SINH LY MAU Dai cuong vB mau va Sinh IY huydt ‘yong > Sinh ly hing cu y 2 Nh ma SINH LY MAU roe > inh ly bach edu > Sinh ly tBu cu » Bong chm mau DAI CUONG TINH CHAT CUA MAU “mau: hay zomg + huyt + CHUC NANG CHUNG CUA MAU » B69 mach: ab tI. tinh mach 48 sm PHehip (mau trong héthéng mach ph hi nau ink dong ee Mau toan phn: 1.059 ~ 1.080 poeta >>Huyét trong: 1.090 -Huyét eu: 1100 B80 ve co tne $09 nher Mau: 38m1 4511 2 Théng nh va idu ha hoat dng co thé Mau obn 6 thd nang du hoa nhigt dco thd >Huyéttvong la 1601 1.74 > Néng 60 protein va sé long huyét edu + W7 trong va 39 nhotTINH CHAT CUA MAU AST: 7,5 tm (NaCI, protein hea tan) > phan ‘ph8i nude rong co the “pH mau: 7,357.45 (HCOs, HY) “@Kndi Ivgng mau: 7 — 9% trong hyong co tb (WE 13) Trang binh & ngudi ting than 6 Khodng 65 — ‘Tomimauikg P ‘eHuyét trom 9: 55% | Hessatcrit = eHuydt clu: 45% a THANH PHAN CUA MAU Huyét edu as%) SINH LY HUYET TUONG ‘$Huyét twong:hén hop phie tap >be chit ign gist cae endt hou co: Prats: hormon,enzym, Khang thé iia Carbohydrate “Vitamin niu enue nang quan trongCAC CHAT DIEN GIAI Tn ti duéi dang cde ion > Cation: Na K’, Ca", Mg, HY > Anion: Ct, HCOy, H;PO,, HPO, S04 ‘Val tr cua mai chat au quan trong Na’. Cl: ASTT > phan phbi nuge tong -ngoal 16 bao >: hung phn thn kin, co/Bop ce tm) Gat": clu tgo xuOMG, rang: Ong mau UNG phn co tha kin > P: gi cin bing 6ifn gal rong HC, eibu hda cin bing ace-kidm CAC CHAT DIEN GIAI + pl mau phy hue chée dia gi (H", HCOs) 94 co tay abi nbng 48 ion -+ RL chuyén hod trong bao 17 Vong > dh hung dén mei host dng # sy sng > Thar hin vs zona pha un iby ha ch ch > Net: 1425 £9.67 mel. — hay di trong se > Ke 14,37 £0.37 mEq — non 0 eu ohay > Ca™5)1£086 meh » Oh 2107 24,37 mEgL HOO} : 27 meat > P ADET EOL CAC CHAT HOU CO CUA HUYET TUONG > Protein huyét twang > Lie huyét wong > Carbohycrato hy6t wong > vitamin huyét wong ‘CHOC NANG PROTEIN HUYET TUONG Tao dp sult keo cia méu “Albumin: hd ning Kp ute xung quanh + gi nugolal wong mach mau <$¥9n chuyée:chuyen cht ct whe > Nein: acid béo ty do, Chel, Ca, Ma > Proton (aGo, Gio} TG, PL, hor steroid > Condoplasmin ransferin ‘Gay d6ng mau: > Cay 18 dng mau (globulin) do gan sin st #Biove cot > Garima Gc: 1g6, IM, oA IE, sD Cac protein kde "Cac in pm bit cia 16 tao, a ty do, enzymeLIPID HUYET TUONG “$Ngodl acid béo ty do, phin lem & dang két hop proein (hod tan) ‘Chie nang line > Vn cbuyén: “Chylomicton: T-Chol-PLvé LP, van chuybn lip tic an vio ne bach nuyét Yc-L (HDL) lpi ww md vb gan -LP (LDL): phan tign cho ydu van chuyén cholesterol M (én quan dén cde bent im mech) “Tibn fL.P (VLDL} acid Be 11 mo LIPID HUYET TUONG ‘= chie ning lipid Denn avon Acid béo: nguyén Hu téng bop lip ‘Tré coton:nguén nguyen tb (ain 46) ~Chalesterot: tng hep harmon sinh duc, thuong than, dich mat > Har twong Hpi ton phi, te gia ce thanh phn duge dibu hea chat he. CARBOHYDRTATE HUYET TUONG Hau hd 8 dang Glucose ty do D>NhUng chét chuya hoa Not s6 protein chi duéng ‘=Ngvdn nang hung va nguyen Hee tbng hop nhidu endt quan trong cia té bao (nao, im) Chie ning chi yéu i dn dvbng VITAMIN HUYET TUONG > Hau hit ede varia Ham lwgng thay él tuy theo ché <9 din uong‘SINH LY HONG CAU Hinh dang héng cdt ‘kong nan $68 7- Bum ‘Hon ota, 18m nal mat > Trung tam tum ‘KN van chuyéaRhi: > Nooeivi2-3um >t dn tic ep xde > 1 ie 86 khubeh én nt > Dn tn na ‘THANH PHAN CAU TAO HONG CAU Mang bin th > ae dn aie bn HE > Lop goa ycoprten sycoiped {20 sai tic gn &m-» HC Wing anh nau iu i6 nd tp ie PL Gee, Gt men nh dog > Lap trang cing: sv th, dng ithe calmodulin, prin oinr 80 twang: rt bao quan chi you Hb SINH LY HONG CAU “®Nguoi Vit Nam tug than, binh thud ‘Nam : 4:300,000 ~ §.800.000imm® Na :3:900,000 — 5 400.000imm° > Luon duge diéu hoa d8 cung cp da oxy cho m6 [#65 vba aon mown [Pre nang Ning cr P-uvong cay aa me x nip Prtec ab reat cong Pc Pisa - 96% Diu ha tena bing tea] lite >i baitét Eyeopeitn Saar )-Ta0 ap sutkeo SINH LY HONG CAU Sone nang chi yu cia hong chu vn ehuyén Khi oxy 10 n ‘cacbonic tirmd dén phéh Thue hin nhé Hemogiobin trong hing chu Hb + 0, = HO, Het CO, =& HBCO, Hb + CO ecoHEMOGLOBIN Oryhaemegebin Deoryhaenogbbi Me wo: 4480 o TONG HOP HEMOGLOBIN ‘core tana zaman Gen sta ena Ne cue vedio [> Cac cht cln tit cho sy thinh lip hamogiobn cid amin; Fo > “chat phy: Cu, Bs CoN SO LUQNG HEMOGLOBIN ‘@Néng a Hb trong HC: 14 ~16g/ (9%) Hib duge mang hing cu bao ve Bently (Boe chat, bénh ty bm sinh.) ‘Sie bin mang HC gidm Hong chu _, HINT, JON van chuyén tnt HEMOGLOBIN VAN CHUYEN OXY “Hemoglobin van chuyén O, tr phi» md “Hemoglobin vin chuyén CO3tir mé > phd + Opa iFe“Mem) =e HbO, HO, +0, Ho(0., = HO(0,),+ 0; ge HO(Oa)y H(O2)s* Oz gee Hb(O2)s Bont > Hinh thanh, phan ly HbO,: r&t nhanh, tuy thuge than Sp >For a Fe: Meth‘CAC YEU TO ANH HUONG LEN Al LY CUA HEMOGLOBIN VA OXY hit pHL (Chat 2,3 — diphosphoglycerate trong HC Hop chat phosphate thai ra le van dona, 5. Phan &p CO, CAC LOAI HEMOGLOBIN ‘@Nguei binh thug: * HDA (us): ngut ton + HDF (a): bao thai ‘$Binh thung, sau khi ra dbi (6 thang) HDF -> HOA 1D. Thir ty cdc acid amin trong Hb duge xac sinh trong gen ot truyn > bién di —> HO khong binh tnubng —> thay abi hinh dang, tinh chat > HC 8 vor thigu mau tan yet BAT THUONG HEMOGLOBIN 2 Bénh Hemoglobin: bat thyrdng v8 clu tric chubi polypopte “HS ThiBu mau HC hin ibm SHE SHbM : Meth > Bénh Thalassemie: bat thudng vé sb lugng chudi polypeptid. mar Thalassemia =f Thalassomie ‘SY’ THOAI BIEN HEMOGLOBIN Bd! s6ng tung binh eda HC & mau ngoal vile 120 ngay FHC olds Bi pha ve trong he thing ving ndi ms ~ Ho tach thann Hem va lobia + Globinchuyén nos nhw cde protein knde + Hem: Fe“ va brain,CHU NANG KHAC CUA HONG CAU ‘2Mién och > Git’ cae phic hop KN-KT-B6 thé: thye bao > KN bé mat héng chulnhém miu -@0%8u hoa can bing toan — Kid > Hg démHb “Tao dp ive keo: protein ea hing chu CAC CHAT CAN THIET CHO TAO HONG CAU Psat > Vitamin Bye > Acid folic > Ngoal ra, amino acid, cac vitamin nhém B khae va’ eae yu 18 vi lugng: mangan, coat. DIEU HOA TAO HONG CAU Erythopoveti: Ton) preven no x ‘Phare hop cén cu ther tht uh can Exytvegena Pog nehropoiatin escrito are Teather ele DIEU HOA TAO HONG CAU > Androgen: tao Erythropoietin + kich thich bit héa t6 bao abe 2 Hormon tang trudng cla tuyén yén (GH): * ‘go erythropoietin >LH: kich thichtiét testosterone gay 7 6 erythropoietin > Thyroxin‘DIEU HOA TAO HONG CAU ‘Binh thydrg: ~ Thy xuong: sin xudt 0,5 -1%HOIngy HE chét: 1%ingay (mau ngos! vi, ch) “hi nbu cdu tang (tan huyét nang) > 7 san xuat 66 lan binh thuong = 86 lvong té bao dong HC tong ty tang Thai gian trading than rat ngn HC ra mau ngoai vi sém (hich thuwe lon, con hen) NHOM MAU He théng nhom mau ABO ‘8Co si phan loi: dyva vao su 66 mét hay) Khéng e6 mat cia khéng nguyén va khéng thé > Khang nguyen A, B trén mang héng os > Khang thé chdng A, B (antl A, enti B) trong buyét tanh ‘CAC NHOM MAU HE THONG ABO. uhm mau] Kiang nguyén| ——_Khdng thé a x ‘nti8 @) 8 5 ‘Ant (a) 28 a8 rng ° Kring | AFA va ant-8 (5) Whore THE), Genotype miu VN | chiwA |Chiwau| © a wf we | wo | AA 8 2a ||| nes a8 4 5 re oO) «8 | 4) 45 | 00 UNG DUNG TRONG TRUYEN MAU > Kring dure db céc khdng rouyén va thing thd tweng dng gp pau Wong mau Nguoi ahin > 00 ti yuydn Ande hsm nhupg pha tak a gwen the sheng dé thang nguyen @réng cau cha raha ore noe oe > Lrgng mau tuyén va0 kong wot qud 250 mi > Truybn vor tbc 36 cham va pha theo da chatSO BO TRUYEN MAU HE RHESUS 1904 Landeoinor tint Whi Maccacus Rhésus > ton KN yeu 18 Bh -Yéu 16 Rh: he thdng nhidu KN, trong 66 KN'D mani nt, nga tong tan mu > Rs HC ob yu 6 Rh (0°) Ri HC khong c6 yéu té Rh Naud VN: Rh 99,96% KT mign dich IgG (anti-D) HE THONG NHOM MAU Rh nm -xenang thd rh chi 66 & ngubi eb nhém mau Rr, ‘hung khdng tnt sn trang huyét than “@Ngubi nhém mau Rr ohn nhibu in mau Rh “Me nhém mau Rh phiBu ln mang thal eon meu ae SINH LY BACH CAU 76 bao mau lon nhbt B30 v8 co thé bing céch thye bao va min dich 10‘SO LUONG VA PHAN LOAI BACH cAU 5000 - 9000/mm? mau 42 nhom: 5 dang bach cu > Bach cau 06 hat: + Bach cu het trung tinh (Neutrophil) + Bach clu hat wa acid (Eosinophil) + Bach chu hat wa kibm (Basophil) » Bach cau khéng hat: + Bach cdu mono (Monocyte) + Bach cu lympho (lymphocyte) BACH CAU BA NHAN TRUNG TINH (Neutrophil) > Chit ning chi yéulatnve bo F phanté > Trutma how wen A réntworgma V3I98 awe PN Ng Png ch OC vo mtu) toynstng ¢ Tang 0 sn uitBC a nan » Blu tin: BTB + Noutophil 5 87S > -Nva DT» nh dhe va cht din BACH CAU BA NHAN TRUNG TINH (Neutrophil) bc tinh cla bach cu tung tinh van gong ‘Bam mach & = xuyen mae Hoa tng 6 ~Thye be i) aoe BACH CAU DANHANUAACID (Eosinophil) > Thye bio: yéu hon bech ebu N > Kho de cdo proten la -> tap tung & avon teu hoa, no nép > Ching ky sinh tring: gén KST > ii phéng chat dibt KST (men thay phan, polypepta cit fv tang) > Tan oye mau déng: gi phéng plasminogen -> losin “> tan oot fibrin 1"BACH CAU DANHAN UA KIEM (Basephil) Him gap trong mau > Khéng 6 KN van dng va thye bao > Chire nang: Glial phong heparin >Gial hong histamin va met it bradyi Val tro rong mets phan ung ang Wn ‘quan dén IgE BACH CAU DON NHAN (Monocyte) > Trong mau: chua trvéng thanh > khong chire nang Monolmau vaiga cae mo: Bai thc bao (00 dinh veTou Gong) Chir nang cia dal thyc bao: ~Thye bao: rt lan > vai trd trong. ahiém shun man dh = Mién igh: cl dng val wo Kh6t dong qua ‘rin min ee ‘CHUC NANG CUATUNG LOAI BACH ‘CAU LYMPHO ‘Lympho B: min dich dich thé > Hinn tanh 8 bao rb » Ci lal king h8: 196, 10M, oA, IGE > He théng bd the > He tndng phan vB ‘CHIC NANG CUA TUNG LOAIBACH ‘CAU LYMPHO ‘*Lympho T min oichté bao > Gil phéng lympho T ang > Tao thanh 6 080 ahd > Ph hy enh xi in = Tive tp - Giantibp 2‘BACH CAU LYMPHO, ea Saeed onamate Weare wd] “Horas laos rote a ina sadereeontnatm ap TIEU CAU (Thrombocyte) ‘274 bao khng nhn ‘Hinh dang khéng mhét ginh, thong hinh dia @ trang thal tion e4=2-4un Co chb hinh thank: gi phan bao cua miu teu chu +2 Yb 6 albu hoa: thrombopotetin (gan) ‘CAU TRUC TIEU CAU }#Mang TC: nhibulim—e P dién tich tibp xe va lam TC x6p) Mat ngodt lp khi quyén — val ¥® quan tone trong kat doh va gun tp TC Mat wong ne Nbng 50, ¥! Sng ~ uy Wt hina ang Te =H néng tau onan va oil phong ce ont }@T8 bao chat TC: Hot df: cht hch hogt TC Hat alpha: 60-80%, cic protein dic bt cia TC }sngoai ra, mang va ‘bao tong TC: hé théng protein co gian thrombosthenin ‘SO LUONG VA CHUC NANG > Phan bb; 2/9 mau ngoa vi 19 lich >SLTC binh thug: 150.000 ~ 400.000? mau > di sing: 8- 12 ngay (7 - 10ngay) >> Pha ily: chi yéu léch -» gan, ty xwong > Chie nang ~ chi yu: tam oi va qu tn cm mau vd ‘fing miu = Bio 8 bdo na ma anh mach = Ngodira, rung hia host dong chéng déng cba ‘hepann ing Rep protein va ipa, dap ung viem. 13QUA TRINH CAM MAU Chm mau la mt tép hap nhong qu tinh lian Ghd Bea? mtn con Such a hl mach khithanh mach Bi ton tang =I 2 = Co CO MACH 2 Ngay sau khi mach mau bj t6n thyong >> Dai va manh & ede dng mach, inh mach Kon > Corchb: = Phx th Kn Co thdt cota cd — Tid cu bt serotonin, adrenalin va thomboxan A, »T90 dibu kign JB TC Két dinh vo no} tn thong > Bib kign co mach tt thanh mach vong che, ‘dan ht, néu khong -» XH bat thong, ‘THANH LAP NUT CHAN TIEU CAU > Cc giai doan: ~ Kit din bu eu: GPX von Wilebrand, (Pata - Cotagen ~Kich hoot du ob ‘Thay ai cbu tc 4 Phan dng phéng must =Ngung tap tba chu: (ADP) GPIiila - Tinopen ee > Val tr = Go eh cht yéu a6 chm ma = Quan trong trong dong kin ybt yong xay ra thygng suyén @ ede mach mau rhe 4ONG MAU HUYET TUONG > Binh thudmg, méu khong bi dong = Thanh mach tanh man = The db law thing ahét in ~ chit ehéng ding > Béng mau: la hign tong thay 68 IY tinh tir lng sang gel (tao oye méu), he’ qué tinh bién 661 cdc protein trong mau va ty xic te CAc YEU TO BONG MAU vow Tenge Chicana] (riage Hiiaren [= [romenne fran men [Mt Tremp nd oh pl ng [er astcig heaps xe vautisue xt esti nosrad DONG MAU HUYET TUONG ‘S0'BO BONG MAU HUYET TUONG >Giai doan 1: thanh lap phic hop men Téntuorathammach Hoa eh mb) ere Ho thbog a cam “Toromboplestne m8) ca ~ Go ché ngogi sinh ~ Cored ni sinh > Giai doan 2: thanh lap thrombin > Giai doan 3: thanh lap fbrin 15TIEU SOI HUYET Don cde cye mau déng nhé ft trong tong mach, ngan sy hinh than huyét khdi Cyc mau tan dén hi plasmin ~ enzym eu protein rét_manh, tn chét 1a plasminogen CAC YEU TO HOAT HOA Plasminogen > Thrombin > Yéu t6 Xila > Enzym ea lysosom tr cdc mtn thuong J Nhiing yéu 16 hoat héa do 16 bao ngi mo ‘nan mach bal tiét Men urokinase ctia than Doc té vi Khun: Streptokinase cia lién cu ‘DIEU HOA DONG MAU Cac chat chéng dong: = 88n 66: antithrombin Il heparin, protein C, protein S ~ Chat dung chéng dong: nat citrate, Kall oxalate, dlcoumarin, Mbt s6 phuong phap lam méu mau déng: = Yau 18 ng ma = Vitamin —Huyét tog wo! = Mat edt ms toi Acid gammacaproie CHUYEN HOA NANG LUQNG 16Muc tiéu 4. Trinh bay qué trian chuyén héa nang luong va ese dang nding long tong co tis 2. Thinh bay duge e&e nguyén nhint6u hao ning ong. 3. Phuong phap do nang lvong teu nao 4. Tinh bay duge qué inh diéu ha chuyén toa nang vena. 5. Nou duve met 28 trang hop 15i loon aiéu hoa chy hoa nding hong 6. Tinh bay tng quan qué Winn chuyén hoa cde ‘hat trong co ihé lui, prot, pid DAI CUONG CChuydn ha nang Wyong 18 aus tinh bn gi nang lugng sinh ra thank cae dang nang wong kre tniét cho 2 Ngay c4 Wwe nghl ago cong ein nang Wong DAI CUONG Hoa nang thee an Nhigt nang Hoa nang ATP Nhigt ning Hoa nang ptr ign nang CAC DANG NANG LUQNG 7DAI CUONG “@Nang lweng: hi vo co thé, Hndng sin a them, ‘tng Kg mat dtm lg dud ee dang ke hay “Cae dang nang iweng: oo thé chuyén hoa te dang ny sang dang tha ‘¢Nang wong tiéu hao: bSt cu dusi dang nao Kh ‘naa ngoal co thé du 6 dang nhiet ‘Don vj do nhigt lngng: Caloric 96 ahigtueng ‘bn thidt nang nhigt 26 cua 1 gram nue te 15°C lon 46°C, viét tia cal 41Keal= 1000 ealorid NANG LUQNG VAO CO THE ‘@Ngubn: thie &n, gi tang wong phy thuge ham lugng cla chét sinh nang tgng 43 chat sinh nang chink > Guicd 1g= 4.1 keal >Protid 1g =4.1 kcal FLipid 19-93 kcal Tye sL C= 12:25:69 CHUYEN HOA NANG LUQNG lucid, prot, ind JPrrencnrna tn > Quatrinh oxy hoa Khir AIP > Quatinn phospnory no Jessie cos nia 4.dang nang lweng TIEU HAO NANG LUQNG ‘Nang lurong cho sy duy ti co thé: > Chuyén héa co so Ven co >Bidunhist >Tieu hoa ‘Nang lurgng cho sy phat trién co thé ‘Nang lung cho sinh san 18NANG LUQNG CHO Sy DUY TRI CO THE La nang twgng cn cho oo the t8n tai binh thueng (khong thay dBi vb thé ‘tong, khéng sinh sn), gdm: > Chuyén hod oo sé >Van co > Dieu nhigt > Tibu hoa CHUYEN HOA CO’ SO” ‘Chuyén hoa co sé: | chuyén hod dé ccung cdp nang lvgng edn thiét cho co thé hhoat dong trong didu kign oo” s6 (khong van co, khéng ti8u hod, khBng diéu nhiét) > dam b&o cho hoat ding tun hoan, ho hp va chuyén hod ctia cac t& bao. Bon vj do: kcalim/giv. CHUYEN HOA CO SO }= YEU TO ANH HUONG ° Tuel: tub tr cao nh. gi din theo tu > Gis: no < nam 2 Nhip ngay dém: bub sing < bud chidu > Tinh tang sinh ++ Nou: CHES glam + Phy nic thai vo quy cud, nia sau chu ky kn, {im ang bub phn fo fing: CHES tang, > Tinh trang béah iy + Sét, tang nest giap: Tang + Glam hoat aiép, suy inn duema nang: CHES aid. VAN co” ‘Kh ven co = hos nang b teu nao: 25%: dng ca hoe ei Sy 60 ce, 78%: mht nang > Nang lvong cho van ea r&t len +$Che ybu td anh huréng dn vin cor > Curong 48 vn co-> bée nhe, tung binh, nang > Tur thé lao dong Pché tao dng oy, may moe 2 Mae dp thanh thao dong tic yeu cau chuyén rin hos lao ng 19DIEU NHIET “Gi than nbigt &n ginh (37°C) “Khi trbi lanh: tang chuyén hoa a sinh nhiet. “¢Kbitroi néng: mat néng luong 48 chéng rnéng, tod nib TIEU HOA -#An ubng 48 cung cép nang luong, nhung viée an ‘ubng, i8u hod cong lim eu bn nang lvgng “Nang vend: ding chuyén hod ede sin phim tu hoa #3 hap thu ac dung dong lye dae neu cua thie da (SDA: specie jynamie action) ‘®SDA bing % mic tigu hao E s0 v6 tude Khan ‘eve SDA theo ché 40 &n PSDACia prot 20 »SDAcia lipid 14 SDA Cia glucit 06 PSDAcia ché d@ hin hop = 10 NANG LUQNG CHO SY PHAT TRIEN “Binh nghia: Co thé cdn tang téng hop céc thanin phn igo inh va du irr > bién d6i hoa ning eta TA thanh hod néing cia chat tao hinh va dtr Host dong: Qua tinh Kon ten cat > Rén luyén co thé > Thay thé mo gia, cht > Phy hdi sau bénh NANG LUQNG CHO SY SINH SAN ‘Bjnhnghia: Can nang lvgng 48 tao thai, thal phat tign, duy vi, phat trién co thé gut me, bai tit stra sau ki sinh, ‘Host dong >Sinh duc Mang thai: 60.000-80.000Kcal Nui con: 500Kcal 20[PHONG PHAP BO NANG LUONG TIEU HAO 200 bang nhigt ké: E tibutao 2 nnigt ning > Phong nhigt yong ke: kin, cach nhigt voi ben ngoai 2 Nang long ta ra lam tang nhigt 9 dong muse cchdy vao phong @= V (tt) > 96 chinh xe 620, hitb phibe tao ‘Qua théng 56 hé hip: aya phn ung OXH (055%) > QEV.S (Vans ich oxy teu thy, 414 tn hievOXy) > PP ving nia me > PP veng kin ‘Qua thong #6 teu hoa: theo do tong tung trong ‘het gin dat 2 Nang von hp thy Ihren ~ E phan bal dt |DIEU HOA CHUYEN HOA NANG LUONG “eCép té bao #Cap cor thé ‘DIEU HOA CHUYEN HOA NANG LUONG NauYEN TAC #bidu hda: 3 chp > TE bao »Coquan > Goths #Corché: co chi thé dich & co ché than kinh Phuong thite: feedback (ém tinh! dong tinh) ‘$Tién trinh: 2 mie a6 > Chip toi > Lau dai [DIEU HOA CHUYEN HOA NANG LUQNG Mire d6 té bao “#Yéu t6¢idu hoa chinh la ATP “#Khi ham lugng ATP tang, ce phn Ging sinh nang kzong tang ‘SIGH ham lung ATP gidm, tbe 66 chuyén ha nang iugng giam AIP ———— ADP +P, > Duy 01 lwong ATP/TB &n dinh trong aie) ign binh thong 21lDIEU HOA CHUYEN HOA NANG LUQNG Mire 6 co thé +#Co ché thin kinh: thn kinh giao cdr 2 Than kinh giao cém kich thich > tang chuyén hoa nang lverg > Ying du6i abi 1a tung tam cao ofp cia he than kinh thue vat aan hugng dén didu hoa chuyén héa nang lyons. ‘DIEU HOA GHUYEN HOA NANG LUONG -#Didu hda thoo co’ché thé dich: > Hormon tuyén aidp: thie dy OXHRy lp thé tang chuyén héa nang leone > Hormen ty thugng than: thie dy pan oid lycogen dtr glucose > Viomon v8 TT Elect amin > ha nangioluds > Hormon glucagon va insulin ete tuyén ty: tim co ‘és dung d9eNL ty gheogen > GH cba én yen alm qua tiny tieu 46t glue buy dong nang brong dy tt Hit ea md > Homon SD nam: ting déng héa prot sinh NL *Hormen SD ng (estiogensrogesteron); ting chuyén héa nang lvong NHU CAU NANG LUNG. +Céch tinh nhu cdu nang lugng: Pan ag Wana vay (am vite sinha TE] Devan ara tc esto tn eb due aT > Nu cbu nang trong cho ngudt lon: E= E+E +Céng thire Harris Benedict CEnning| Nhu chuningivgng | Nhuchunube 10a |to0keatto 100 i “02089 [1000+ Sokeing rn 10/1000 +50 ming ren 10 {52049 _[ss00+ okeang bin 20| 600 +20 mig win 20 etuuy: NHUCAU NANG LUQNG 2 Clich tinh nhu ebu nding leon: 6 tinh ube hong Nhu cl nang lung Khae nha ga ede ca thd (2 V1 vay cin theo dBi vide cung cp nang lvong bing ch theo d0 can nang 0 ngubi lon, tng can ln tuo hang thang “> vide ung edp ning iveng vwot qué nhu edu va nguoe la 26 trb-om, theo dBi edn ning thoo 6 tub bing bibu 48 tang dng (len quan cnibu oxo) > Banh gis tinh tang thie anh dng: ph so dung Bang ch s6c4n nang theo chibu c20 22ROI LOAN CHUYEN HOA NANG LUQNG. Bilan NL durong khi E (&n) lon hon E (tu hao) Bilan NL ém khi € (&n) nhs hon & ( tiéu hao) Bilan NL quan binh khi E (@n) bang E (teu hao) }Bilan NL qua am hoae qua dvong déu knong| ht, co thé dn aén tinh trang benh ly. ROI LOAN CHUYEN HOA NANG LUQNG | Bilan nang long am “Trdg hop thiéu an, ri loan hép thu gidm lam gidm nang lyon &n v80 ‘Ki st, 6 15 dd man tinh, hoe &6 kB Ulam tang NL teu hao suy dinh duréng, ngusi gay sat > thidu nang lvong, ngubi ub od, it hich host ong ROI LOAN CHUYEN HOA NANG LUQNG. Bilan nang wong dong Truong hop néng lugng &n vao tang len, oo” thé dy uw NL tang, nguéi béo map zing qua muic sé dan dén béo phi (obesity) ‘Nguoi béo phi thyong tang trong qua mirc (over weight), dan dén cc tinh trang ve tim mach, DTD. DIEU HOA THAN NHIET 23DIEU HOA THAN NHIET Muc tiéu: 1. Néu duge cae yéu 5 anh hurting an than nist 2. Tinh bay duge cae qua trinh sinh nhigt va thai niet 3. Tinh bay étage co ché diéu hoa than nhigt 4. Néu duoc met s6 trutng hop réiloan than nmvt THAN NHIET |e Thin nhigt: 1 nb a8 ce co th |e nnigt a trung tém: }> Lannie 69 cac phn sau trong co thé nhw gan, nao va che tang, > Binh thutng:tr26-97 5% (hay 98 26.6-27°C) }> Tray abi theo ting ve én eo thé vd theo nit a mai rvang leo 3 cach oo: }> D0 & ruc tang: void sau chudn 5-t0cm (teu bib) }> 50 mig (due us) tp hon rye tng 040,516 |» 0 ham nach: thi hom mbit dé rye tring 0,65IC. THAN NHIET Cae ybu t6 anh wrong: 5 you td 1. van 60: c6 thé nigt 20 tung tam fen 25C ogc hon > C6 thb lon 38,5-40°C (lao dng thd Ive nang). 41°C trong tng hop vn eo qué mire va kéo dl 2. Nhip sinh hee (ngay dém): dao dGng khoding 116 » Tang ate vao sang som > Bat tia va busi chibu kh co thé oat dong nhdt THAN NHIET Cac yéu té anh hudng: 5 yéuté 2. Chu ky kink nguydt vi thal Wj: 2 Sau naay ura mg co 8 ang 03-056 Nama thn cut thei Ky ch ting thm 0.5.0.8 4A. Tub: Tr om 06 thin igtcao hon now toa 5. B9nn Wy: +» S6t, cutng giap hoac u tuyén thyong than: tang > Ben 4d gi anh node suy gid iim 24THAN NHIET (Qué trinh sinh nhigt: tr cdc chuyén héa ‘> qua trinh héa hoe ‘*Chuyén néa co $6: chuyén Noa ETB (G,F,L) “Tac dung dong lye cua thire an: E sir dung ab ng hoa the dn > tha ra Gv6% dang nh » Protein 30%; Glucose 6%, Lipid 4% ‘#8y co co: clucese, lip bj OXH 75% dang nhiét >>Hlen tuong run: nguyen nnan sinh abit quan tong ‘THAN NHIET (Qua trinh sinh nit: (77) kich té: > Epinephrine, norepinephrine va kch hich giao dm tren TB 2 tang 1c do chuyén hoa E, khong dy a ATP, tae dng ahann nhung again han >» Thyroxin:tg0 ahigt cham nung Kéo di -8Tré om: ogi me nau 8 xv0ng vai va oe not knde > Sét,cubng giap hod utuyén thug than: ting > Ben thé gd lanh hose suy alan: om THAN NHIET Niét ng dug t90 ra trong co thé > rab mat da “> ud tinh vat THAN NHIET (Qué trinh thai nhigt: 1. Bure x9 nhigt: ca vat kong tlép wc nau > Trapbn dui dang tia hing ngoe:nhist dBide cao hon ahi dpimottarong > truyén niet ra ngoal > Binh thedng, nh a prong > Bue xa nhigt 60% >» Phy huge mau sic: > Vato mau don 2 hip thu oan be bie 39 161 » Vatmau trdng > phan chu toan bd bae xa nit 25THAN NHIET (Qua trinh thai nhigt: 2. Truydn nbldt: cic vattitp wie nhou ‘Tre tdp: (tmnt) cde vat ép wdc nha niu oh gb. 3% -#Ddi lu: tray nit co thé 1} mei rubng xu ‘quant (15%) Su chuydn dong dBi lu cng rhidu co thé ong thal nhidw nhit (ng quat hose c6 96 > mat) 2>bibu ki: niet ab ca da phal cao hon nhigt 46 mea trvang (aguge ial co thé $6 bl tuyén net 8Y mol twweng va) THAN NHIET (us rin tha age 2.99 bbe ot mr (2%) Sad, aring Mo hdp: tyne > 08a! > xay hg uy: ng (12-1) *-Loeng emt eng ci ny va sheng ay weft cb co tv a go knong 4 Si dtm nap thine ocr Pkt vin don: TT tena, orpinaphn rong i Kn ove nog: bw Hg atrmitean co tn mbt nuGe ve mit be hot qua ing vith cae HAN NHIET Cau tric co thé: 4. Lap céch nhigt: > Gbm dava tb che due da cyt niet trung tam trong kh nit 9 dab xubng hp theo niet d@ meitrvang > Mp la chSt cach niet bt ahd (vb dn not bane 118 cée chic kngc) 2, Dang mau mang nhigt trang tim ra ngost vi: > Cénhibu mach mau xuyén qua lop céch nhs gy sat ovat mat a, > Chiu sy abu Kido eda ng mn kinh giao cam THAN NHIET Didu ha than nhigt: Corché feedback thin kinh 26THAN NHIET CCung phan xa didu nhigt: 1. Thy thé: > Vung tv6e thivang aver i tee: nhibu TBTK nay cém voi net 9 nngicg thé (anh: 13) > Da: thy thé ahay cm voi niet a6 tanh (10 sn thy thé nhigt ab néng) > Tay sng, e4e tang: thy thd nhigt 8 lanh ahi hon “> phat hig thay thn ahi rang tim THAN NHIET ‘Gung phan xq didu nhigt: 2. Trung tam alu da than nit: > Ving dud Bi sau ~ ich hap ce tin Niu > Céctin higu nhgn cm aigt ngoaibién hay trang ‘yong 3 ving du6i dB sa, > Trung tam dibu nda tbag hop fal > kibm soat qua ‘inh sit nhigt va gl Ane ca co hs clip bu hoa than ohigt THAN NHIET Phan xa chéng néng [_mnai>| sinn: Didu nnige vatiy THAN NHIET Phan xa chéng néng Gian mach da > Lam da 8 dng Do su de ché trung tim giao cém (gay co mach) B ving dv6% deat, Bay hoi mé hoi > Buge du khibn bol tn kth giao edm (no-on a0. cm. nay. it aoetyichotine thay Rotepineptiine) “Glam sinh nhigt > Uc ché sy run og va sy sinh niet hos hoe. 27THAN NHIET Phan xa chéng lanh 1 sinh > | ma: Bidu mhigt héa hoc THAN NHIET Phan xa chéng lan ‘Co mach da: gm mse mang ah ung tim co ‘hb aca nén glam ma nat ‘Phan xa alg tang: do wich tien giao cém cd ‘8 ch anh ath > iguor ign tpgng son da gh: King 6 tae dung exbng ann Tang sinh anit > Run ca > hoat dong ki nhén tin Wu lan dav ty sino > Sinh nhl hod hoe do te dung ca giao cen: ng gay lap te be ao chuyn naa so 2 Sinh nhit hod hoe do King Ht thyroxine: do ting ehuyén host bio SINH LY HO HAP KHAI NIEM CHUNG VE HO HAP ‘Dinh nghia Qué trinh hé hp: 4 giai doen > Thong khié phbi > Khuch tin O, va CO, tal phd >Chuyén ché 0, va CO; }Trao bi O; va CO, tal té bao =: luBn lub duge sid haa bai TTHH “Mye dich chinh cua ho hip: Hp thu duoc O, + sinh E CO: thai ra ngoai 28HE HO HAP Co quan rao dt kh: phi ‘Bom dé thong khi: > Ling rave Peon hp 2-H thin i hp ‘She ning: by 02 thi Ox ratowe Phat am Tan, a1) mbt 6 chit yo cae cvcrmtu ding ‘BUONG DAN KHi Cau tao: 3 Bung HH trén: mai, hau, than quan 2 Butng hé hép dus: duémg HH trung tam, urong HH nho (khi quan ~ pié quan ~ teu phé quan) 2 Vong sun gidm din (kh quan ~ phé qun) + Tibu PQ: 1,5 ~ 1mm, khong ob sun > Thanh tibu PQ toan co tron > Tibu PO né theo AS auyén phi (PN) DUONG DAN KH +#ThEn kinh giao cém: > Tryetiép du Kiba oo ron TPO — yeu Epinophrin & Neropinephyn (ty thyorg thin): te ng th thé Ba gin phe quan ‘Than kinh ph giao céms nih ea diy X Tit Acetychoin co tht TPQ (nb = rang bin) 2B kich hich Bt kh de, bu, olan, idm. TPQ bj co tht do += ThuySn te mach phi Histamin va SRSA (pn ig 6 ng) Leukotriene (bech chu it) co HOC HO HAP |e kn nhiem: b> chan ch dp sub (AS Kn quyén As ph nang) b> Sy tham ga eta cae co ho nip }>Kidu mo am: AS phi nang kidu the dong: AS phé nang > AS khi quyén 29CO HOC HO HAP (Co hs bp hb ha hs Hitvae 7 Sean wah AY em 2am SGhng oe 2 Catan dvr kin voc a 2 Ga am gaara > Ben thong FGingswe Thin P Ty enusbowwsing > Mang el: b6 bung ben CO HOC HO HAP +#The dung eo he hip: > Tang, gdm th tichlbng ngye > Bong tac hs hd: ~ Ht va: ca ream, coun suem moat Hi vio ging we “There = Teraging sie > Po kno sat co hoo: = Boden cont = Bodp suit ring = bombtenies CO HOC HO HAP ‘Phi: cau tao gdm >Phé nang: >T6 bao: = Loal 1: bio vé phé nang = Loai 2: tit chat hoat ign 2 He théng mau = Mau den = Mau 68 co HOC HO HAP ‘Tinh dn hd cba phi: > Seidanhds (13) 2 Sie cing bib mac cch it phé nang (28) > Chit oat dich: idm ive hit cba phén ty ehop ‘cht ph nang (gm Sie cng Bb mgt 2-14 in) 30COHQC HO HAP Chat hot dich: anh hung » Sur &n dinh cia phé nang: anh hudng ién sue cang than phé nang (T) = Binh luat Laplace: P=2TIr Pa cust phé nang Tsaeeang ha phd arg ‘oan hin ph ang = T gid —r gidm va ngugc let =P éndinh CO HQC HO HAP | Chat hoat dich: anh hwréng P> Ngan sir tch ty cic pho | trong phd nang: | Binh thudng ap lve 3 mmHg |. Thiéu chat hoat dich: - 10 + - 20 mmHg |+ phi phi, suy ho hdp |. Co thé sigu ty ong cach bof surfactant rye bp voo phi KET QUA CO HOC HO HAP #Phé dong ky: >Ghi cir dng ota Keng ngye qua trung gian ‘5 thay dBi the ich ca ong Marey “PHO hdp ky: > Ghilpi sy thay di thé ich phd trong cde Ky hi hap (Binh thudng va gang strc) “Bo thé tich khi can Bo khoang chét “sThéng khi phé nang HO HAP KY 31HO HAP KY 3: (nam, 20%, S5kg, 4,65m) 4, Tan 96 hd hép: (16 lén/phat) 2. The tich tau thong (TV=0,4lt) 3, Tha tich dy tet hit vao (IRV=1, 8) 4, Thé tich duet the ra (ERV=1,300) 5, Dung tich s6ng (VO=IRV+TV+EF 6 7. 8 sit) “Thé tichthéng kni phat (TV x t&n $6) “Thé tich thong khi phat ti da Thé tich the ra 181 da trong 1 giay dau (FEV,): thi lap chi s6 Tifeneau HO HAP KY ‘Dung tich séng: chi sb quan trong — hoi ching hen ohé > Thay 4b theo: got, tub, chidu cao, cn tbe > Phy thuge:- Vite a0 = Site man cia co no hip Tinh dan hii cia phd — ling ngue + Site chia eda phé nang ‘8TH tich the ra t6 da trong 1 gidy au (FEV): = no ching tae nghen, mire do va en kong Cchiaé Tifoneau: FEV/VC x 100% = 80% (20116) — glam dn theo wb 2_<70%—: hi ching the nahn SY TRAO BOI KHI TAI PHO! “Ks nig » Bude thir hai: Khuéch tn O, ts phd nang + mao ‘mach phi va.CO: theo chibu nguge la +18 qua tinh quan vong ahdt, nue dich oda sy thang bhi tap > Chixay ra noi mang phé nang c6 khang kh, bp xe vor mao mach e6 mau chay qua (70-802) SY TRAO DOI KHI TAI PHO! Thanh phn vpn 6 4p nar ma6 meh‘SY’ TRAO BOI KHi TAI PHO! ‘Mana phé nana~ mae mach: ‘SY TRAO BOI KHi TAI PHO! ‘©Co ché trao déi qua mang phé nang - mae inh nan tera glkhuseh tan ty dong “Sy tao aK 6p inn hung ch cn 0.255 (thi gian mau chay qua 0,75s) — thich ting kh van dong $Két qua trao di kh: > Kha nang Khuéch tan Oz: 2imliphctimmHg — 200-250m! O, vao mau/pht > Kha nang khuéch tan CO;: >20 lin kha nna khuéch tan O, ~ thal 400mal/pnt (co tre can thai 200miphit) CHUYEN CHO KHi TRONG MAU Sy chuyén cho ony: Dang hoa tan: 2-3% VO, = PaO, x 0,00314 95 x 0.00314 = 0,91 Owidl. mau = TH8 trye tiép vei phan 4p O, — tang Iugng oxy dn md Tuy nhién oxy nguyén chét gay nhiéu téc hai cho BN (ngd doc oxy) 33CHUYEN CHO KHi TRONG MAU > Dang kit hop Hb: 97% tng cng Barco POJDMMOSmmg, 73 Hb aver bso has PoyTM=dOmtig, 76H eae bo ha Heo any tong oN bn deh PO, bong ms CHUYEN CHO KHi TRONG MAU #Yéuté anh huéng al lye Hb 461 v6i oxy: > Nnigt a6: + | dilve > pH: |-+ duéng cong Barcrof lich phi, Pao tang > 60s: 1-» vong cong Barerot lech pal. Pas sna > Chit 2,8-0PG (ving cao, thibu oxy, vin dng) > 1Oznha te Ho > Hop chit phosphat (vin dong): 1+ €ubng cong Barcrot ch phi, Pes tang (CHUYEN CHO KHi TRONG MAU sy ganiny cho me: 7 Sinn thang (i #90, 250m Ost RB nyo bg tin 7Men dong (81400, Bae a Fe Cangteongmeang ian NE | St | Bet “ugg. go them ing TS n= 3780 rssh 31 ang ory coa me , SOs tr maa ene 18 0, 8 Ro = soma Posto” 23mnt DIEU HOA HO HAP ‘Ibu haa no hd: Do trang tim he hp & hah ndo va edu nao eae nép ‘My dich: Gi cho pO pCO, va pH mau — t6/ uv, dao tong Co ehé: ThE dich: Oy HY, Op 2-Thn kinh: v8 nao, pn, hy thd than tn, ty th ap sult, ubng TK huang tam 34DIEU HOA HO HAP fess ree ae | GE Gar a Com feovec DIEU HOA HO HAP tg tm np rung mnt vee 2 Fingums aoe ws ZS unglamiien rican. > unum abr “thatthe tao. coon (@8)gurg 946 ro ang ten cn ens rg a gamer genni tang aie Yang py ung 8: yr arg ob ght Bare he Lesser teint) 77 Mngt aH gg aon eh ving ounce ves YEU TO HOA HOC TAC NHAN DIEU HOA TRUNG Ving etm img héahge rung wong: | TAM HO HAP itor Cee nie eB torgaeneso ava HS hg we gto wen | Pisses ee eee > ving cam tng “Vang em tng héa hoe trang wong “ang cim ing héa hoe agoatbisn #0Ac YEUTO KHONG HOAHOC Luang TK ty cc tung tim, thy HB, 8p sud, hig 4, phan x, 1602 qu hang rao mando 8 ang iH" vo EO! enim) tan Rete okt wing ‘ung > thay a6. cOmau> thay 1H he 2 PaC0 tar an gc m0 ‘io 60, vo di henge ang > place aotiy 732,88 ey yi 6 C0; nen Bn 35YEU TO HOA HOC “etd edn va nd OM cha ogo Ben Mae 6 oot chino l= SHB tatcepamine > Geen king 1 dn (8 cnn). (ca 9 “ “Cau ona rau fm on coco 1005 m9) > Thu oy — png catchalarin — ich intB ut ste seang Bt can (0). PaQectny ch eh TH eo. Tir trung tam van mac Tur cc ap cm thy quan ap suat Cac phan xa noi tang Nong CAC YEU TO KHONG HOA HOC. #Ludng TK tir céc trung tam cao hon 5 wsdng TK ir v8 no — bu chinh cit dng hi hap theo y muén BN bj ép hanh no, sét 18 ligt thy, tbo thyong wing bén tude cia 2 bén opt s6ng->mat ty dong, nhung ty ¥ theo ve no vn con Bau, cém xic, 39, hai-lubng TK tir vO rnao-~thay di 6 Rap SINH LY HE NIEU THAN 36DAI CUONG esc roa ee % Don vi than > Nu mo than: dai thé. gdm Yang v5: nim & phia be i cia than, "Bp ade vbi vo wor may Néng 6 6 km tm hat.'Bay laviot chu yeu tap tung cau than (loc huyét tung). Vang ti: nam 6 phia be lim, mu dng hat 06 van tua, Day la noi tap trung cac Ong than (tai hap thu dich loc va bai tiét 1 86 chat), Niew quan Be ER m0 et Niu dao | CAU TRUC - CHUC NANG THAN CAU TRUC - CHU'C NANG THAN > Céu tao vi thé: boi cde don vi thn gdm ‘chu than va cde 6ng than + Hai than, mBi than 6 1 ~ 1,3 tru don vi chive ning than la Nephron *+ Chi cén 25% nephron host déng eding dim bao chi nang than. 37‘Quy tinh tgo nw6c figu eta nephron su' Loc 0 T1éu CAU THAN ‘CAU TAO CUA MANG LOC CAU THAN t PERLE G ANG LOC TIEU CAU THAN Chu to: 8 op Lap TB nbi mo eda mao mach bu clu tn > Ming dy > Lap TB bidu mo cua bao Bowman Tinh thd 2 Tinh thm cia mao mach cbu than edt man > Phu thude phan trong Pr Taividm [Chit 00 05 [Prien 38‘THANH PHAN CUADICHLOC. 4Giéng thanh phan huyét tuong nhung 0.03% protein inuyét tong > Khéng 6 té bao mau Car, acid béo khing duge loc ty do & cu than (ching két hgp véi protein/huyét twong) > Cr va HCO, > huyét tucng khodng 6% Na‘, K* < huyét turong khodng 5% ‘BONG HOC LOC CAU THAN CO CHE LOC CAU THAN SU’ TAI HAP THU VA BAI TIET CUA ONG THAN 38TAI HAP THU - BAI TIET TAI ONG THAN ‘TAL HAP THU TAI ONG GAN a Es om ‘et weile =. = ta = SS [eo apt Saga] GLUCOSE ‘¢Tai hép thu hoan toan & éng gn > Phu thude ndng d Glucosemhuyét tuong > Nguing s180mlldL—THT hoan toan > >480mlldL THT kndng hét 800 ché: >88ng van chuyén voi Na C6 protein mang ‘ACID AMIN - PROTEIN ‘TEI hdp thu hoa toin 6 éng gn 30g protein loc qua cau than /ngay_ > KGng qua duge mang igo—-THT hoan toan ‘C0 ché: am bao qua bb ban cha » Protein vao bao yong — acid amin Acid amin -+ qua bo mang day rho chdt mang — vao TB bang van chuyen tich ovo thu phat Jo Na" — kuch Yan v80 mao ‘mach quanh 6ng than 40‘TAI HAP THU MOT SO CHAT HOA TAN KHAC. ‘Creatinine, inulin, manitol, sucroz: Mang TB khong thém vai nhtng chat nay —+néu diz0c loc > 100% c6 trong nutic tibu + Tai hap thu uric act: > La san phém cui cing I chuyén héa purine Bai it 10% lugng dug loc ‘Vitamin: THT theo nhu cu, co ché tich cue ‘TAIHAP THU MOT SO CHAT KHAC ‘¢Tai hap thu Na’ Cr 65 -70% 6 6ng gan > Khodng 5% Chép quai Henle > Khoang 15% & phn day nhanh len quai Henle 0% 6 bng xa va 6ng gin dudi téc dung cca Aldosteron TAIHAP THU MOT SO CHAT KHAC. +$Tai hdp thu BICARBONATE > Kihoding 90%4/6ng gan: két hop H’ —+ Oz Khuéch tan nhanh qua mang TB, phan HCOs dur nuée tbu > Khodng 5% / quai Henle > Khoang 3% /6ng xa TAIHAP THU MOT SO CHAT HOA TAN KHAC Uc: > 25-30gingiy ty thuse ché 46 an prorein Ong gan: bai xuét 50% vao nude tidu, THT theo chéch léch Cm Ong xa khéng thém véi ure Ong g6p. phn v6 khong thém vor ure Phan tiy thém vira phi + 106 thim infin kb THT nude — 0 ae mute tu aTAIHAP THU MQT SO CHAT KHAC ¢eTAI HAP THU UOC 65-70% & Ang gin 10% & nhanh xuéng quai Henle > 10% éng xa va 9%/6ng gan do ADH diéu hoa BAITIET CAC CHAT ‘Bai tiét H*: 1 p= 2 Thong qua sw hoan dBi vei Nat ~ H* két hop voi HOOs ~ H* kit hop voi ne dom PO? ~ H" két hop voi he dm NH 40,05 (7,0-7.7) > Tac dung (ADH >Bom H ATPase BAITIET CAC CHAT BAITIET CAC CHAT Ae eter Bai tét NH eee i - NH duge tao thanh & éng xa benzoic > Amoniac: duo tao ra ti glutamin Urocrom: chat séc t6 cla nude tiéu ~ Chi yéu do glutamin bj khd amin dudi tae dung cia glutaminase - NH; 48 dang khuéch tén qua mang t6 bao vao lang éng than - NHy duge kt hgp vai ion H", tgo thanh NH” 42BAITIET CAC CHAT 4 yéu 16 anh hudng dén bai tit NHy = pH/ mau (CO;) = pH! urine = Tée dé dong chay = Trt lung K"/ body ‘QUA TRINH BAI XUAT NUOC TIEU +#Didu hoa mirc bai xvdt nude tid Cae cht thm thu: GucoseDTD, sure, mannitol, uré Ap sust keolhuyét tuong: AS keo t->tthai nue tidu do = Gidém ap lt locinué tid = Tang THT/ng than TK giao cm: kich thich —> co TBM an — iam loc va nguge lai Ap sudt OM than: tf misc thai nue Su QUA TRINH BAI XUAT NUOC TIEU #Y6u 16 anh hung sy tao thanh nude tibu cba than: >Luu lwgng méu va huyét 4p > Thanh phan héa hoc ca méu > Tuyén nf ist tuyén thang than, tuyén yén > Than kinh > Thue ii ti6u ‘QUA TRINH BAI XUAT NUOC TIEU +2Van chuyén nu tu que nigu quar: Nude tibu bé than 1+ AST > nigu quan — bang quang Ap suat BQ > AS NO: nuée tu khong chay rnguce vo NO hi tig tibn > Phan xa NQsthan ~ cm giée dau ti NO: = NQ bi tc (s6i) —sphn xa co mann — cm ide dau -- gay phan xa giao cd — than — 0 TDM then —*| lwong nurée tibu 43,s+ CO CHE THUOC LOI TIEU “Thude igi tiéu qua tham théu »Chét duge loc, khéng THT ASTTHing ng 1—+thuse tidu (mannitol) + Thuéc Io’ tiéu tac dung trén quai Henle: Uc ché THT Na‘, Cr > ASTT/ing Sngt—t nude tiéu ‘Thude loi téu khang aldosteron: tie ché THT Nat ASTT/ong éngi—1 nude iéu DIEU HOA NOI MOI CUA THAN ‘Thanh phain & Cm cdc chdthuyét trong “$Didu hoa ndng 6 NaCl “Ap sual thm thduldich ngoal bao ‘27h tich mau & dich ngoal bao Cm Hva pH alla co thé ‘DIEU HOA NOI MOI CUA THAN ‘Thanh phan & Om cdc chatthuyét tong > Thong qua THT va bal tist “NACI: ki vir hn: do thi NaCl kém — mush Varad iat vong ese m= ph Ap suat thm thduldich ngoai bao: chi ‘yu do Na, glucose, ure ADHiviing dui dBi (éng xa, 6ng gop) > Cap ide kat: mat nuve, tang No’, mbt Co chb thim fn mubi: gidm Navfaich rngoai bao, suy tuan hoan 4aDIEU HOA NOI MOI CUA THAN (TK giao Cam Restuel OM chu. 2oang OM anh agin TOM den Nae Na YE Wo Bu Na (ANF) Vay => 2 tm nv ting bal uat Na hub teu > Aldseren THT Nat Ko tone ‘Vu Angiotensin, — Vu do gay & Na & muse, fich tich aid” °° SY ADH Vi DIEU HOA NOI MOI CUA THAN “Dich ngogi bao: cae yéu 16 chin gy phi > Tang ap suét mao mach > Giam ap suat keo huyét tuong > Tang ap sudt keo t6 chive Tang tinh thm ola mao mach CHUC NANG NOI TIET CUA THAN + He Renin — angiotensin: Len he mach: gay co mach -»t HATTr & HATT > Lén tuyén thueng thin: ting tt Ad >t TH Na nae IVa, OHA > He TK: he giao cdm —- tt Noradre —-7dn truyén. pHA, ADH, cd gide kat > Than: = Gomanh TOM ai-+,AS-+4dbng mau thn—loe + TAS mit toe + thay 681 me le TAC DUNG CUA ANGIOTENSIN I ‘Tren mach Co cae tu DM > 8 lan so w6i Nordre 2-Lam 7 sinh tb co tram thanh mach = tng sire cén ‘8Tr6n he TK giao cm: 7-Kich thich to sau hach cla h@ giao cm — NorAdre ‘#Thube ire ché ACE: > Tanai, Captop, Enalapril, Accupril, 45‘CHU NANG NOI TIET CUA THAN ‘He onythrogenin~ erythropoisn > Thiéu méu (oxy) — ki thich phe hop en tibu chu tét erythrogenin — erythropoietin — thy sxvong chuyén ten HC than HC twéng thanh He 1,25 ~ (OH), ~Ds (vitamin Dy} “Ten rub: | hip thu Car*BPO? + ihuySt wong ‘Wen than: ) THT Ca"& POR —> nus tu “een aang: kichthich hy cbt bao —-thuy dng Cat" & POS rama > Dibu hos: PTH, Cm Ca" & PO muyét wong SINH LY HE SINH SAN HOA a a ae cocansmioye GQ.” Sis vat we con gen ait) Vs an nase G6 2-W6 hai gb nh how any patria -| OX *OH inh hoa a enn msisais + “No + v8 phat ibn — bg tring =o oy er nen 46SSS" glethéa be phan pp ‘sinh dye ngoai iy somes Wet paytH! [ DUGIDO! }e—— TUYEN YEN sx TT T. SINH DUC DAY THI ‘SBit du chire nang ni it va tg0 giao the NG: 8~ 13 10), Nam 9~ 14 14d “Nhung bién dBi co thé > Tang rong ivong ca thé + Nam: phat tn co bp. +N oh tm adi, > Xudt nin ce dac tinh sin dye tho pha > Co quan sinh duc than thu: + Nam: sn xu in tng, + Nar rung tng (26 kin nguyt) MAN KINH your ae DUC! DO! | TUYEN YEN os: |t T. SINH DUC oa a7(MAN KINH “Man kin > Gidm dp tong GnRH, gidm tft hormon, te cung, ‘im 890 too lat NO: 45-55 tubs ‘$Tefu ching (doth estrogon|: > Cam gc none > Tinh ki thay >Viteo lal M6 x09 bimst > Tang nguy co bésh mach vanh ‘SINH SAN NAM Chute = #Chire ning tinh hoan 80% dng sinh tinh, 209% 16 en Kot >Thtch fog sinh toh —> {oo tinh tang W 2100200 ulny ; Bd veo dng phing tn) == 6) = nigu dao (uyén ten ve) E81 Hinh thanh tinh tring) b> Tir tb mam —> tinh fring tudng thank (74:ngay) I-Té bao Sertoli > lainn cong tinh trang 1+ Ong din tinh —» mao lin (24 ngay) l>-Trwéng thanh va |chuyén dong due 48‘CAU TAO TINH mun Lacan chin > andi (\3 $5 1 Wf ‘Cae yu 6 anh rong qua tin san xt tinh ting ‘eHormon > GaRH tac dung ba St LH va FSH LH — 16 bao Leydig ~ bal tt estostron dese + Kich thie phat tn 6g sinh tn hihi # baa Serta» cht inh dadng + Kich thich tbo Sertoli ba iét ABP testostoron “yao dich lng éng sinh tinh —rudng than ca sinh ting " GH — chire ning chuyén hod cia tinh hoan va {hae dy 6v phan enia eae th nguyen bao. TPintibin =» feedback nguoe YEU TO ANH HUONG SAN XUAT TINH TRUNG ‘Cae yéuté kha: > Mid le hm i nt 1 2.48 T tog = cfg ing fet ng a tt eng. 2 B® pk tung tinh hose hot dm vat rug a, im bal dong 6 ri tong ace 2 Kndng thc th He it Bs dng th > Rug, ma uj lam gdm kh ng sth Eo rang > Tia X, png xa Hoge virus qual bam tn hong t8 ‘go dong tinh, do 68 nh hudng din sy san sn tr tara > Cag tng ko dal cng 06th a idm sin st ten ‘ng DAY THIO NAM > Tb th noan ng Wen And 2 Thy pcan os ca nar thing 15-16 uh > bath iecingteststron va homon tng tun ke ca on har va walt en Cae Br a am teh cg vat tt va ye Oba IStpAE co nang 8 ly, pong Sts bit oh ob kg hot Bg th dv i in F Go enb ety “bay eva qua eee tung nan + Kn vg ie era arog th Nu alt 4 0 eh Hath ng de 3 ving imbie 8 6d maa ug duet bal belo png Gnket enue nang cure ng hue = tuyén yon tuydn sinh due day 49‘SU’SUY GIAM HOAT DONG SINH DUC NAM >i nn ig Be en net ag tno Siege lahat Sauer. eos Re Eee 2 Bomar e smote SMieae Eerie anima tne favre ciara nameoneenie fe dahcvenan a at wrgmar aeng ce saenanasardartin Rohaeminnegee ere a See gute chaen 3 ‘= Trwong hop bat throng: > Tinh hoan trong 8 bung/éng ben: = 10% tr8 06 1 tinh hoa khéng xubng biu ~ Bibu i: ni knoa (gonadotropin) hoa phdu thuat > Suy tuyén sinh san nam = Sau dy thi cham + Tré em: syn ddu xuong vin phat ibn (20) vai gp, co nn (giéng nit) CHUG NANG NOI TET TESTOSTERONE Jsnguén géc: oH D-Té bao Leys & khoang ke cae 6ng sinh tinh e Tostasterone fan androgany hu tg0 nba hoe TESTOSTERON leo1eU HOA }-Thoi ky be hai: ting tt aa) }> Trwéng thnk: LH ting ét‘SINH SAN NO’ 51HORMONE SINH DUC NO ESTROGEN, ESTROGEN rene ——On JeNgudn gée: |soidu hoa oe) (Samm) D-T6 bao hat & lop Ao trong cia nang trim }-LH tg ba ut Pee D-T6 bao hat trong hoang ih OH Essraol (an axtragen) Cu tao hoa hoe HORMONE SINH DUC NO" PROGESTRONE PROGESTRONE |soidu nos Beene] JeNgudn gée: pase ernde )>Té baw trong hong thé. Hy Poe D>Té bao nang eda ting 20 Sho oS) o eneseone (apooesin Cu tao héa hee: 52CHU KY KINH NGUYET CHU KY BUONG TRUNG — CHU KY BUONG TRUNG Nang nguyén thy: ting hich thuse Nang ti (eo cp): chu thy thé FSH, estrogen va androgen 2 Nang th ep ‘Chi tac yng cba Gonadotropin LC 1 nang thi ep duy ahat dupe tuybn chon 2>Nang twig than (nang wot ti): Yet ostrogon, >Dinh LH (ngay 14) —-phéngthish non vao xeang hue mae 2>Hodng tb éuge thanh ip CHU KY TU CUNG eenncas || || Th *Giai doan truée rung \ ‘tring: tuyén ti cung \ \ tétniito trogen & progestoron — nnigu ‘mach ma, noi pha 53IBién adi & nism Imac tur cungi chuyén phot ‘vao tr eung lLamté & tircungtana Placenta in cross-section] ‘ST umbiieat cord Cc Lamté o than tiv cung Sa 2 ‘partial moved) Estrogen [tae dyng: [rang kich thus va rong wong corti cung, 57Estrogen Phat tin bo pngn sinh duc ngosi Estro wal Lam gian va mém thanh am dao. ‘Me rong am dao. (Gan Khop mua gin day ching xz0n9 mu Phat tidn dng tuyén a va va m6 dem & tuyén va Estrogen Progesterone ‘Tang tbe 66 sinh san t6 bao & cdc m6 cla thai ah Phat trién mang rung & noi mac ti? cung gidp nu6i dudng bao thai © gia doan dau, eo ee. W/Progesterone {Glam co bop co to cung, ‘Tang bait ch & vol zag va niem mac ti cung, Progesterone Lam phat tién cae thay Iva boc tuyén va. Progesterone ich hich tb bao vs tng bal tit dich giau inh dag 59‘86 thal Re WS. Birth Process — Stage 4Birth Process — Stage 2 sb tha! $6 thal NGUYEN LY CAC BIEN PHAP TRANH THAI ché rung trong DUO! BOI on, TUYEN YEN rx [fuzz T. SINH DUC ate 6wa | we a | me were |eung Binh ak Khéng cho trimg va tinh tring gap nhau ny ¥ eC O83) op. Se ee ee e| Ee a 62