心脏解剖和生理

1Cardiac Anatomy & Physiology2心脏的解剖和生理3Reference PointsAnatomical locationsLateralSideLateral SidePosterior BackMidlineMedialInferiorBottomSuperior TopDistalFarthestAnteriorFrontProximalNearest4观察点解剖位置侧面Side 侧面 Side后面 BackMidline中间下面Bottom上面 Top远端Farthest前面Front近端Nearest5LocationMidlineApexBetween the lungs and behind the sternum6位置中线心尖部心脏在两肺之间，胸骨的后面7Wall & CoveringEndocardiumMyocardiumPericardial SacEpicardiumCoronaryArteryTissue surrounding the heart8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9Chambers4 chambersRight AtriumRight VentricleLeft AtriumLeft Ventricle10心腔4个心腔右心房右心室左心房左心室11ValvesRightAtriumRightVentricleLeftAtriumLeftVentricle4 sets of valvesPulmonic ValveMitral ValveAortic ValveTricuspid Valve12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 13Interior ViewArteries to Head & ArmsSuperior Vena CavaPulmonary ValveLeft Coronary ArteryAortic ValveMitral ValveAortic ArchTricuspid ValveRight Coronary ArteryA look inside14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15Anterior ViewRight Coronary ArteryRight Ventricle Left VentricleLeft Coronary ArteryLeft AtriumGreat Cardiac VeinRight AtriumAnterior / Exterior16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17Posterior ViewBacksideLeft Circumflex Coronary ArteryCoronary SinusInterior Vena CavaLeft VentricleRight VentricleRight Coronary ArteryPulmonary VeinsAortic ArchSuperior Vena Cava18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19Superior ViewTricuspid Valve Pulmonary VeinsRight AtriumAortic ValvePulmonary ValveLeft AtriumMitral ValveLooking down at the valves20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21Anterior 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 imageSternum is directly over the spineRibs angle downwardSilhouette of heart is right of center on image 22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2324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25Right Anterior Oblique ViewRight anterior oblique (RAO) view: Long axis view of the heart Spine to the left Sternum to the right Perpendicular to the intraventricular septum26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2728二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29Right Anterior Oblique ViewRARVIVCSVC30右前斜位RARVIVCSVC31Left Anterior Oblique ViewIn 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 heartIn LAO, the left ventricle will have: The septal wall to the left of the image The lateral wall to the right of the image32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33Left Anterior Oblique view34左前斜位35Left Anterior Oblique ViewTV MVCS36左前斜位TV MVCS37Veins & ArteriesArteriesHigh-pressure system moves blood from heartSmooth muscle in vessel walls facilitates perfusionArterioles connect to capillariesVeins Low-pressure system returns blood to heart Intravascular valves facilitate return of blood Venules connect to capillariesEnd-to-end a 5,000 mile span38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39CapillariesCapillaries Tissue CellsVenuleArterioleArteryFromheartVeinToheartThe connection between arteries & veins40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41Rhythmic CycleContraction / 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 bloodSystolecontraction occursDiastolerest between contractions42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43Right HeartRight Pulmonary ArteryRightAtriumLobar Branches to Right LungRightVentricleLeft VentricleLeft AtriumPulmonaryVeinLobar Branches to Left LungTricuspid ValveLeft Pulmonary ArteryPulmonaryVeinAorticArchLung PumpSuperiorVena CavaInferiorVena Cava44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45Left HeartRightPulmonary ArterySuperiorVena CavaInferiorVena CavaRightAtriumLobar Branches to Right LungRightVentricleLeft VentricleLeft AtriumPulmonaryVeinLobar Branches to Left LungTricuspid ValveLeft Pulmonary ArteryPulmonaryVeinAortaAortaArchBody Pump46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47Systemic & Pulmonary CirculationHead & Upper LimbsArmsHeartDigestive TractKidneysLungsTrunk & Upper LimbsSystemic CirculationSystemic CirculationPulmonary CirculationHow blood flows through the body48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49Myocardial InfarctionWhat happens during a heart attackDamaged Heart MuscleOccluded Coronary Artery Ischemia decrease in blood supply leading to hypoxia Infarction tissue death caused by lack of oxygen Arrhythmiasforce or rhythm irregularitiesWhen a coronary artery is blocked, oxygenated blood cant reach cells downstream50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51Ejection FractionCardiac Output Stroke VolumeHeart RateHR EFPerformance4 key measurements (CO, SV, HR, EF)Volume of blood pumped from the heart in a minuteVolume of blood pumped from the heart during a single contractionNumber of heartbeats per minutePercent of blood pumped from the heart per strokeCO = HR x SVNormal = 4-8 L/minuteEF = Volume EjectedTotal VolumeNormal = 50-60%Systolic Heart Failure = EF of 40%CO SV52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/mEF = 射出的血液量总血液量