新版备课绪论到消化.ppt

第四部分 器官循环 一.冠脉循环 1.解剖特点 2.血流量为心输出量5％（80ml）100克/心肌/分，运动时增加5倍或更多。 3.左心血流特点及意义 4.血流调节特点 思考：1.增加左心供血的主要因素及临床。 2.心脏（尤以左心室）在一个心动周期中的机械活动、代谢和自身供血三者间的关系。 The pressure rises during cardiac systole and falls during diastole. The peak pressure value reached during systole is termed as the systolic pressure, while the minimum pressure value reached during diastole is termed as the diastolic pressure. The difference between the systolic and diastolic pressure is called the pulse pressure. The mean of the pressure value during the entire cardiac cycle is called the mean arterial pressure. Mean arterial pressure equals the product of cardiac output and total peripheral resistance. Mean arterial pressure can be estimated as diastolic pressure plus 1/3 pulse pressure. BP can be affected by the stroke volume of the left ventricle, heart rate ,peripheral resistance, elasticity of the large vessel walls and the quantity of blood in the circulation. 讨论：1.大动脉弹性扩张和回缩的作用，随年龄增大有何变化？ 2.用三因素思维模式，动态阐述BV、D和PR在血压形成中的相互作用。 课后讨论： １．血压过高或过低对机体功能的影响。　 ２．影响动脉血压的因素（提示：心血管、神经（包括社会、精神和心理因素）和体液调节、其他系统器官的疾病等）。 ３．面对一个血压异常的病人，你如何从众多因素中抓住主要矛盾进行及时和准确的处理？ 二、微循环 1.Microcirculation 的概念 2.组成 3.功能（三条通路的功能） 思考：机体失血后对微循环可能产生哪些影响？ 三.组织液的生成和回流 （一）概念 （二）机制--提示： 1.生成的动力和阻力的分析 2.有效滤过压（滤过的力和重吸收力之差为生成组织液的有效滤过压，effective filtration pressure,EFP）及其形成机制 3.组织液的生成和回流及平衡（根据下图思考EFP公式及结果） （三）影响因素 根据组织液生成和回流的机制进行分析。 思考主要矛盾。 思考：体内水肿可在哪些病理状态下发生？为什么？ The formation of interstitial fluid is determined by the effective filtration pressure （EFP）. EFP consists of the capillary pressure, the interstitial fluid pressure, the plasma colloid osmotic pressure and the interstitial fluid colloid osmotic pressure. Filtration from plasma to interstitial fluid is favored by the hydrostatic pressure difference between the capillary and the interstitial fluid. Absorption from interstitial fluid to plasma is favored by the plasma protein concentration difference between the plasma