Sie sind auf Seite 1von 63

ANATOMI KLINIK

KARDIOVASKULAR

Dian Mediana

1
Bahasan
• Letak jantung dalam rongga thorax
• Lapisan pembungkus dan dinding jantung
• Ruang jantung
• Katup jantung
• Sistem konduksi dan inervasi
• Vaskularisasi jantung
• Sirkulasi sistemik dan pulmonal
• Sistem vaskular
2
3
LOKASI DAN ORIENTASI DALAM
RONGGA THORAX

Jantung terletak dalam mediastinum media 4


LOKASI DAN ORIENTASI DALAM
RONGGA THORAX

5
6
LOKASI DAN ORIENTASI DALAM
RONGGA THORAX
4 titik batas jantung
• Kiri bawah: Apex cordis:
spatium intercostal V, 9 cm ke
kiri dari linea midsternalis
• Kanan bawah: articulatio
sternocostalis VI/VII kanan
• Kanan atas: cartilago costalis III
kanan, 1 cm lateral linea
sternalis kanan
• Kiri atas: tepi bawah cartilago
costalis II kiri, 2,5 cm lateral
linea sternalis kiri 7
LAPISAN PEMBUNGKUS dan
DINDING JANTUNG

8
LAPISAN PEMBUNGKUS dan
DINDING JANTUNG
• Perikardium
o fibrosa
o Serosa
- parietal
cavitas pericardii
- visceral = epikardium
• Miokardium
• Endokardium
• Persarafan pericardium oleh N. Phrenicus/C-VI
 Pada pericarditis  nyeri menjalar ke bahu kiri

9
RUANG JANTUNG
• 2 atrium dan 2 ventrikel
• Tebal dinding ventrikel > atrium
• Tebal dinding ventrikel kiri 2-3x > kanan
• Penebalan abnormal otot ventrikel = hipertrofi

10
11
12
13
14
KATUP JANTUNG
• Struktur katup: skeleton fibrosa = anulus
fibrosus
• Tempat melekatnya cuspis katup
• Mencegah overdilation valve opening
• Tempat melekatnya otot jantung pada atrium
dan ventrikel
• Memblok impuls elektrik dari atrium ke
ventrikel
15
16
17
18
19
Suara Jantung
• I: “Lub”
menutupnya katup AV,
terjadi pada permulaan
kontraksi ventrikel
• II: “Dup”
menutupnya katup
semilunaris, terjadi pada
akhir kontraksi ventrikel
• III: terdengar split/lemah
karena katup mitral
menutup lebih cepat
daripada tricuspid, pada
anak2 atau orang dg
hipertensi pulmonal 20
SISTEM KONDUKSI DAN INERVASI

21
Lokasi pemasangan elektroda pada dinding dada
• V1: ics 4 sternalis kanan
• V2: ics 4 sternalis kiri
• V3: pertengahan antara V2
dan V4
• V4: ics 5 midclavicularis
• V5: sejajar V4, linea axillaris
anterior
• V6: sejajar V5, linea axillaris
media

22
Inervasi
Kecepatan kontraksi
dipengaruhi juga oleh
kontrol saraf ekstrinsik:
serat sensorik visceral
• parasimpatis: n. Vagus,
leher dan thorax
• simpatis: ganglia cervicalis
dan thoracalis superior
23
VASKULARISASI JANTUNG

24
Arteri coronaria
26
27
28
29
30
31
32
33
34
35
Peripheral Vascular Disease
Peripheral artery disease
• PAD in the Legs
• Carotid (Neck) Artery Disease
• Renal (Kidney) Artery Disease
• Aortic Disease
Peripheral Vein Disease
• Deep Vein Thrombosis (blood clots in the deep veins of the
limbs) and Pulmonary Embolism (blood clots that travel to
the lungs)
• Chronic Vein Disease
Peripheral Artery Disease (PAD)

• PAD in the Legs


• Carotid (Neck) Artery Disease
• Renal (Kidney) Artery Disease
• Aortic Disease
PAD in the leg
• Atherosclerosis  tissues damage
• Men > women
• mild pain when walking (claudication)
• severe pain when walking relatively short
distances (intermittent claudication)
• pain while resting (rest pain), mostly in the
feet, increasing when the limb is raised
• biological tissue loss painful sores on the
toes or feet  dry, gray, or black sores 
gangrene
Carotid(Neck) Artery Disease

• Carotid artery atherosclerosis  plaque rupture  Thrombus 


Stroke
Kidney Artery Disease
Aortic aneurysm
• Atherosclerosis  the walls of the
aorta less flexible + inflammation
 weakening of the artery walls.
• Smoking + problems with the
artery lining + the force of blood
flowing through the aorta  a
breakdown of the aortic wall 
aneurysm.
Peripheral Vein Disease
• Deep Vein Thrombosis (blood clots in the deep veins of
the limbs) and Pulmonary Embolism (blood clots that
travel to the lungs)
• Chronic Vein Disease
Deep Vein Thrombosis (DVT)

• The formation of blood clots in the body's large veins,


usually in the lower leg or calf.
• Partially or completely block the vein
Deep Vein Thrombosis (DVT)
Risk Factors Triggers
• Obesity and overweight A " trigger" event causes the blood
clot to form.
• Smoking
• Major surgery
• Thrombophilia
• Trauma (especially fractures of
• Cancer
the pelvis, hip, or leg)
• Varicose veins
• An extended period of
Unique risk factors for women immobility, for example:
•Oral contraceptives – During a hospital stay
•Hormone replacement therapy (HRT) – In a nursing home
•Pregnancy
Deep Vein Thrombosis (DVT)

• DVT is often "silent"


• Swelling in one leg or along a vein in a
leg or arm
• Pain or tenderness in one limb (may
only appear when standing or walking)
• Warmth, redness, or discolored skin in
the affected leg or arm
• Unfortunately, the first sign of DVT is
often a life-threatening pulmonary
embolism
Pulmonary embolism
Chronic Venous Insufficiency (CVI)
• Outflow obstruction (intravascular thrombosis
(DVT) / extrinsic compression
• Superficial veins dilated  valve incompetence
in the deep or superficial veins
• The veins to bulge out and twist
Chronic Venous Insufficiency (CVI)
• No symptoms at first
• Swelling, pain, cramping, muscle fatigue,
and restless legs.
• telangiectasia (spider veins)
• skin discoloration
• inflammatory dermatitis
• recurrent or chronic cellulitis,
• Varicose veins
• Bleeding from varicose veins
• Recurrent thrombophlebitis
• Chronic non healing leg ulcers
• Grant’s Atlas of Anatomy
• Netter’s Clinnical Anatomy
• Human Anatomy Marieb

62
63