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CARDIOVASCULARCARDIOVASCULAR
SYSTEM ISYSTEM I
dr.dr. Rahmiyah fadilahRahmiyah fadilah
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The Cardiovascular SysteThe Cardiovascular Syste
!eart!eart ++ circulatory systecirculatory syste
== cardiovascularcardiovascular
systemsystem""
The heart #or$s as aThe heart #or$s as a
%u% that %ushes &lood%u% that %ushes &lood
to the or'a(s) tissues)to the or'a(s) tissues)
a(d cells o* your &ody"a(d cells o* your &ody"
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,u('si Uu -ardiovas$uler,u('si Uu -ardiovas$uler
Melaya(i $e&utuha(Melaya(i $e&utuha( .ari('a(/ .ari('a(/ Me('a('$ut (utrisi 0Me('a('$ut (utrisi 0
o$si'e( $e .ari('a(o$si'e( $e .ari('a( Me('a('$ut sisaMe('a('$ut sisaeta&olise dari .ari('a(eta&olise dari .ari('a(
Me('a('$ut horo( $e selMe('a('$ut horo( $e seltar'ettar'et
Meelihara li('$u('a(Meelihara li('$u('a(i(ter(al u(tu$ $ehidu%a( 0i(ter(al u(tu$ $ehidu%a( 0*u('si o%tial sel"*u('si o%tial sel"
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Anatomi Anatomi
Jantung BeratJantung Berat ± 250 – 360± 250 – 360
grgr
Jantung mrp 2 pompaJantung mrp 2 pompa
Ukuran, lokasi, lapisanUkuran, lokasi, lapisan
pelindung, lapisan dinding,pelindung, lapisan dinding,
ruang, katup, & jalur sirkulasiruang, katup, & jalur sirkulasi
darahdarahSupla darah !nutrisi" keSupla darah !nutrisi" ke
jantung jantung
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KatupKatup JantungJantung
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SIRKULASI SISTEMIKSIRKULASI SISTEMIK
5 Arteri
5 arteriola
5 $a%iler
5 ve(ula
5 ve(a
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,u('si 7a'ia( -ardiovas$uler ,u('si 7a'ia( -ardiovas$uler
Jatu!Jatu!// Meo%a darahMeo%a darah
ArteriArteri// Tra(s%or darah di &a#ah te$a(a( ti(''i $e .ari('a("Tra(s%or darah di &a#ah te$a(a( ti(''i $e .ari('a("
ArteriolArteriol// Me('atur alira( darah y' e(u.u $a%iler Me('atur alira( darah y' e(u.u $a%iler
Ka"iler Ka"iler // 8ertu$ara( caira() (utrisi) ele$trolit) horo( a(tara8ertu$ara( caira() (utrisi) ele$trolit) horo( a(tara
darah da( caira( i(terstisialdarah da( caira( i(terstisial
#eula#eula// Me('alir$a( darah dari $a%iler $e ve(a seda('Me('alir$a( darah dari $a%iler $e ve(a seda('
#ea#ea// Me('alir$a( darah dari .ari('a( $e .a(tu('Me('alir$a( darah dari .ari('a( $e .a(tu('
Reservoir darah ter$e(daliReservoir darah ter$e(dali..
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Sirkulasi KoronariaSirkulasi Koronaria
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ALIRA; DARA! ALIRA; DARA!
ATRIUM
RIGHT
LEFT
ATRIUM
RIGHT
VENTRICLE
LEFT
VENTRICLELow O2Blood from
Lower
Body
Low O2 Blood
from Upper Body
High O2 Blood
from L!g"
Low O2 Blood #o L!g"
Valves in the
heart are
one-way
only and
stop blood
running
back from
the
ventricles
into the
atria.
AORTAAORTA
High
O2 Blood #o re"# of
$ody
%ep#m
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$ISI%L%&I %T%T JA'TU'&$ISI%L%&I %T%T JA'TU'&
Dis$us i(tercalatusDis$us i(tercalatus e&ra(e&ra(sel ya(' eisah$a( asi('
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$isiolo!i$isiolo!i
1"1" !u$u all or (o(e &erla$u) arti(ya &ila atriu atau!u$u all or (o(e &erla$u) arti(ya &ila atriu atau
ve(tri$el sudah e$sitasi) selalu dii$uti oleh $o(tra$sive(tri$el sudah e$sitasi) selalu dii$uti oleh $o(tra$si
seluruh .a(tu('seluruh .a(tu('
2"2" Si*at dasar otot .a(tu(' /Si*at dasar otot .a(tu(' /
a" irrita&ility =&athotro%ic> ? %e$a ra('ra('a(a" irrita&ility =&athotro%ic> ? %e$a ra('ra('a(
&" co(ductivity =drootro%ic> ? ha(tar ra('sa('a(&" co(ductivity =drootro%ic> ? ha(tar ra('sa('a(
c" co(tractility =i(otro%ic> ? da%at &er$o(tra$sic" co(tractility =i(otro%ic> ? da%at &er$o(tra$sid" rhythicity = chro(otro%ic> ? &ersi*at ritisd" rhythicity = chro(otro%ic> ? &ersi*at ritis
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(%')U(T S*STEM(%')U(T S*STEM
Si*at @ si*at .ari('a( $o(du$si /Si*at @ si*at .ari('a( $o(du$si /
1"1" OtoatisasiOtoatisasi $ea%ua( e('hasil$a($ea%ua( e('hasil$a(
i%uls secara s%o(ta(i%uls secara s%o(ta(
2"2" RitisasiRitisasi %e&a('$ita( i%uls ya('%e&a('$ita( i%uls ya('teratur teratur
+"+" -o(du$tivitas-o(du$tivitas $ea%ua( e(yalur$a($ea%ua( e(yalur$a(
i%ulsi%uls"" Daya ra('sa('Daya ra('sa(' $ea%ua( e(a(''a%$ea%ua( e(a(''a%
stiulasistiulasi
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Co(duct systeCo(duct syste
Diulai da( &erasal dari SA ;ode =Si(oarterial>Diulai da( &erasal dari SA ;ode =Si(oarterial>
di(di(' %osterior atriu $a(a( de$at uara va(a $avadi(di(' %osterior atriu $a(a( de$at uara va(a $ava
su%erior su%erior " -ece%ata( $o(du$si :):+ deti$" -ece%ata( $o(du$si :):+ deti$
;odus AV =Atriove(tri$ularis>;odus AV =Atriove(tri$ularis> .alur i%uls a(tara .alur i%uls a(tara
atriu da( ve(tri$elatriu da( ve(tri$el"" ,u('si AV (ode /,u('si AV (ode /
I%uls .a(tu(' ditaha( disi(i selaa :):6 @ :)12 deti$I%uls .a(tu(' ditaha( disi(i selaa :):6 @ :)12 deti$
u(tu$ %e('isia( ve(tri$el selaa $o(tra$si atriuu(tu$ %e('isia( ve(tri$el selaa $o(tra$si atriu
Me('atur .ulah i%uls atriu ya(' e(ca%aiMe('atur .ulah i%uls atriu ya(' e(ca%ai
ve(tri$elve(tri$el
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(%')U(T S*STEM(%')U(T S*STEM
SA ;odeSA ;ode AV AV
(ode(ode &er$as&er$as
!IS!IS
sera&utsera&ut8ur$i(.e8ur$i(.e
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SA nodeSumber impuls normal/
alamiah , 6 ! " #/m
AV node$isa mengeluarkan
impuls %-&#/menit
$erkas 'is
Serabut (urkin)e
Ventrikel$isa mengeluarkan impuls
* #/m
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SIKLUS JA'TU'&SIKLUS JA'TU'&
Si$lus .a(tu('Si$lus .a(tu(' %eriode%eriodeya(' diulai dari &a'ia(ya(' diulai dari &a'ia(a$hir satu $o(tra$sia$hir satu $o(tra$si
.a(tu(' sa%ai %ada a$hir .a(tu(' sa%ai %ada a$hir$o(tra$si &eri$ut(ya$o(tra$si &eri$ut(ya
A;TU;B /A;TU;B / %o%a %rier =atriu>%o%a %rier =atriu> 8o#er %u%s =ve(tri$el>8o#er %u%s =ve(tri$el>
SistoleSistole $o(tra$si$o(tra$sive(tri$elve(tri$el
DiastoleDiastole rela$sasirela$sasive(tri$elve(tri$el
TD ? 12:6: !'TD ? 12:6: !'
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2:2:
SI-LUS A;TU;BSI-LUS A;TU;B
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SIKLUS JA'TU'&SIKLUS JA'TU'&
1"1" Mid
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Pengontrolan KerjaPengontrolan Kerja
JantungJantung
,aal-Vi$u(2::3
22
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,re$ue(si .a(tu(',re$ue(si .a(tu('
,re$ue(si (oral/ 3: @ 1:: de(yute(it),re$ue(si (oral/ 3: @ 1:: de(yute(it)
rata2/ 4 e(it F si$lus .a(tu('rata2/ 4 e(it F si$lus .a(tu('
&erla('su(' selaa :)6 deti$) sistole :)&erla('su(' selaa :)6 deti$) sistole :)
deti$ da( diastole :)+ deti$deti$ da( diastole :)+ deti$
Ta$i$ardi/ %e(i('$ata( *re$ue(si .a(tu(' GTa$i$ardi/ %e(i('$ata( *re$ue(si .a(tu(' G
1:: e(it1:: e(it
7radi$ardi/ %e(uru(a( *re$ue(si .a(tu(' H7radi$ardi/ %e(uru(a( *re$ue(si .a(tu(' H
3: e(it3: e(it
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De(yut (adiDe(yut (adi
De(yut arteri adalah 'elo&a(' te$a(a( ya('De(yut arteri adalah 'elo&a(' te$a(a( ya('era&at 3 @ 9 %er deti$) se$itar 1 le&ihera&at 3 @ 9 %er deti$) se$itar 1 le&ihce%at dari darahce%at dari darah
De(yut da%at dirasa$a( %ada arteri ya(' de$atDe(yut da%at dirasa$a( %ada arteri ya(' de$at$ulit =arteri radialis %ada %er'ela('a(>$ulit =arteri radialis %ada %er'ela('a(>
Dua &u(yi .a(tu(' se&a(di(' de('a( satuDua &u(yi .a(tu(' se&a(di(' de('a( satude(yut arteride(yut arteri
,re$ue(si de(yut e&eri$a( i(*orasi,re$ue(si de(yut e&eri$a( i(*orasie('e(ai $er.a .a(tu(') %e&uluh darah da(e('e(ai $er.a .a(tu(') %e&uluh darah da(sir$ulasisir$ulasi
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(URA JA'TU'&(URA JA'TU'&
Curah .a(tu('Curah .a(tu(' volue darah ya(' di%o%a olehvolue darah ya(' di%o%a oleh
ve(tri$el %er e(it = lt>ve(tri$el %er e(it = lt>
Stro$e volueStro$e volue volue darah ya(' di$eluar$a(volue darah ya(' di$eluar$a(
ve(tri$el %er deti$" Se$itar 2+ volue darah ve(tri$elve(tri$el %er deti$" Se$itar 2+ volue darah ve(tri$el
%ada a$hir diastole =4:%ada a$hir diastole =4:
Curah jantung = heart rate x stroke volume
Curah .a(tu(' di%e('aruhi /
1" !R
2" SV
+" Ve(ous retur(
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Curah Jantung
Denyut Jantung Stroke volume
Parasimpatis Epinefrin plasma
Simpatis
End diastole(preload)
Ejeksi sistole(afterload)
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enous return
!ekanan vena
olume darah "kti#tas pernafasan
$angsang simpatis !onus vena
Pompa
Posisi tu%uh
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+:+:
Stro$e volue ter'a(tu(' /Stro$e volue ter'a(tu(' /1"1" 8reload8reload
2"2" -o(tra$tilitas-o(tra$tilitas
+"+" a*terloada*terload
Hukum Frank Starling peregangan sera%ut miokardium selamaDiastole melalui peningkatan volume akhir diastolik akan meningkatkan
&ekuatan kontraksi saat sistolik
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,re$ue(si de(yut .a(tu(' .a(i( (oral 1: @ 13:,re$ue(si de(yut .a(tu(' .a(i( (oral 1: @ 13:$alie(it"$alie(it"
7ila le&ih dari 1:: $alie(it dise&ut Ta$i$ardi"7ila le&ih dari 1:: $alie(it dise&ut Ta$i$ardi" 7ila $ura(' dari 3: $alie(it dise&ut 7radi$ardi"7ila $ura(' dari 3: $alie(it dise&ut 7radi$ardi" 8e('atura( *re$ue(si/8e('atura( *re$ue(si/
Sara* oto(o"Sara* oto(o"
Rese%tor"Rese%tor"
8e('aruh lai("8e('aruh lai("
' aktor yang menye%a%kanfrekuensi jantung meningkat*+ Saraf simpatis,
+ $eseptor di vena -ava yang sensitif thdpenurunan tek darah,
+ $eseptor saraf kulit,
+ Emosi,
+ .iperkalemi,
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+2+2
,a$tor2 ya(' e(ye&a&$a( %e(uru(a( *re$ue(si .a(tu('/,a$tor2 ya(' e(ye&a&$a( %e(uru(a( *re$ue(si .a(tu('/
Sara* %arasi%atis"Sara* %arasi%atis"
7arorese%tor di aorta"7arorese%tor di aorta"
!i%o$alei"!i%o$alei"
+ aktor yang memper%esar -urah jantung*
' "kti#tas %erat,
' Peningkatan aliran %alik vena,' Pompa otot rangka kaki,
' /nspirasi pernapasan,
+aktor yang menurunkan -urah jantung*' Posisi tu%uh,
' Perdarahan he%at,
' !ekanan darah tinggi,
' Penyakit jantung,
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++++