Te Pupuhi Toto o te Manawa
Ko te ngākau te miihini matua o te pūnaha tohanga toto o te tangata. Ia hēkona, ka mahi tonu tēnei okana iti nei te rahi ki te tohanga toto puta noa i te tinana. Ka haria e te toto te hāora me ngā matūkai ki ngā pūtau, me te tango atu hoki i te hauhā waro me ngā para pākia hei tukunga atu. Ki te kore te manawa e pupuhi tonu ana, kāore e taea e ngā okana nui pēnei i te roro, ngā whatukuhu, me te ate te mahi tika. Nō reira, me pēhea te pupuhi toto a te manawa?
Te hanganga taketake o te ngākau hei papu
E whā ngā rūma o te ngākau: e rua ngā atria me ngā ventricles e rua. Ka whiwhi te atria i te toto e tomo ana ki te ngākau, ko ngā ventricles ia ka pupuhi i te toto i waho o te ngākau. Ko ēnei rūma e whā:
1. Te ātrium matau: ka whiwhi i te toto "paru" (he iti te hāora) mai i te tinana katoa.
2. Te pūkahukahu matau: ka pupuhi toto ki ngā pukahukahu hei kohi hāora.
3. Te ātrium maui: ka whiwhi i te toto "ma" (he nui te hāora) mai i ngā pukahukahu.
4. Te pūkahukahu maui: ka pupuhi i te toto whai hāora puta noa i te tinana.
Kei waenganui i ēnei rūma ngā takirere o te ngākau, e mahi ana pērā i ngā tatau kotahi te ara. Mā ēnei ka whakarite kia rere te toto i te huarahi tika, ā, kāore e hoki whakamuri. Ko ngā takirere matua ko te takirere tricuspid (i waenganui i te atrium matau me te ventricle matau), te takirere pūkahukahu (e anga atu ana ki te uaua pūkahukahu), te takirere mitral/bicuspid (i waenganui i te atrium maui me te ventricle maui), me te takirere aorta (e anga atu ana ki te aorta).
Haunga ngā rūma me ngā takirere, he uaua ngakau kaha, he ngāwari hoki (myocardium) tō te ngākau. Ka whakapoto tēnei uaua hei whakaputa pēhanga, ka panaia te toto ki waho.
E rua ngā ara rere toto: te rere pūkahukahu me te rere toto ā-pūnaha
Ka taea te mārama ki te mahi a te ngākau he rite ki ngā ara iahiko e rua e hono tahi ana:
1. Te tohanga o te pūkahukahu (tohanga iti)
Ka haria te toto mai i te ngākau ki ngā pukahukahu, ā, hoki atu ki te ngākau. Ko tōna kaupapa he whakawhiti hau: tangohia te hauhā waro me te ngongo i te hāora.
2. Te tohanga toto pūnaha (tohanga toto nui)
Ka haria te toto mai i te ngākau puta noa i te tinana, ka hoki ki te ngākau. Ko tana mahi he kawe i te hāora me ngā matūkai ki ngā kiko, kātahi ka kawe atu i ngā para pākia.
Ko te mahi matua a te ventricle matau ko te tohanga toto o te pūkahukahu, ko te ventricle maui ia te "papu matua" mō te tohanga toto ā-tinana nā te mea me whakaputa e ia he pēhanga nui ake hei pana i te toto puta noa i te tinana. Koia te take he matotoru ake ngā pakitara o te ventricle maui i ō te ventricle matau.
Te huringa o te ngākau: te manawataki o te whakaheke me te whakangā
Ka mahi te papu o te ngākau i roto i tētahi tauira e kīia ana ko te huringa ngākau, e rua ngā wāhanga matua:
– Diastole: ka whakangā te ngākau, ka kī tonu ōna rūma i te toto.
– Systole: ka kōpiri te ngākau, ka pupuhi hoki te toto ki waho.
Ko te raupapa he rite ki tēnei:
1. Te whakakī i te atria
Ka tomo te toto mai i te tinana ki te atrium matau mā te vena cava, ko te toto mai i ngā pukahukahu ka tomo ki te atrium maui mā ngā uaua pūkahukahu. I tēnei wāhanga, ka tuwhera ngā takirere i waenganui i te atrium me ngā ventricles, ka taea ai te rere o te toto ki roto i ngā ventricles.
2. Te whakahekenga o te atria (atrial systole)
Ka paku whakawhāiti te atria hei "whakaoti" i te whakakī o te ventricle. Mā tēnei ka whakarite kia tino whakakīia ngā ventricles i mua i te whakawhāiti kaha e whai ake nei.
3. Te whakahekenga o te ventricle (te systole ventricular)
Ka tīmata te whakawhāiti i ngā ventricles. Ka kati ngā takirere tricuspid me mitral kia kore ai te toto e rere ki te atria. Kātahi, ina tino teitei te pēhanga i roto i ngā ventricles, ka tuwhera ngā takirere pulmonary me te aorta, ka panaia te toto ki waho: te ventricle matau ki te uaua pulmonary ki ngā pukahukahu, me te ventricle maui ki te aorta ki te toenga o te tinana.
4. Te whakangā o te puku (te diastole o te puku)
I muri i te papu, ka whakangāwari ngā ventricles. Ka heke te pēhanga, ā, ka kati ngā takirere aorta me ngā takirere pūkahukahu hei ārai i te rere whakamuri. Kātahi ka tūwhera anō ngā takirere tricuspid me ngā takirere mitral, ka tīmata te huringa e whai ake nei.
Ko te pao o te manawa e rangona ana e tātou, ko te hua o te whakatuwheratanga me te katinga o ngā takirere me te whakahekenga o te uaua o te ngākau. Ko te tangi "lub-dub" e rangona ana i runga i te stethoscope e hono ana ki te katinga o te takirere: "lub" ina katia ngā takirere mitral me tricuspid, me te "dub" ina katia ngā takirere aortic me te pulmonary.
Te pūnaha hiko o te ngākau: te whakahaere i te manawataki pupuhi
Hei whakarite i te pai o te pupuhi, he pūnaha hiko ā-roto tō te ngākau. Mā tēnei pūnaha e tohu te wā e mimiti ai te uaua.
– Pūnaha SA (sinoatrial): e kiia ana ko te "pacemaker tūturu." Kei te atrium matau te pūnaha SA, ka whakaputa te pūnaha i te hiko e tīmata ai te pao o te ngakau.
– Pūnaha AV (atrioventricular): ka whiwhi i ngā nekehanga mai i te atrium, ā, ka whakarato i tētahi okiokinga poto kia whai wā ai ngā ventricles ki te whakakī i mua i te whakawhāiti.
– He paihere muka His me muka Purkinje: ka tukuna ngā nekehanga ki ngā uaua ventricular katoa kia kaha ai te whakahekenga me te puta i te wā kotahi.
Ina pakaru tēnei pūnaha hiko, ka rerekē te auau o te manawa (arrhythmia). Ka taea e ētahi arrhythmia te whakaiti i te whai huatanga o te pupuhi toto.
Te toto toto me te mahi a ngā oko toto
Ko te ngākau te papu matua, engari he mea nui anō hoki ngā uaua toto hei pupuri i te rere o te toto. E toru ngā momo uaua matua:
1. Ngā uaua: ka haria te toto mai i te ngākau, he matotoru, he ngāwari hoki ō rātou pakitara hei tu atu i te pēhanga teitei.
2. Ngā uaua: ka haria te toto ki te ngākau, he takirere hei ārai i te rere o te toto ki raro nā te kaha o te kaha ā-papa.
3. Ngā uaua toto: ngā oko toto tino iti e puta ai te whakawhitiwhiti hāora, te hauhā waro, me ngā matūkai.
Ka pāngia te pēhanga toto e te kaha o te whakawhāititanga o te ngākau, te rahinga toto, me te ngāwari me te whānui o ngā uaua toto. Ina whaiti, ina pakari rānei ngā uaua toto, me kaha ake te mahi a te ngākau kia mau tonu te rere o te toto.
E hia te toto e pupuhihia ana e te ngākau?
I te wā okioki, e 60–100 ngā wā e pāorooro ana te ngākau o te pakeke i ia meneti. I ia pāorooro ka pupuhihia he nui o te toto e kiia nei ko te nui o te toto e pāorooro ana. Mā te whakarea i te tere o te ngākau ki te nui o te toto e pāorooro ana ka puta he cardiac output, arā, te nui o te toto e pupuhihia ana i ia meneti.
I te wā e whakakorikori tinana ana, ka nui ake te hāora e hiahiatia ana e te tinana. Ka whakautu te ngākau mā te whakanui ake i te tere o te manawa me te rahinga o te whiu. Nō reira, ka tino piki ake te putanga o te manawa hei whakatutuki i ngā hiahia o ngā kiko e mahi ana.
He aha i ngoikore ai te pupuhi o te ngākau?
He maha ngā āhuatanga ka pā kino ki te kaha o te ngākau ki te pupuhi toto me te whai hua, hei tauira:
– Mate ngakau: ka whaiti ngā oko toto ngakau, ā, ka kore he hāora e tae atu ki te uaua o te ngakau.
– Te ngoikore o te ngākau: kāore te ngākau i te kaha ki te pupuhi i ngā toto e ai ki ngā hiahia o te tinana.
– Ngā rerekētanga o te takirere: ngā takirere turuturu, whaiti rānei, ā, kāore e pai te rere o te toto.
– Te toto toto tiketike: ka kaha ake te mahi a te ngākau i te toto toto tiketike mō te wā roa.
Ko ngā tohu hei tūpato ko te poto o te manawa, te ngenge, te pupuhi o te waewae, te mamae o te uma, te pā o te ngakau kāore i te tika. Mēnā ka puta ngā tohu, me rapu awhina hauora.
Kia ora tō ngākau mō te pupuhi pai rawa atu
Hei pupuri i te manawa kia pai te pupuhi toto, he mea nui ngā tikanga oranga hauora. Ko ētahi mahi āwhina ko:
– Kai i tētahi kai taurite, whakaitihia te ngako whakawhiti, te huka nui, me te tote.
– Whakakorikori tinana auau e ai ki tō kaha (hei tauira, te hikoi tere, te eke pahikara, te kaukau).
– Kia nui te moe, kia whakahaere hoki i te ahotea.
– Kaua e momi hikareti, kaua hoki e whakaiti i te waipiro.
– Tirohia te toto toto, te huka toto me te cholesterol i ia wā.
Te Katinga
Ka pupuhi te ngākau i te toto mā roto i te mahi taunga o ōna rūma, ngā takirere kotahi-ara, te uaua ngākau kaha, me te pūnaha hiko e whakahaere ana i te manawataki. E rua ngā tohanga toto—pūkahukahu me te pūnaha—ka whakarite kia tukuna tonutia te hāora ki te toto mai i ngā pūkahukahu, kia tohatohahia hoki puta noa i te tinana. Mā te mārama ki te mahi a te ngākau, ka taea e tātou te mōhio ake ki te hiranga o te pupuri i te hauora o te pūnaha manawa, nā te mea ko te ngākau hauora he tuku tonu i te hāora me ngā matūkai ki ia pūtau o te tinana.
