ʻAno a me ka Hana o ka Myocardium
ʻO ka myocardium, a i ʻole ka ʻiʻo puʻuwai, he ʻāpana koʻikoʻi ia o ka ʻōnaehana cardiovascular o ke kanaka. ʻO kāna hana nui ka pamu ʻana i ke koko ma ke kino holoʻokoʻa, kahi kuleana e koi ai i ka pono kiʻekiʻe a me ke ahonui, ʻoiai ʻo ka puʻuwai e hana mau ana i ke ola o ke kanaka. No ka hoʻomaopopo ʻana i kona mau paʻakikī, he mea nui ka noiʻi ʻana i kona ʻano a me kāna hana. E kūkākūkā kēia ʻatikala i ke anatomy, ke ʻano cellular, a me ka histology o ka myocardium, a me nā hana kumu a me ka physiology paʻakikī o kēia ʻiʻo puʻuwai.
ʻAnatomy a me ke ʻano o ka Myocardium
ʻEkolu papa nui o ka puʻuwai: ka endocardium (papa o loko), ka myocardium (papa waena, ʻo ia kā mākou mea nui), a me ka epicardium (papa o waho). ʻO ka myocardium ka papa mānoanoa i hoʻomalu ʻia e nā olonā ʻiʻo cardiac, a i ʻole nā cardiomyocytes.
Nā Cardiomyocytes
He ʻano kūikawā o nā ʻiʻo nā cardiomyocytes me nā hiʻohiʻona kū hoʻokahi e hiki ai iā lākou ke hana pono a hoʻomau me ka luhi ʻole. ʻO kekahi o nā hiʻohiʻona kūikawā o nā cardiomyocytes:
1. ʻĀkea a me ka lālā: He ʻano lōʻihi a lālā ko kēia mau pūnaewele, e ʻae ana iā lākou e pili kekahi i kekahi ma kahi pūnaewele paʻakikī.
2. Nuklea hoʻokahi a pālua paha: Loaʻa iā lākou hoʻokahi a ʻelua paha mau nuklea i kēlā me kēia cell.
3. Nā diski intercalary: ʻAe kēia mau ʻano i nā pilina ikaika ma waena o nā cell a me ka hoʻoili wikiwiki ʻana o nā impulses uila, he mea nui ia no ka hoʻonohonoho ʻana i nā ʻūlū puʻuwai.
4. Nui nā mitochondria: ʻAe i ka hana ATP kūpono e kākoʻo i ka hana hoʻoemi mau.
Nā Disc Intercalary a me nā Gap Junctions
He mau ʻano kūikawā nā diski intercalated i loaʻa wale i loko o nā pūnaewele ʻiʻo cardiac. Aia lākou i:
1. Desmosomes: Nā ʻano hana e hoʻopili ai i nā cell ma ke ʻano mechanical, e hāʻawi ana i ka ikaika a me ke kūpaʻa.
2. Nā Huina o ke Kaʻawale: Hāʻawi i kahi ala no ka hoʻoili ʻana o nā ion a me nā mole liʻiliʻi ma waena o nā cardiomyocytes, e ʻae ana i nā hōʻailona uila e laha koke a me ka hōʻoia ʻana i ka ʻūlū like ʻana o ka ʻiʻo puʻuwai.
Ka Hoʻopili ʻana o ke Alanui Myocardial
Hoʻolako maikaʻi ʻia ka myocardium me ke koko ma o nā aʻa coronary. Hōʻoia kēia pūnaewele coronary e loaʻa i nā cardiomyocytes kahi lako kūpono o ka oxygen a me nā meaʻai e kākoʻo i kā lākou hana mau. ʻO nā hoʻopilikia i ke kahe koko coronary, e like me ka hōʻeha puʻuwai (myocardial infarction), hiki ke hōʻeha nui i ka myocardial.
Hana o ka Myocardium
ʻO ka hana nui o ka myocardium ka ʻūmiʻi ʻana, ka mea e hiki ai i ka puʻuwai ke pamu i ke koko. Hoʻokō ʻia kēia hana ma o ke kaʻina hana e pili ana i nā pae he nui a me nā ʻāpana mechanical a me biochemical.
Ka Hoʻopaʻa ʻana a me ka Hoʻomaha ʻana
ʻO ke kaʻina hana o ka ʻūlū ʻana o ka puʻuwai ua kapa ʻia ʻo systole, ʻoiai ʻo ke kaʻina hana o ka hoʻomaha ʻana ua kapa ʻia ʻo diastole. I ka wā systole, ʻūlū nā cardiomyocytes a kaomi i ke koko mai loko mai o nā keʻena o ka puʻuwai. A laila, i ka wā diastole, hoʻomaha lākou a ʻae i nā keʻena e hoʻopiha hou me ke koko.
ʻAno Molekala o ka Hoʻopaʻa ʻana
ʻO ka hoʻemi ʻana o ka cardiomyocyte e pili ana i nā pilina ma waena o nā protein actin a me myosin i loko o ka sarcomere, ka ʻāpana liʻiliʻi loa o ka ʻiʻo. Eia nā hana nui e pili ana:
1. Membrane Depolarization: Hoʻolaha nā impulses uila i hana ʻia e ka sinoatrial node (SA node) ma o ka ʻiʻo puʻuwai, e hana ana i ka depolarization o ka membrane cardiomyocyte.
2. Ka wehe ʻana o nā kahawai kalipuna: ʻO kēia depolarization ke kumu o ka wehe ʻana o nā kahawai kalipuna ʻano L i loko o ka membrane cell, e ʻae ana i ke kahe ʻana o nā ion kalipuna i loko o ke kelepona.
3. Ka Hoʻokuʻu ʻana o ka Kalipuna mai ka Sarcoplasmic Reticulum: Hoʻoulu nā ion kalipuna e komo mai ana i ka hoʻokuʻu ʻana o ka kalipuna hou mai ka sarcoplasmic reticulum, e hoʻonui ana i ka nui o ka kalipuna intracellular.
4. Ka Hoʻopaʻa ʻana o ka Kalipuna i Troponin: Hoʻopaʻa ka Kalipuna i ka protein troponin, e hana ana i kahi loli conformational e wehe ai i kahi hoʻopaʻa myosin ma ka actin.
5. Ka Neʻe ʻana o Actin a me Myosin: Me ka wehe ʻana o kēia mau wahi hoʻopaʻa, hiki i nā poʻo myosin ke hoʻopaʻa i ka actin a hoʻohana i ka ATP e hana i ka ʻūlū ʻana ma o kahi ʻano "power stroke".
Hoʻoponopono kino
ʻAʻole hana hoʻokahi ka myocardium; ua hoʻoponopono paʻa ʻia kāna hana e nā ʻano hana like ʻole:
1. ʻŌnaehana Aʻalolo Autonomic: Hoʻopili pololei nā ʻōnaehana aʻalolo sympathetic a me parasympathetic i ka helu o ka puʻuwai a me ka ikaika o nā ʻūmiʻi.
2. Nā Hormones: Hiki i nā hormones e like me ka epinephrine ke hoʻonui i ke alapine (frequency) a me ka ikaika o nā ʻūmiʻi puʻuwai.
ʻO ka Circadian Drive a me nā kuleana Metabolic
Hoʻoulu pinepine ʻia nā arrhythmias a me nā maʻi puʻuwai i kekahi mau manawa o ka lā, e hōʻike ana i kahi mana circadian ma ka hana myocardial. Pono pū nā ʻāpana puʻuwai e mālama i kahi kaulike metabolic ma waena o ka hoʻohana ʻana i nā carbohydrates a me nā waikawa momona ma ke ʻano he kumu ikehu.
ʻO ka maʻi Myocardial
Hiki i nā kūlana pathological e hoʻopilikia ana i ka myocardium ke hoʻopilikia i kāna hana a hoʻoulu i nā ʻano pilikia olakino koʻikoʻi. ʻO kekahi o nā kūlana pathological maʻamau:
Ka Infarction Myocardial
ʻO ka myocardial infarction, i ʻike nui ʻia he hōʻeha puʻuwai, hana ʻia ke oki koke ʻia ke kahe koko i kahi ʻāpana o ka myocardium, pinepine ma muli o ka hoʻokumu ʻia ʻana o kahi plaque atherosclerotic a i ʻole kahi clot koko i loko o nā aʻa coronary. Me ka lawa ʻole o ka oxygen, make ka ʻiʻo myocardial a nalowale kāna hana.
ʻO ke cardiomyopathy
ʻO ka Cardiomyopathy kahi huaʻōlelo laulā no ka maʻi puʻuwai e hoʻonui ai, ʻoʻoleʻa ai, a mānoanoa paha ka ʻiʻo puʻuwai, e hōʻemi ana i kona hiki ke pamu i ke koko. Aia kekahi mau ʻano nui, me ka dilated cardiomyopathy, hypertrophic cardiomyopathy, a me restrictive cardiomyopathy.
Ka hāʻule ʻana o ka puʻuwai
ʻO ka hāʻule ʻana o ka puʻuwai kahi kūlana i hiki ʻole ai i ka puʻuwai ke pamu i ke koko lawa e hoʻokō ai i nā pono o ke kino. Loaʻa ia mai nā ʻano maʻi puʻuwai like ʻole e hōʻino a hoʻonāwaliwali paha i ka myocardium.
ʻArrhythmia
Hiki ke loaʻa nā haunaele o ka puʻuwai, a i ʻole nā arrhythmias, ke lilo nā hōʻailona uila e hoʻoponopono ana i nā ʻūlū o ka puʻuwai i mea ʻano ʻole. Hiki i nā arrhythmias ke ʻano mai ka mea ʻino ʻole a hiki i ka mea hoʻoweliweli i ke ola a hiki ke loaʻa ma muli o nā kumu like ʻole, me ka hōʻino ʻana i ka myocardium.
ʻO ka maʻi puʻuwai
ʻO ka myocarditis ka mumū o ka ʻiʻo puʻuwai i hiki ke hana ʻia e kahi maʻi viral, bacteria, a i ʻole kahi hopena autoimmune. Hiki i kēia kūlana ke hōʻino i nā cardiomyocytes a hoʻopilikia i ka hana o ka puʻuwai.
Ka hopena
ʻO ka myocardium ka papa ʻiʻo o ka puʻuwai, kahi papa o nā ʻiʻo e hana nui ana i ka hoʻokahe ʻana i ke koko ma ke kino holoʻokoʻa. ʻO ka hoʻomaopopo ʻana i ke ʻano a me nā ʻano hana o ka myocardium, mai ke kelepona a i ke ʻōnaehana, he mea nui ia no ka hoʻomaopopo ʻana i ke olakino a me nā maʻi o ka puʻuwai. ʻO kēia ʻike e hiki ai ke pale aku, ʻike, a me ka mālama ʻana i nā maʻi e pili ana i ka ʻiʻo o ka puʻuwai, e hoʻolilo ana i ke aʻo ʻana i ka myocardium i wahi koʻikoʻi o ka cardiology.
