%95ל הרצאה מערכת קרדיווסקולרית

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"

:

: 29.1.2008

( ) Coronary arteries. Left coronary artery pulmonary trunk . " :

1)Left anterior descending Apex .

2) Circumflex artery Coronary sinus .

Left marginal artery .

Right coronary artery Inf. Vena cava. " Auricle s.a node.

Right marginal artery :

1) Transverse artery Coronary sinus Circumflex artery .2) Right posterior descending - Apex.

Left anterior descending Right posterior descending ( ).

Left anterior descending:

1) Diagonal artery 2) Anterior inter ventricular arteries .

Intra ventricular septum Left anterior descending Right posterior descending. .

Right coronary artery a.v node .

:

1. nodal fibers . .

2. Purkinje fibers- , . . . s.a node . a.v node. a.v node bundle of his. right / left branch .

:

right branch Endocardium anterior papillary muscle. Purkinje.

left branch . anterior papillary muscle Plexus .

Endocardium ( right branch Endocardium Plexus ).

- Ischemia. . , Ischemia. Ischemia . . ( ), Ischemia. .

. , ( 15 -20) . . , . 2-3 . . , Atheroma.AtheromaAtheroma . Atheroma . Atheroma . . Coronary arteries ( ). . " .( -3 "). Atheroma . .

( ) Lumen. Lumen Atheroma. . . .

. . , . Atheroma. . , Anerobic metabolism . . . ( ). Anerobic metabolism Lactic acid

:

1)

2) , . Lactic acid , Angina pectoris .

Angina ', .

Pectoris - . .

Lactic acid , .

. ( ). ,, , . . Lactic acid . . :

..- .. , . (... Ischemia , ). - , ...- . ... Ischemic heart disease . , :

- , (Atheroma). . Atheroma .( Atheroma ). , Coronary artery bypass .

Internal mammary/ phoracic artery , , . Atheroma , . . ( Atheroma.) . , ( ) .

.

. ( , , , ).

? . . Atheroma Atheroma : , . . . ( '() .

. , . Atheroma . . .

, ( ) . () ( , ), , Lumen ( ), . . :1) .

2) .

, , . . . Myocardial infarction .

:

1) ? left coronary artery , ( ). , .

2) ? - ? : - - , . cardiac insufficiency. . , . - - Ischemia ( ) , . . conducting system , (s.a node), . . , -3/4 , , . . .( . . . nodal fibers , purkinje fibersu- .').

.

? , , . . ( , ). , .

- , . .

?-

right atrium

superior/ inferior vena cava ,

right ventricle

pulmonary trunk .

left atrium 4 pulmonary veins . ( ).

left ventricle-

Aorta.

Aorta ( ) , , Arterial capillaries ( ). Arterial capillaries Venous capillaries. Venous capillaries

, vena cava . " " Greater circulation. ( ).

pulmonary trunk . Pulmonary arteries . Arterial capillaries " Venous capillaries pulmonary veins. " ", Lesser circulation.( ).

Aorta O2 .

pulmonary veins .

pulmonary trunk CO2.

superior/ inferior vena cava . , . .

, :

= Valve

Aortic valve

Pulmonary valve

Tricuspid valve

Miteral valve

Aortic valve - Pulmonary valve Semi lunar valve.

= .

= .

Aortic valve

Aortic valve , - Aorta. , .

Pulmonary valve

Pulmonary valve , pulmonary trunk . .

Tricuspid valve

Tricuspid valve . .

Miteral valveMiteral valve . .

. . , Placenta.

, . .

Aorta , -3 ( ), Ascending aorta () Aortic arch (), Descending aorta (). Aorta , Right /left common iliac arteries . External/internal External iliac arteries.

[ External/internal , Medial/lateral? :

1) - External internal . .

2) - - External () - internal .]

internal External iliac ( ) Umbilical artery . (

Right /left). , , Umbilicus.

( Umbilical arteries Urachus . .

Urachus , Urachus , ).

Umbilical arteries Umbilicus Placenta, . Placenta ( ), . Placenta Umbilical vein . . Umbilicus . "" . inferior vena cava. Placenta . inferior vena cava . . .

inferior vena cava .

pulmonary trunk . .

.

Inter atrial septum- .

Inter atrial septum . . Foramen ovale =oval.

Inter atrial septum Foramen ovale . .

Foramen ovale . -Aorta .( Aorta Aorta .)

?

pulmonary trunk . . pulmonary trunk . ( ). . Ductus arteriosus Aorta

Aortic arch. " " Aorta .

' :

* , . , . , , Foramen ovale . . .

Inter atrial septum Foramen ovale Fossa ovalis .

Ductus arteriosus Ligamentum arteriosum . . .

, Umbilical arteries, . , .

:

* , , Umbilical arteries. Umbilical arteries . Aorta. Intra arterial catheterization.

* Ductus arteriosus Aorta. .* Foramen ovale . .

30% Patent Foramen ovale .

Foramen ovale . , . . . , . C.V.A, .

C.V.A Patent Foramen ovale (P.F.O .) . P.F.O ( ) Foramen ovale , .