- •27. Pathophysiology of heart.
- •27.1. What is insufficiency of circulation of the blood?
- •27.2 What is result of the insufficiency of circulation of the blood for organs, tissues and organism in whole?
- •27.3 What is cardiac insufficiency?
- •27.4 What is the classification of cardiac insufficiency?
- •27.5 Give short characteristic of different pathogenic variants of cardiac insufficiency.
- •27.6. What types of heart’s overloading can cause the development of cardiac insufficiency?
- •27.7. What mechanisms can provide the compensation of heart during the effect of the increased leading on it?
- •27.8. What is the essence of the heterometric mechanism of the compensation of the heart?
- •27.9. What is the essence of the homeometric mechanism of the compensation of the heart?
- •27.10. What is the essence of the chronoinotropic mechanism of the compensation of the heart?
- •27.11. What is the roll of catecholamines in the realization of mechanisms of urgent compensation of the heart?
- •27.12. Name the variants of prolonged adaptation of the heart to the effect of ladings.
- •27.13. What mechanism lay on the base of development of the heart’s hypertrophy?
- •Hypertrophy
- •27.14. What phases can be distinguished in the process of development of compensatory hypertrophy of the heart? Give their characteristics.
- •27.14 What strategy allocate during development compensatory hypertrophies of heart? Give their characteristic.
- •27.15 What features of the hypertrophied heart are the precondition of its development of decompensation?
- •27.16. What can cause the development of the myocardial insufficiency of heart?
- •27.17. What is hearts arhythmy? How does they classified?
- •27.18. What arhythmias of heart can be a result of infringement of function of automatism?
- •27.19 What reasons and mechanisms of development of a sinus tachycardia and bradycardia?
27.16. What can cause the development of the myocardial insufficiency of heart?
Myocardial insufficiency of heart develops owing to primary defeats of a myocardium. As the myocardium consists of two types of muscular tissues - atypical, making spending system of heart, and constrict cells of a working myocardium - that development of insufficiency of heart can be connected with damage both the first, and the second. From here, it is possible to allocate two variants myocardial insufficiency of heart:
a) Caused by defeat of spending system of heart - arhythmical.
b) Caused by damage of a working myocardium. Sometimes it name (pathology of myocardium) myocardiopathological.
27.17. What is hearts arhythmy? How does they classified?
Heart’s arhythmy name infringements of frequency, a rhythm, a coordination and sequence of its reductions. Development of arithmy can be connected with infringements of the basic functions of spending system of heart: automatism, excitability and conductivity. Classification is based on it arhythmy according to its allocation:
1. Arhythmias, caused by infringements of automatism.
2. Arhythmias, the excitabilities connected with infringement.
3. Arhythmias, connected with infringements of conductivity.
4. Arhythmias, the excitabilities connected with infringements and conductivity
27.18. What arhythmias of heart can be a result of infringement of function of automatism?
Two groups of arhythmias, connected with infringement of automatism of heart
1. Nomothopical arhythmias. Generation of impulses to reduction, as well as in norm, occurs in sinus- auricle node. To this group concern:
a) Sinus tachycardia - increase in frequency of intimate reductions;
b) Sinus bradycardia - reduction of frequency of intimate reductions;
c) Sinus (respiratory) arhythia - change of frequency of intimate reductions in different phases of a respiratory cycle (increase at a breath and decrease at an exhalation).
2. Heterothopical arhythmia - a syndrome of weakness sinus-auricle node. Generation of impulses to reduction occurs not in sinus-auricle node, and in other structures of the spending system, being drivers of rhythm 1 and 2 orders. The syndrome develops as a result of reduction of activity or the decreasing of activity of sinus-auricle node at damage of activity sinus-auricle node at damage of its cells or primary functional infringements
Thus following kinds of pathological rhythms of heart can develop:
auricular a slow rhythm - the driver of a rhythm is in structures of the left auricle, frequency of intimate reductions is less 10 1 minute;
atrioventricular rhythm - a source of impulses are drivers of a rhythm 2 orders (the top, average or bottom part аtrioventricular node), frequency of intimate reductions depending on a place of generation of impulses decreases from 70 up to 40 1 minute
idioventricular rhythm - generation of impulses occurs in drivers of a rhythm 3 orders (Gis’s bunch or its legs), frequency of reductions of heart is less 40 1 minute