He aha te mea te automatism o te ngakau? automaticity cardiac

He aha te mea te automatism o te ngakau? roto i te whakautu ki tēnei pātai i roto i te tuhinga i raro nei. I tua atu, kei reira ngā kōrero i runga i maumaui o te pānga hauora tangata e pā ana ki te ariā i faahitihia.

He aha te mea te automatism o te ngakau?

weu uaua i roto i te tangata i te kaha ki te tauhohe ki te whakaiti o te pini hōhā, me te ka raupapa whakawhiti reira puta noa te whakaiti o te hanganga uaua. Kei te whakamatauria te reira e taea ki te whakaputa takitahi anaanatae, me te hanga contractions naki te uaua ngakau taratahi ko. huaina ana tēnei kaha te ngakau automatism.

Take o te automaticity cardiac

Kia matau ki ta te mea te automatism o te ngakau, ka taea e te mea i te whai. He te kaha motuhake ki te whakaputa i te pini hiko, aru e pupuri i te reira ki runga ki ngā hanganga uaua te ngakau.

kōpuku Sinoatrial - tautau peysmekerskih ngā pūtau momo tuatahi (kei roto e pā ana ki 40% pungaraungao ūpoko kei myofibrils, Kei kahore-pūnaha T he maha nui o konupūmā free te ruarua whakawhanakehia whatunga sarcoplasmic) kei roto i te taiepa matau o te iahoki vena cava pai, i te kongutu o te marae tika .

Rangitahi kōpuku atrioventricular o te rua o nga momo i hanga e pūtau e whakahaere ponana i te kōpuku sinoatrial, engari i raro i ngā āhuatanga motuhake kia takitahi whakaputa he tiaki hiko. Kei roto ngā pūtau tauwhirowhiro pungaraungao iti (20-30%) me myofibrils ahua nui atu i te pūtau kia tuatahi. kōpuku Atrioventricular kei roto i te pakitara wehewehe interatrial runga e whakawhitia ki te excitation kurupae me waewae paihere poraka manga (i roto i pungaraungao 20-15%).

muka Purkinje e muri whakawhiti atamira o excitation. whakawhānui ratou āhua i te pātaki waenganui i ia o te poraka peka paihere rua. Kei roto ēnei pūtau pungaraungao e pā ana ki 10%, nui atu te hanganga atu rite ki muka uaua cardiac.

Ko te ahua noa o te pini hiko puta i roto i peysmekerskih pūtau kōpuku sinoatrial, e potentiates excitation poipoi 60-80 kapakapa ki te meneti whakaongaonga. Ko ia he taraiwa tuatahi-kia. Katahi ka tuku poipoi whakatika te ki te rua, me te tuatoru o nga taumata hanganga conductive. E taea e ki te kawe e rua te roangaru excitation me takitahi kaha ai whakaiti o iarere o raro ratou. Ko te kaiarataki o te rua o nga taumata i muri i te kōpuku pakohu atrioventricular, i te mea e taea ki te hanga i to ratou ake tukunga 40-50 meneti i roto i te ngaro o te mahi inhibitory o te kōpuku pakohu. I tua atu, tuku te excitation te ki te hanganga o te paihere o tana, e whakamahi 30-40 kapakapa ki te meneti, ka rere te tiaki hiko ki te paihere o ana waewae (25-30 cpm) me te pūnaha Purkinje muka (20 ngātere ia meneti) me tomo ki te pūtau uaua mahi o te myocardium .

Tikanga ponana i te kōpuku kaha motuhake sinoatrial ki te pehi i te mahi hiko o ngā hanganga whāriki. Ki te ohorere te mahi o te tikanga tuatahi o te kaiakiaki, tona mahi i runga i ngā hononga tango-tu i raro i te pūnaha kawenga.

tukanga matū e whakarato automaticity ngakau

He aha te mea te automatism o te ngakau i roto i ngā o te matū? I te taumata rāpoi, te pūtake mō te takanga motuhake o te tiaki hiko (te pūmanawa mahi) i runga i te kiriuhi peysmekerskih pūtau ko te aroaro o pera-ka karanga impulsatora. Tona mahi (ngakau mahi automatism) ngā o toru ngā wāhanga.

Ngā wāhanga o te impulsatora:

• wāhanga 1 faaineineraa (superoxide i te pāhekoheko o te hāora ki te phospholipids pai whakatupato i runga i te membrane mata pūtau peysmekerskoy riro te reira i te tiaki kino, homai ana e ia te pūmanawa takoto);
• 2 pāhare pāporo wāhanga me te konutai waka kaha, i roto i nei riro i te tiaki waho o te pūtau rite ki te 30 MW;
• wāhanga 3 iahiko peke - te whakamahi i te pūngao hanga i roto i te hangarua o ngā momo hāora urupare (o hāora ionized me te hauwai waikuratei) te whakamahi i whākōkī catalase me dismutase superoxide. Meinga pūngao quanta hua biocapacity pacemaker kia faatupu te reira i te pūmanawa mahi.

Tukanga pini te whakaputa pūtau - pacemakers tika puta i roto i ngā āhuatanga rawaka aroaro o te hāora rāpoi, tukua nei te tukunga erythrocytes inflowing toto.

Whakaiti mahi paipa wāhanga o te mahi o tetahi atu ranei wāhanga impulsatora maumau'i pūnaha nga pūtau mahi peysmekerskih whakaae, meinga arrhythmia ranei. Ārai tetahi o nga tukanga o tenei pūnaha ai hopu cardiac ohorere. Ite e taua automatism o te ngakau, ka taea e matau me te tukanga.

Ko te pānga o te pūnaha io autonomic ki te uaua ngakau

I tua atu ki o ratou ake kaha ki te whakaputa ponana hiko, te mahi o te ngakau e whakahaeretia e te tohu i te uaua innervating raru pukuaroha, me te parasympathetic, i runga i te kore o e kia waimaero automaticity cardiac.

Ko te pānga o te wehenga pukuaroha tere ake te ngakau, he pānga whakaongaonga. innervation kaungāongo'i he chronotropic, inotropic, pānga pai dromotropic.

I raro i te mahi ukiuki i o te pūnaha io parasympathetic , whakapōturinga depolarization ngā pūtau peysmekerskih (mahi inhibitory), a konei tērā o te auau ngakau (tōraro mahi chronotropic), te hekenga kawe ia i roto i te ngakau (pānga tōraro dromotropic), he hekenga i roto i te pūngao systolic hukihuki (pānga tōraro inotropic), engari excitability whakarei o te ngakau (pai mahi batmotroponoe). Kei te mau ano te whakamutunga rite te takahi o te mahi automaticity cardiac.

Take o te automatism ngakau

1. ischemia myocardial.
2. Mumura.
3. Haurangi.
4. Tūkinotanga konutai toenga, pāhare pāporo, konupora, konupūmā.
5. pōrearea hormonal.
6. Tūkinotanga o te pānga o te hopearaa pukuaroha, me te parasympathetic motuhake.

Ngā momo o arrhythmias tika ki maumaui o automaticity o te ngakau

1. Pakohu tachy-me bradycardia.
2. Kupukupu (pakeke taitamariki) arrhythmia.
3. arrhythmia Extrasystole (pakohu, Atrial, atrioventricular, ventricular).
4. tachycardia Paroxysmal.

Wehewehe arrhythmia tika ki disorders āriponga automaticity me reentry ki te hanga i ngaru (ngaru reentry) i roto i te kotahi ranei atu tauwhāiti wahi o te ngakau, te hua ko te fibrillation kaka Atrial ranei.

fibrillation Ventricular - tetahi o te nuinga o arrhythmias ora-whakawehi, i te mea he putanga o ohorere hopu cardiac me te mate. Ko te tikanga whai hua te nuinga o te maimoatanga - defibrillation hiko.

mutunga

Heoi whakaaro, he aha te mea te automatism o te ngakau, ka taea e matau he aha maumaui e taea i roto i te take o te mate. Tenei, i roto i te tahuri, hanga taea reira ki te whawhai tikanga te mate pai me te ake whai hua.