Fisiologi sirkulasi fetus, bayi,

dewasa
dr. Rohmania Setiarini
The Heart: Blood Flow
Deoxygenated
blood in from
body
Oxygenated
blood in lungs
Atria Contract Ventricles Contract
Deoxygenated
blood out
to lungs
Oxygenated
blood out to
body
The Heart: Blood Flow (cont.)
Right
Atrium
Right
Ventricle
Pulmonary
Semilunar
Valve
Left
Atrium
Bicuspid
Valve
Left
Ventricle
Pulmonary
Valve
Tricuspid
Valve
Aortic
Semilunar
Valve
Lungs Body
The Heart: Cardiac Cycle
Right atrium contracts
Tricuspid valve opens
Blood fills right ventricle

Right ventricle contracts
Tricuspid valve closes
Pulmonary semilunar valve
opens
Blood flows into pulmonary
artery
Left atrium contracts
Bicuspid valve opens
Blood fills left ventricle

Left ventricle contracts
Bicuspid valve closes
Aortic semilunar valve opens
Blood pushed into aorta
One heartbeat = one cardiac cycle
Atria contract and relax
Ventricles contract and relax
Conducting System of Heart
Blood Vessels: Arteries and Arterioles
Strongest of the
blood vessels
Carry blood away
from the heart
Under high pressure
Vasoconstriction
Vasodilation
Arterioles
Small branches of
arteries
Aorta
Takes blood from the
heart to the body
Coronary arteries
Supply blood to heart
muscle
Blood Vessels: Veins and Venules
Blood under no pressure in
veins
Does not move very easily
Skeletal muscle contractions
help move blood
Sympathetic nervous system
also influences pressure
Valves prevent backflow
Venules
Small vessels formed when
capillaries merge
Superior and inferior vena
cava
Largest veins
Carry blood into right atrium
Blood Vessels: Capillaries
Branches of arterioles

Smallest type of blood vessel

Connect arterioles to venules

Only about one cell layer thick

Oxygen and nutrients can pass out of a capillary into
a body cell

Carbon dioxide and other waste products pass out of
a body cell into a capillary
Circulation
Pulmonary circuit
right atrium right ventricle pulmonary artery
trunk pulmonary arteries lungs
pulmonary veins heart (left atrium)

Systemic circuit
left atrium left ventricle aorta arteries
arterioles capillaries venules veins
vena cava heart (right atrium)
Blood Flow Through Heart
Systemic and Pulmonary
Circulation
FETAL CIRCULATION
By the third month of development, all major blood
vessels are present and functioning.

Fetus must have blood flow to placenta.

Resistance to blood flow is high in lungs.
UMBILICAL CIRCULATION
Pair of umbilical
arteries carry
deoxygenated
blood & wastes
to placenta.
Umbilical vein
carries
oxygenated
blood and
nutrients from
the placenta.

THE PLACENTA
Facilitates gas and
nutrient exchange
between maternal
and fetal blood.
The blood itself does
not mix.
UMBILICAL VEIN TO PORTAL
CIRCULATION
Some blood from the
umbilical vein enters
the portal circulation
allowing the liver to
process nutrients.
The majority of the
blood enters the ductus
venosus, a shunt which
bypasses the liver and
puts blood into the
hepatic veins.

FORAMEN OVALE
Blood is shunted
from right atrium to
left atrium, skipping
the lungs.
More than one-third
of blood takes this
route.
Is a valve with two
flaps that prevent
back-flow.
DUCTUS ARTERIOUSUS
The blood pumped
from the right
ventricle enters the
pulmonary trunk.
Most of this blood is
shunted into the
aortic arch through
the ductus
arteriousus.

WHAT HAPPENS AT BIRTH?
The change from fetal to postnatal
circulation happens very quickly.
Changes are initiated by babys first
breath.
Foramen ovale Closes shortly after birth,
fuses completely in first
year.
Ductus arteriousus Closes soon after birth,
becomes ligamentum
arteriousum in about 3
months.
Ductus venosus Ligamentum venosum
Umbilical arteries Medial umbilical ligaments
Umbilical vein Ligamentum teres
PROBLEM WITH PERSISTENCE
OF FETAL CIRCULATION
Patent (open) ductus arteriosus and patent
foramen ovale each characterize about 8%
of congenital heart defects.
Both cause a mixing of oxygen-rich and
oxygen-poor blood; blood reaching tissues
not fully oxygenated. Can cause cyanosis.
Surgical correction now available, ideally
completed around age two.
Many of these defects go undetected until
child is at least school age.