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血液循环 Blood Circulation

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. 收缩细胞. 心肌类型： 心房肌 心室肌 特殊传导系统. 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.

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血液循环 Blood Circulation

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  1. 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

  2. 心血管系统 • 心脏Heart • 血管系统Vascular system • 血液Blood

  3. 血液分布 • 安静，舒适状态人体

  4. 心 脏Heart • 泵血Pumping • 内分泌Endocrine

  5. 收缩细胞 • 心肌类型： • 心房肌 • 心室肌 • 特殊传导系统 自律细胞

  6. 特殊传导系统

  7. 心肌兴奋顺序

  8. 心脏各部分心肌细胞的跨膜电位

  9. 心室肌的动作电位

  10. 自律细胞的动作电位

  11. 窦房结P细胞

  12. 浦肯野细胞

  13. 心电图Electrocardiogram (ECG)

  14. 心电图中导联的位置

  15. 0.04 sec • ECG interpretation • Measurements • Rhythm analysis • Conduction analysis • Waveform description • Comparison with previous ECG (if any)

  16. Normal Partial block Complete block

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

  18. 心动周期Cardiac cycle 收缩期Systole 舒张期Diastole

  19. 心 音Heart Sounds • 第一心音1st 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

  20. 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

  21. 血管生理Vascular Physiology

  22. 动脉血压Arterial blood pressure

  23. 血压测量 • 直接有创法

  24. 血压测量 • 间接无创法

  25. Classification of blood pressure for adults age 18 years and older 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?

  26. 中国高血压防治指南（2005）

  27. 2014 Hypertension Guideline Management Algorithm • http://jama.jamanetwork.com/article.aspx?articleid=1791497

  28. 动脉脉搏Arterial pulse

  29. 微循环Microcirculation • 主要功能： • 物质交换

  30. 毛细血管Capillaries

  31. Pc EFP

  32. 静脉血压Venous pressure

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

  34. Varicose vein

  35. 淋巴系统Lymphatic System

  36. 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.

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