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Bloedsomloop tekeningen Verbrugghe

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Bespaar jezelf uren tekentijd met dit document. Als Verbrugghe nog steeds zijn tekeningen in aparte videos op toledo zet is dit de exacte kopie van wat hij in deze lessen tekent. Dit document is volledig digitaal getekend en printklaar. De uitleg die Verbrugghe bij de tekeningen geeft staat er soms...

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  • October 17, 2022
  • November 12, 2023
  • 135
  • 2021/2022
  • Class notes
  • Peter verbrugghe
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By: ellaopdeweegh • 3 months ago

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By: gjgf • 1 year ago

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Bloed en Bloedsomloop :
Morfologische Aspecten




PROF. DR. PETER VERBRUGGHE

,Inhoudsopgave
Inleiding ....................................................................................................................................... 5

1 Bloed .................................................................................................................................... 6
1.1 Morfologie van het bloed ...........................................................................................................6
1.1.1 Inleiding: samenstelling van bloed ....................................................................................6
1.1.2 Het beenmerg ....................................................................................................................8
1.1.2.1 Morfologie van het beenmerg .......................................................................................8
1.1.2.2 Bloedcelvorming in het beenmerg: hematopoiëse .......................................................9
1.1.3 De milt ............................................................................................................................. 10
1.1.3.1 Macroscopisch uitzicht ............................................................................................... 10
1.1.3.2 Opbouw ....................................................................................................................... 11
1.1.3.3 Integratie ..................................................................................................................... 13
1.1.4 De rode bloedcellen (erytrocyten) .................................................................................. 14
1.1.4.1 De rijpe erytrocyt ........................................................................................................ 14
1.1.4.2 De levenscyclus van de erytrocyt: “erytropoïese”...................................................... 15
1.1.4.3 Termen betreffende afwijkende morfologie van rode bloedcellen ........................... 17
1.1.5 De bloedplaatjes (trombocyten) ..................................................................................... 18
1.1.5.1 De rijpe trombocyt ...................................................................................................... 18
1.1.5.2 De levenscyclus van de trombocyt: “megakaryopoïese” ........................................... 19
1.2 Fysiologische aspecten van het bloed ..................................................................................... 21
1.2.1 Inleidende begrippen ...................................................................................................... 21
1.2.2 Processen van bloedstolling............................................................................................ 22
1.2.2.1 Vasoconstrictie ............................................................................................................ 22
1.2.2.2 Aggregatie: ‘Primaire hemostase’ ............................................................................... 23
1.2.2.2.1 Adhesie ................................................................................................................. 23
1.2.2.2.2 Activatie ............................................................................................................... 23
1.2.2.2.3 Aggregatie ............................................................................................................ 23
1.2.2.3 Coagulatie: ‘secundaire hemostase’ ........................................................................... 24
1.2.2.3.1 Extrinsieke stollingspathway ................................................................................ 25
1.2.2.3.2 Intrinsieke stollingspathway ................................................................................ 25
1.2.2.3.3 Common stollingspathway................................................................................... 25
1.2.3 Processen van anti-stolling ............................................................................................. 27
1.2.3.1 Natuurlijke anti-stolling als controle mechanisme tijdens stolling ............................ 27
1.2.3.2 Afbraak van een bloedklonter: fibrinolyse ................................................................. 28
1.2.3.3 Toepassingen: therapie ............................................................................................... 28
1.2.3.3.1 Antiplaatjesmiddelen ........................................................................................... 28
1.2.3.3.2 Antistolling ........................................................................................................... 29

2 Het hart (cor) ...................................................................................................................... 31
2.1 Uitwendige bouw van het hart ............................................................................................... 32
2.2 Het pericard............................................................................................................................. 36
2.3 Inwendige bouw van het hart ................................................................................................. 42
2.3.1 Ventriculi, valvae ............................................................................................................. 46
2.3.1.1 Ventriculus dexter, valva tricuspidalis, valva trunci pulmonalis ................................. 47
2.3.1.2 Ventriculus sinister, valva mitralis, valva aortae ........................................................ 52
2.3.1.3 Septum interventriculare ............................................................................................ 56
2.3.2 Atria ................................................................................................................................. 57
2.3.2.1 Atrium dextrum, septum interatriale ......................................................................... 57
2.3.2.2 Atrium sinistrum ......................................................................................................... 60
2.3.3 Geleidingsweefsel ........................................................................................................... 61
2.3.3.1 Sino-atriale knoop ....................................................................................................... 61




2

, 2.3.3.2 Atrioventriculaire knoop en Hiss-bundel .................................................................... 62
2.3.3.3 Geleiding in de kamers ................................................................................................ 63
2.4 Histologie ................................................................................................................................ 64
2.4.1 Myocard .......................................................................................................................... 66
2.4.2 Kleppen ........................................................................................................................... 69
2.4.3 Geleidingsweefsel ........................................................................................................... 69
2.5 Integratie................................................................................................................................. 71
2.5.1 Arteriële toevoer ............................................................................................................. 71
2.5.1.1 A. coronaria dextra ..................................................................................................... 71
2.5.1.2 A. coronaria sinistra .................................................................................................... 71
2.5.2 Veneuze drainage............................................................................................................ 73
2.5.3 Lymfatische drainage ...................................................................................................... 74
2.5.4 Innervatie ........................................................................................................................ 74

3 Het vaatstelsel .................................................................................................................... 77
3.1 Anatomie ................................................................................................................................. 77
3.1.1 Arteries van de systeemcirculatie ................................................................................... 80
3.1.1.1 Aorta ascendens en takken ......................................................................................... 81
3.1.1.2 Arcus aortae en takken ............................................................................................... 82
3.1.1.2.1 A. carotis communis ............................................................................................. 83
3.1.1.2.2 A. subclavia .......................................................................................................... 92
3.1.1.2.3 A. axillaris ............................................................................................................. 96
3.1.1.2.4 A. brachialis en verder : zie andere cursussen..................................................... 98
3.1.1.3 Aorta descendens thoracalis ....................................................................................... 98
3.1.1.3.1 Viscerale takken ................................................................................................... 99
3.1.1.3.2 Parietale takken ................................................................................................... 99
3.1.1.4 Aorta abdominalis ..................................................................................................... 101
3.1.1.4.1 Pariëtale takken ................................................................................................. 101
3.1.1.4.2 Viscerale takken ................................................................................................. 102
3.1.1.5 A. iliaca communis .................................................................................................... 106
3.1.1.6 A. iliaca interna ......................................................................................................... 106
3.1.1.7 A. iliaca externa ......................................................................................................... 111
3.1.1.8 A. femoralis en verder: zie andere cursussen ........................................................... 112
3.1.2 Venen van de systeemcirculatie ................................................................................... 112
3.1.2.1 Vv. cordis ................................................................................................................... 112
3.1.2.2 V. cava superior......................................................................................................... 113
3.1.2.2.1 Vv. Jugulares....................................................................................................... 114
3.1.2.2.2 V. subclavia......................................................................................................... 115
3.1.2.2.3 V. azygos............................................................................................................. 117
3.1.2.3 V. cava inferior .......................................................................................................... 118
3.1.2.4 V. iliaca communis, interna en externa .................................................................... 121
3.1.3 Arteries van de longcirculatie ....................................................................................... 123
3.1.4 Venen van de longcirculatie .......................................................................................... 124
3.1.5 Lymfatisch systeem ....................................................................................................... 124
3.1.5.1 Ductus thoracicus ...................................................................................................... 125
3.1.5.2 Ductus lymphaticus dexter ....................................................................................... 125
3.1.5.3 Belangrijkste lymfeklierstations ................................................................................ 127
3.2 Histologie .............................................................................................................................. 128
3.2.1 Capillairen ..................................................................................................................... 128
3.2.2 Grotere bloedvaten ....................................................................................................... 132
3.2.2.1 Arteries ...................................................................................................................... 134
3.2.2.2 Venen ........................................................................................................................ 136
3.2.3 Lymfevaten.................................................................................................................... 137




3

, In dit theoretisch deel van het vak ‘Bloed en Bloedsomloop’ wordt de
morfologie van het bloed en de bloedsomloop besproken. De morfologie omvat zowel
de macroscopische, microscopische als ultrastructurele kenmerken.
Deze cursus vormt de basis voor de hoorcolleges en de blended learning
onderdelen met de kennisclips te vinden op Toledo. In de tekst staan telkens ook links
naar de Ackland video’s ( https://aclandanatomy-com.kuleuven.ezproxy.kuleuven.be/ .
Aanvullende informatie kan u tevens terugvinden via Toledo.
Ik wens u een leerzame periode toe.




4

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