心脏解剖和生理

Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Cardiac Anatomy & Physiology,1,心脏的解剖和生理,2,Reference Points,Anatomical locations,Lateral,Side,Lateral,Side,Posterior,Back,Midline,Medial,Inferior,Bottom,Superior,Top,Distal,Farthest,Anterior,Front,Proximal,Nearest,3,观察点,解剖位置,侧面,Side,侧面,Side,后面,Back,Midline,中间,下面,Bottom,上面,Top,远端,Farthest,前面,Front,近端,Nearest,4,Location,Midline,Apex,Between the lungs and behind the sternum,5,位置,中线,心尖部,心脏在两肺之间，胸骨的后面,6,Wall & Covering,Endocardium,Myocardium,Pericardial Sac,Epicardium,CoronaryArtery,Tissue surrounding the heart,7,心脏壁和遮盖物,心内膜,心肌,心包,心外膜,冠状,动脉,围绕着心脏的组织,8,Chambers,4 chambers,Right Atrium,Right Ventricle,Left Atrium,Left Ventricle,9,心腔,4,个心腔,右心房,右心室,左心房,左心室,10,Valves,Right,Atrium,Right,Ventricle,Left,Atrium,Left,Ventricle,4 sets of valves,Pulmonic Valve,Mitral Valve,Aortic Valve,Tricuspid Valve,11,瓣膜,右心房,右心室,左心房,左心室,4,个瓣膜,肺动脉瓣,二尖瓣,主动脉瓣,三尖瓣,12,Interior View,Arteries to Head & Arms,Superior Vena Cava,Pulmonary Valve,Left Coronary Artery,Aortic Valve,Mitral Valve,Aortic Arch,Tricuspid Valve,Right Coronary Artery,A look inside,13,内部观,至头和手臂的动脉,上腔静脉,肺动脉瓣,左冠状动脉,主动脉瓣,二尖瓣,主动脉弓,三尖瓣,右冠状动脉,从内部看,14,Anterior View,Right Coronary Artery,Right Ventricle,Left Ventricle,Left Coronary Artery,Left Atrium,Great Cardiac Vein,Right Atrium,Anterior / Exterior,15,前面观,右冠状动脉,右心室,左心室,左冠状动脉,左心房,心大静脉,右心房,从前面看,16,Posterior View,Backside,Left Circumflex Coronary Artery,Coronary Sinus,Interior Vena Cava,Left Ventricle,Right Ventricle,Right Coronary Artery,Pulmonary Veins,Aortic Arch,Superior Vena Cava,17,后面观,左冠状动脉回旋支,冠状静脉窦,下腔静脉,左心室,右心室,右冠状动脉,肺静脉,主动脉弓,上腔静脉,从后面看,18,Superior View,Tricuspid Valve,Pulmonary Veins,Right Atrium,Aortic Valve,Pulmonary Valve,Left Atrium,Mitral Valve,Looking down at the valves,19,上面观,三尖瓣,肺静脉,右心房,主动脉瓣,肺动脉瓣,左心房,二尖瓣,从上往下看瓣膜,20,Fluoroscopic Imaging,Anterior Posterior view (AP), AP (also sometimes called PA) is a straight-down view into the heart. The x-ray tube and intensifier line up directly over the spine and sternum.,Spine is slightly left of the heart on the image,Sternum is directly over the spine,Ribs angle downward,Silhouette of heart is right of center on image,21,透视影像,前后位,(AP), AP (,有时也称作,PA),是心脏的正面观，,X,线球管和影像增强仪与脊柱和胸骨在一条直线上,影像上脊柱在心脏的稍左侧,胸骨在脊柱的正上方,肋骨的角度向下,心脏的轮廓在影像中心偏右侧,22,23,右心室,左心室,右心房,左心耳,二尖瓣环,三尖瓣环,主动脉瓣环,肺动脉瓣环,右肺静脉,右肺动脉,上腔静脉,左肺动脉,肺动脉干,下腔静脉,膈肌,主动脉,24,Right Anterior Oblique View,Right anterior oblique (,RAO,) view:,Long axis,view of the heart,Spine,to the,left,Sternum,to the,right,Perpendicular to the intraventricular septum,25,右前斜位,右前斜位,(,RAO,):,观察心脏,“,长轴”,脊柱,在,左侧,胸骨,在,右侧,垂直于室间隔,26,27,二尖瓣环,三尖瓣环,左心室,右心室,主动脉瓣环,主动脉,右心房,肺动脉瓣环,肺动脉干,28,Right Anterior Oblique View,RA,RV,IVC,SVC,29,右前斜位,RA,RV,IVC,SVC,30,Left Anterior Oblique View,In the LAO view, you will see:,The,spine rightward,of the heart,The,sternum to the left,The,ribs angled downward,to the left,The,short axis silhouette,of the heart,In LAO, the left ventricle will have:,The,septal wall,to the,left,of the image,The,lateral wall,to the,right,of the image,31,左前斜位,(LAO),在,LAO,位,可见到,:,脊柱在心脏的右侧,胸骨在左侧,肋骨角度向左向下,心脏的短轴轮廓,在,LAO,位,左心室,:,间隔壁在影像的左侧,侧壁在影像的右侧,32,Left Anterior Oblique view,33,左前斜位,34,Left Anterior Oblique View,TV,MV,CS,35,左前斜位,TV,MV,CS,36,Veins & Arteries,Arteries,High-pressure system moves blood from heart,Smooth muscle in vessel walls facilitates perfusion,Arterioles connect to capillaries,Veins,Low-pressure system returns blood to heart,Intravascular valves facilitate return of blood,Venules connect to capillaries,End-to-end a 5,000 mile span,37,静脉和动脉,动脉,高压系统，将心脏的血液运送至全身,血管壁上的平滑肌有利于灌注,小动脉与毛细血管连接,静脉,低压系统，回收血液至心脏,血管内的瓣膜有利于血液回收,小静脉与毛细血管连接,起始到结束的距离约,5000,英里,38,Capillaries,Capillaries,Tissue Cells,Venule,Arteriole,Artery,From,heart,Vein,To,heart,The connection between arteries & veins,39,毛细血管,毛细血管,组织细胞,小静脉,小动脉,动脉,从心脏,静脉,至心脏,动脉和静脉之间的连接,40,Rhythmic Cycle,Contraction / Relaxation,Valves,play key roles in the hearts one-way blood flow,Pressure changes,in the chambers and vessels facilitate the valves to open and close tightly, preventing the backflow of blood,Systole,contraction occurs,Diastole,rest between contractions,41,有节奏的周期,收缩,/,舒张,在心脏单向血流中，瓣膜起到了关键作用,心腔和血管内压力的变化有利于瓣膜打开和紧密关闭，阻止血液倒流,收缩期,发生收缩,舒张期,收缩之间,的休息,42,Right Heart,Right Pulmonary Artery,Right,Atrium,Lobar Branches to Right Lung,Right,Ventricle,Left Ventricle,Left Atrium,Pulmonary,Vein,Lobar Branches to Left Lung,Tricuspid Valve,Left Pulmonary Artery,Pulmonary,Vein,Aortic,Arch,Lung Pump,Superior,Vena Cava,Inferior,Vena Cava,Superior,Vena Cava,Inferior,Vena Cava,Right Pulmonary Artery,43,右心,右心房,右肺动脉分支,右心室,左心室,左心房,肺静脉,三尖瓣,左肺动脉,肺静脉,主动脉弓,肺泵,上腔静脉,下腔静脉,右肺动脉,左肺动脉分支,44,Left Heart,Right,Pulmonary Artery,Superior,Vena Cava,Inferior,Vena Cava,Right,Atrium,Lobar Branches to Right Lung,Right,Ventricle,Left Ventricle,Left Atrium,Pulmonary,Vein,Lobar Branches to Left Lung,Tricuspid Valve,Left Pulmonary Artery,Pulmonary,Vein,Aorta,Aorta,Arch,Body Pump,Left Atrium,Left Ventricle,Aorta,45,左心,右肺动脉,上腔静脉,下腔静脉,右心房,右肺动脉分支,右心室,肺静脉,左肺动脉分支,三尖瓣,左肺动脉,肺静脉,Aorta,主动脉弓,体泵,左心房,左心室,主动脉,46,Systemic & Pulmonary Circulation,Head & Upper Limbs,Arms,Heart,Digestive Tract,Kidneys,Lungs,Trunk & Upper Limbs,Systemic Circulation,Systemic Circulation,Pulmonary Circulation,How blood flows through the body,47,体循环和肺循环,头和上肢,手臂,心脏,消化道,肾脏,肺,躯干和上肢,体循环,体循环,肺循环,血液是如何流向身体的,48,Myocardial Infarction,What happens during a heart attack,Damaged Heart Muscle,Occluded Coronary Artery,Ischemia, decrease in blood supply leading to hypoxia,Infarction, tissue death caused by lack of oxygen,Arrhythmias,force or rhythm irregularities,When a coronary artery is blocked, oxygenated blood cant reach cells downstream,49,心肌梗死,心肌梗死时发生了什么,坏死的心肌,阻塞的冠状动脉,缺血,血液供应减少，导致组织缺氧,坏死,由于缺氧导致组织死亡,心律失常,使节律不规则,当冠状动脉被阻塞时，含氧的血液不能到达下游细胞,50,Ejection Fraction,Cardiac Output,Stroke Volume,Heart Rate,HR,EF,Performance,4 key measurements (CO, SV, HR, EF),Volume,of blood,pumped,from the heart,in a minute,Volume,of blood,pumped,from the heart,during a single contraction,Number,of heartbeats,per minute,Percent,of blood,pumped,from the heart,per stroke,CO = HR x SV,Normal = 4-8 L/minute,EF =Volume Ejected,Total Volume,Normal = 50-60%,Systolic Heart Failure = EF of 40%,CO,SV,51,射血分数,心输出量,每搏输出量,心率,HR,EF,评估指标,4,个主要评估指标,(CO, SV, HR, EF),心脏每分钟泵出的血液量,一次心脏收缩期间，心脏泵出的血液量,每分钟心跳数,心脏每搏泵出的血液百分比,CO = HR x SV,正常值,= 4-8 L/m,EF =,射出的血液量,总血液量,正常值,= 50-60%,收缩性心力衰竭,= EF40%,CO,SV,52,Cardiac Function,Systole:,Contraction of cardiac chambers,Diastole:,Dilation (relaxing) of cardiac chambers,Cardiac Output:,volume of blood ejected from the heart during a specific amount of time normally 4-7 liters per minute at rest,Ejection Fraction:,The volume of blood pumped from the ventricle with each beat compared to the amount of blood that was in the ventricle just before the contraction (Measured in %) Normal “EF” is 50-70%.,Mechanical Events,53,心脏功能,收缩期,:,心腔的收缩,舒张期,:,心腔的舒张,心输出量,:,在一特定的时间内，心脏射出的血液量在静息状态下，正常值为,4-7,升,/,分,射血分数,:,每次心跳中，心室泵出的血液量与收缩前心室的血液量之比,(,用,%,测量,),正常的,EF,值为,50-70%,机械运动,54,