CARDIOVASCULAR

SYSTEM
Anatomy & Physiology
dr. Jeffrey Wirianta
March 8
th
2004
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
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 )
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
Anatomy of the Heart
Pericardium :
Outer fibrous sack
Myocardium :
Thick muscle walls
Endocardium :
Innermost surface
Endothelium
Simple squamous
epithelium
Interventriculer Septum
Papillary muscle
Semilunar Valve
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
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
Anatomy of the Heart
Aorta
Coronary arteries
Arterioles
Capillaries
Venules
Coronary sinus
Right atrium
Coronary circulation
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 )
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
Sel Autoritmik
Fase Depolarisasi
Fase Repolarisasi
Fase Istirahat
Sel Kontraktil
Fase Depolarisasi
Fase Plateu
Fase Repolarisasi
Fase Istirahat
Conduction System
SA Node
Internodal branch
AV Node
Hiss Bundle
Purkinje Fiber
Contraction
Cardiac Action Potentials
Cardiac Muscle Tissue
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
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
+/-
+
-
The Electrocardiogram
The three standard
measurements can
be used to
electronically
calculate the
currents flowing
towards each limb
aVR
aVL
aVF

+
The Cardiac Cycle
Systole :
Period of ventricular contraction
Blood ejected from heart
Diastole :
Period of ventricular relaxation
Blood filling
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


Starlings 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

Definitions

Chronotropy Change in heart rate
Inotropy Change in contractile
force
Dromotropy Change in conduction
velocity
Can be positive or negative