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CARDIOVASCULAR SYSTEM Anatomy & Physiology dr. Jeffrey Wirianta March 8 th 2004
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Anatomy and Physiology of the Heart

Jan 19, 2016

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Page 1: Anatomy and Physiology of the Heart

CARDIOVASCULAR SYSTEM

Anatomy & Physiology

dr. Jeffrey Wirianta March 8th 2004

Page 2: Anatomy and Physiology of the Heart

THE HEART

Page 3: Anatomy and Physiology of the Heart

Lokasi Jantung

Di dalam Pericardium di rongga mediastinum dalam rongga Thorak

Tepat di belakang tulang dada ( sternum )

Kurang lebih 2/3 bagian terletak di sebelah kiri dari garis tengah

Page 4: Anatomy and Physiology of the Heart

Fungsi dan Ukuran

Fungsi : sebagai pompa ganda agar terjadi

aliran dalam pembuluh darah yang

disebabkan adanya pergantian antara

kontraksi ( sistolik ) dan relaksasi

( diastolik )

Ukuran : 250 – 350 gram

( kira-kira sebesar kepalan tangan )

Page 5: Anatomy and Physiology of the Heart
Page 6: Anatomy and Physiology of the Heart

Fibrous Skeleton

Kerangka jantung yang terdiri dari jaringan kolagen yang tebal dan kuat

Penunjang fisik jantung

Pegangan katup

Mencegah kelebihan regangan otot jantung

Electrical insulation

Page 7: Anatomy and Physiology of the Heart

Anatomy of the Heart

Pericardium :

Outer fibrous sack

Myocardium :

Thick muscle walls

Endocardium :

Innermost surface

Endothelium

Simple squamous epithelium

Page 8: Anatomy and Physiology of the Heart

Interventriculer Septum

Papillary muscle

Semilunar Valve

Page 9: Anatomy and Physiology of the Heart

Perikardium

Perikardium Fibrosa

Lapisan paling luar rongga Pericardium

Menjaga kedudukan jantung di rongga mediastinum

Perikardium Serosa

Lapisan parietalis

Lapisan bagian dalam dari rongga pericardial

Lapisan visceralis / epicardium

Rongga Perikardium

Cairan pericardium

Mengurangi gesekan saat jantung bergerak

Page 10: Anatomy and Physiology of the Heart
Page 11: Anatomy and Physiology of the Heart

Anatomy of the Heart

Heart chambers :

Left & right atria

Left & right ventricles

Heart valves :

Atrioventricular valves :

Right : Tricuspid

Left : Bicuspid/Mitral

Semilunar valves

Right : Pulmonary valve

Left : Aortic valve

Page 12: Anatomy and Physiology of the Heart

Anatomy of the Heart

Aorta

Coronary arteries

Arterioles

Capillaries

Venules

Coronary sinus

Right atrium

Coronary circulation

Page 13: Anatomy and Physiology of the Heart

Tipe-tipe sel Otot Jantung

Autoritmik autoritmik – mampu berdepolarisasi spontan

produce pacemaker potentials

menyalurkan aksi potensial ( impulses ) melewati myocardium

tidak berkontraksi

Kontraktil Potensial aksi menimbulkan kontraksi

Aliran darah ditimbulkan oleh pergantian dari

kontraksi ( SISTOLIK ) dan Relaksasi ( DIASTOLIK )

Page 14: Anatomy and Physiology of the Heart

Intrinsic Conducting System

Sinoatrial node

Electrical pace maker

Atrioventricular node

Receives impulses originating from SA node

Bundle of His

Electrical link between atria and ventricles

Purkinje fibres

Distribute impulses to ventricles

Page 15: Anatomy and Physiology of the Heart

Sel Autoritmik

• Fase Depolarisasi

• Fase Repolarisasi

• Fase Istirahat

Sel Kontraktil

• Fase Depolarisasi

• Fase Plateu

• Fase Repolarisasi

• Fase Istirahat

Page 16: Anatomy and Physiology of the Heart
Page 17: Anatomy and Physiology of the Heart
Page 18: Anatomy and Physiology of the Heart

Conduction System

SA Node Internodal branch

AV Node Hiss Bundle Purkinje Fiber Contraction

Page 19: Anatomy and Physiology of the Heart
Page 20: Anatomy and Physiology of the Heart

Cardiac Action Potentials

Page 21: Anatomy and Physiology of the Heart

Cardiac Muscle Tissue

Page 22: Anatomy and Physiology of the Heart
Page 23: Anatomy and Physiology of the Heart
Page 24: Anatomy and Physiology of the Heart
Page 25: Anatomy and Physiology of the Heart

The Electrocardiogram ( ECG )

P wave : atrial depolarisation

QRS complex : ventricular depolarisation

T wave : ventricular repolarisation

Atrial repolarisation hidden by QRS

P

Q

R

S

T

Page 26: Anatomy and Physiology of the Heart
Page 27: Anatomy and Physiology of the Heart
Page 28: Anatomy and Physiology of the Heart
Page 29: Anatomy and Physiology of the Heart

The Electrocardiogram (ECG)

Leads can be placed on wrists and left ankle

( right ankle is earthed )

Voltages are measured across each point as shown I = L wrist to R wrist

II = R wrist to L ankle

III = L ankle and L wrist

The heart sits in the centre of the triangle

I

II III

+/-

+

-

Page 30: Anatomy and Physiology of the Heart

The Electrocardiogram

The three standard measurements can be used to electronically calculate the currents flowing towards each limb

aVR

aVL

aVF

+

Page 31: Anatomy and Physiology of the Heart
Page 32: Anatomy and Physiology of the Heart
Page 33: Anatomy and Physiology of the Heart

The Cardiac Cycle

Systole :

Period of ventricular contraction

Blood ejected from heart

Diastole :

Period of ventricular relaxation

Blood filling

Page 34: Anatomy and Physiology of the Heart
Page 35: Anatomy and Physiology of the Heart

Stroke Volume

The amount of blood ejected from the heart in one beat

Average is 60 - 100 ml

Depends on preload, contractile force and afterload

Cardiac Output

The amount of blood ejected from the heart in one minute

Cardiac output = heart rate x stroke volume

Page 36: Anatomy and Physiology of the Heart

Starling’s Law

The more the myocardium is stretched, the greater the stroke volume

Has limits

Dependent upon venous return

Blood Pressure

BP = cardiac output x systemic vascular

resistance

Page 37: Anatomy and Physiology of the Heart

Definitions

Chronotropy Change in heart rate

Inotropy Change in contractile force

Dromotropy Change in conduction velocity

Can be positive or negative

Page 38: Anatomy and Physiology of the Heart