulmonary artery just as it
leaves the heart. When the right ventricle relaxes, the valves
are forced close to prevent back-flow of blood.
l The pulmonary artery then carries the deoxygenated blood to
the two lungs, where the blood becomes oxygenated again and
returns the heart via the pulmonary vein.
l Now the blood comes to the right side of the heart. The left
side of the heart works much like the right side.
l Blood from the pulmonary vein flows into the left atrium,
and enters the left ventricle. Between the left atrium and the
left ventricle is the bicuspid valve. This is similar in structure
and function to the tricuspid valve but as the name
suggests, it has only two flaps instead of three. When the
left ventricle contracts, blood leaves by way of a large
artery, the aortic arch. From the aortic arch blood is
distributed to all parts of the body. The aortic arch curves
upwards from the left ventricle as a U-shaped tube and it
also possesses valves to prevent the back-flow of blood.
l The heart muscle of the left ventricle is thicker than muscle
of the right ventricle. This is because, the right ventricle only
needs to pump blood to the lungs, which are not far away
from the heart. Less force is required to send the blood to
the lungs. However, the left ventricle has a much harder job
of pumping blood to the rest of the body.
 The Valves in The Heart

l Valves in the heart plays a significant part in

helping the heart to pump the blood around the
body efficiently. A valve is just like a door.
However, a valve opens only into one direction and
only allow the passage of one way
l There are four valves in the heart:
l the tricuspid valve between the right auricle
and right ventricle,
l the bicuspid valve between the left auricle
and left ventricle, and
l the two pulmonary valves, one each at
between the right ventricle and the
pulmonary artery and at between the left
ventricle and the aorta
 Siklus Jantung
l Bagian-bagian jantung secara normal berdenyut
dengan urutan teratur. Pada saat jantung berdenyut
terjadi 2 fase, yaitu:
l Systole. Merupakan fase kontraksi, yang meliputi
kontraksi atrium (atrium systole) dan kontraksi
ventrikel (ventricle systole).
l Diastole. Merupakan fase relaksasi. Selama fase
ini semua empat rongga jantung dalam keadaan
relaksasi.
l Pada saat atrium berkontraksi (atrium systole) darah
mengalir ke ventrikel. Sedangkan pada saat ventrikel
berkontraksi (ventricle systole) darah mengalir ke
arteria pulmonalis dan ke aorta. Kemudian atrium
dan ventrikel relaks untuk sementara waktu. Periode
relaksasi ini disebut Diastole.
l Otot jantung memiliki sifat unik yaitu berkontraksi
dan mengalami repolisasi lebih cepat saat
kecepatan denyut jantung tinggi, dan durasi
sistolik menurun dari 0,3 detik pada kecepatan
denyut jantung 65 menjadi 0,16 pada kecepatan
200 denyut/menit
l Pemendekan ini terutama disebabkan oleh
penurunan durasi semprotan sistolik. Namun
durasi sistolik lebih konstan daripada durasi
diastolik, dan apabila kecepatan denyut jantung
meningkat, distolik mengalami pemendekan lebih
besar. Hal ini memiliki dampak fisiologis dan klinis
yang penting
l Selama distolik (diastole) lah otot jantung
beristirahat, dan darah koroner mengalir ke
bagian subendocardium ventrikel kiri terjadi hanya
selama distolik. Selain itu sebagian besar
pengisian ventrikel terjadi selama distolik.
 Bunyi Jantung (Heart Sound)

l Dalam keadaan normal terdengar dua bunyi

jantung melalui stetoskop selama setiap siklus
jantung.
l Bunyi pertama berbunyi "lub”: bernada rendah,
sedikit lama atau sedikit memanjang,
disebabkan oleh getaran yang ditimbulkan oleh
penutupan mendadak katup mitral dan
trikuspidalis pada permulaan sistolik ventrikel.
Memiliki durasi sekitar 0,15 detik dan frekuensi
25-45 Hz. Bunyi ini lembut saat kecepatan
denyut jantung lambat karena ventrikel terisi
penuh oleh darah dan daun-daun katup AV
mengapung bersama sebelum sistolik.
l Bunyi kedua adalah "dub”: lebih singkat dan
bernada tinggi yang disebabkan oleh getaran
penutupan katup aorta dan pulmonaris tepat
setelah akhir sistolik ventrikel. Bunyi kedua
berlangsung sekitar 0,12 detik dengan frekuensi 50
Hz. Bunyi ini keras dan tajam apabila tekanan
distolik di aorta atau arteri pulmonalis meningkat,
yang menyebabkan katup-katup menutup dengan
cepat pada akhir sistolik. Interval antara
penutupan katup aorta dan pulmonaris selama
inspirasi sering cukup panjang sehingga bunyi
kedua mengalami reduplikasi (pemisahan fisiologis
bunyi jantung ke dua). Pemisahan juga terjadi
pada berbagai penyakit.
l Pada orang dewasa muda, terdengar bunyi ketiga
yang lembut dan bernada rendah di dengar kira-
kira pada 1/3 jalan diastolik. Bunyi ini bersamaan
dengan masa pengisian cepat ventrikel dan
mungkin disebabkan oleh getaran yang
ditimbulkan oleh aliran darah masuk.
l Kadang-kadang terdengar bunyi keempat sesaat
sebelum bunyi pertama saat tekanan atrium tinggi
atau ventrikel kaku pada keadaan seperti
hipertropi ventrikel. Ini disebabkan karena
pengisian cepat ventrikel dan jarang didengar
pada individu dewasa normal
l Selain bunyi tersebut diatas, sering juga muncul
bunyi abnormal, yaitu murmur.
 Murmur

l A heart murmur is a swishing or a whistling

sound. A murmur is usually present when there is
a heart valve problem.
What Causes a Heart Murmur?
l There are many different causes of heart
murmurs. They can be caused by a heart attack,
high blood pressure, rheumatic fever, pregnancy,
fever, thyrotoxicosis or anemia. Thyrotoxicosis is
a condition caused by an overactive thyroid gland.
u Blood pressure is the force created by the
heart as it pushes blood into the arteries and
the circulatory system. When the heart
pumps, it causes blood to flow through the
arteries and into the arterioles. As the blood
goes through the arterioles, the arterioles
either contract or expand altering both the
amount of blood flow and the resistance to
blood flow. If the arterioles remain in a
contracted form, they create high blood
pressure. The heart must then pump harder
because the arterioles are exerting a greater
resistance to blood flow. High blood
pressure is often called the "silent killer".
u Iron Deficiency Anemia (also called IDA) is a
condition where a individu has inadequate
amounts of iron to meet body demands. It is a
decrease in the amount of red cells in the blood
caused by having too little iron. IDA is usually
caused by a diet insufficient in iron or from blood
loss.
What is the Thyroid?
l The thyroid produces hormones that influence every organ,
tissue and cell in the body. The hormones also control heart
rate, body weight, body temperature, energy level, muscle
strength and menstrual regularity. When the thyroid becomes
faulty or malfunctions, metabolic disorders occur. There are two
main types of thyroid malfunctions: hypothyroidism and
hyperthyroidism.

Hypothyroidism
Hypothyroidism occurs when the thyroid gland produces too little
amounts of thyroid hormone, causes the body to function at a lower
rate. Hypothyroidism can contribute to heart disease. It can
contribute to heart disease because one of the side effects is an
increased amount of LDL (bad) cholesterol circulating in the blood.
Hyperthyroidism
Hyperthyroidism occurs when the thyroid gland produces too much
hormone. Hyperthyroidism increases the rate at which each cell
functions, increasing all the reactions that occur in the body. Some
of the symptoms of hyperthyroidism are: nervousness, decreased
menstrual flow, weight loss, and irregular heartbeat.
l Types of Heart Murmurs?
There are two main types of heart murmurs: diastolic and
systolic. A diastolic murmur occurs when the heart muscle
relaxes between beats. It occurs after the second heart
sound. A systolic murmur occurs between the first and
second heart sounds.

l Heart Valve Problems

Heart Valve disease occurs when a valve doesn't work
properly. If a valve doesn't open all the way, less blood can
move through the smaller opening. If a valve doesn't close
tightly, blood may leak backward. These problems can cause
the heart to work harder to pump the same amount of blood.
Or blood may back up in the lungs or body because it's not
moving efficiently through the heart.
When the valve doesn't open completely, it is called
Stenosis. When it doesn't close completely it is called
Insufficiency or Regurgitation.