Samenvatting hart en vaten 1-prof. Heidbuchel-2e Bach
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Course
Hart en vaten 1 (1026GENGE2)
Institution
Universiteit Antwerpen (UA)
Een samenvatting van Hart en Vaten 1, gegeven in het eerste semester van Ba2 gegeven door H. Heidbuchel en enkele gastprofessoren.
Behaald resultaat 17/20
........................................................................................................................................................................... 34
Interac?e vasculaire en cardiale func?e curve: ....................................................................................................... 35
Inspanning: interac?es curves ................................................................................................................................. 35
Chronisch harWalen: interac?es curves.................................................................................................................... 35
Me?ng van de CVD: ................................................................................................................................................. 36
Neurohumorale controle hart en circula<e: ........................................................................................................ 36
Controle via autonoom zenuwstelsel.................................................................................................................. 36
Autonoom zenuwstelsel: .......................................................................................................................................... 36
Adrenerge en muscarine receptoren in het hart en bloedvaten: ............................................................................. 37
Ligging van de arteriële baroreceptoren: ................................................................................................................ 38
Belangrijkste reflexen: ........................................................................................................................................ 38
Brainbridge reflex: ................................................................................................................................................... 38
Chemoreceptoren: ................................................................................................................................................... 38
CNS: ischemic respons ............................................................................................................................................. 38
Cushing reflex: ......................................................................................................................................................... 39
Pijnreflexen: ............................................................................................................................................................. 39
Bezold-jarisch reflex: ................................................................................................................................................ 39
Stretch receptoren: .................................................................................................................................................. 39
Duik reflex: ............................................................................................................................................................... 39
Humorale controle: ............................................................................................................................................. 40
Effect catecholamines: ............................................................................................................................................. 40
Syncope: ............................................................................................................................................................. 42
Vasovagale syncope:................................................................................................................................................ 42
Head up ?l?ng test: ................................................................................................................................................. 43
Vasovagale syncope:................................................................................................................................................ 44
Syncope tgv orthosta?sche hypotensie: .................................................................................................................. 44
Cardiovasculaire aanpassingen bij inspanning: .................................................................................................... 44
Aanpassingen: ......................................................................................................................................................... 44
Orgaandoorbloeding bij inspanning: ....................................................................................................................... 45
Mechanismen bij inspanning: .................................................................................................................................. 45
Veranderingen hemodynamica: .............................................................................................................................. 45
Factoren met invloeden op de CV aanpassingen: .................................................................................................... 45
Orgaanperfusie: .................................................................................................................................................. 46
DistribuGe van het hartdebiet per orgaan: ......................................................................................................... 46
Pathologie van de lymfecircula<e:....................................................................................................................... 73
Anatomie: ................................................................................................................................................................ 73
Func?es van het lymfa?sch systeem: ...................................................................................................................... 73
Pathologie lymfoedeem: .......................................................................................................................................... 74
,Inleiding cardiovasculair systeem
Schikking organen en vaatbedden:
• Pulmonale en systeem-circula1e in serie
(Maw pompen eenzelfde debiet, wat binnenkomt wordt terug uitgepompt)
• Circula1e orgaansystemen gebeurt in parallel
- Lever staat in serie met gastro-intes1nale tractus
- Auto-regula1e
• Verband druk, debiet, vaatweerstand: F=P/R
- Weerstanden in parallel: 1/R1+2/R2+…
- Weerstanden in serie: R1+R2+…
• Bestaat uit endotheel omgeven door basaalmembraan
1. Con1nu capillair:
- Con1nu basaal membraan
- Pericyten (gladde spiercel)
- Verbinding door 1ght junc1ons en transport door transcytose (caveolae)
§ Voorbeeld: alveolaire wanden
2. Gefenestreerd capillair:
- Fenestrae met of zonder diafragma
§ Voorbeeld mét: darmwand
§ Voorbeeld zonder: nier glomeruli
3. Discon1nu capillair (=sinusoïden):
- Onderbrekingen in het capillair groot
- Discon1nu basaal membraan
Venen:
• Wandlagen:
- Géén m. elas1ca interna
- Tunica media: meer collagene vezels
- Tunica muscularis dunner
- Kleppen
, 1. Post-capillaire venulen:
- Diapedese (d.m.v. selec1nes en integrines)
- Hoog-endotheliale venulen in lymfoide organen
2. Musculaire venulen
Lymfevaten:
1. Lymfa1sche capillairen:
- Endotheel
- Geen volledig basaal membraan
- Aanwezig in alle weefsels, behalve: kraakbeen, bot, epitheel, CZS, beenmerg
2. Grotere lymfevaten: (cfr venen)
- Tunica in1ma
- Tunica media
- Tunica adven11a
- Met kleppen en lymfeklieren
Overzicht Hart:
Wandlagen:
• Hartskelet:
- Dicht collageen bindweefsel
- Scheiding atria/ventrikels
- Aanhech1ng kleppen
- Annuli fibrosi, trigona fibrosa, septum membranaceum
• Endocard:
- Rond de atria, ventrikels en kleppen
- Binnenste laag: endotheel en subendotheliaal bindweefsel
- Middelste laag: gladde spiervezels en elas1sche
- Buitenste laag: bindweefsel, bloedvaten en adipocyten
• Myocard:
- Rond het hartspierweefsel
- Ertussen het endomysium: bindweefsel met capillairen
- Niet gefuseerde cellen en veel mitochondria
- Intercalaire schijven (gap junc1ons, 1ght junc1ons en desmosomen)
- Gespecialiseerde cardiocyten
§ Myo-endocriene cardiocyten (produc1e ANF)
§ Nodale cardiocyten
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