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ANATOMY AND PHYSIOLOGY

OF CARDIOVASKULAR
Ns. Yunie Armiyati., M.Kep., Sp.KMB
THE CARDIOVASCULAR SYSTEM

 A closed system of the heart and


blood vessels
 The heart pumps blood
 Blood vessels allow blood to circulate to all
parts of the body
 The function of the cardiovascular
system is to deliver oxygen and
nutrients and to remove carbon
dioxide and other waste products
THE HEART
LOCATION
• Besar : Seperti kepalan
tangan
• Panjang : 12 cm, lebar :
8 – 9 cm, berat : 310 gr
(laki-laki) dan 255 gr
(wanita)
 Location
 Thorax between the
lungs
 Pointed apex directed
toward left hip
THE HEART COVERINGS

 Pericardium  a double serous membrane


 Visceral pericardium (Next to heart)
 Parietal pericardium (Outside layer)
 Serous fluid fills the space between the
layers of pericardium
THE HEART WALL
 THREE LAYERS
 Epicardium
 Outside layer
 This layer is the parietal pericardium
 Connective tissue layer
 Myocardium
 Middle layer
 Mostly cardiac muscle
 Endocardium
 Inner layer
 Endothelium
LAPISAN JANTUNG
OTOT JANTUNG
THE HEART CHAMBERS
 Right and left side act as separate pumps
 Four chambers
 Atria
 Receiving chambers
 Right atrium
 Left atrium
 Ventricles
 Discharging chambers
 Right ventricle
 Left ventricle
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
ATRIUM DAN VENTRIKEL
• Atrium kiri dan atrium kanan  tekanan rendah
Fungsi :
 Atrium kanan menerima darah dari vena kava
superior dan inferior
 Atrium kiri menerima darah dari vena pulmonalis.
• Vetrikel kiri dan kanan  kekuatan utama pompa
jantung.
Fungsi :
 Ventrikel kanan menerima darah dari atrium kanan
dan memompakannya ke arteri pulmonalis
 Ventrikel kiri menerima darah dari atrium kiri dan
memompakan darah ke aorta.
THE HEART VALVES
 Allow blood to flow in only one direction
 Four valves
 Atrioventricular valves  between atria
and ventricles
 Bicuspid valve (left)
 Tricuspid valve (right)
 Semilunar valves  between ventricle and
artery
 Pulmonary semilunar valve
 Aortic semilunar valve
KATUP JANTUNG
OPERATION OF HEART VALVES
BLOOD CIRCULATION
ASSOCIATED GREAT VESSELS

 Aorta  Leaves left ventricle


 Pulmonary arteries  Leave right
ventricle
 Vena cava  Enters right atrium
 Pulmonary veins (four)  Enter left
atrium
BLOOD CIRCULATION AORTA
High O2 Blood to rest of
Low O2 Blood body
from Upper Body
Low O2 Blood to Lungs

High O2 Blood
from Lungs

LEFT
RIGHT
ATRIUM
ATRIUM Valves in the
heart are one-
way only and
stop blood
running back
LEFT from the
Low O2 RIGHT VENTRICLE ventricles into
Blood from the atria.
Lower VENTRICLE
Body

Septum
SIRKULASI KORONER
SISTEM KERJA JANTUNG
• OTOMATICITY
• CONDUCTIVITY
• CONTRACTILITY
OTOMATICITY

• JANTUNG DIPERSARAFI OLEH


SARAF OTONOM SIMPATIS DAN
PARASIMPATIS
• SISTEM SARAF AUTOMATIS 
SIMPATIS UNTUK MENINGKATKAN
HEART RATE, PARASIMPATIS UNTUK
MENURUNKAN HEART RATE
CONDUCTIVITY

• SINOATRIAL NODE (SA-NODE) PACE


MAKER JANTUNG ALAMI,
MEMBERIKAN AUTOMATIK/INTRINSIK
RATE JANTUNG
• ATRIOVENTRIKULAR NODE (AV-NODE)
• BUNDLE OF HIS DAN SERABUT
PURKINYE.
SPECIAL CONDUCTION SYSTEM
• SA node (pace maker), di
dinding atrium kanan
dekat muara vena cava
superior; 70-80x/mnt
• AV node, di dasar atrium
ka dkt sekat atrium-
ventrikel; 40-60x/mnt
• Berkas his, berkas dr AV
node msk ke septum
interventrikel (20-
40x/mnt)
• Serat purkinje, serat yg
menyebar ke miokard
ventrikel (20-40x/mnt)
Faal_KV/ikun/2006 25
CARDIAC CYCLE

 Atria contract simultaneously


 Atria relax, then ventricles contract
 Systole = contraction
 Diastole = relaxation
CONTRACTILITY

• BEKERJA DENGAN MELAKUKAN


KOMPRESI DENGAN BANTUAN
OTOT-OTOT JANTUNG
• ADANYA PROSES KOMPRESI AKAN
MENGHASILKAN DAYA POMPA
JANTUNG UNTUK MENGALIRKAN
DARAH
HEART CONTRACTIONS

Figure 11.5
AKTIVITAS KELISTRIKAN JANTUNG
• Jantung memiliki kemampuan membentuk depolarisasi
spontan & potensial aksi sendiri  Sistem Penghantar
Khusus (sel autoritmis)
• Sifat sistem penghantar khusus:
(1) Otomasi  kemampuan menghasilkan impuls
spontan
(2) Ritmis  keteraturan membangkitkan impuls
(3) Daya penerus  kemampuan menghantarkan
impuls
(4) Peka rangsang  kemampuan berespons thd
rangsang
FILLING OF HEART CHAMBERS –
THE CARDIAC CYCLE
CARDIAC OUTPUT

 CARDIAC OUTPUT (CO) : CURAH JANTUNG


 Jumlah darah yang dipompa oleh masing-
masing sisi jantung dalam satu menit
 CO = (heart rate [HR]) x (stroke volume [SV])
 STROKE VOLUME : ISI SEKUNCUP
 Volume darah yang dipompa oleh setiap
ventrikel dalam satu kontraksi (satu denyut)
CARDIAC OUTPUT
• CO = HR x SV
• 5250 ml/min = 75 beats/min x 70 mls/beat
• Normal CO = 5000 ml/min
• Entire blood supply passes through body once
per minute.
• CO varies with demands of the body.
PENGONTROLAN CURAH JANTUNG

• Setiap berdenyut, ventrikel memompa  2/3


volume ventrikel;
Mili liter darah yang dipompa  fraksi ejeksi
Sisa darah yg masih ada di ventrikel setelah
sistol berakhir  volume akhir sistol (ESV
= end systolic volume)
 Jumlah darah yang dapat ditampung ventrikel
sampai diastol berakhir  volume akhir
diastol (ESD = end diastolic volume)

Faal_KV/ikun/2006 34
REGULATION OF MAP (MEAN ARTERIAL PRESSURE)
KONTROL SYARAF DALAM FUNGSI KARDIOVASKULER
CARDIAC OUTPUT REGULATION
FAKTOR YANG MEMPENGARUHI
CURAH JANTUNG
REGULATION OF HEART RATE

 Stroke volume usually remains relatively


constant
 Starling’s law of the heart  the more
that the cardiac muscle is stretched, the
stronger the contraction
 Changing heart rate is the most
common way to change cardiac output
REGULATION OF HEART RATE (1)
 INCREASED HEART RATE
 Sympathetic nervous system
 Crisis
 Low blood pressure
 Hormones
 Epinephrine
 Thyroxine
 Exercise
 Decreased blood volume
REGULATION OF HEART RATE

 DECREASED HEART RATE


 Parasympathetic nervous system
 High blood pressure or blood volume
 Dereased venous return
 In Congestive Heart Failure the heart is
worn out and pumps weakly. Digitalis
works to provide a slow, steady, but
stronger beat.
BLOOD VESSELS: THE VASCULAR
SYSTEM

 Taking blood to the tissues and back


 Arteries
 Arterioles
 Capillaries
 Venules
 Veins
THE VASCULAR SYSTEM

Figure 11.8b

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings


ANATOMY OF BLOOD VESSELS

 Three layers (tunics)


 Tunic intima  Endothelium
 Tunic media
 Smooth muscle
 Controlled by sympathetic nervous
system
 Tunic externa  Mostly fibrous connective
tissue
PERBEDAAN ANTARA JENIS PEMBULUH
DARAH

Dinding arteri adalah tebal


Lumen pembuluh darah yang lebih besar
Dinding kapiler hanya satu lapisan sel tebal
untuk memungkinkan pertukaran antara
darah dan jaringan
STRUKTUR PEMBULUH DARAH
MOVEMENT OF BLOOD THROUGH
VESSELS
KAPILER
 Capillary beds consist of
two types of vessels
 Vascular shunt 
directly connects an
arteriole to a venule
 True capillaries 
exchange vessels
 O2 and nutrients cross
to cells
 CO2 and metabolic
waste products cross
into blood
DIFFUSION AT CAPILLARY BEDS

Figure 11.20

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings


Pulse

 Pulse 
pressure wave
of blood
 Monitored at
“pressure
points” where
pulse is easily
palpated
BLOOD PRESSURE
 Measurements are made on the
pressure in large arteries
 Systolic  pressure at the peak of
ventricular contraction
 Diastolic  pressure when ventricles relax
 Pressure in blood vessels decreases as
the distance away from the heart
increases
Measuring Arterial Blood Pressure

Figure 11.18

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings


VARIATIONS IN BLOOD PRESSURE

 Human normal range is variable


 Normal
 140–110 mm Hg systolic
 80–75 mm Hg diastolic
 Hypotension
 Low systolic (below 110 mm HG)
 Often associated with illness
 Hypertension
 High systolic (above 140 mm HG)
 Can be dangerous if it is chronic
REFERENSI
• Corwin, E.J., (2008). Handbook of
pathophysiology. 3rd edition. Philadelphia:
Lipincot William & Wilkins.
• Guyton AC, Hall JE. (2006). Buku ajar fisiologi
kedokteran. Edisi 11. Penerjemah: Irawati,
Ramadani D, Indriyani F. Jakarta: Penerbit Buku
Kedokteran EGC
• Smeltzer,S.C,. Bare,B.G., Hinkle,J.L & Cheever,K.H.
(2010 ). Textbook of medical –surgical nursing. ed
12. Philadelpia: Lippincott William & Wilkins.
• Stanfield., C.L (2014). Principles of human
physiology fifth edition., Pearson
THANK YOU