Mmene Magetsi Amagwirira Ntchito ndi Mmene Mtima Umagwirira

Mphamvu yamagetsi ya mtima ndi yofunika kwambiri ku ntchito ya mtima. Mphamvu yamagetsi imayesa kuthamanga kwa mtima (momwe mtima ukugunda), komanso umagwirizanitsa ndikukonza kugunda kwa minofu ya mtima, kuti mtima ugwire bwino ndi kumenya mtima.

Kuwonongeka kwa kayendedwe ka magetsi kumabweretsa mavuto ndi kuthamanga kwa mtima (mofulumira kapena pang'onopang'ono), kapena kukhoza kusokoneza mmene thupi limagwirira ntchito - ngakhale minofu ndi miyendo ya mtima ili yachibadwa.

Kuyankhula za magetsi a mtima wamagetsi ndi zizolowezi zosasangalatsa za mtima kungakhale zosokoneza kwambiri. Tikamayankhula za matenda a mtima, anthu ambiri amaganiza za mitsempha yowonongeka yomwe ingabweretse matenda a mtima kapena kufunika kwa opaleshoni yopitirira. Komabe, mavuto ndi magetsi akhoza kuchitika ngakhale ngati minofu ya mtima ndi yachibadwa.

Ndizothandiza kufotokoza mtima wanu ngati nyumba, ndi magetsi anu a magetsi monga waya wonyumba m'nyumba mwanu. Mwina mungakhale ndi mavuto ndi makina a nyumba yanu ngakhale nyumba yanu ngati dongosolo ndi yachilendo. Chimodzimodzinso, mtima wanu ukhoza kukhala wabwino koma vuto la magetsi lingabweretse vuto la mtima wosadziwika.

Matenda a mtima angayambitse kuwonongeka kwa magetsi a mtima wanu, monga momwe nyumba yowonongeka mu chimphepo kapena kusefukira kwa madzi kungakhale ndi mavuto ndi magetsi. Ndipotu, kuwonongeka kwa magetsi pamtima nthawi zambiri kumayambitsa imfa mwadzidzidzi ndi matenda a mtima, ngakhale kuwonongeka kwa mtima kumene kumayambitsa matenda ndi mtima wofatsa kapena wochepa. Ichi ndi chimodzi mwa zifukwa zomwe zimachititsa kuti CPR ikhale ndi mwayi wokhala ndi mwayi wopeza zofooka. Ngati mtima wamtima ukhoza kubwezeretsedwa, zina mwazirombozi (ndi zina zomwe zimayambitsa arrhythmias) zimatha kupulumuka.

Tiyeni tiwone momwe magetsi a magetsi amagwirira ntchito kuti mtima wanu uzimenya, komanso matenda omwe angakhudze kupsa kwanu.

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Kuyamba kwa Chizindikiro Chakumagetsi cha Magetsi

Mtima umapanga chizindikiro cha magetsi (chomwe chimatchedwanso magetsi), chomwe chingalembedwe mwa kuika electrode pachifuwa. Izi zimatchedwa electrocardiogram (ECG, kapena EKG).

Mbali yamagetsi ya mtima imayendetsa kugunda kwa mtima m'njira ziwiri. Choyamba, popeza kuganiza kwa magetsi kumapangitsa kuti mtima umodzi ukhalepo, chiwerengero cha zida zamagetsi chimayesa kugunda kwa mtima . Ndipo chachiwiri, ngati chizindikiro cha magetsi "chikufalikira" pamtima, chimayambitsa minofu ya mtima kuti igwirizane motsatira ndondomeko yoyenera, motero kugwirizanitsa chikho cha mtima ndi kutsimikizira kuti mtima umagwira ntchito moyenera.

Chizindikiro cha magetsi chimapangidwa ndi kanyumba kakang'ono kamene kamadziwika kuti node ya sinus , yomwe ili kumtunda wapamwamba wa atrium yoyenera. (Kutengera kwa zipinda zamtima ndi ma valve kumaphatikizapo ma atria awiri pamwamba pa mtima ndi zitsulo ziwiri pansi),

Kuchokera ku nthenda ya sinus, chizindikiro cha magetsi chikufalikira pa atrium yoyenerera komanso kumanzere kumbali (kumbali ziwiri zapamtima), zomwe zimachititsa kuti atria agwirizane, ndi kukankhira magazi awo muzitsulo zoyenera ndi za kumanzere (pansi pawiri zipinda za mtima). Chizindikiro cha magetsi chimadutsamo kachilombo ka AV kupita ku zinyama, komwe zimayambitsa zitsulo zamagetsi.

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Zomwe Zimayambitsa Magetsi a Magetsi

Chithunzi 1: Zomwe zimagwiritsidwa ntchito pamagetsi a mtima kuphatikizapo node ya sinus (SN) ndi node ya atrioventricular (AV node) ikuwonetsedwa pano. Kuchokera pamagetsi, mtima ukhoza kuganiziridwa ngati wopatulidwa m'magawo awiri: a atria (zipinda zam'mwamba), ndi zinyumba zam'munsi (zipinda zam'munsi). Kusiyana kwa atria kuchokera ku ventricles ndi "disc" ya fibrous. Disi iyi (yotchedwa AV disk mu chiwerengero), imalepheretsa kayendedwe ka magetsi pakati pa atria ndi ventricles. Njira yokha yomwe chizindikirocho chingatenge kuchokera ku atria kupita ku ventricles ndi kudzera muzithunzi za AV. M'chiwerengero ichi:

• SN = nambala ya sinus
• AVN = AV nambala
• RA = atrium yolondola
• LA = atrium wotsalira
• RV = kayendedwe kolondola
• LV = chimbudzi chotsalira
• TV = ma valve (valve yomwe imasiyanitsa maulendo oyenera kuchokera ku ventricle yoyenera)
• MV = valve valve (valve yomwe imalekanitsa mbali ya kumanzere ya atrium kuchokera kumanzere ventricle)

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Chizindikiro Chakumagetsi Chakumagetsi Chimafalikira Ponse pa Atria

Chithunzi 2: Kuchita magetsi kumachokera mu mfundo ya sinus. Kuchokera kumeneko, imafalikira ponseponse pena (yomwe imasonyezedwa ndi mizere ya buluu yomwe ili pachithunzi), kuchititsa kuti atria agwirizane. Izi zimatchulidwa kuti "kuperewera kwa chiwindi."

Pamene mphamvu ya magetsi imadutsa pa atria, imapanga mawonekedwe omwe amatchedwa "P" pa ECG. (P wave ikusonyezedwa ndi mzere wofiira wolimba pa ECG kuchokera kumanzere).

Sinus bradycardia ("wolimba mtima" amatanthawuza pang'onopang'ono) ndilo chifukwa chofala kwambiri cha mtima wamtima, ndipo chimayambitsidwa ndi kuwombera kwazithunzi za SA pang'onopang'ono. Sinus tachycardia ("chizoloŵezi" amatanthawuza mofulumira) imatanthawuza kuthamanga kwa mtima mofulumira ndipo ingayambidwe ndi kuwombera kwachidziwitso kwa SA kuwonjezeka kwa mlingo.

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Chizindikiro Chakumagetsi cha Cardiac Chifikira Node ya AV

Chithunzi 3: Pamene magetsi akufika pamtundu wa AV, imayimitsidwa, kupatula pa vesi la AV. Chikoka chimayenda kudzera muzithunzi za AV pang'onopang'ono. Mzere wofiira wolimba pa ECG mu chiwerengerochi ukuwonetsera nthawi ya PR.

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Chizindikiro cha Magetsi cha Cardiac Chimalowera ku Ventricles

Chithunzi 4: Njira yapadera yopangira AV ili ndi kachilombo ka AV (AVN), "Mtolo wake," ndi nthambi zowongoka ndi zamanzere (RBB ndi LBB). Nkhungu ya AV imayendetsa magetsi pang'onopang'ono ndipo imaipititsa ku mtolo wake (wotchulidwa "wake"). Mtolo Wake umalowetsa AV disk, ndipo umapereka chizindikiro ku nthambi zowongoka ndi zamanzere. Nthambi zamanja ndi zamanzere pamatumba, zimatumizira magetsi kumagulu abwino ndi kumanzere. (Chiwerengerocho chikuwonetsanso kuti LBB imadzigawanika kumbali yakumanzere ya fascicle (LAF) ndi kumbuyo kotsika kwambiri (LPF).

Chifukwa chakuti amayendayenda pang'onopang'ono kudutsa muzithunzi za AV, pali pause mu ntchito yamagetsi pa ECG, yotchedwa nthawi ya PR. (Nthawi ya PR ikuwonetsedwa pa ECG pa Chithunzi 3). "Pause "yi muchitetezo amalola kuti atria agwirizane bwino, kutaya magazi awo muzitsulo zam'mimba zisanayambe kugwira ntchito.

Mavuto paliponse pamsewu uwu kuchokera ku vutolo la AV angayambitse zovuta mu ECG (ndi mtima wamtima).

Vuto la AV ( mtima block ) ndi chimodzi mwa zifukwa ziwiri zomwe zimayambitsa mtima wamtima (bradycardia). Pali madigiri osiyana, ndi bolodi la mtima wachitatu kwambiri ndipo nthawi zambiri amafuna pacemaker.

Bungwe la ubongo limapezeka mu nthambi yamagulu kapena nthambi yamanzere, ndi omwe ali mu nthambi yotsalira yachitsamba nthawi zambiri. Maofesi a nthambi amatha kupezeka popanda chifukwa chomveka, koma nthawi zambiri zimachitika pamene mtima uwonongeka chifukwa cha matenda a mtima kapena matenda ena. Ndipotu, nthambi yamanzere yochokera ku matenda a mtima ndi chifukwa chofunikira cha imfa ya modzidzimutsa.

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Chizindikiro Chakumagetsi cha Cardiac Chifalikira Ponse pa Ventricles

Chithunzi chachisanu: Chiwerengerochi chikuwonetsa kugwedeza kwa magetsi kukufalikira mu ma ventricles abwino ndi kumanzere, kuchititsa zipindazi kuti zigwirizane. Pamene chizindikiro chogwiritsira ntchito magetsi chimayendayenda m'makinawa, chimapanga "QRS complex" pa ECG. Makompyuta a QRS amawonetsedwa ndi mzere wofiira wolimba pa ECG pansipa.

Momwemonso, magetsi a mtima amachititsa kuti minofu ya mtima ikhale yogwirizana ndi kutumiza magazi ku ziwalo zonse za thupi (kudzera kumapeto kwa ventricle) kapena kumapapo (kudzera mwa ventricle yoyenera).

Mfundo Yofunika Kwambiri pa Magetsi a Magetsi ndi Ntchito Yamtima

Kuchokera pakuyambika kwa kugunda kwa mtima mu chipangizo cha SA, kupyolera mu zitsulo, mphamvu yamagetsi ya mtima imayambitsa mtima kugwirizanitsa, ndikupangitsa kuti mtima ukugwire bwino.

> Zotsatira:

> Crawford MH, Bernstein SJ, Deedwania PC, ndi al. Mauthenga Otsatira / Okhazikitsa Ma Electrocardiography Ambulatory: Summary Executive and Recommendations. Lipoti la American College Of Cardiology / American Heart Association Task Force On Practice Guidelines (Komiti Yowonongeka Malangizo Othandizira Ma Electrocardiography). Kuyendayenda 1999; 100: 886.

> Fogoros RN, Mandrola JM. Kusokonezeka kwa Mtima Wachikhalidwe: Mfundo Zenizeni. Mu: Fogoros 'Electrophysiologic Testing. Wiley Blackwell, 2017.