He aha ka ka automatism o ka naau? Cardiac automaticity

He aha ka ka automatism o ka naau? Ke pane i keia ninau ua hookomoia ma o ka 'atikala ma lalo nei. Eia hou, ka mea, he 'ike e pili ana i' aʻe 'ana i ke ola kino ona kanaka pili me ka hua manaʻo.

He aha ka ka automatism o ka naau?

Muscle olona, i loko o kānaka i ka hiki e pane koke ai i ka ka ho'ēmiʻana o ka lolouila pāpaʻa, a sequentially laila hoolilo ia ma ka ka ho'ēmiʻana o ke Muscle 'ole. Ua Ua hoao aku au ia ia i ka noho kaʻawale naau Muscle mea hiki ke hoʻomakaʻia kā lākou mau pīhoihoi a hana rhythmic contractions. Ua hiki ua kapa automatism naʻau.

Kumu o cardiac automaticity

Maopopo ka mea i ka automatism o ka naau, ka mea hiki ia ia mai ka eia. I ka naau i ka mea i ho'ākāka 'hiki e paha i ka uila pana, i ukali ia e paʻa ia i ke muscular hale.

Sinoatrial wahi - huiwaina peysmekerskih mua type aeee (i loaʻa ma kahi o 40% mitochondria loosely ke aupuni 'myofibrils,ʻaʻohe T-'ōnaehana maupaʻa he nui helu o noa kalipuna ua poorly ulu sarcoplasmic ulana pukapuka,) aia i loko o ka pa akau o ke kūlana vena cava, ma ka confluence o ka atrium akau .

Transient atrioventricular wahi o ka lua o ka type ua hanaʻia ma aeee i hoʻomaka impulses mai ka sinoatrial wahi, akā, ma lalo o kūikawā rula e kū kaʻawale paha i ka pila kauoha. Transitional keena iloko poʻeʻuʻuku mitochondria (20-30%) a me kekahi mau mea nui myofibrils ma mua o ka mea mua o ka papa aeea. Atrioventricular wahi aia i loko o ka atrial septum ma luna iho ua pū i hiki ai i ka mea nana i ulana, a excitation mau wawae pua lala hihia (20-15% pihaʻi me mitochondria).

Purkinje olona, i kekahi kahua hoolilo o ka excitation. Ka mea, hohola aku ka hola ma ke kiʻekiʻe o ka waenakonu paku o kela a me keia o na mau pua lala hihia. Mau keena no mitochondria ma kahi o 10%, oi structurally oi like i cardiac Muscle olona.

Ka noho'na makaainana i ulu helehelena o ka uila pāpaʻa ia lŘlŘ ma peysmekerskih sinoatrial wahi keena, i potentiates nalu excitation noho haumāna kahi 60-80 kui iho oe a no minuke. He He He mua-mea Keaukaha. A laila, ua pū i hiki ai i ka lua a me ke kolu lawelawe 'ole kaʻilikai ku ae la ka nalu. e hiki ke lawe pu i ka excitation ke kōā nalu, a kū kaʻawale induce ka ho'ēmiʻana o lalo nä alapine lakou. Ke Keaukaha o ka lua o kaʻilikai ma hope o ka sinus atrioventricular wahi, i mea hiki ke hana i kā lākou mau 40-50 minuke hookuuia ma ka wa e kaawale aku o inhibitory ha awina o ka sinus wahi. Eia, i ka excitation ua pū i hiki ai i ka 'ole o ka puapua o kona, a reproduces 30-40 kui iho oe a no minuke, a laila, i ka uila kauoha kahe ana i ka pua o kona mau wawae (25-30 cpm) a me Purkinje puluniu'ōnaehana (20 lāʻau ikiʻai wale no minuke), a komo i loko o ka hana Muscle keena o ka myocardium .

Nō kāu impulses mai ka sinoatrial wahi kuokoa hiki, e uhi i ka pou hana o nń ku 'ole. Inā pilikia i ka hana o ka mua o ka papa o ka Keaukaha, kana hana ma ka lawe-ku loulou ma lalo o ka conduction nenoaiu.

Nine keʻano o ka hanaʻana i i naau automaticity

He aha ka ka automatism o ka naau, mai ke oiai ua ike mai o kemika? Ma ka hakakino 'ilikai, i ke kumu no ka kuokoa hanana o ka uila uku ole (ka hanaʻia) ma luna o na membranes peysmekerskih keena o ke alo o ka ai-kapaia impulsatora. Kana hana (ka hana ana o ka naau automaticity) oia o ekolu kahua o ka hoʻonaʻauao.

Kahua o ka hoʻonaʻauao o ka impulsatora:

• 1st pae e hoomakaukau ai (superoxide ma ka AaOIeIOUIeXAOAaIN ~ o o oxygen me na phospholipids olelo ikaika mai ia ma luna o ka halepaahaoʻilikaiʻili lahilahi peysmekerskoy ka mea loaʻa iā ia kekahi o ka io ka uku ole, ke kau mai ana iluna Loaʻaʻia ka mea i hāʻawi mai);
• 2nd pae potasiuma a me ka paʻakaiʻeleu amo, oiai i ka mawaho malama o ka halepaahao i like i 30 mW;
• 3rd pae Jump electrochemical - hoʻohana ikehu ua loaʻa i hoʻopōʻaiapuni o kū'ē i oxygen ioeo (o ionized o oxygen, a hydrogen peroxide) hoʻohana 'ana i nā'ūhū catalase a me superoxide dismutase. Kena ae la ka ikehu quanta mahuahua biocapacity pacemaker no laila, i ka mea e hookomo ana i ka hanaʻia.

Keʻano o ka hanaʻana lāʻau ikiʻai wale hoʻomakaʻia keena - pacemakers pono ana i kumu lawa alo o hakakino oxygen, a ua haawi mai ia erythrocytes inflowing koko.

Hoemi hana a hapa cessation o ka hana ana o kekahi a oi kahua o ka hoʻonaʻauao impulsatora'ōnaehana aʻe i kaʻaelike hana peysmekerskih keena, ma o na la arrhythmia. Ka paleʻana i kekahi o nā keʻano o ka hanaʻana o kēia 'oihana a nā ulia cardiac hopu. Hoʻomaopopo i ka mea automatism o ka naau, ke maopopo a me ka kaʻina.

Ka hopena o ka autonomic ko mākou hopohopo'ōnaehana i ka naau Muscle

Ma waho aʻeo i kā lākou mau hana e paha pou impulses, i ka hana o ka naau ua hoi malalo o ka lepa o ka Muscle innervating kōkua aloha a me ka parasympathetic nä olonä, ma ka hoʻokō 'ole' ana i ke hihia hoʻi i loko cardiac automaticity.

I ka hopena o ke aloha o māhele ka mämä holo i ka naau, i ka noho haumāna kahi ia. Kōkua aloha o innervation i ka maikaʻi chronotropic, inotropic, dromotropic hopena.

Ma lalo o ka maʻamau hana o ka parasympathetic ko mākou hopohopo'ōnaehana , deceleration depolarization peysmekerskih aeee (inhibitory hana), a nolaila ka meheu o ka naau i kela (io chronotropic hana), ka conductivity emi ana i loko o ka naʻau (io dromotropic hookoia), he emi ma ka ikehu systolic contraction (io inotropic hookoia), akā, hoʻokāʻoi excitability o ka naau (maikaʻi batmotroponoe hana). I ka la mahope Ua hoi ia i ka 'aʻe' ana o cardiac automaticity kuleana pili i.

Kumu o ka naau automatism

1. Myocardial ischemia.
2. Li nui.
3. Intoxication.
4. Kue koena paʻakai, potasiuma, makanekiuma, kalipuna.
5. Hormonal dysfunction.
6. 'Aʻe' ana i ka hopena o ka hana nona iho kōkua aloha a me ka parasympathetic a hāʻule pahū wale.

Kind o arrhythmias aie i ka 'aʻe' ana o automaticity o ka naau

1. Sinus tachy-a me ka bradycardia.
2. Ha ('ōpio makua) arrhythmia.
3. Extrasystole arrhythmia (sinus, atrial, atrioventricular, ventricular).
4. Paroxysmal tachycardia.

Hoomaopopo arrhythmia manawa e conduction kāna hana automaticity a me ka reentry e lilo ale (reentry nalu) i loko o kekahi a oi kekahi māhele o ka naau, i ka hopena o ka fibrillation a atrial koliliʻana.

Ventricular fibrillation - kekahi o ka loa ola-hooweliweli arrhythmias, i mea heʻilihune o koke cardiac hopu a me ka make. Ka loa ka hoʻokō iaoiaeii o ka lapaʻau - uila defibrillation.

ka hopena

Nolaila, noonoo iho la, i mea ka automatism o ka naau, ke maopopo e hiki i 'aʻe' ma ka hihia o ka maʻi. Kēia, ma ka huli, i ka mea hiki ke kaua aku i ka maʻi maikaʻi oi pono a me epekema.