Dr. Nia-Fisiologi Sirkulasi Fetus, Bayi, Dewasa
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Transcript of Dr. Nia-Fisiologi Sirkulasi Fetus, Bayi, Dewasa
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Fisiologi sirkulasi fetus, bayi,
dewasa
dr. Rohmania Setiarini
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The Heart: Blood Flow
Deoxygenatedblood in frombody
Oxygenatedblood in lungs
Atria Contract Ventricles Contract
Deoxygenatedblood outto lungs
Oxygenatedblood out tobody
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The Heart: Cardiac Cycle
Right atrium contracts Tricuspid valve opens Blood fills right ventricle
Right ventricle contracts Tricuspid valve closes Pulmonary semilunar valve
opens Blood flows into pulmonary
artery
Left atrium contracts Bicuspid valve opens Blood fills left ventricle
Left ventricle contracts Bicuspid valve closes Aortic semilunar valve opens Blood pushed into aorta
One heartbeat = one cardiac cycleAtria contract and relax
Ventricles contract and relax
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Conducting System of Heart
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Blood Vessels: Arteries and Arterioles
Strongest of theblood vessels
Carry blood awayfrom the heart
Under high pressure Vasoconstriction Vasodilation
Arterioles Small branches of
arteries Aorta
Takes blood from theheart to the body
Coronary arteries Supply blood to heart
muscle
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Blood Vessels: Veins and Venules
Blood under no pressure inveins
Does not move very easily
Skeletal muscle contractionshelp move blood
Sympathetic nervous systemalso influences pressure
Valves prevent backflow
Venules Small vessels formed when
capillaries merge
Superior and inferior venacava
Largest veins
Carry blood into right atrium
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Blood Vessels: Capillaries
Branches of arterioles
Smallest type of blood vessel
Connect arterioles to venules
Only about one cell layer thick
Oxygen and nutrients can pass out of a capillary intoa body cell
Carbon dioxide and other waste products pass out ofa body cell into a capillary
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Circulation
Pulmonary circuitright atrium right ventricle pulmonary artery
trunk pulmonary arteries lungs pulmonary veins heart (left atrium)
Systemic circuitleft atrium left ventricle aorta arteries
arterioles capillaries venules veins vena cava heart (right atrium)
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Blood Flow Through Heart
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Systemic and PulmonaryCirculation
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FETAL CIRCULATION
By the third month of development, all major bloodvessels are present and functioning.
Fetus must have blood flow to placenta.
Resistance to blood flow is high in lungs.
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UMBILICAL CIRCULATION
Pair of umbilicalarteries carrydeoxygenatedblood & wastesto placenta.
Umbilical veincarriesoxygenatedblood andnutrients fromthe placenta.
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THE PLACENTA
Facilitates gas andnutrient exchange
between maternaland fetal blood. The blood itself does
not mix.
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UMBILICAL VEIN TO PORTAL
CIRCULATION
Some blood from theumbilical vein entersthe portal circulation
allowing the liver toprocess nutrients. The majority of the
blood enters the ductusvenosus, a shunt whichbypasses the liver andputs blood into thehepatic veins.
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FORAMEN OVALE
Blood is shuntedfrom right atrium toleft atrium, skipping
the lungs. More than one-third
of blood takes thisroute.
Is a valve with twoflaps that preventback-flow.
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DUCTUS ARTERIOUSUS
The blood pumpedfrom the right
ventricle enters thepulmonary trunk. Most of this blood is
shunted into theaortic arch throughthe ductusarteriousus.
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WHAT HAPPENS AT BIRTH?
The change from fetal to postnatalcirculation happens very quickly.
Changes are initiated by babys firstbreath.
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Foramen ovale Closes shortly after birth,fuses completely in firstyear.
Ductus arteriousus Closes soon after birth,becomes ligamentumarteriousum in about 3
months.Ductus venosus Ligamentum venosum
Umbilical arteries Medial umbilical ligaments
Umbilical vein Ligamentum teres
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PROBLEM WITH PERSISTENCE
OF FETAL CIRCULATION
Patent (open) ductus arteriosus and patentforamen ovale each characterize about 8%of congenital heart defects.
Both cause a mixing of oxygen-rich andoxygen-poor blood; blood reaching tissuesnot fully oxygenated. Can cause cyanosis.
Surgical correction now available, ideallycompleted around age two.
Many of these defects go undetected untilchild is at least school age.