英文医学课件：10 血管生理学
合集下载
中英文双语PPT精品课件心血管系统Cardiovascular
Rapid but regular contractions of atria or ventricles
Cardiovascular System
Pathological Conditions
fibrillation 纤维颤动 xian wei chan dong Rapid, random, ineffectual and irregular contractions of the heart(350 beats or more per minute) Congenital heart disease先天性心脏病xian tian xing xin zang bing Abnormalities in the heart at birth
Coarctation of the aorta 主动脉缩窄zhu dong mai suo zhai
Narrowing of the aorta
Cardiovascular System
Pathological Conditions
Patent ductus arteriosus 动脉导管未闭dong mai dao guan wei bi A small duct between the aorta and the pulmonary artery, which normally closes soon after birth, remain open Septal defects 间隔缺损jian ge que sun Small holes in the septa between the atria or the ventricles
舒张 shu zhang
endocardium
心内膜 xin nei mo
Cardiovascular System
Pathological Conditions
fibrillation 纤维颤动 xian wei chan dong Rapid, random, ineffectual and irregular contractions of the heart(350 beats or more per minute) Congenital heart disease先天性心脏病xian tian xing xin zang bing Abnormalities in the heart at birth
Coarctation of the aorta 主动脉缩窄zhu dong mai suo zhai
Narrowing of the aorta
Cardiovascular System
Pathological Conditions
Patent ductus arteriosus 动脉导管未闭dong mai dao guan wei bi A small duct between the aorta and the pulmonary artery, which normally closes soon after birth, remain open Septal defects 间隔缺损jian ge que sun Small holes in the septa between the atria or the ventricles
舒张 shu zhang
endocardium
心内膜 xin nei mo
心血管生理学(英文版)课件
• Ca2+ influx , [Ca2+ ]i , contractility
Cardiac effect of parasympathetic stimulation
Interaction of sympathetic and parasympathetic nerves
Predominance of autonomic nerves
sympathetic constrictor nerve, vagus nerve • Effector: heart & blood vessels
Baroreceptor neurons function as sensors in the homeostatic maintenance of MAP by constantly monitoring pressure in the aortic arch and carotid sinuses.
Cardiovascular Center
A collection of functionally similar neurons that help to regulate HR, SV, and blood vessel tone
Vasomotor center
Located bilaterally mainly in the reticular substance of the medulla and of the lower third of the pons
180 mmHg ➢Receptors within the aortic arch are less
sensitive than the carotid sinus receptors
Cardiac effect of parasympathetic stimulation
Interaction of sympathetic and parasympathetic nerves
Predominance of autonomic nerves
sympathetic constrictor nerve, vagus nerve • Effector: heart & blood vessels
Baroreceptor neurons function as sensors in the homeostatic maintenance of MAP by constantly monitoring pressure in the aortic arch and carotid sinuses.
Cardiovascular Center
A collection of functionally similar neurons that help to regulate HR, SV, and blood vessel tone
Vasomotor center
Located bilaterally mainly in the reticular substance of the medulla and of the lower third of the pons
180 mmHg ➢Receptors within the aortic arch are less
sensitive than the carotid sinus receptors
血管病理生理学经典课件
● 受体操纵性性钙通道 + cAMP
β + 腺苷酸环化酶 +
G
血管病理生理学经典课件
ATP
②内钙释放： 肌浆网(SR)是内钙释放的主要来源，SR上
有两类钙池， * IP3 敏感的钙池：SR上的IP3 受体，胞外兴奋
信号(如NE)通过G蛋白产生的IP3作用于SR，使 SR中的钙释放 * IP3 不敏感的钙池：为咖啡因敏感的、Ca2+ 引 起的Ca2+ 释放。
肌原纤维
心肌质膜
T管
线粒体
线粒体
I带
A带
肌浆网
终末小池
Z线
肌球蛋白
肌动蛋白,向肌球蛋白,肌钙蛋白
ADP+Pi
肌球蛋白
Ca+
ATP
I TC
肌钙蛋白
肌动蛋白 向肌球蛋白
心肌收缩
肌球蛋白
横桥 向肌球蛋白
肌动蛋白
肌钙蛋白
IC T
心肌舒张
质膜
Na+
肌节
Ca2+
ATP Ca2+源自ADP+PiATP
Ca2+
血管生理与 病理生理 （Vascular physiology and pathophysiology）
血管病理生理学经典课件
主要内容
•血管平滑肌 •血管内皮细胞 •血管壁基质 •血管运动功能的异质性
血管病理生理学经典课件
概述
• 血管 — 血液循环的通道，(传统的“血管”概念)。 具有复杂功能的器官 • 分泌功能： • 调节自身的张力、结构等的因子，参与多种生理功能的
Caveolae：主要由脂类和蛋白质组成。脂类成分主要为 胆固醇、鞘磷脂和鞘糖脂。这些脂质分子特别是胆固醇 对于Caveolae的正常结构和功能的维持非常重要。
β + 腺苷酸环化酶 +
G
血管病理生理学经典课件
ATP
②内钙释放： 肌浆网(SR)是内钙释放的主要来源，SR上
有两类钙池， * IP3 敏感的钙池：SR上的IP3 受体，胞外兴奋
信号(如NE)通过G蛋白产生的IP3作用于SR，使 SR中的钙释放 * IP3 不敏感的钙池：为咖啡因敏感的、Ca2+ 引 起的Ca2+ 释放。
肌原纤维
心肌质膜
T管
线粒体
线粒体
I带
A带
肌浆网
终末小池
Z线
肌球蛋白
肌动蛋白,向肌球蛋白,肌钙蛋白
ADP+Pi
肌球蛋白
Ca+
ATP
I TC
肌钙蛋白
肌动蛋白 向肌球蛋白
心肌收缩
肌球蛋白
横桥 向肌球蛋白
肌动蛋白
肌钙蛋白
IC T
心肌舒张
质膜
Na+
肌节
Ca2+
ATP Ca2+源自ADP+PiATP
Ca2+
血管生理与 病理生理 （Vascular physiology and pathophysiology）
血管病理生理学经典课件
主要内容
•血管平滑肌 •血管内皮细胞 •血管壁基质 •血管运动功能的异质性
血管病理生理学经典课件
概述
• 血管 — 血液循环的通道，(传统的“血管”概念)。 具有复杂功能的器官 • 分泌功能： • 调节自身的张力、结构等的因子，参与多种生理功能的
Caveolae：主要由脂类和蛋白质组成。脂类成分主要为 胆固醇、鞘磷脂和鞘糖脂。这些脂质分子特别是胆固醇 对于Caveolae的正常结构和功能的维持非常重要。
血管病理生理学 经典课件
N型。
* 受体与Ca2+ 通道本身为一复合体，配体作用于受体后， 经G蛋白转导信号使Ca2+ 通道开放。 * 受体与Ca2+ 通道不为一复合体，但通过G蛋白将两者耦联 到一起 * 配体作用于受体后，经G蛋白转导信号使某些酶激活，产
生第二信使，进而调节Ca2+ 通道的开放。如腺苷酸环化 酶AC。
● 受体操纵性性钙通道
激活的钙调蛋白启动钙泵 → Ca2+↓，钙调蛋白
与肌球蛋白轻链激酶脱离，肌球蛋白轻链激酶失活， 磷酸酶脱去肌球蛋白轻链磷酸 →肌球蛋白与肌动蛋 白结合脱离 → SMC松驰。 (1) cGMP与血管平滑肌舒张：NO、心房肽 → GC激活 → cGMP↑→ 激活蛋白激酶G (PKG)→ 钙泵活性↑→ Ca2+↓;PKG还抑制钙通道，阻碍钙内流等。 (2) PKC活化可能通过以下途径引起VSMC的舒张
转化
四.血管平滑肌上的主要受体
(一)肾上腺素受体(adrenergic receptor, AR)
包括: α1(α1A，α1B，α1D，); α2(α2A，α2B，α2C);
血管生理与 病理生理
（Vascular physiology and
pathophysiology）
主要内容
•血管平滑肌
•血管内皮细胞
•血管壁基质 •血管运动功能的异质性
概述
• 血管 — 血液循环的通道，(传统的“血管”概念)。 具有复杂功能的器官
• 分泌功能：
• 调节自身的张力、结构等的因子，参与多种生理功能的 调控。
γ ），收缩表型以α-actin为主，合成表型以β-actin 为主。调节成份包括filamin(细丝蛋白，骨骼肌未发 现)，tropomyosin？(原肌球蛋白)，troponin？(肌钙 蛋白)。
生理学PPT：血管生理
↓
↓
血流速↑
SP↑(明显)
↓
心舒末期A血量↑（不明显）→ DP↑（不明显）
(2)心率↑→心舒期↓→心舒末期A血量↑→管壁侧压力↑
↓
↓
回心血量↓
DP↑(明显)
↓
搏出量↓→SP↑（不明显）
(3)外周阻力↑→心舒期血流速↓→心舒期A血量↑
↓
↓
心缩期血流速↑ ↓
管壁侧压力↑ ↓
SP↑（不明显）
DP↑（明显）
②高低取决：射血力、V回流速和量
与射血力呈负相关；
与V回流速和量呈正相关。
⑶意义：①反映心功和V回流量 ②控制补液速和量的指标
（如CVP低，常提示输液的量不足）
中心静脉压与动脉血压变化的意义
-----------------------------------------------------
中心V压 动脉血压
3.形成机制
前提条件：足够的血液充盈 闭合的血流环路
决定因素：心室射血对血流产生的动力; 外周血管口径变化对血流产
生的阻力.
心室收缩
心室舒张
↓ 射血入主A ＋ 外周阻力
↓ 推血（1/3）流动 ＋ 大A扩张（2/3）
(动能消耗) （势能贮存+缓冲力） ↓
大A回弹 （势能释放）
推血继续流动
血液对动脉壁的侧压 上升到最大值=收缩压
的大小
脉搏实质是随心室缩舒所形成的大A压力波， 沿血管壁传布的能量表现，非血液流到所摸A对A壁 的冲击波动。
四．静脉血压与血流 （一）静脉血压
1.分类：
1外周静脉压：各器官的静脉压。当心脏 射 血功能降低，静脉回流降低时，血液将留 滞在外周静脉，静脉压升高。
心血管系统英文PPT课件
14
Arteries of lower limb Femoral a. 股动脉 Popliteal a. 腘动脉 Posterior tibial a.
胫后动脉
Anterior tibial a.
胫前动脉
dorsal a. of foot
足背动脉
15
The Veins 静脉
General feature Thin walls, larger lumens,
12
Abdominal aorta 腹主动脉
Visceral branches 脏支
Paired branches
Middle suprarenal artery
肾上腺中动脉
Renal artery 肾动脉 Testicular (ovarian) artery
睾丸（卵巢）动脉
Unpaired branches
Left common carotid a. 左颈总动脉 Left subclavian a. 左锁骨下动脉
Descending aorta 降主动脉
Thoracic aorta 胸主动脉 Abdominal aorta 腹主动脉
9
Arteries of head and neck Common carotid a.颈总动脉
venous angle
19
Veins of upper limb
Deep vein: have the same names as their companion arteries
Superficial veins:
cephalic v. 头静脉 basilica v. 贵要静脉 median cubital v.
Lymphatic node
Arteries of lower limb Femoral a. 股动脉 Popliteal a. 腘动脉 Posterior tibial a.
胫后动脉
Anterior tibial a.
胫前动脉
dorsal a. of foot
足背动脉
15
The Veins 静脉
General feature Thin walls, larger lumens,
12
Abdominal aorta 腹主动脉
Visceral branches 脏支
Paired branches
Middle suprarenal artery
肾上腺中动脉
Renal artery 肾动脉 Testicular (ovarian) artery
睾丸（卵巢）动脉
Unpaired branches
Left common carotid a. 左颈总动脉 Left subclavian a. 左锁骨下动脉
Descending aorta 降主动脉
Thoracic aorta 胸主动脉 Abdominal aorta 腹主动脉
9
Arteries of head and neck Common carotid a.颈总动脉
venous angle
19
Veins of upper limb
Deep vein: have the same names as their companion arteries
Superficial veins:
cephalic v. 头静脉 basilica v. 贵要静脉 median cubital v.
Lymphatic node
血管生理-精品医学课件
2. 静脉回心血量及其影响因素
（1）体循环平均充盈压 （2）心脏收缩力量
左心衰、右心衰的不同表现 （3）体位改变 （4）骨骼肌的挤压作用：肌肉泵（静脉泵） （5）呼吸运动：呼吸泵
五、微循环 （microcirculation）
定义：微动脉和微静脉之间的血液循环
微循环的生理意义
＊血液和组织之间的物质交换 ＊控制流经组织的血流量 ＊影响全身或局部体液的分布
定义：血管内的血液对于单位面积血管 壁的侧压力，即压强。
单位：帕 Pa，牛顿/米2 1kPa＝7.5mmHg；1mmHg=0.133kPa
1 mmHg =1.36 cm H2O
三、顺应性（compliance）和可扩张性（distensibility）
C=ΔV/ΔP D= ΔV/V0
ΔP
C=D×Vo
（一）微循环的组成
(1) 微动脉（arteriole）
管壁有完整的平滑肌层
毛
控制微循环血流的“总闸门”
细
血
(2) 后微动脉（metarteriole）
管 前
管壁有平滑肌
阻 力
微循环血量调节的一个“分闸门”
血 管
(3) 毛细血管前括约肌（precapillary sphincter）
对代谢物敏感，是微循环的又一“分闸门”
Distribution of blood in the body at rest.
The overall blood flow in the systemic circulation is identical to the cardiac output.
（三） 血压 (blood pressure)
2. 血流速度（velocity of blood flow） 血流速度与血流量成正比，与血管截面积 成反比
相关主题
- 1、下载文档前请自行甄别文档内容的完整性，平台不提供额外的编辑、内容补充、找答案等附加服务。
- 2、"仅部分预览"的文档,不可在线预览部分如存在完整性等问题,可反馈申请退款(可完整预览的文档不适用该条件!)。
- 3、如文档侵犯您的权益，请联系客服反馈,我们会尽快为您处理(人工客服工作时间：9:00-18:30)。
Vascular Physiology
?
Hemodynamics（血流动力学）
• Blood flow Q= DP/R = (P1-P2)/R
Q= PA/R
Q: cardiac output, 5 L/min R: total peripheral resistance PA: aortic pressure
Which and what order? 1. Radial artery
Where and how?
•Radial side of wrist. •With tips of index and middle fingers.
2. Brachial artery
•Medial border of humerus at elbow medial to biceps tendon. •Either with thumb of examiner's right hand or index and middle of left hand.
To estimate systolic and diastolic pressures, pressure is released from an inflatable cuff on the upper arm while listening as blood flow returns to the lower arm.来自 我国四次高血压患病率调查结 果
引自中国高血压防治指南（2010）
中国高血压防治指南（2010）
Factors affecting arterial blood pressure
• Stroke volume • Heart rate
Ventricular ejection
• Peripheral resistance
• Elastic vessels
• Blood volume
1 5
3 2
4
The blood moved in a single heart contraction stretches out the arteries, so that their recoil continues to push on the blood, keeping it moving during diastole.
查DynaMed
引自中国高血压防治指南（2010）
电子血压计原理？
JNC8高血压管理指南要点（2014）
The joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
Pulse pressure (PP，脉压): the difference between SP and DP
Mean arterial pressure (MAP， 平均动脉压): the average pressure in the cardiac cycle (=DP+1/3PP)
Mean arterial pressure (MAP)
r: main determinant of blood flow
Arterial blood pressure（动脉血压）
Arteries
Blood pressure measurement
1. Direct (invasive) measurement technique
2. Indirect (non-invasive) measurement technique
Systolic pressure (SP，收缩压): the maximum arterial pressure reached during peak ventricular ejection
Diastolic pressure (DP，舒张压): the minimum arterial pressure just before ventricular ejection begins
pulses of pressure move throughout the vasculature, decreasing in amplitude with distance
Clinical Application of Arterial Pulse
?
Systematic examination of pulses:
Movement of blood into and out of the arteries during the cardiac cycle
引自中国高血压防治指南（2010）
Arterial pulse（动脉脉搏）
In response to the pulsatile contraction of the heart:
Resistance of blood flow
Poiseuille Law: Q=pDPr4/8hL
h: viscosity r: radius of the vessel L: length of the vessel
Q= DP/R
R= 8hL/pr4
Jean Louis Marie Poiseuille \pwä-'zəi\ (April 22, 1799 - December 26, 1869) was a French physician and physiologist. Poiseuille was born in Paris, France. From 1815 to 1816 he studied at the École Polytechnique in Paris. He was trained in physics and mathematics. In 1828 he earned his D.Sc. degree with a dissertation entitled Recherches sur la force du coeur aortique. He was interested in the flow of human blood in narrow tubes.
?
Hemodynamics（血流动力学）
• Blood flow Q= DP/R = (P1-P2)/R
Q= PA/R
Q: cardiac output, 5 L/min R: total peripheral resistance PA: aortic pressure
Which and what order? 1. Radial artery
Where and how?
•Radial side of wrist. •With tips of index and middle fingers.
2. Brachial artery
•Medial border of humerus at elbow medial to biceps tendon. •Either with thumb of examiner's right hand or index and middle of left hand.
To estimate systolic and diastolic pressures, pressure is released from an inflatable cuff on the upper arm while listening as blood flow returns to the lower arm.来自 我国四次高血压患病率调查结 果
引自中国高血压防治指南（2010）
中国高血压防治指南（2010）
Factors affecting arterial blood pressure
• Stroke volume • Heart rate
Ventricular ejection
• Peripheral resistance
• Elastic vessels
• Blood volume
1 5
3 2
4
The blood moved in a single heart contraction stretches out the arteries, so that their recoil continues to push on the blood, keeping it moving during diastole.
查DynaMed
引自中国高血压防治指南（2010）
电子血压计原理？
JNC8高血压管理指南要点（2014）
The joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
Pulse pressure (PP，脉压): the difference between SP and DP
Mean arterial pressure (MAP， 平均动脉压): the average pressure in the cardiac cycle (=DP+1/3PP)
Mean arterial pressure (MAP)
r: main determinant of blood flow
Arterial blood pressure（动脉血压）
Arteries
Blood pressure measurement
1. Direct (invasive) measurement technique
2. Indirect (non-invasive) measurement technique
Systolic pressure (SP，收缩压): the maximum arterial pressure reached during peak ventricular ejection
Diastolic pressure (DP，舒张压): the minimum arterial pressure just before ventricular ejection begins
pulses of pressure move throughout the vasculature, decreasing in amplitude with distance
Clinical Application of Arterial Pulse
?
Systematic examination of pulses:
Movement of blood into and out of the arteries during the cardiac cycle
引自中国高血压防治指南（2010）
Arterial pulse（动脉脉搏）
In response to the pulsatile contraction of the heart:
Resistance of blood flow
Poiseuille Law: Q=pDPr4/8hL
h: viscosity r: radius of the vessel L: length of the vessel
Q= DP/R
R= 8hL/pr4
Jean Louis Marie Poiseuille \pwä-'zəi\ (April 22, 1799 - December 26, 1869) was a French physician and physiologist. Poiseuille was born in Paris, France. From 1815 to 1816 he studied at the École Polytechnique in Paris. He was trained in physics and mathematics. In 1828 he earned his D.Sc. degree with a dissertation entitled Recherches sur la force du coeur aortique. He was interested in the flow of human blood in narrow tubes.