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Samenvatting Bloedsomloop morfologie
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Samenvatting bloedsomloop morfologie slides prof. Verbrugghe
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By: gjgf • 1 year ago
By: groenethee • 1 year ago
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INHOUDHoofdstuk 1: bloed .................................................................................................................................................. 4
Morfologie van het bloed.................................................................................................................................... 4
Inleiding: samenstelling van het bloed ........................................................................................................... 4
Het beenmerg ................................................................................................................................................. 5
Morfologie van het beenmerg .................................................................................................................... 5
Bloedcelvorming in het beenmerg: hematopoïese ..................................................................................... 5
De milt ............................................................................................................................................................. 6
Macroscopisch uitzicht ................................................................................................................................ 6
Opbouw ....................................................................................................................................................... 6
Integratie ..................................................................................................................................................... 7
De rode bloedcellen (erythrocyten) ................................................................................................................ 7
De rijpe erythrocyt ...................................................................................................................................... 8
De levenscyclus van de erythrocyt: erythropoïese ..................................................................................... 8
Termen betreffende afwijkende morfologie van RBC ................................................................................. 9
De bloedplaatjes (thrombocyten) ................................................................................................................... 9
De rijpe thrombocyt .................................................................................................................................... 9
De levenscyclus van de thrombocyt: megakaryopoïese ........................................................................... 10
Fysiologische aspecten van het bloed ............................................................................................................... 10
Inleidende begrippen .................................................................................................................................... 10
Processen van bloedstolling .......................................................................................................................... 11
Vasoconstrictie (20-30 min aanhouden) ................................................................................................... 11
Aggregatie: primaire hemostase ............................................................................................................... 11
Adhesie .................................................................................................................................................. 11
Activatie ................................................................................................................................................ 11
Aggregatie ............................................................................................................................................. 12
Coagulatie: secundaire hemostase ........................................................................................................... 12
Extrinsieke stollingspathway ................................................................................................................. 12
Intrinsieke stollingspathway.................................................................................................................. 13
Common stollingspathway .................................................................................................................... 13
Processen van anti-stolling ........................................................................................................................... 13
Natuurlijke anti-stolling als controlemechanisme tijdens stolling ............................................................ 13
Afbraak van een bloedklonter: fibrinolyse ................................................................................................ 14
Toepassingen: therapie ............................................................................................................................. 14
Anti-plaatjesmiddelen ........................................................................................................................... 14
Anti-stolling ........................................................................................................................................... 14
1
,Hoofdstuk 2: het hart (cor) ................................................................................................................................... 16
Inleiding ............................................................................................................................................................. 16
Uitwendige bouw van het hart ......................................................................................................................... 16
Facies sternocostalis ..................................................................................................................................... 17
Facies diaphragmatica ................................................................................................................................... 17
Het pericard ...................................................................................................................................................... 17
Inwendige bouw van het hart ........................................................................................................................... 18
Ventriculae, valvae ........................................................................................................................................ 18
Ventriculus dexter, valva tricuspidalis, valva trunci pulmonalis ............................................................... 19
Ventriculus sinister, valva mitralis, valva aortae ....................................................................................... 20
Septum interventriculare .......................................................................................................................... 22
Atria ............................................................................................................................................................... 22
Atrium dextrum, septum atriale ............................................................................................................... 22
Atrium sinistrum ....................................................................................................................................... 23
Geleidingsweefsel ......................................................................................................................................... 23
Sino-atriale knoop ..................................................................................................................................... 23
Atrioventriculaire knoop en His-bundel .................................................................................................... 23
Geleiding in de kamers .............................................................................................................................. 24
Histologie .......................................................................................................................................................... 24
Myocard ........................................................................................................................................................ 24
Kleppen ......................................................................................................................................................... 25
Geleidingsweefsel ......................................................................................................................................... 25
Integratie ........................................................................................................................................................... 26
Arteriële toevoer ........................................................................................................................................... 26
A coronaria dextra ..................................................................................................................................... 26
A coronaria sinistra ................................................................................................................................... 26
Veneuze drainage.......................................................................................................................................... 27
Lymfatische drainage .................................................................................................................................... 27
Innervatie ...................................................................................................................................................... 27
Hoofdstuk 3: het vaatstelsel ................................................................................................................................. 28
Anatomie ........................................................................................................................................................... 28
Arteries van de systeemcirculatie ................................................................................................................. 29
Aorta ascendens en takken ....................................................................................................................... 29
Arcus aortae en takken ............................................................................................................................. 29
A carotis communis ............................................................................................................................... 29
A subclavia............................................................................................................................................. 32
A axillaris ............................................................................................................................................... 33
2
, A brachialis en verder ............................................................................................................................ 34
Aorta descendens thoracalis ..................................................................................................................... 34
Viscerale takken .................................................................................................................................... 34
Parietale takken .................................................................................................................................... 34
Aorta descendens abdominalis ................................................................................................................. 35
Viscerale takken .................................................................................................................................... 35
Parietale takken .................................................................................................................................... 36
A iliaca communis ..................................................................................................................................... 36
A iliaca interna........................................................................................................................................... 37
A iliaca externa .......................................................................................................................................... 38
A femoralis en verder ................................................................................................................................ 38
Venen van de systeemcirculatie ................................................................................................................... 38
Vv cordis .................................................................................................................................................... 38
V cava superior .......................................................................................................................................... 39
Vv jugulares ........................................................................................................................................... 39
V subclavia............................................................................................................................................. 40
V cava inferior ........................................................................................................................................... 41
V iliaca communis, interna en externa ...................................................................................................... 42
Arteries van de longcirculatie ....................................................................................................................... 44
Venen van de longcirculatie .......................................................................................................................... 44
Lymfatisch systeem ....................................................................................................................................... 44
Ductus thoracicus ...................................................................................................................................... 45
Ductus lymphaticus dexter........................................................................................................................ 45
Belangrijkste lymfeklierstations ................................................................................................................ 45
Capillairen ..................................................................................................................................................... 46
Grotere bloedvaten ....................................................................................................................................... 48
Arteries ...................................................................................................................................................... 49
Venen ........................................................................................................................................................ 51
Lymfevaten .................................................................................................................................................... 51
3
,BLOED & BLOEDSOMLOOP: MORFOLOGIE
HOOFDSTUK 1: BLOED
MORFOLOGIE VAN HET BLOED
INLEIDING: SAMENSTELLING VAN HET BLOED
5-6l circulerend bloed = 8% lichaamsgewicht = 75 ml/kg
- 55-60% plasma (extracellulair vocht + mineralen + eiwitten)
o Waterige oplossing
o Elektrolyten
o Plasma proteïnen (albumine + fibrinogeen + globulines)
▪ Meeste productie in de lever
▪ Meeste belangrijk bij bloedstolling
▪ 7g/dl
▪ 25 mm Hg
▪ Elektroforese om deze plasma-eiwitten te scheiden
- 40-45% bloedcellen (erythrocyten + leukocyten + trombocyten)
Volume aantal RBC = hematokrietwaarde
- Te laag (< 45) → anemie → moeilijk transport
o Leukemie
o Te hoge afbraak van RBC
- Te hoog (> 45) → polycythemie → moeilijk stromen, viskeus → risico hart- en vaatziekten
Cellulaire componenten
- Erythrocyten
- Granulocyten (WBC)
o Neutrofielen
o Eosinofielen
o Basofielen
- Lymfocyten (WBC)
- Monocyten (WBC)
- Thrombocyten
4
, HET BEENMERG
MORFOLOGIE VAN HET BEENMERG
Embryonaal: hematopoïese in dooierzak → lever → milt
Postnataal: hematopoïese in rode beenmerg in botten
- Rode beenmerg
o Actief
o Grote hoeveelheden precursoren
▪ Granulocyten + megakaryocyten in hematopoïetische eilandjes
• Lichtere kernen (nog geen verdichting van chromatine)
▪ Macrofagen
▪ Lymfocyten + plasmacellen (aangevoerd vanuit de secundaire lymfoide organen)
o Grote hoeveelheden erythrocyten
▪ Herkenbaar door kernpycnose (= verdikken van de kern) → massa donkere kernen
o Reticulair bindweefsel (andere opvulling dan geel)
▪ Van hieruit gaan de rijpe BC naar de sinusoïden → tussen endotheel → in bloedvat
- Gele beenmerg
o Inactief
o Grote hoeveelheden vetcellen
o Kan terug overgaan naar rood beenmerg door innesteling van hematopoïetische SC
o Reticulair bindweefsel (andere opvulling dan rood)
- Rood beenmerg gaat progressief over in geel beenmerg (vervangen door vetcellen)
Volwassen: enkel nog rood beenmerg aanwezig in axiale beenderen
BLOEDCELVORMING IN HET BEENMERG: HEMATOPO ÏESE
Hematopoïetische SC gaat ontwikkelen richting BC
- SC differentiëren tot specifieke voorlopercel (bepaalde richting gedwongen)
- Afhankelijk van hormoonachtige stoffen → ontwikkeling tot RBC, WBC of BP
HSC gaan delen (schema p10)
- Myeloïde SC (progenita)
o Megakaryocyten
▪ Thrombocyten
o Erythrocyten
o Mastcellen
o Myeloblast
▪ Basofiel
▪ Neutrofiel
▪ Eosinofiel
▪ Monocyt
• Macrofagen
- Lymfoïde SC (progenita)
o B-lymfocyten
▪ Plasmacellen
o T-lymfocyten
5
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