Ke automatism ba pelo ke efe? Cardiac automaticity

ke seo automatism ba pelo? The karabo ea potso ena e leng sehloohong se ka tlaase mona. Ho phaella moo, ho na le tlhahisoleseding e mabapi le ditlolo tsa litla bophelo batho amanang le khopolo boletsoeng ka holimo.

ke automatism ba pelo ke efe?

Muscle likhoele ka batho ba na le matla a ho itšoara ho phokotsong ea pulse length tena ebe sequentially fetisetsa ho pholletsa le phokotseho ya sebopeho mesifa. E bontšitse hore ho ka thōko pelo mesifa ea ka khonang ho le nosi hlahisa thabo le ho etsa pelehi morethetho. Bokhoni bona bo bitsoa automatism pelo.

Lisosa tsa automaticity cardiac

Utloisisa seo ke automatism ba pelo, ho ka ba ho tloha tse latelang. Pelo o na le bokhoni bo itseng ho hlahisa e pulse length motlakase, lateloa ke tšoere ka ho fihlela ho mehaho e mesifa.

Sinoatrial noute - lesihla peysmekerskih lisele tse mofuta pele (e nang le ba ka bang 40% mitochondria loosely teng myofibrils, ha ho na T-tsamaiso e khopo kenyelletsa ditokiseletso palo e khōlō ea mahala k'halsiamo e hampe ntshetswa pele sarcoplasmic marangrang) sebakeng leboteng tokelo ea ba phahameng vena cava, ka confluence ea atrium nepahetseng .

E fetang atrioventricular noute tsa mofuta oa bobeli Ho thehoa ke lisele tsa tsamaisa litakatso tsa ho tloha noute sinoatrial, empa tlas'a maemo a khethehileng a ka nosi hlahisa e qoso motlakase. lisele tse phetoho na mitochondria fokolang (20-30%) le myofibrils batla kholoanyane ho feta a pele a ka cell odara. Atrioventricular noute teng ka interatrial septum hodima yona e isoa nyakallo toloki le maoto a sosobaneng ea lekala le literata (mitochondria na 20-15%).

Purkinje likhoele tse sethaleng latelang fetiswa ha nyakallo. Ba eketsa ka bang ka, partitions bohareng le e mong le ba tse peli le literata sosobaneng lekala. lisele tse tsena li na mitochondria ka 10%, structurally ho feta ho feta a tšoanang le likhoele mesifa cardiac.

Ponahalo itlelang feela ya pulse length motlakase le hlaha ka lisele tse peysmekerskih sinoatrial noute, eo potentiates tsokoang nyakallo Stimulating otla 60-80 ka motsotso. O ke mokhanni ea pele-e le hore. Ebe ho ile ha hlaha e tsokoang e fetisoa ho la bobeli le la boraro conductive boemo ba sebopeho. Ba kgona ho jara bobeli sa nyakallo wavelength le nosi susumelletsa phokotso ya maqhubu a ka tlaase. Mokhanni ea boemo ba bobeli ka mor'a noute sinus atrioventricular, eo e khone ho bopa tsa bona 40-50 metsotso e lutla ka ho ba sieo ha mosebetsi inhibitory ya noutu sinus. Ho feta moo, nyakallo e fetisoa ho sebopeho sa ea sosobaneng ea Hae, eo reproduces otla 30-40 ka motsotso, joale tefello motlakase phallang ho sosobana maoto hae (25-30 cpm) le tsamaiso Purkinje faeba (20 linaoa ka motsotso) le kena ho sebetsa liseleng tse mesifa ea myocardium ho .

Ka tloaelo ho litakatso tsa ho tloha sinoatrial noute bokhoni ba ikemetseng ho thibela tšebetso ea motlakase oa mehaho e ipatileng. Haeba tšoenngoa ho sebetsa ha taelo ea pele ea mokhanni e, mosebetsi oa hae ka maqhama ipheng-a eme mona ka tlase tsamaiso conduction.

dithulaganyo lik'hemik'hale tse fanang ka pelo automaticity

ke automatism ba pelo ya ka dipehelo tsa k'hemistri eng? Boemong ba limolek'hule, motheo oa ho ketsahalo e ikemetseng ho tefo ea motlakase (sa bohato 'nang) ka lera le peysmekerskih lisele tse ke ho ba teng ha seo ho thoeng ke impulsatora. mosebetsi oa hae (pelo mosebetsi automatism) e na le mekhahlelo e meraro.

Mekhahlelo ea impulsatora:

• 1st mohato tsa go baakanyetsa (superoxide ke sebelisana oksijene le phospholipids sebele qosoa ka lera seleng e holim'a peysmekerskoy e fumanang qoso mpe, ho fana ka le monyetla oa ho phomola);
• 2nd mohato potassium le sodium lipalangoang mafolofolo, e leng nakong eo qoso Link ea sele fetoha lekanang 30 MW;
• mohato 3rd qhoma motlakase ya - sebelisa eneji, le generated nakong botjha ha thepa ea mefuta e arabelang oksijene (oksijene ionized le peroxide hydrogen) sebelisa enzyme catalase le superoxide dismutase. Bakileng eneji, le quanta keketseho e biocapacity sethusapelo e le hore ao bo a bakang e ka 'nang bohato.

Tšebetso pulse length generating lisele tse - swallow hakaalo etsahala maemo ho ba teng ha ka ho lekaneng oksijene ea limolek'hule, o ile a fana tlhokeng erythrocytes inflowing mali.

Fokotsa mosebetsi kapa leeme cessation ea tšebetso ea mekhahlelo e 'ngoe kapa ho feta impulsatora oona tsamaisong tlōla o ile a lumela le ka liseleng tsa mosebetsi peysmekerskih, a etsa hore arrhythmia. Thibela e mong oa le thulaganyo a tsamaiso ena e etsa hore ka tšohanyetso cardiac tšoaroa. Hlokomela hore automatism joalo ba pelo, ka utloisisa le tshebetso.

Sephetho sa ho tsamaiso ea methapo autonomic ho mesifa pelo

Ho phaella ho bokhoni ba bona ba itefeletseng ho hlahisa litakatso tsa motlakase, mosebetsi oa pelo e laoloa ke matšoao tloha mosifa innervating le kutloelo-bohloko le parasympathetic methapo, ka ho hlōleha ha e ka 'na tsa fokodisa cardiac automaticity.

Sephetho sa karohano le kutloelo-bohloko lebelo ho fihlela pelo, e na le phello hlasimollang. Kutloelo-bohloko innervation na e ntle chronotropic, inotropic, dromotropic sebediswa.

Tlasa bohato atileng ea tsamaiso parasympathetic tšohile , deceleration depolarization lisele tse peysmekerskih (inhibitory bohato), 'me ka hona slowing ba otla ha pelo (mpe chronotropic bohato), le conductivity fokotseha ka hare botebong ba pelo (mpe dromotropic e le hantle), ea fokotseha ka eneji, le systolic khutsufatso (mpe inotropic e le hantle), empa ntlafatsoa excitability ba pelo (positive, batmotroponoe bohato). bobeli o boetse o nkiloe e le tlōlo ea cardiac automaticity mosebetsi.

Lisosa tsa pelo automatism

1. Myocardial ischemia.
2. Ho ruruha.
3. Botahoa.
4. Tlōlo ho leka-lekana sodium, potassium, magnesium, khalsiamo.
5. Hormonal ho se sebetse.
6. Tlōlo ea sephetho sa ikemetseng dipheletso le kutloelo-bohloko le parasympathetic.

Types of arrhythmias ka lebaka la ho tlōla ba automaticity ba pelo

1. Sinus tachy-le bradycardia.
2. Hema (mocha batho ba baholo) arrhythmia.
3. Extrasystole arrhythmia (sinus, atrial, atrioventricular, ventricular).
4. Paroxysmal tachycardia.

Khetholla arrhythmia ka lebaka la ho mafu a conduction automaticity le reentry ho theha maqhubu (reentry tsokoang) ho e 'ngoe kapa e itseng ho feta likarolo tse ling tsa pelo, le ka lebaka ke fibrillation kapa atrial flutter.

Ventricular fibrillation - e mong oa ka ho fetisisa arrhythmias behang bophelo kotsing, e leng ka lebaka la tšohanyetso cardiac tšoaroe le lefu. The mokhoa o atlehang ka ho fetisisa kalafo - motlakase defibrillation.

bofello

Kahoo nkoa, seo ke automatism ba pelo, ka utloisisa seo ditlolo lia khoneha tabeng ea ho kula. Sena, le eena, o etsa hore ho ka khoneha ho loanela mekhoa lefu lena le molemo le e atlehang haholoanyane.