The Maphunziro Akakhalidwe Kazolengedwa a mtima wa munthu

The Maphunziro Akakhalidwe Kazolengedwa mtima ndi lingaliro limene dokotala aliyense ayenera kudziwa. Kudziwa zimenezi ndi zofunika kwambiri kuchita matenda ndi kulola kumvetsa mtima yachibadwa kuyerekeza ntchito mu nkhani ya matenda a minofu mtima likafunika.

ndi ntchito ya minofu mtima wotani?

Kuti kumvetsa zimene Ntchito mtima, ndi Maphunziro Akakhalidwe Kazolengedwa wa thupi ndiye kuti anamvetsa bwino. Choncho, ntchito yaikulu ya minofu mtima ikukoka magazi m'mitsempha ya mu mtsempha wamagazi mu mayendedwe rhythmic, amene amalenga kufinya masinthidwe amtundu zimenezi zingabweretse kayendedwe ake mosadodometsedwa. Kuti ndi ntchito ya mtima ndi kupereka magazi uthenga magazi mphamvu kayendedwe. Anthu ambiri sadzagwirizanitsa myocardium ndi mpope. Only, mosiyana limagwirira ichi, mtima ali ndi ntchito yapamwamba ndi liwiro transients smoothness ndi malire a chitetezo. Pa minofu mtima mowirikiza kusinthidwa.

Kufalitsidwa ndi zigawo zake

Kumvetsa Maphunziro Akakhalidwe Kazolengedwa wa kufalitsa mtima magazi, izo zamveka, kodi zigawo zikuluzikulu za magazi.

Mitsempha ya magazi imakhala zinthu zinayi: minofu mtima, mitsempha, malamulo limagwirira ndi matupi, ndiwo dziwe magazi. dongosolo - chigawo chimodzi cha dongosolo mtima chigawo (ndi dongosolo lymphatic ali m'gulu dongosolo mtima).

Chifukwa cha dongosolo la mwazi atsopano limayenda bwino kudzera ziwiya. Koma pali amaona zinthu monga: ntchito ya minofu mtima monga "mpope" kuthamanga mlingo kusiyana mu dongosolo mtima, mtima mavavu ndi mitsempha kuti kuteteza magazi loyenda kumbuyo, ndi kudzipatula. Komanso kulimbikitsa elasticity makoma chotengera intrapleural zoipa kuthamanga, umene magazi "timitengo" ndi mosavuta umabwerera kwa mtima mwa mitsempha ndi kukakamiza magazi yokoka. Ndi kuchepetsa magazi akankhidwira, chigoba minofu kupuma amakhala pafupipafupi ndi aakulu, ndipo zimenezi zimapangitsa chakuti pleural kuthamanga yafupika, kuchuluka proprioceptors ntchito, kukula excitability a dongosolo chapakati mantha ndi mtima minofu contractile pafupipafupi.

kufalitsidwa

Mu thupi la munthu pali awiri kufalitsidwa: yaikuluikulu. Pamodzi ndi mtima, kupanga dongosolo chatsekedwa-kuzungulira. Kusanthula ya Maphunziro Akakhalidwe Kazolengedwa wa ziwiya mtima ndi magazi, bwino ngati magazi amazungulira iwo.

Back mu 1553, M. Servetus anafotokoza makope m'mapapo mwanga. Iye anachokera ku ventricle chabwino ndi akulowa thunthu m'mapapo mwanga ndipo kenako mu mapapo. Ilo liri mu kuwombola m'mapapo mpweya ikuchitika, ndiye magazi umadutsa mitsempha ya kuwala ndi akulowa atrium kumanzere. Chifukwa ichi pali mwazi oxygenation. Komanso, mpweya, izo amalowa pa ventricle kumanzere, omwe unalembedwa ndi bwalo lalikulu.

Za zokhudza zonse makope anthu izo zinadziwika mu 1685, ndipo anatsegula lake William Harvey. Malinga ndizosowa Maphunziro Akakhalidwe Kazolengedwa wa mtima ndi mitsempha ya magazi, magazi amene apindula ndi mpweya, limayenda limodzi msempha popita chotengera yaing'ono kudzera amene anasamutsidwa ndi ziwalo ndipo zimakhala. Mu iwo, mpweya kuwombola amapezeka.

Komanso mu thupi la munthu pali chapamwamba ndipo m'munsi vena cava kukhetsa mu atrium bwino. Malinga ndi iye akusuntha magazi venous muli mpweya pang'ono. Iwo ayenera kukumbukira kuti lalikulu magazi bwalo wolumikizira umadutsa mitsempha, ndipo venous - kudzera mitsempha. Mu yaing'ono bwalo njira yonse mozungulira.

The Maphunziro Akakhalidwe Kazolengedwa mtima ndi mtima dongosolo

Tsopano tiyeni tione bwinobwino za Maphunziro Akakhalidwe Kazolengedwa za mtima. The myocardium ndi striated minofu minofu, yomwe imakhala ndi maselo wakupambulika dzinache cardiomyocytes payekha. Maselo amenewa ali cholukanalukana kupanga Nexus ndi minofu CHIKWANGWANI za mtima. The myocardium si anatomically kwathunthu thupi, koma ntchito syncytium a. Nexus msanga kuchititsa malemeredwe ku selo wina ndi mzake.

Malinga ndi Maphunziro Akakhalidwe Kazolengedwa ya mtima dongosolo, pali mitundu iwiri ya minofu pa limatchula za opaleshoni, ndipo minofu atypical ndi kumachita myocardium, amene wapangidwa ndi ulusi minofu, yodziwika ndi bwino anayamba-wovulidwa striations yopingasa.

Waukulu thupi katundu wa myocardium ndi

Mtima Maphunziro Akakhalidwe Kazolengedwa zikusonyeza kuti thupi nazo katundu zingapo zokhudza thupi. Ndipo izi:

• Excitability.
• Madutsidwe ndi otsika lability.
• Contractility ndi refractory.

Pankhani excitability, ndi mphamvu minofu striated kuyankha zikhumbo mitsempha. Ndi yaikulu monga wa ofanana mtundu chigoba minofu. Maselo kwa myocardium yodziwika ndi phindu lalikulu lingathe Kakhungu, zomwe zimabweretsa anachita awo okha kwambiri mkwiyo.

Maphunziro Akakhalidwe Kazolengedwa a dongosolo mtima conduction ndi chifukwa chakuti mlingo conductive malemeredwe ndi zazing'ono, atria ndi ventricles kuyamba kutenga alternately.

Refractivity, Mosiyana, lochitidwa yaitali, umene uli kulankhulana ndi nthawi n'loonadi. Chifukwa chakuti nthawi refractory ndi yaitali, minofu mtima yafupika mtundu imodzi, mogwirizana ndi chilamulo "kapena kanthu".

Atypical wofatsa ulusi minofu chibadidwe contractility katundu, koma ulusi amenewa adzalandira mkulu mlingo wa kagayidwe. Apa pakubwera kwa mitihondrii thandizo, ntchito amene ali ntchito pafupi ulusi mitsempha. Mitihondrii kuchititsa zikhumbo mitsempha ndi kupereka oscillation. Mtima conduction dongosolo anapanga ndendende chifukwa cha infarction atypical.

Atypical myocardium ndi katundu amafotokoza

• Atypical mlingo wa excitability wa myocardium ndi zosakwana kuti minofu chigoba, koma koposa kuti ndilo khalidwe la contractile myocardium. Mitsempha zikhumbo amayambira pano.
• Madutsidwe atypical infarction ndi poyerekeza kuti minofu chigoba, koma M'malo mwake, ndi apamwamba kuposa contractile m'mnyewa wamtima.
• Nthawi refractory ndi yaitali uka kanthu kuthekera ndi calcium ayoni.
• Pakuti infarction atypical amakhala ndi lability ang'ono ndi luso yaing'ono kuti kuotcha.
• Maselo paokha kupanga ndi mitsempha kugula (basi).

Dongosolo conductive atypical minofu

Mwa kuphunzira Maphunziro Akakhalidwe Kazolengedwa mtima, tiyenera munanena kuti dongosolo conductive atypical minofu imakhala sinoatrial mfundo ili bwino pa khoma kumbuyo, pa malire kulekanitsa chapamwamba ndipo m'munsi vena cava, mfundo atrioventricular kutumiza nyemba ventricles (ili pansipa septum interatrial), mtengo His- (umadutsa ndi septum matenda ndi chapamimba ventricle). Wina chigawo atypical minofu - ndi ulusi Purkinje, nthambi imene apatsidwa cardiomyocytes.

Komanso, pali nyumba ina: mitolo Kent ndi Meygaylya (woyamba ikuyenda pamodzi mphepete lateral a minofu mtima ndi kulumikiza atrium ndi ventricle, ndipo lachiwiri ndi pansipa mfundo atrioventricular, ndi transmits chizindikiro kwa ventricles popanda okhudza mtolo Ake). Chifukwa nyumba izi, pamene mfundo atrioventricular yoyendetsedwa kutali, kulanda zimachitika amaperekedwa, zomwe zikuphatikizapo zosafunika otaya mudziwe matenda ndi chifukwa chidule winanso wa minofu mtima.

Kodi mkombero mtima?

Maphunziro Akakhalidwe Kazolengedwa wa ntchito mtima ngati kuti chidule cha minofu mtima angatchedwe ndi mwadongosolo mtanda ndondomeko. Konzani ndondomeko izi zimathandiza mtima dongosolo conduction.

Monga Mapangano mtima rhythmically, zina magazi wachotsedwa mu m'thupi. mkombero mtima ndi nthawi imene zimenezi minofu mtima ndi pansi. mkombero tichipeza systoles ndi yamitsempha yamagazi fibrillation, ndipo perekani. Pamene matenda systole kuthamanga ukuwonjezeka kuchokera 1.2 mamilimita Hg kwa 6-9 ndi 8-9 mamilimita Hg ku lamanja ndi lamanzere atria motero. Chifukwa, magazi amapita ku ventricles mwa mipata atrio-yamitsempha yamagazi. Pamene kuthamanga mu kumanzere ndi ventricles chabwino 65 nufikira 5-12 mamilimita Hg, motero, kumachitika ndi mwazi athamangitsidwe amapezeka yamitsempha yamagazi diastole, entailing dontho mofulumira kuthamanga mu ventricles lapansi. Zimenezi kuthamanga m'zotengera lalikulu chopatsa kugwa mavavu semilunar. Pamene kuthamanga mu ventricles kuti kugwa ziro, chikuyamba ndi mavavu khumudwitsidwa mtundu ndi kubwera gawo limene ventricles ali odzazidwa. imeneyi yomalizira diastole.

ndi nthawi ya magawo kuzungulira kwa minofu mtima wotani? Funso limeneli ndi lofunika kwa anthu ambiri achidwi mu Maphunziro Akakhalidwe Kazolengedwa cha lamulo mtima. Tikhoza kunena chinthu chimodzi chokha: Kutalika awo si mtengo nthawi zonse. Apa chinthu zoopsa akuti ndi pafupipafupi kayendedwe ka minofu mtima. Ngati ntchito ya mtima ndi poona kuti pa yemweyo mungoli gawo nthawi zosiyanasiyana.

zizindikiro kunja ntchito mtima

Kwa mtima minofu khalidwe zizindikiro kunja ya ntchito yake. Njirazi ndi monga:

• Kukankhira pamwamba.
• Magetsi zochitika.
• Mtima zikumveka.

Minute ndi systolic buku la infarction komanso ndi zizindikiro za ntchito zake.

Pa nthawi imeneyo, pamene pali systole yamitsempha yamagazi, mtima amapanga kukhota kuchokera kumanzere kupita kumanja, kusintha choyambirira mawonekedwe elliptical kuti zozungulira a. The kumtunda kwa minofu mtima liukitsidwa amasiyiratu kuthamanga pa chifuwa mu V woboola pakati intercostal danga pa mbali ya kumanzere. Motero tingafunse kugunda apical.

Pankhani ya Maphunziro Akakhalidwe Kazolengedwa wa malankhulidwe mtima, ndiye iwo ayenera otchulidwa payokha. malankhulidwe ndi zochitika phokoso zimenezi pa ntchito minofu mtima. Chiwerengero cha mtima olekanitsidwa malankhulidwe awiri. Choyamba kamvekedwe - iye systolic - amene Ndi mmene kwa mavavu atrioventricular. Chachiwiri kamvekedwe - diastolic - kumachitika pa nthawi ya kutseka mavavu wa thunthu m'mapapo mwanga ndi msempha. Nyimboyi woyamba, dzenje ndi pansipa wachiwiri. Nyimboyi chachiwiri ndi mkulu ndi waufupi.

Malamulo a ntchito mtima

Monga awiri malamulo mtima ntchito akhoza kukhala wolemekezeka: lamulo ndi lamulo la mtima ulusi kayendedwe ka minofu mtima.

Woyamba (O. Frank - E. Starling) limanena kuti kwambiri minofu CHIKWANGWANI lidakali, mphamvu adzakhala lawo Ndikulichepetsa zina. Pa mlingo Tambasula zimakhudza kuchuluka kwa magazi amene anapeza mu mtima pa diastole. Kwakukulu voliyumu, mwamphamvu kwambiri adzakhala kuchepetsa nthawi systole.

The chachiwiri (F. Bainbridge) limanena kuti pamene magazi limatuluka mitsempha dzenje (mu mitsinje), kumaonjezera pafupipafupi ndi mphamvu ya contractions minofu pa mlingo reflex.

Onse malamulo awa ntchito imodzi. Zikugwirizanirana limagwirira wodzilamulira malamulo, amene amathandiza kuti azolowere ntchito ya minofu mtima m'malo osiyanasiyana aliko.

Poganizira Maphunziro Akakhalidwe Kazolengedwa za mtima mwachidule, osanenapo chakuti ntchito za thupi chimenechi anakhudzidwa ndi mahomoni ena, timene ndi mchere salt (electrolytes). Mwachitsanzo, atsetilhopin (nkhoswe) ndi zotsala ayoni potaziyamu kufooketsa ntchito mtima, kupanga kayimbidwe kotani yosowa kuti mwina ngakhale mtima kumangidwa. A wambirimbiri ayoni calcium, zikuwonjezereka masiku ano ndi noradrenaline M'malo mwake, zimathandiza kulimbitsa ndi ntchito mtima ndiponso pafupipafupi. Epinephrine, komanso lakamba zambiri za mitsempha inatsekeratu, potero chikusintha zakudya m'mnyewa wamtima.

Zimagwirira ntchito ya lamulo la zochitika mtima

Mogwirizana ndi zofunika kwa mpweya chakudya pafupipafupi ndi mphamvu ya chidule cha minofu mtima siyana. Ntchito za mtima ndi Lamulo njira yapadera neurohumoral.

Koma mtima ali njira yake zolimbana ndi ntchito. Ena mwachindunji zokhudzana ndi katundu wogwidwa ndi ulusi m'mnyewa wamtima. Apa pali kugwirizana pakati pa mphamvu ndi ulusi kuchepetsa kukula kwa kayendedwe ka minofu mtima, komanso kudalira wa kuchepetsa mphamvu ndi digiri ya mavuto CHIKWANGWANI pa diastole.

Zotanuka zimatha ulusi m'mnyewa wamtima, amene kumaonekera osati m'kati conjugations yogwira, wotchedwa chabe. Onyamula katundu zotanuka ankaona trophic thandizo-chimango ndi actomyosin milatho zomwe zili osati minofu yogwira. Mafupa a zotsatira zabwino kwambiri pa elasticity wa myocardium pamene pali sclerotic njira.

Ngati munthu asunga ischemic contracture kapena yotupa matenda m'mnyewa wamtima, chinawonjezeka stiffness wa Kuthana ndi.

Ntchito ya dongosolo mtima ndi ndondomeko zovuta. kulephera aliyense zingadzetse kukumana ndi mavuto. Zonse dokotala ndi musanyalanyaze malangizo ake. Ndipotu, kuteteza matenda ndi kosavuta kuposa kuchiritsa izo, ndalama pa mankhwala okwera mtengo.