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Transcript
血壓、心電圖與週圍循環操作步驟 生物醫學工程學系 邱文泰 102.10.29 Cardiac anatomy and flow patterns Pulmonary artery Superior vena cava Pulmonary vein Right atrium Left atrium Inferior vena cava Left ventricle Right ventricle Conducting system of the heart AV node Hiss SA node Cardiac excitation cycle (1) Sinoatrial node Atrioventricular node Cardiac excitation cycle (2) Electrocardiography (ECG) = Electrocardiogram An ECG records extracellular potentials using electrodes adhered to the body surface. Sinoatrial node Electrocardiogram (ECG) limb leads (1) (2) (3) Bipolar limb leads: three bipolar limb leads Augmented limb leads: three unipolarl eads Precordial (chest) leads: Precordial (chest) leads The electrocardiogram 60-100 ms 80-100 ms Isoelectric line Ventricular depolarization Atrial depolarization SA node Ventricular repolarization Papillary muscle repolarization AV node Bundle of His 120-200 ms 300-430 ms Q wave: the intraventricular septum R wave: the apex and the free walls S wave: the region near the base Sequence of cardiac excitation R T P Q S Heart sounds Atrial contraction Blood rushing into the LV A2 P2 Heart murmurs Heart murmurs are sounds associated with turbulent blood flow. (1) Stiffening and stenosis of the aortic and pulmonary valves obstruct blood flow and cause systolic ejection murmurs. (2) Mitral and tricuspid insufficiency allows blood to flow backward from ventricle to atrium during systole. (3) Incompetent aortic and pulmonary valves cause diastolic murmurs. Types of blood vessels Blood vessel structure Collagen fibers With resting tone Capillaries & venules without elastic fibers Vascular smooth muscle cells (VSMCs) Blood velocity and vessel cross-sectional area across the systemic vasculature 50 cm/s 4 cm2 4000 cm2 < 1 mm/s Resistance vessels Elastic arteries Perfusion pressures across the systemic vasculature