血液循环 Blood Circulation 夏 强，PhD 浙江大学医学院生理学系 医学院科研楼C座518室 电话：88208252 Email：xiaqiang@zju.edu.cn

心血管系统 心脏Heart 血管系统Vascular system 血液Blood

血液分布 安静，舒适状态人体

心 脏 Heart 泵血Pumping 内分泌Endocrine

心肌类型： 心房肌 心室肌 特殊传导系统 收缩细胞 自律细胞

特殊传导系统

心肌兴奋顺序

心脏各部分心肌细胞的跨膜电位

心室肌的动作电位

自律细胞的动作电位

窦房结P细胞

浦肯野细胞

心电图 Electrocardiogram (ECG)

心电图中导联的位置

Comparison with previous ECG (if any) ECG interpretation Measurements Rhythm analysis Conduction analysis Waveform description Comparison with previous ECG (if any)

Normal Partial block Complete block

心肌的兴奋-收缩偶联 Excitation-Contraction Coupling in Cardiac Muscle

心动周期 Cardiac cycle 收缩期Systole 舒张期Diastole

心 音 Heart Sounds 第一心音1st sound 第二心音2nd sound soft low-pitched lub associated with closure of the AV valves Marks the onset of systole 第二心音2nd sound louder dup associated with closure of the PA and aortic valves Occurs at the onset of diastole

Four traditional value areas – Aortic space: 2RIS – Pulmonic valve: 2LIS – Tricuspid valve: 4ICS LLSB – Mitral valve: Apex RIS--right intercostal space LIS—left intercostal space ICS--intercostal space LLSB--left lower sternal border

血管生理 Vascular Physiology

动脉血压 Arterial blood pressure

血压测量 直接有创法

血压测量 间接无创法

Blood Pressure Classification Chart Classification of blood pressure for adults age 18 years and older Blood Pressure Classification Chart Category Systolic (mm Hg) Diastolic (mm Hg) Normal Lower than 120 Lower than 80 Prehypertension 120 - 139 80 - 89 Hypertension   Stage 1 140-159 90-99 Stage 2 160 or higher 100 or higher Adapted from The Seventh Report on the joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), NIH Publication No. 03-5233, May 2003 The classification chart is based on adults, aged 18 and older, who are not taking high blood pressure medicines and who are not acutely ill. If systolic and diastolic measurements fall into different categories, the higher category should be used to classify the person's blood pressure status. JNC 8?

中国高血压防治指南（2005）

动脉脉搏Arterial pulse

微循环 Microcirculation 主要功能： 物质交换

毛细血管Capillaries

EFP Pc

静脉血压 Venous pressure

At rest, approx. 60% of the total blood volume is in the veins At rest, approx. 60% of the total blood volume is in the veins. Sympathetically mediated venoconstriction can substantially increase venous return to the heart.

Varicose vein

淋巴系统 Lymphatic System

Elephantiasis: Chronic, often extreme enlargement and hardening of cutaneous and subcutaneous tissue, especially of the legs and external genitals, resulting from lymphatic obstruction and usually caused by infestation of the lymph glands and vessels with a filarial worm.

呼 吸 Respiration

肺通气 Pulmonary ventilation

Thorax & respiratory muscle Primary muscles of respiration: external intercostals & diaphragm

The Heimlich maneuver increases the alveolar pressure (Palv) by supplementing the upward movement of the diaphragm, thus compressing the thoracic cavity to dislodge foreign objects in the airways.

气胸 Pneumothorax Air escapes from the lungs or leaks through the chest wall and enters the pleural cavity

Lateral Bilateral

气体交换

Hemoglobin is the gas-transport molecule inside erythrocytes.

发绀Cyanosis Hb>50g/L

Carbon monoxide poisoning CO competes for the O2 sides in Hb CO has extremely high affinity for Hb O2 CO

呼吸调节

谢谢专注！