PLENARY DISCUSSION

By Group 16 C

The Member of Group 16 C

Syafrida Yulia RosaEka PutriDoppy AndikaAufa Azry DaniAndini AchiarMellyana Putri Ningsih Anas ZakariaRifky YSWinda FatwinataNavasilan A/L Karuppiah

Scenario : Andi’s heart was pounding

Andi go to the heart’s policlinic in RSMJ to find the condition of his heart because he often feel that his heart was pounding and sesak napas, especially after sport, because andi like to drank some coffee to finish his work as a new student college of medicine faculty.

Doctor take the blood pressure and after sphighnomanometer manset was opened, andi ask the docter soon, “how much doc?”, and doctor answer,”Systole 140 and diastole 90 mmHg”, andi think, what it mean? He only knew the blood pressure?. And next, doctor doing the auscultation andi’s heart and said that there is an arrythmia. Doctor said that andi should to do ECD p[emeriksaan and andi agree. This alat placed in some place in andi’s body and connect with listrik. The result in a graph, and then doctor menandai with P,Q,R, and S, doctor said, “This picture show the myocrdium activity melalui the pace maker to the purkinje fibrin heart’s cycle”. In High school, the setting melalui brain and nervous, andi said . How you explain the andi’s problem?

Scheme

Learning Objective

The student can explain1. The cardiac electric activity2. The cardiac mechanic activity3. The work of Electrocardiogram4. Cardiac sound5. The nervous of cardiac6. The ill in impulse and denyut of cardiac

1. The cardiac electric activity

Impulse come to cardiac at first in SA or sinus node. Then, the impulse goes to AV node with normal velocity. When the impulse goes to the purkinje fiber, the velocity is slower than before. And then, the impulse goes to the endocardium of ventricle with velocity that faster then normal. And finally, with normal velocity, the impulse goes to the surface of ventricle’s epicardium

2. The cardiac mechanic activity

• Left atrium, with fresh blood from pulmo• The fresh blood goes to left ventricle melewati

bikuspidalis valve• Left ventricle pomp the fresh blood into all of body,

melalui aorta• The blood from all of body, come into the right atrium

melalui superior and inferior vena cava.• Then, the dirty blood goes to the right atrium melewati

trikuspidalis valve• And then, right atrium will pomp the blood into pulmo

melalui pulmonalis artery

3. Elektrocardiogram

4. Cardiac’s Sound

• First cardiac sound : the AV valve was closed, that makes turbulance of blood

• Second cardiac sound : the pulmo and aorta valve was closed

• Third cardiac sound : 1/3 last part of ventricle diastole

• Fouth cardiac sound : the contraction of atrium

5. The Nervous Of Cardiac

• Sympatis nerve> Set the Sinoatrium node and Atrioventricular

node, right and left of atrium and a litle of ventricle

• Parasimpatis nerve> Set the purkinje node and right and left atrium

6. The Ill of Impulse and Denyut Of Cardiac

• FibrillationÞ There are so many impulse that found in

myocardium and out of coordination• Abnormal pace maker=> There are some pace maker abnormal, such

as AV node. It’s caused abnormal contraction and decrease the cardiac pomp

• Node Block=> Usually happen in AV node