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LILIK HERAWATI
[email protected][email protected]
Sistem Kardiovaskular
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Nutrisi jantung
• Sirkulasi koroner
– Arteri koronaria kanan & kiri caang dari aorta
• !enyakit jantung koroner
nyeri khas "AN#$NA !%'()$S*
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!%)+,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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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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a1illary eds
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!engukuran
'ekanan darah
!ulse 1ressure
"Cean arterial 1ressure*
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!engukuran '/
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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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!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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LILIK HERAWATI
Physiology Departement
Faculty of Medicine
Airlangga University
lilik_wahyu99@yahoocom
Faal DARAH
(singkat)
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'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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• +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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*ungsi Leuksit
• the mobile units of the odys 1rotecti2e
system
• Cekanisme kekealan0
(1)phagocytosis
"3*forming antibodies and sensitized
lymphocytes
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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
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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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