anatomi fisiologi sirkulasi fetus bayi dan dewasa 2013

8/19/2019 Anatomi Fisiologi Sirkulasi Fetus Bayi Dan Dewasa 2013

1/23

ANATOMI FISIOLOGISIRKULASIFETUS, BAYI & DEWASA

Rahmatina B. Herman

Baian Fi!i"#"iFa$%#ta! Ke"$teran Uni'er!ita!Ana#a!


2/23

Feta# (ir)%#ati"n

Di*er! +r"m the "!tnata# -a+terirth/ )ir)%#ati"n, e)a%!e

L%n!, $ine0!, an

a!tr"inte!tina# tra)t aren"n+%n)ti"na#

O1 an n%trient! are eri'e +r"mmaterna# #""

(O1 an 2a!te! are e#iminate int"

materna# #""


3/23

3#a)enta

i! the 4+eta# #%n5H"2e'er )e##%#ar #a0er! )"'erin the'i##i are thi)$er an #e!! ermea#e

than the a#'e"#ar memrane! in the#%n! an e6)hane i! m%)h #e!!e7)ient

i! a#!" the r"%te 0 2hi)h a##n%triti'e materia#! enter the +et%!

an 2a!te! are i!)hare t" the

materna# #""


4/23


5/23

Arranement "+ Feta# (ir)%#ati"n

88 9 "+ +eta# (O3 "e! thr"%h #a)enta

B#"" in %mi#i)a# 'ein : ;< 9 !at%rate2ith O1 -in arteria# )ir)%#ati"n "+ a%#t= :

>; 9 /D%)t%! 'en"!%! i'ert! !"me "+ the #""ire)t#0 t" In+eri"r ?ena (a'a -I?(/anremainer! mi6e! 2ith "rta# #""

@ I?( #"" i! : 9 !at%rate 2ith O1

@ 3"rta# an !0!temi) 'en"%! #"" i!"n#0 : 1 9 !at%rate 2ith O1


6/23

C.Arranement "+ Feta#(ir)%#ati"n

M"!t "+ the #"" enterin heart thr"%hI?( i! i'erte ire)t#0 t" #e+t atri%m 'ia+"ramen "'a#e #e+t 'entri)#e

M"!t "+ #"" +r"m S?( enter! riht'entri)#e an i! e6e##e int" %#m"nar0arter0

Re!i!tan)e "+ )"##a!e #%n! i! 'er0 hih

3re!!%re in %#m"nar0 arter0 a"rta

M"!t "+ the #"" +r"m %#m"nar0 arter0a!!e! int" a"rta 'ia %)t%! arteri"!%!


7/23

C.Arranement "+ Feta#(ir)%#ati"n

In thi! +a!hi"n=

Re#ati'e#0 %n!at%rate #"" +r"m riht'entri)#e i! i'erte int" tr%n$ an #"2er

"0The hea "+ +et%! re)ei'e! the etter@"60enate #"" +r"m the #e+t 'entri)#e

Fr"m a"rta, !"me "+ #"" i! %me int"

the %mi#i)a# arterie! an a)$ t" #a)entaO1 !at%rati"n "+ the #"" in #"2er a"rtaan %mi#i)a# arterie! i! : < 9 !at%rate2ith O1


8/23


9/23


10/23


11/23

Feta# Re!irati"n

Ti!!%e! "+ +eta# an ne2"rn mamma#!ha'e a remar$@a#e %t ""r#0%ner!t"" re!i!tan)e t" h0"6ia

O1 !at%rati"n "+ materna# #"" in#a)enta i! !" #"2 that the +et%! miht!%*er h0"6i) amae i+ +eta# re )e##!i n"t ha'e a reater O1 a7nit0 than

a%#tFeta# re )e##! )"ntain +eta# H -H F/ 2hi#e a%#t re )e##! )"ntain a%#t H-H A/


12/23

C..Feta# Re!irati"n

The +eta# "60hem"#"in i!!")iati"n)%r'e i! !hi+te t" the #e+t at e%a#re!!%re "+ O1, +eta# #"" )arrie!

!ini)ant#0 m"re O1 than "e!materna#

In ear#0 +eta# #i+e, the hih )aria)#0)"en #e'e#! that re'ai# ma0 r"te)tthe heart +r"m a)%te eri"! "+ h0"6ia

The #0)"en #e'e#! e)rea!e in the #ate+eta# #i+e an rea)h a%#t #e'e#! 0 term


13/23

Umi#i)a# ?e!!e#!

Umi#i)a# 'e!!e#! ha'e thi)$ m%!)%#ar 2a##!2ith a m%!)%#ar !hin)ter

Hem"rrhae "+ the ne2"rn i! re'ente 0)"n!tri)ti"n "+ the %mi#i)a# 'e!!e#!, e)a%!e

the0 are 'er0 rea)ti'e t" tra%ma,!0math"mimeti) amine!, ra0$inin,ani"ten!in, an )hane! in 3O1

(#"!%re "+ the %mi#i)a# 'e!!e#! in)rea!e! the

t"ta# erihera# re!i!tan)e an the #""re!!%re

When #"" "2 )ea!e! thr"%h the %mi#i)a#'e!!e#!, the %)t%! 'en"!%! )#"!e! -the e'entthat )#"!e! "+ %)t%! 'en"!%! i! !ti## %n$n"2n/


14/23

(hane! inFeta# (ir)%#ati"n & Re!irati"n at Birth

At irth, #a)enta# )ir)%#ati"n i! )%t"* an erihera# re!i!tan)e!%en#0 ri!e!

3re!!%re in a"rta ri!e! %nti# in%#m"nar0 arter0

Be)a%!e "+ #a)enta# )ir)%#ati"n ha!

een )%t "*, the in+ant e)"me!in)rea!in#0 a!h06ia# an )""#in "+the "0 a)ti'ate! re!irat"r0)enter

Fina##0, in+ant a!! !e'era# time!an the #%n! e6an 'a!)%#arre!i!tan)e e)rea!e t" : J<

Mar$e#0 neati'e intra#e%ra#

re!!%re -@< t" @8< mmH/ %rin


15/23

C..(hane! inFeta# (ir)%#ati"n & Re!irati"n at Birth

The !%)$in a)ti"n "+ the r!t reath #%!)"n!tri)ti"n %mi#i)a# 'ein !%eee!


16/23


The #e+t atri%m re!!%re i! rai!e I?( anriht atri%m 0=

.The e)rea!e in %#m"nar0 re!i!tan)e #are "2 "+ #"" thr"%h the #%n! t" the

#e+t atri%m1.The re%)ti"n "+ "2 t" the riht atri%m "))#%!i"n "+ the %mi#i)a# 'ein

.The in)rea!e re!i!tan)e t" #e+t 'entri)#e

"%t%t "))#%!i"n "+ the %mi#i)a# arterie!

Ar%t#0 )#"!e! the 'a#'e "'er the +"ramen"'a#e

The !eta# #eaet! +%!e "'er !e'era# a0!


17/23


The e)rea!e in %#m"nar0 'a!)%#arre!i!tan)e

the re!!%re in the %#m"nar0 arter0 +a## t": P -t" : 8 mmH/

The !#iht in)rea!e in a"rti) re!!%re re'er!e! the #"" "2 thr"%h the %)t%!arteri"!%! -DA/

The #are %)t%! arteri"!%! ein t" )"n!tri)t

Mani+e!te a! a m%rm%r in the ne2"rn,e)a%!e "+ t%r%#ent "2


18/23


D%)t%! arteri"!%! )"n!tri)t! 2ithin a +e2 h"%r!a+ter irth, r"%)in +%n)ti"na# )#"!%re, anermanent anat"mi) )#"!%re +"##"2! in the ne6t 1Q@Q; h"%r! %e t" e6ten!i'e intima# thi)$enin

Me)hani!m r"%)in the initia# )"n!tri)ti"n i! n"t

)"m#ete#0 %ner!t"", %t the in)rea!e in arteria#O1 ten!i"n #a0! an im"rtant r"#e a! +"##"2!=. The hih O1 ten!i"n "+ the arteria# #"" that a!!e!thr"%h the DA1. The %#m"nar0 'enti#ati"n 2ith O1 that )#"!e! the

DA.?enti#ati"n 2ith air #"2 in O1 "en! thi! !h%nt 'e!!e#

Whether O1 a)t! ire)t#0 "n the DA, "r thr"%h there#ea!e "+ a 'a!")"n!tri)t"r !%!tan)e i! n"t $n"2n


19/23


Re#ati'e#0 hih )"n)entrati"n! "+'a!"i#at"r! -e!e)ia##0

r"!ta#anin/ are re!ent in the DA

S0nthe!i! "+ the r"!ta#anin i!

+a)i#itate 0 )0)#""60ena!e at irth

In man0 remat%re in+ant! the %)t%!

+ai#! t" )#"!e !"ntane"%!#0, %t

)#"!%re )an e r"%)e 0 in+%!i"n

"+ r%! that inhiit )0)#""60ena!e


20/23


21/23


22/23

The Wa##! "+ (ari"'a!)%#ar S0!tem

At irth=@ The 2a##! "+ the t2" 'entri)#e! are

ar"6imate#0 "+ the !ame thi)$ne!!, 2ith a

"!!i#0 !#iht re"neran)e "+ the R?

@ The m%!)#e #a0er "+ the 3A i! thi)$, 2hi)h i!art#0 re!"n!i#e +"r the hih %#m"nar0

'a!)%#ar re!i!tan)e "+ the +et%!

A+ter irth=

@ The thi)$ne!! "+ the R? an 3A 2a##!imini!he!

@ The L? 2a##! e)"me thi)$er

The!e )hane! are r"re!!i'e "'er a eri"

"+ 2ee$! a+ter irth


23/23

han$ Y"

anatomi fisiologi sirkulasi fetus bayi dan dewasa 2013

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