faal - dr aris

7/28/2019 Faal - Dr Aris

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CARDIOVASCULAR

SYSTEM

dr Aris Prasetyo, MKes


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TIGA BESAR

PENYEBAB KEMATIAN

PENYAKIT JANTUNG

CANCER

PENYAKIT INFEKSI


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BIAYA YG DIKELUARKAN

274 M $ US / th cardiovascular disease

99 M $ US / th alcohol related disease

72 M $ US / th smoking related diseases

67 M $ US / th drug abuse


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Diantara paru paru

Sebelah kiri pusat dada

Dekat dinding anterior dada Persis di posterior sternum

Potongan midsagittal tidak akan membagi 2 samabesar, tapi

(1) terletak agak ke kiri dari midline,

(2) membuat sudut dg longitudinal axis dari tubuh

(3) berputar ke sisi kiri

Lokasi


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diliputi pericardial cavity, ada di bagian anterior dari mediastinum
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Fisiologi Jantung

Tidak pernah istirahat

Berdetak + 100.000 kali/hari

Memompa 8.000 liter/hari

Pompa


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Empat ruang

Atrium: kanan

kiri

Ventrikel: kanan

kiri

Ukurannya sekepalan tangan

Beratnya kira kira 1 pound

Menghasilkan tekanan untuk mensirkulasikan

darah ke seluruh tubuh


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Aliran darah melalui jantung

Darah miskin oksigen dari vena cava inferior dansuperior masuk ke atrium kanan

Melalui katub tricuspidalis masuk ke ventriclekanan

Meninggalkan ventricle kanan menuju paru-paruuntuk mengambil oksigen dan kembali ke jantungsebagai darah yang kaya oksigen

Darah kaya oksigen masuk ke atrium kiri

Mengalir melalui katub mitral masuk ke ventriclekiri

Meninggalkan ventricle kiri melalui aorta keseluruh tubuh


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Bagian penting jantung

Katub

Ventricle kiri

Septum


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Katub

AV : tricuspidalis

bicuspidalis/mitralis

Semilunar : pulmonalis

aorta

Katub AV: mencegah arus balik dari ventrikel ke

atrium saat sistol Katub semilunar : mencegah arus balik dari

pulmonal dan aorta ke ventrikel


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Katub AV

Chorda tendinea

Jaringan ikat

Musculus papilaris

Mendapat persyarafan langsung dari serabut

purkinje

Berkontraksi lebih dulu sesaat sebelum sistol


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Khas histologi otot jantung

Intercalated disc

Syncitium

Septum AV

Atrium dan ventrikel terpisah


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Rangsangan listrik pada jantung

Autorhytmicity

SA node

AV node

Conducting cell:

Internodal pathway

AV bundle

Bundle branches

Purkinje fibers


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Conducting system


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KARDIODINAMIK

Pergerakan dan kekuatan yang muncul

selama kontraksi jantung

Siklus jantung:Sistol

Diastol


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End-diastolic volume (EDV). Jumlah darah di tiapventrikel pada akhir diastol ventrikel (awal sistol

ventrikel). End-systolic volume (ESV). Jumlah darah yang

tersisa di tiap ventricle pada akhir sistol ventrikel(awal ventricular diastole).

Stroke volume (SV). Jumlah darah yg dipompa keluarsekali denyutan EDV - ESV = SV.

Ejection fraction. prosentase EDV dibanding SV.

Cardiac output (CO), Jumlah darah yg dipompamasing masing ventricle dalam 1 menit


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CO = SV x HR

(ml/min) = (ml/beat) x (beats/min)

stroke volume 80 ml

heart rate is 75 bpm

cardiac output?

CO= 80 ml x 75 bpm= 6000 ml/min (6

l/min)


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Cardiac output is precisely adjusted so that peripheraltissues receive an adequate circulatory supply under avariety of conditions.

When necessary, stroke volume in a normal heart canalmost double, and the heart rate can increase by 250

percent.

In most healthy people, increasing both the stroke

volume and the heart rate, as during heavy exercise,can raise the cardiac output by 300-500 percent, to18-30 l/min.

Trained athletes exercising at maximal levels mayincrease cardiac output by nearly 700 percent, to 40l/min.

The difference between resting and maximal cardiacoutput is the cardiac reserve


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EDV tergantung :

Filling time depends entirely on the heartrate. The faster the heart rate, the shorter the

available filling time. Venous return changes in response to

alterations in cardiac output, blood volume,patterns of peripheral circulation, skeletal

muscle activity, and other factors that affectthe rate of blood flow through the venaecavae


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ESV tergantung:

(1) thepreload,

(2) the contractility of the ventricle, and

(3) the afterload.


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Preload

The degree of stretching experienced during

ventricular diastole


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The Frank-Starling Principle.

The relationship between the amount of

ventricular stretching and contractile force

means that within normal physiologicallimits

increasing the EDV results in a

corresponding increase in the strokevolume.

This general rule of "more in = more out"


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Contractility

is the amount of force produced during a contraction,

at a given preload increase contractility -positive inotropic action

decrease contractility -negative inotropic action.

Positive inotropic agents typically stimulate Ca2+entry into cardiac muscle cells, thus increasing theforce and duration of ventricular contractions

Negative inotropic agents may block Ca2+ movement

or depress cardiac muscle metabolism in some way. Positive and negative inotropic factors include ANS

activity, hormones, and changes in extracelluar ionconcentrations.


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Suara jantung

S1-S4.

usually hear thefirstandsecond heart sounds.

These sounds accompany the action of your heartvalves.

The first heart sound, known as "lubb" (S1) lasts alittle longer than the second.

S1, which marks the start of ventricularcontraction, is produced as the AV valves close.

The second heart sound, "dupp" (S2) occurs at the

beginning of ventricular filling, when thesemilunar valves close.


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ELEKTROKARDIOGRAM

SEMUA AKTIVITAS LISTRIK JANTUNG

DAPAT DIREKAM DGN ALAT

ELEKTROKARDIOGRAF.

ELEKTROKARDIOGRAM, DIPEROLEH DGN:

MENEMPATKAN ELEKTRODA MELALUI

SANDAPAN BIPOLER/UNIPOLER

MEMPELAJARI FIVE BASIC VENT.PATTERN. REKAMAN 12 LEAD/SANDAPAN EKG. YG

BERPEGANG HIPOTHESIS EINTHOVEN.


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DIAGRAM EKG~ INTERVAL & SEGMEN


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detik

V

OLTAG

E

DIAGRAM EKG INTERVAL & SEGMEN

Gel. PPR~i/sQRSiVAT

QTiST-s

Gel T

Penilaian:

Kotak kecil:

Datar: o,o4 detikTegak:o,1 mV= 1 mm


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Heart Attack


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Heart Attack


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Sirkulasi


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The lymphatic system consists of :

1. A network of lymphatic vessels

2. Lymph, a fluid that resembles plasma but

contains a much lower concentration ofsuspended proteins.

3. Lymphoid organs


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Fungsi pembuluh limfe:

1. Memproduksi, mengatur danmendistribusikan lymphocytes.

2. Sarana kembalinya cairan dan solutesdari jaringan perifer ke dalam darah.

3. Mendistribusikan hormon, nutrien dan

sampah tubuh dari jaringan asal kesirkulasi general.


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Structur dinding pembuluh darah


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Arteri & vena

The thicker walls of the arteries can be felt if thevessels are compressed.

Arteries usually retain their cylindrical shape,

whereas veins often collapse. Arteries are more resilient; when stretched, they

keep their shape and elongate, and when releasedthey snap back. A small vein cannot tolerate asmuch distortion

Veins typically contain valves, internal structuresthat prevent the backflow of blood toward thecapillaries.


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control of the sympathetic division of the

ANS.

When stimulated, arterial smooth musclescontract and thereby constrict the artery, a

process called vasoconstriction.

Relaxation of the smooth muscles causes anincrease in the diameter of the lumen, a

process called vasodilation.


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Vasokonstriksi dan vasodilatasi

mempengaruhi: (1) afterload jantung,

(2) tekanan darah perifer,

(3) capillary blood flow.


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Capillaries


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Arterial Blood Pressure

systolic pressure

diastolic pressure

Hipertensi

Hipotensi
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Edema

Akumulasi abnormal cairan interstitial

Banyak sebab edema

Problem yg mendasari semua tipe edemaadalah gangguan keseimbangan antara

tekanan hydrostatic dan osmotic di tingkat

kapiler


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Respirasi

Dr ArisPrasetyo,MKes

FUNGSI SYSTEM


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FUNGSI SYSTEM

RESPIRATORY

1. Area untuk gas exchange

2. Menggerakkan udara ke dan dari paru.

3. Melindungi permukaan respiratory dari dehydrasi,perubahan temperatur, dan dari invasi bakteri pathogen

4. Bersuara.

5. Mencium /membau


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Compliance

The connective tissue structure of the lungs. Theloss of supporting tissues resulting from alveolardamage, as in emphysema, increases compliance.

The level of surfactant production. The collapseof alveoli on expiration, due to inadequatesurfactant, as in respiratory distress syndrome,reduces compliance.

The mobility of the thoracic cage. Arthritis orother skeletal disorders that affect the articulationsof the ribs or spinal column will also reducecompliance.


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Otot Inhalation


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Otot Inhalation

Diaphragma 75 percent. elevating the ribs.

25 percent

Sternocleidomastoid serratus anterior,

pectoralis minor

scalenes,

external intercostals


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Otot Exhalation

The internal intercostals

transversus thoracis

external and internal obliques the transversus abdominis, and

the rectus abdominis


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Alh d lill h


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Alhamdulillah.

faal - dr aris

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