9. Cvs_darah Fkm 2012

7/27/2019 9. Cvs_darah Fkm 2012

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LILIK HERAWATI

[email protected][email protected]

Sistem Kardiovaskular

7/27/2019 9. Cvs_darah Fkm 2012


Nutrisi jantung

• Sirkulasi koroner

– Arteri koronaria kanan & kiri caang dari aorta

• !enyakit jantung koroner

nyeri khas "AN#$NA !%'()$S*

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7/27/2019 9. Cvs_darah Fkm 2012


!%)+,A-AN A$)AN /A)A- ()(N%)

S$S'(% 0 !enekanan kuat otot jantung

Aliran darah ↓↓

/$AS'(% 0)elaksasi otot jantung

/arah mengalir ce1at

!enurunan aliran darah di 2entrikel erlawanan dengan

aliran darah di semua jaringan tuuh

Aliran darah koroner 0 334 ml 5 min "674 8 (*

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Atherosklerosis

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• etiol0 aterosklerosis

:. enda1an lemak "ercak lemak*

3. 1enimunan lemak

;. 1lak firosa

6. 1lak ateroma

4. 1eruahan degenaratif

Penyakit jantung koroner

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7/27/2019 9. Cvs_darah Fkm 2012


1eru 1atologis 1em darah elum

menunjukkan tanda7tanda gangguan1rosesnya erlangsung selama 3<76< tahun

timul keluhan klinis jika lumen telah tertutu1=>48

− lumen sem1it

− 1erdarahan 1ada 1lak aterom

− tromus

− emolus

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)isk factors

tidak dapat diubah• umur

• se?

• ras• riwayat keluarga

dapat diubah

• mayor

– li1id serum glukosa...

– -'

– merokok – diet tinggi...

• minor

– gaya hidu1 kuranggerak

– stres

– ti1e ke1riadian

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Sistem konduksi

• SA node "1ace

maker*

• A node

• ,erkas -is

• ,erkas 1urkinye

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Siklus jantung

• B 1eriode mulai dari akhir kontraksi s.d

akhir kontraksi erikutnya

• Sistole

• /iastole

• Normal denyut jantung B denyut nadi

"cermin siklus jantung*

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Suara jantung

• /idengar dgn telinga & alat antu

• Suara : B S: – Lub

– Cenutu1nya katu1 atrio72entrikular

• Suara 3 B S3 – Dub

– Cenutu1nya katu1 semilunar

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/aya 1om1a jantung

• -eart rate "denyut jantung*

• Stroke 2olume "2olume sekuncu1*

• ardiac (ut1ut "curah jantung*

-) ? S B (

>< 1m ? >< ml B 69<< ml5mnt D 4 liter5mnt

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!engaturan faal jantung

• $nstriksik nodus & sistem konduksi

• %kstrinsik saraf otonom "= dominan*

– Sim1atis

– !arasim1atis

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Eaktor yg mem1engaruhi

1om1a jantung0

• :. tekanan darah

• 3. kadar ion

• ;. suhu

• 6. hi1erka1nea

• hi1oksia

• asidosis

• 4. (at mis0 /igitalis,arituratafein teofilin

• F. e?ercise

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7/27/2019 9. Cvs_darah Fkm 2012


a1illary eds

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!engukuran

'ekanan darah

!ulse 1ressure

"Cean arterial 1ressure*

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!engukuran '/

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elocity

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RegulasiJangka pendek: Kimiawi

-ormon "adrenalin & noradrenalin* Atrial natriuretic 1e1tide "AN!*

− disekresi atrium jantung

− antagonis aldosteron− efek0 2adil

A/-

Angiotensin $$

− 2akonst

− menrang aldosteron

%/E "endothelium7deri2ed factors*

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A l i r a

n

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• S$)+AS$ S$S'%C$

• S$)+AS$ !A)+

• S$)+AS$ ('A• S$)+AS$ S!ANN$-

• S$)+AS$ ()(N%)

• /

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7/27/2019 9. Cvs_darah Fkm 2012


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!emuluh $CE%

• Cuara akhir saluran 5 1emuluh limfe ada

di 1emuluh darah yaitu 2ena sukla2ia

Eungsi a.l0

• Cemantu aliran darah

• 'em1at asor1si lemak "misal khilomikron*

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7/27/2019 9. Cvs_darah Fkm 2012


LILIK HERAWATI

Physiology Departement

Faculty of Medicine

Airlangga University

lilik_wahyu99@yahoocom

Faal DARAH

(singkat)

7/27/2019 9. Cvs_darah Fkm 2012


'he lood functions

transports materials: oxygen and carbon dioxide food molecules (glucose, lipids,

amino acids) ions (e.g., Na+, Ca2+, HCO!) "astes (e.g., urea) #ormones#eatdefense of t#e body against infectionsand ot#er foreign materials

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!lasma

• roles in homeostasis

BB= such asmaintaining0 – normal 1lasma 1-

– osmolality

• com1osed0

– mostly of water "9:8* – !roteins F7G8

– li1ids "fats* <F8

– #lucose <:8

– amino acids – 2itamins

– minerals

– hormones

– wastes – cofactors

– gases

– electrolytes

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Red Bld !ells "Er#thr$#tes%

• Eungsi utama0 mengandung hemoglobin

yang membawa o?ygen

• 'he other functions0 – they contain a large Huantity of carbonic

anhydrase, an enIyme that catalyIes (3 J

-3( -3(;

– acid-base buffer

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#uyton 3<<4

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• 'he 1eriod from stem cell to thereticulocyte in the circulation normally takesa11ro?imately : week

• Caturation of reticulocyte to erythrocytetakes a11ro?imately 36 to 6G hours – the red cell loses its mitochondria and

riosomes along with its aility to 1roducehemogloin and engage in o?idati2emetaolism

• Cost maturing red cells enter the lood as

reticulocytes BB= A11ro?imately :8• &&' er#thrpieti$ a$ti(it# ) the bnemarrw

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,ahan aku eritrosit

• a.l0 –1rotein

–2itamin ,:3 –asam folat

–esi

l

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Regulasipembentukan eritrossit

• hipoksia jaringan• kemampuan fungsional eritrosit &

tubuh mentranspor O2 ke jaringan

BUKAN HANYA oleh konsentrasieritrosit dalam darah

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7/27/2019 9. Cvs_darah Fkm 2012


• +mur :3<

hari

• 'erutama di

lien diameter ;K

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/isease

• Anemia "kekurangan eritrosit5 -* – !erdarahan akutL kronik – +mur 1endek0 hemolytic anemia – !roduksi tergangguL

1arik rusakL ahan kurangL %!( MMM

• !olisitemia "eritrosit erleih "= F juta5 mm;* –

)elatif 0 dehidrasi – Asolut0 – Sekunder

– era "eritrema*

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7/27/2019 9. Cvs_darah Fkm 2012


*ungsi Leuksit

• the mobile units of the odys 1rotecti2e

system

• Cekanisme kekealan0

(1)phagocytosis

"3*forming antibodies and sensitized

lymphocytes

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O,s

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Eungsi+eutr)il :

• fagositosis akteri & enda asing

Esin)il :

• Eagosit lemah• menanggulangi inf.1arasit terliat dlm

1roses radang

• P QQ 1d kead. 0 alergi

E i

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EungsiBas)il :

• 1roduksi R histamin radikinin serotoninhe1arin enIim lisosom

• er1eran dalam terjadi alergi

–$g % terikat dengan asofil Ada Ag & Agterikat di $g% asofil ru1tur sekresi Iat

,nsit-makr)ag

• Eagositosis

• monosit7makrofag system5 reticuloendothelial

sytem

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)es1on leukosit terhada1

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)es1on leukosit terhada1

eradangan

:st line defense

makr)ag .aringan

3nd line defense 0netr)il

• :. 1emuluh darah R netrofil marginasi

dia1edesis & kemotaksis• 3. Cengirim sinyal ke sutul R moilisasi leukosit

R leukositosis5neutrofilia

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)es1on leukosit terhada1eradangan

;rd line defense 0,nsit makr)ag

,utuh waktu

6th line defense 0

memicu stem cell "di one marrow*+tk meningkatkan

• 1ementukan lekosit aru

• R granulosit monosit dan limfosit

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/ i ti d A tib d

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/a$$inatin and Antibd#

Respnse

Platelet /

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• the megakaryocytes fragment• : to 6 micrometersL nuclei 7 & re1roduction 7• normal B :4<<<< 7 ;<<<<< 1er microliter • lifes1an0 01 t 21 da#s in the circulation

• !roduction0 in the one marrow from megakaryocytes

Platelet /

Trombosit

/%E$N$'$(N &

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/%E$N$'$(N &C%-AN$SCS

• Hemostasis means 1re2ention of lood

loss "whene2er a 2essel is se2ered orru1tured*

• Cechanisms in hemostasis0":* 2ascular constriction

"3* formation of a 1latelet 1lug

";* formation of a lood clot as a result oflood coagulation

"6* growth of firous tissue to close the holein the 2essel 1ermanently

3latelet 3lug *rmatin

7/27/2019 9. Cvs_darah Fkm 2012


3latelet 3lug *rmatin• $f the cut in the lood 2essel BB= sealed y a

platelet plug

BL44D !L4T 5 ! l ti d

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BL44D !L4T 5 !agulatin $as$ade

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,lood 'y1es

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,lood 'y1es

AB4• according to antigenson red lood cells

• 'y1e A0 A antigens

• 'y1e ,0 , antigens• 'y1e (0 no antigens

"uni2ersal donor*

• 'y1e A,0 A and ,

antigens "uni2ersalreci1ient*

Rhesus• 4 main )hesus antigens

" c / % and e*• a.)h factor 1ositi2e0 /

antigen is 1resent

• .)h factor negati2e0 /antigen is not 1resent

• antiodies are

de2elo1ed against the)h factor BB= through1lacental sensitiIation ortranslation

Wh t Bl d T 6

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What are Bld T#pes6• Karl Landsteiner in the earl# 0788s9 There are )ur t#pes

) bld in the AB4 s#stem: A B AB 49

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Bld Trans)usins

•whole lood

•fractionated into com1onents

including0 – ),s – 1latelets –

1lasma

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7/27/2019 9. Cvs_darah Fkm 2012


Good Luck

9. Cvs_darah Fkm 2012

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