dr. Teuku Heriansyah Sp. JP THE HEART Lokasi Jantung Di dalam Pericardium di rongga mediastinum dalam rongga Thorak
Tepat di belakang tulang dada ( sternum )
Kurang lebih 2/3 bagian terletak di sebelah kiri dari garis tengah Fungsi dan Ukuran Fungsi : sebagai pompa ganda agar terjadi aliran dalam pembuluh darah yang disebabkan adanya pergantian antara kontraksi ( sistolik ) dan relaksasi ( diastolik )
Ukuran : 250 350 gram ( kira-kira sebesar kepalan tangan ) Fibrous Skeleton Kerangka jantung yang terdiri dari jaringan kolagen yang tebal dan kuat
Penunjang fisik jantung
Pegangan katup
Mencegah kelebihan regangan otot jantung
Electrical insulation Anatomy of the Heart Pericardium : Outer fibrous sack
Myocardium : Thick muscle walls
Endocardium : Innermost surface Endothelium Simple squamous epithelium Perikardium Perikardium Fibrosa Lapisan paling luar rongga Pericardium Menjaga kedudukan jantung di rongga mediastinum
Perikardium Serosa Lapisan parietalis Lapisan bagian dalam dari rongga pericardial Lapisan visceralis / epicardium
Rongga Perikardium Cairan pericardium Mengurangi gesekan saat jantung bergerak Anatomy of the Heart Heart chambers : Left & right atria Left & right ventricles Heart valves : Atrioventricular valves : Right : Tricuspid Left : Bicuspid/Mitral Semilunar valves Right : Pulmonary valve Left : Aortic valve Anatomy of the Heart Aorta Coronary arteries Arterioles Capillaries Venules Coronary sinus Right atrium Coronary circulation Tipe-tipe sel Otot Jantung Autoritmik autoritmik mampu berdepolarisasi spontan produce pacemaker potentials menyalurkan aksi potensial ( impulses ) melewati myocardium tidak berkontraksi
Kontraktil Potensial aksi menimbulkan kontraksi Aliran darah ditimbulkan oleh pergantian dari kontraksi ( SISTOLIK ) dan Relaksasi ( DIASTOLIK ) Intrinsic ConductingSystem Sinoatrial node Electrical pace maker Atrioventricular node Receives impulses originating from SA node Bundle of His Electrical link between atria and ventricles Purkinje fibres Distribute impulses to ventricles Conduction System SA Node Internodal branch AV Node Hiss Bundle Purkinje Fiber Contraction Cardiac Action Potentials Cardiac Muscle Tissue The Electrocardiogram ( ECG ) P wave : atrial depolarisation
QRS complex : ventricular depolarisation
T wave : ventricular repolarisation
Atrial repolarisation hidden by QRS P Q R S T The Electrocardiogram (ECG) Leads can be placed on wrists and left ankle ( right ankle is earthed ) Voltages are measured across each point as shown I = L wrist to R wrist II = R wrist to L ankle III = L ankle and L wrist The heart sits in the centre of the triangle
I II III +/- + - The Electrocardiogram The three standard measurements can be used to electronically calculate the currents flowing towards each limb aVR aVL aVF
+ The Cardiac Cycle Systole : Period of ventricular contraction Blood ejected from heart Diastole : Period of ventricular relaxation Blood filling The Cardiac Cycle Stroke Volume The amount of blood ejected from the heart in one beat Average is 60 - 100 ml Depends on preload, contractile force and afterload
Cardiac Output The amount of blood ejected from the heart in one minute Cardiac output = heart rate x stroke volume
Starlings Law The more the myocardium is stretched, the greater the stroke volume Has limits Dependent upon venous return
Blood Pressure BP = cardiac output x systemic vascular resistance
Definitions
Chronotropy Change in heart rate Inotropy Change in contractile force Dromotropy Change in conduction velocity Can be positive or negative The Electrocardiogram Thank You
Dokumen Serupa dengan Anatomy and Physiology of the Heart (Rev)
