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1、第四章血液循環(huán)Bloodcirculation回顧:循環(huán)系統(tǒng)內(nèi)容心臟的生物電現(xiàn)象心肌的生物電現(xiàn)象血管生理淋巴液的生成和回流心血管活動(dòng)的調(diào)節(jié)心臟的泵血功能第一節(jié)心臟的泵血功能Thefunctionoftheheartasapump一、心動(dòng)周期(CardiacCycle,CC)CC的概念、HR的概念Concept:Thecardiaceventsthatoccurfromthebeginningofoneheartbeattothebeginningofthenext.Iftheheartbeats75beatspermi
2、nute,theneachcardiaccycletakes0.8second.ThecardiaccycleiscomposedofdiastoleandsystoleAtrialsystole0.1secondAtrialdiastole0.7secondVentricularsystole0.3secondVentriculardiastole0.5secondAtriaVentriclesLengthofsystole&diastole2.CC中心房atrium、心室ventricle收縮systole與舒張d
3、iastole時(shí)間Atrialsystolebeginsfirst,takingabout0.1secondthenrelaxationfor0.7second.Ventricularsystolebeginsaftertheendofatrialsystoleandlastsfor0.3secondandthenrelaxes.3.全心舒張期的概念A(yù)triaVentricles射血過(guò)程和充盈過(guò)程(泵血機(jī)制)注意⑴壓力變化Pressure⑵容積變化Volume⑶血流情況Bloodflow⑷瓣膜開(kāi)關(guān)Valve二、心臟泵血
4、過(guò)程pumpingevents(一)心房的初級(jí)泵血功能RoleoftheatriainheartpumpAccumulation積聚ofbloodduringventricularcontractionandprimerpump.10~30%oftotalfillingvolume.(二)心室的射血和充盈過(guò)程(以左心室LV為例)以左心室為例1.心室收縮期Ventricularsystole⑴等容收縮期:0.05S⑵射血期a.快速射血期:2/3totalejectionvolume,rapid,0.1sb.減慢射血期:1
5、/3totalejectionvolume,0.15S.2、心室舒張期⑴等容舒張期⑵心室充盈期Periodoffillinga.快速充盈期Rapidfillingphase:2/3oftotalfillingvolumeduration:0.11sb.減慢充盈期Reducedfillingphase1/3oftotalfillingvolumeduration:0.22s3、心房收縮期Periodofatrialcontraction:(收縮期前,處于全心舒張10~30%⑴全心舒張期時(shí)⑵心房收縮時(shí)(三)CC中心室壓力、
6、容積變化、血流情況、瓣膜開(kāi)關(guān)等容收縮期快速射血期減慢射血期等容舒張期快速充盈期減慢充盈期心房收縮期容積壓力二尖瓣主A瓣不變急劇關(guān)關(guān)不變急劇關(guān)關(guān)達(dá)min開(kāi)關(guān)開(kāi)關(guān)開(kāi)關(guān)達(dá)max關(guān)開(kāi)關(guān)開(kāi)(三)心房在心臟泵血活動(dòng)中的作用心房Functionoftheatria:1.心房的接納和初級(jí)泵作用接納靜脈回流的血液和通道作用初級(jí)泵:可使心室的充盈再增加10%~30%Atriacontractcausing25%fillingoftheventricle.Beforetheatriacontract,bloodnormallyflowsco
7、ntinuallyfromtheveinsintotheatria;about75%bloodflowsdirectlythroughtheatriaintotheventricles.Theatriaactasprimerpumpsfortheventricles.三、心泵功能的評(píng)定(Estimateofheartfunctionasapump)(一)心臟的輸出量1.每搏輸出量和射血分?jǐn)?shù)(1)搏出量(strokevolume,SV):一側(cè)心室在一次心搏中射出的血液量(60~80ml)SV=end-diastolicv
8、olume–end-systolicvolume=125ml-55ml=70ml(2)射血分?jǐn)?shù)(Ejectionfraction,EF):搏出量和心室舒末容積的百分比。EjectionFractionistheratio比值ofSV搏出量toend-diastolicvolume舒末容積[EDC]舒末容積(end-diastoli