Yintoni na ke automatism zentliziyo? ukuzenzekela intliziyo

Yintoni na ke automatism zentliziyo? Impendulo yalo mbuzo uqulathwe ku nqaku ngezantsi. Ukongeza, ukuba luqulethe ulwazi ukunyhashwa empilweni yoluntu enxulumene ingqiqo ngasentla.

Yintoni na ke automatism zentliziyo?

Imicu kwezihlunu abantu bayakwazi ukuba uyiphendule ekunciphiseni ukubetha okukruqulayo uze ngokulandelelana ukudlulisela kuyo yonke ukuncitshiswa nesakhiwo kwezihlunu. Oku kubonakaliswa ukuba intliziyo kwezihlunu ekwanti unako ukwenza ngokuzimeleyo uchulumanco wenze kwamathumbu ezinesingqi. Le ikhono ngokuba automatism intliziyo.

Izinto ezibangela ukuzenzekela intliziyo

Ukuqonda ukuba yintoni na automatism wentliziyo, kungaba ukusuka zilandelayo. Intliziyo uyakwazi ethile ukujikelezisa i ukubetha zombane, kulandele ngokubamba it up kwizakhiwo kwezihlunu.

node Sinoatrial - cluster peysmekerskih kuqala uhlobo iiseli (equlathe mitochondria lathamba ibekwe myofibrils 40%, akukho T-nkqubo ibandakanya iqela elikhulu calcium free ayiqondakali kuphuhliswa network sarcoplasmic) ibekwe eludongeni lasekunene Vena cava awongamileyo, xa intlanganisela intendelezo ekunene .

Bufutshane node atrioventricular lohlobo yesibini ukhandwa iiseli ukuba baqhube eyenza ukusuka esiludumbo sinoatrial, kodwa phantsi kweemeko ezizodwa ukuze ngokuzimeleyo lungenisa kagesi. iiseli lenguqu ziqulathe mitochondria ezimbalwa (20-30%) kunye myofibrils thile ezinkulu kuno kwiseli order yokuqala. node Atrioventricular akhiwe interatrial ekudibaneni kwawo ikhutshelwa ukuya excitation umqadi kunye nemilenze axel isebe block (mitochondria ziqulathe 20-15%).

Imicu Purkinje ezi transfer isigaba esilandelayo excitation. Awabonisi malunga kwi izahlulelo aphakathi ukusuka nganye ezimbini ibloko yesebe bundle. Ezi seli ziqulathe mitochondria malunga ne-10%, ngakumbi ezakheke ezifanayo ngakumbi kwimicu kwezihlunu intliziyo.

Imbonakalo yezizwe i ukubetha yombane kwenzeka kwizisele peysmekerskih node sinoatrial, leyo potentiates wave excitation okuthoba ibetha 60-80 ngomzuzu. Yena umqhubi lokuqala-oda. Wesuka wave luyasuka ukuya kwinqanaba isakhiwo conductive wesibini nowesithathu. Bona bayakwazi ukwenza zombini kwamaza excitation kunye ngokuzimeleyo eyenza nokuncitshiswa ezitsho asezantsi. Umqhubi yenqanaba lesibini emva udumbo sinus atrioventricular, onako ukwenza eyakho khupha zabo umzuzu 40-50 xa kungekho msebenzi inhibitory ye esiludumbo sinus. Ngaphezu koko, lo excitation luyasuka ukuba isakhiwo umgodlo wakhe, nto leyo iphinde izivelise kwakhona ibetha 30-40 ngomzuzu, ngoko ke intlawulo yombane aqukuqela ukuba inyanda imilenze yakhe (25-30 CMP) kunye nenkqubo Purkinje ifayibha (pulses-20 ngomzuzu) kwaye Asikokungena yokusebenza iiseli kwezihlunu le myocardium .

Ngokuqhelekileyo amaza ukusuka sinoatrial esiludumbo ubuchule esizimeleyo ukucinezela umsebenzi yombane izakhiwo ngxabano. Ukuba iphazamisa ukusebenza komyalelo yokuqala lomqhubi, umsebenzi wakhe ethengiweyo emi amakhonkco ngezantsi inkqubo Uhanjiso.

Iinkqubo zemichiza okunikela ukuzenzekela intliziyo

Yintoni na ke automatism intliziyo ngokwemiqathango chemistry? Kwinqanaba eziphilayo, isiseko isahlakalo ezimeleyo kwentlawulo yombane (isakhono isenzo) peysmekerskih iiseli inwebu kuba phambi ekuthiwa impulsatora. Kwakhe emsebenzini (intliziyo umsebenzi automatism) iqulathe izigaba ezithathu.

Izigaba impulsatora:

• Isigaba 1 yamalungiselelo (superoxide yi impefumlelwano ioksijini kunye phospholipids kakuhle exhuzulwa inwebu yeseli ngaphezulu peysmekerskoy kuyo unenxaxheba ityala elibi, oko kunika amathuba yokuphumula);
• Isigaba 2 potassium kesodiyam yothutho esebenzayo, ngexesha apho isigxina yangaphandle iseli uba ilingana 30 MW;
• Isigaba 3 jump electrochemical - ukusebenzisa amandla eyenziwe ngexesha okutsha kweentlobo ioksijini lovukelo (ioksijini insimbi kunye iperoksayidi yehidrojeni) usebenzisa enzyme catalase kunye dismutase superoxide. Ibangelwa ufaka energy ukunyuka biocapacity ipacemaker ukuze edala isakhono isenzo.

Ukuthatha ukubetha odala iiseli - pacemakers ngokuyimfuneko zenzeka kwiimeko phambi eyaneleyo ioksijini lwalusanda, nto leyo unikelwa noko erythrocytes inflowing igazi.

Ukunciphisa umsebenzi okanye kumiwe kwenxalenye yokusebenza izigaba omnye okanye ngaphezulu impulsatora inkqubo kumosha iiseli umsebenzi peysmekerskih ekuvunyelwene, ebangela arrhythmia. Uvimba omnye iinkqubo zale nkqubo kubangela zokuma ngequbuliso. Ukuqonda ukuba automatism enjalo entliziyweni, uyakwazi ukuqonda kunye nenkqubo.

Ifuthe le nkqubo yawo nervous ukuya umsipha

Ukongezelela ikhono lawo ukwenza ngamaza ombane, umsebenzi intliziyo kulawulwa imiyalezo evela isihlunu innervating luvo enovelwano yaye parasympathetic, ekungaphumelelini okuya kuthi kuphazamisane ukuzenzekela intliziyo.

Ifuthe ngokwahlulwa onovelwano ikhawulezisa entliziyweni, kuba nomphumela ekhuthazayo. innervation onovelwano uba chronotropic, inotropic, isiphumo emihle dromotropic.

Phantsi isenzo olukhoyo nkqubo parasympathetic luvo , iiseli peysmekerskih deceleration depolarization (isenzo inhibitory), yaye ngenxa yoko linyuke kakhulu izinga kwentliziyo (negative intshukumo chronotropic), kukuhla conductivity ngaphakathi entliziyweni (nefuthe elibi dromotropic), ukuhla iSystolic eneji nokuhla (nefuthe elibi inotropic), kodwa excitability lokuwandisa entliziyweni (isenzo batmotroponoe positive). Oku kungasentla kwakhona lithathwe njengendlela kophulwa umsebenzi ukuzenzekela intliziyo.

Izinto ezibangela automatism intliziyo

1. ischemia engabalulekanga.
2. Komtshiso oko.
3. Ukunxila.
4. Ukuhlukunyezwa balance sodium, potassium, nemagnesium, calcium.
5. kwekhono hormone.
6. Ukophulwa ifuthe neziphelo lokuzimela novelwano kunye parasympathetic.

Iintlobo arrhythmias ngenxa sanctions ukuzenzekela intliziyo

1. Sinus tachy-kunye bradycardia.
2. Uphefumla (omdala) arrhythmia.
3. arrhythmia Extrasystole (sinus, atrial, atrioventricular, ventricular).
4. tachycardia Paroxysmal.

Ukwahlula arrhythmia ngenxa ukuya kwizigulo Uhanjiso ukuzenzekela kunye reentry ukwenza amaza (reentry wave) kwelinye okanye ngaphezulu ezithile iindawo intliziyo, isiphumo siya kuba fibrillation okanye enomoya atrial.

fibrillation Ventricular - enye arrhythmias ezininzi ezisongela ubomi, nto leyo ngenxa ukubanjwa ngesiquphe ezesifuba nokufa. Eyona ndlela isebenzayo yokuba unyango - defibrillation zombane.

isiphelo

Ngoko ngazo, yintoni na automatism wentliziyo, bayakuqonda oko ukunyhashwa zinokwenzeka xa ugula. Oku, yenza kube lula ukulwa iindlela esi sifo ngcono ngempumelelo ngakumbi.