血液循环 blood circulation
DESCRIPTION
血液循环 Blood Circulation. 夏 强, PhD 浙江大学医学院生理学系 医学院科研楼 C 座 518 室 电话: 88208252 Email : [email protected]. 心血管系统. 心脏 Heart 血管系统 Vascular system 血液 Blood. 血液分布. 安静,舒适状态人体. 心 脏 Heart. 泵血 Pumping 内分泌 Endocrine. 收缩细胞. 心肌类型: 心房肌 心室肌 特殊传导系统. 自律细胞. 特殊传导系统. 心肌兴奋顺序. 心脏各部分心肌细胞的跨膜电位. - PowerPoint PPT PresentationTRANSCRIPT
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心血管系统• 心脏 Heart• 血管系统 Vascular system• 血液 Blood
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血液分布• 安静,舒适状态人体
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心 脏Heart
• 泵血 Pumping• 内分泌 Endocrine
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• 心肌类型:– 心房肌– 心室肌– 特殊传导系统
收缩细胞
自律细胞
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特殊传导系统
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心肌兴奋顺序
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心脏各部分心肌细胞的跨膜电位
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心室肌的动作电位
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自律细胞的动作电位
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• 窦房结 P 细胞
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• 浦肯野细胞
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心电图Electrocardiogram (ECG)
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• 心电图中导联的位置
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0.04 sec
ECG interpretation•Measurements •Rhythm analysis•Conduction analysis•Waveform description •Comparison with previous ECG (if any)
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Normal
Partial block
Complete block
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心肌的兴奋 - 收缩偶联Excitation-Contraction Coupling in Cardiac Muscle
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心动周期Cardiac cycle
收缩期 Systole
舒张期 Diastole
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心 音Heart Sounds
• 第一心音 1st sound– soft low-pitched lub– associated with closure of the AV valves– Marks the onset of systole
• 第二心音 2nd sound– louder dup– associated with closure of the PA and aortic valves– Occurs at the onset of diastole
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Four traditional value areas – Aortic space: 2RIS – Pulmonic valve: 2LIS – Tricuspid valve: 4ICS LLSB– Mitral valve: Apex
RIS--right intercostal spaceLIS—left intercostal space ICS--intercostal space LLSB--left lower sternal border
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血管生理Vascular Physiology
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动脉血压Arterial blood pressure
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• 血压测量– 直接有创法
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• 血压测量– 间接无创法
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Blood Pressure Classification Chart
Category Systolic (mm Hg) Diastolic (mm Hg)
Normal Lower than 120 Lower than 80
Prehypertension 120 - 139 80 - 89
Hypertension
Stage 1 140-159 90-99
Stage 2 160 or higher 100 or higher
Adapted from The Seventh Report on the joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), NIH Publication No. 03-5233, May 2003
The classification chart is based on adults, aged 18 and older, who are not taking high blood pressure medicines and who are not acutely ill. If systolic and diastolic measurements fall into different categories, the higher category should be used to classify the person's blood pressure status.
Classification of blood pressure for adults age 18 years and older
JNC 8?
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中国高血压防治指南( 2005 )
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• 2014 Hypertension Guideline Management Algorithm
• http://jama.jamanetwork.com/article.aspx?articleid=1791497
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动脉脉搏 Arterial pulse
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微循环Microcirculation
• 主要功能:– 物质交换
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• 毛细血管 Capillaries
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EFP
Pc
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静脉血压Venous pressure
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At rest, approx. 60% of the total blood volume is in the veins. Sympathetically mediated venoconstriction can substantially increase venous return to the heart.
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Varicose vein
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淋巴系统Lymphatic System
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Elephantiasis:
Chronic, often extreme enlargement and hardening of cutaneous and subcutaneous tissue, especially of the legs and external genitals, resulting from lymphatic obstruction and usually caused by infestation of the lymph glands and vessels with a filarial worm.
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呼 吸Respiration
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肺通气Pulmonary ventilation
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Thorax & respiratory muscle
Primary muscles of respiration: external intercostals & diaphragm
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The Heimlich maneuverincreases the alveolar pressure (Palv) by supplementingthe upward movement of the diaphragm, thus compressing the thoracic cavity to dislodge foreign objects in the airways.
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气胸Pneumothorax
• Air escapes from the lungs or leaks through the chest wall and enters the pleural cavity
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Lateral Bilateral
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气体交换
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Hemoglobinis the gas-transportmolecule inside erythrocytes.
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发绀 Cyanosis
• Hb>50g/L
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Carbon monoxide poisoning
• CO competes for the O2 sides in Hb
• CO has extremely high affinity for Hb
OO22
OO22 OO22COCO
COCOCOCO
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呼吸调节
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谢谢专注!