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CARDIOVASCULAR SYSTEM

Anatomy & Physiology


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