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Anatomie en ontwikkelingsbiologie van het hart college uitwerking
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Alle aantekeningen van de hoorcolleges over de Anatomie en ontwikkelingsbiologie van het Hart.
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ONTWIKKELINGSBIOLOGIEVAN HET HART
Deel 2: Anatomie en ontwikkelingsbiologie
6 MAART 2023
5052AOB12Y
Femke te Dorsthorst
,HC 1: The physiology of the heart
Bjarke Jensen
De rede dat de mortaliteit nu nog maar 10-15% is ipv 85% (voor de wereldoorlog) →komt door De
Echo (12 & 24 weken) → als er een afwijking is kan er voor gekozen worden de zwangerschap te
stoppen. Of wanneer de baby geboren wordt kan er chirurgisch ingegrepen worden.
Anestesie nu ook voor kinderen en babies
Aangeboren hartafwijkingen
In 3 hoofdgroepen:
1. Een fout in het bouwplan → Klein foutje tot complexe afwijkingen
2. Cardiomyopathie → De cardiomyocyten zijn niet goed ontwikkeld waardoor ze niet goed
samentrekken en/of relaxeren.
3. Aritmie → De elektrische impuls volgt een verkeerd pad, is te snel of te langzaam.
Onderliggende oorzaak van de aangeboren hartafwijking is niet altijd bekend, maar bijvoorbeeld:
- Genetische defecten → sporadisch of familiaal
- Omgevingsfactoren → teratogeen (vitamine A, lithium, alcohol), ziekte moeder (diabetes,
rubella infectie).
- Hoog lithium (biopolaire stoornis) eerste weken kan leiden tot afwijkingen
- Combinaties
e-learning → komen college vragen over volgorde: het verneuze systeem → normale ontwikkeling
arteriën → abnormale ontwikkeling arteriën.
ISH → whole mount in situ hybridizatie, je laat de verdeling van mRNA in een organisme zien.
- Semi-quantitatieve methode, hier zit minder dan daar, maar niet hoeveelheden.
- Quantitatieve methode = RTqPCR, methode om de hoeveelheid van een mRNA in een
organisme of weefsel te zien.
Verslag
- Methode moet goed geinformeerd zijn, gefixeerd in formahaldine ipv ik heb
formalhaldine gebruikt. → stukje proza.
- Data integreren in disussie, aantal worden is het maximum.
- Expression paper op pudmed. Als voormat gebruiken.
,HC 2: The physiology of the heart
Learining outcomes
- Learn how to analyze the Wiggers diagram to correlate electrical activity, volume
changes, and pressure development.
- Learn how to analyze the pressure-volume loop diagram to derive information on
the blood pressures and pumped volumes.
- Be able to diagnose pathologies on the basis of changes to the pressure-volume
loop
- Appreciate the 3 digressions.
The heart to impart blood pressure → makes the blood move. Pressure is the driving force.
Ischaemic heart disease → refers to heart weakening caused by reduced blood flow to your heart.
Typically, this reduced blood flow is the result of coronary artery disease, a condition that occurs
when your coronary arteries narrow. Ischemic heart disease may also be called cardiac ischemia or
ischemic cardiomyopathy.
200 ml each minute per person on average.
CO2 = acidic, so no breathing out, you blood acidifies.
Diffusion of oxygen is slow even over a small distance. (4 min for
1mm water)
Bloodgas barriers in the lungs = 0,5 micrometer.
All bloodvessels together is 2 rounds around the earth.
Each muscle cell has one cappilair.
Our bulk transport systems (lungs and cadiatic system) overcome the
slowness of diffusion.
Pressures in the heart
The high values for pressures (expressed in mm Hg) in the right
ventricle, left ventricle, pulmonary artery, and aorta represent
the peak pressures during ejection (systolic pressure), whereas
the lower pressure values represent the end of diastole
(ventricles) or the lowest pressure (diastolic pressure) found in
the pulmonary artery and aorta.
Systolic pressure = the pressure in your arteries during ejection
(when your heart beats).
Diastolic pressure = Relaxation. The lowest pressure found in
the pulmonary artery and aorta. the pressure in your arteries
when your heart rests between beats.
LV (left ventricle) = like lifting a bucket.
, Wiggers diagram – the cardiac cycle
The cardiac cycle (zie afb.) The seven phases of the
cardiac cycle are:
1. Atrial systole
2. Isovolumetric contraction
3. Rapid ejection
4. Reduced ejection
5. Isovolumetric relaxation
6. Rapid filling
7. Reduced filling
LV = Left ventricle
ECG = electrocardiogram
A = a-wave
C = c-wave
Ap = aortic pressure
LVP = left ventricular pressure
LAP = left atrial pressure
LVEDV = left ventricular end-diastolic volume
LVESV = left ventricular end-systolic volume
S1-S4 = four heart sounds
Wigger diagram is to correlate:
- electrical activity,
- volume change
- pressure development.
ECG
ECG = Timer for systole and diastole
- P till R = diastole
- R till the end of the T-wave = systole
P, QRS, T -wave:
- P-wave = Depolarization of the atrium
o Delay??
o Repolarization of the Atria is not visible
because it’s to small and gets partially overshadowed by the QRS wave.
- QRS-complex = The beginning of the systole
o Depolarization of the muscle mass. The more muscle mass the higher the peak,
so the QRS is mostly the depolarization of the Left ventricle (has the most
muscle mass).
o Delay ??
- T-wave = The repolarization of the ventricular muscle mase.
The pressure is lower = less muscle needed.
Heart rate = beats per minute.
- The lower Body mass the higher the heart rate or volume blood going around →
Etruscan shew (spits muis).
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