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CARDIOVASCULAR
CARDIOVASCULAR
CARDIOVASCULAR
By
Dr. Agung Kurniawan, MKes
Location Of our Heart
Parts of our heart
HEART AS A PUMP
Heart (COR) consists of two separated pumps,
which are: right COR (dextra) which pumps blood to
the lung; and left COR (sinistra) which pumps blood to
peripheral organs. Each part of the COR is separated
as a beating pump space., consists of one atrium and
one ventricle. Atrium is the weak primary pump that
helps flowing the blood to the ventricle. There is a
special mechanism inside the pulmonal/peripheral
circulation that is responsible to preserve the heart
rythm by spreading the act potensial to the entire
myocardium. The COR cycle consists of one relaxation
periode diastole (The blood filling phase of the COR)
and one constriction periode systole.
HEART AS A PUMP
HEART AS A PUMP
HEART PUMP REGULATION
• The heart is able to pump about 4 to 6 litres of blood in
rest condition, and up to 4 to 7 times in work hard
condition.
• Intrinsic Regulation / Frank-Starling Mechanism
– The heart’s intrinsic ability to adapt of differences volume
consequences of the blood entered.
– In physiology confine, heart pump the entered blood avoid to
create the dike of excessive blood in vein.
• Autonomic Nerve Regulation
– The effectiveness if heart pump is reins by the sympatic and
parasympatic nerves.
– Total blood that pump by the heart for each minute (COP) can
increase more than 100% through the sympatic stimulation and
the other way through parasympatic stimulation.
THE RELATION BETWEEN
THE NORMAL HEART SOUND
AND THE HEART PUMP
A. Atrium sound
B. The effect from atrium
contractionglide blood in to ventrikel
C. Fonocardiografilow frequenc
( SEE THE FIGURE BELOW
TO MAKE IT CLEAR )
THE PHASES OF HEART
CYCLE
Continued diastolic
Depolarisasion disseminate to through
atrium and desist at AV nodus.Atrium
mucle contractedvolume of ventrikel
increase until 20
THE PHASES OF HEART
CYCLE
Early systolic
Depolarisation disseminate from AV nodus
through branch bind myocard of ventrikel
ventrikel conytracted ventrikel pressure
mount to exceed atrium pressure AV
valve close first heart sound. aorta and
artery pulmonalis pressure exceed ventrikel
pressure, semulunar valve still close ~
volumetric contraction ( ventrikel volume
constant )
THE PHASES OF HEART
CYCLE
Continued systolic
Ventrikel pressure exceed vein pressure
semilumar valve open blood flow
to the systemic and pulmoner
circulation.
THE PHASES OF HEART
CYCLE
Early diastolic
Repolarisation pass myocard of ventrikel
ventrikel in a state of rest relaxation
ventrikel pressure decrease lower than
atrium pressure semilunar valve close
second heart sound AV valve open
ventrikel filled by vein blood from atrium
( 80 )
THE PHASES OF HEART
CYCLE
THE PHASES OF HEART
CYCLE
CARDIAC OUTPUT
3. Last Load
Last load is the resultant of the ventricle
contraction during the sistolic in order
to open the semilunaric valve and
push the blood in. This act is called
third contraction volume. Arterial
pressure and the size ventricle hold
the main function.
Lapplace’s formulation :
• Laminar Type:
The blood flows along the vessel with regular
speed every lap blood still has the same
distance from central part of wall, blood is in
the middle of blood vessel.
• Turbulance Type:
The blood flows to every ways and continualky
mixed and form a rotation.
Blood flow type
LAMINER
TURBULENT
THE BLOOD FLOW
RESISTANCE
• Barriers to the blood flow is determined by
the meassure of the blood flow and the
pressure gradient inside the blood flow.
• The unit of the blood flow resistance,
determined by :
– Peripheral unit (peripheral resistance unit /
PRU)-Pressure gradient
– Spot inside the blood vessel 1mmHg and the
flow 1ml/minute
SYSTOLIC AND DIASTOLIC
PRESSURE
• The meassurment of the systolic and diastolic is by the indirect
way AUSCULTATION.
• Put the manset around the arm blow it make a pressure till the
artery close if there is no sound anymoreslowly decrease the
pressure in the manset the blood flow will through some partial
turbulance flow a “snap shot” sound
• First Korotkoff Sound systolic pressure. The pressure is
decreased more further the “snap shot” sound missing a roash
sound Fifth Korotkoff Sound Diastolic pressure.
• There will be a progressive increasing of the blood pressure while
someone’s getting older because of the degradating influences on
the regulating mechanism. The systolic increasing on people over
than 60 y.o is caused by the arteriosclerosis process and that will
increase the blood pressure.
f:CARDIACPHYSIOLOGY/ACRDIAC.A&P.PPT/IBNU/NEW/PAPI/WELCOMEPHYSIOLOGY/2004
PENGUKURAN TEKANAN
DRH
F:CARDIOVASCULERPHYSIOLOGY/CH21.PPT/IBNU/NEW/PAPI/WELCOMEPHYSIOLOGY
MEAN ARTERIAL
PRESSURE (MAP)
• is the rate from the total pressure, that is counted
milisecond per milisecond in such periode. The
resistance = systolic and diastolic pressure. Because
it’s almost the same with the diastolic pressure than
the systolic, then the number of MAP consists of 60%
diastolic pressure and 40% of the systolic pressure.
The MAP is almost the same on all ages (near the
diastolic pressure),especially on the elder. The
hydrostatic pressure (HP) influence the arterial
pressure on the peripher and capillarso when
someone’s standing, the HP will be 100mHg as heart
level, and 190mmHg as feet level.
MEAN ARTERIAL
PRESSURE (MAP)
MEAN ARTERIAL
PRESSURE (MAP)
VEIN AND ITS FUNCTION