心臓の働きとその异常（１）

May 22, 2016Download as pptx, pdf1 like1,137 views

Okamoto yosuke

兴奋収缩连関，ミトコンドリア，心周期，碍测辞迟辞モデル

心臓の働きとその异常（１）
心臓の形態と機能
平成28年 5月9日
医学部薬理学講座
岡本洋介
前にあるプリントと出席カードを一枚ずつ
取って行って下さい．

? なぜ心臓は拍動するのか？
? どうやって心臓は拍動するのか？
心臓は拍動する臓器である

心臓は血液を全身に届ける
人は、1分間に
? ５リットルの空気を呼吸し
? ５リットルの血液を拍出する

脂肪酸＋ H2O ＋ O2
グルコース＋ H2O ＋ O2
ATP
ATPATP
ATP ATP
ATP
ATP
ATP ATP
ATP
ATP
ATP
ATP
ATP
ATP
ATP
ATP
ATP
ATP
ATP
ATP
ATP
ATP
ATP
ATP
ATP
ATP
ATP
ATP
ATP
ATP
ATPβ酸化
クエン酸回路
電子伝達系

心臓は血液を全身に届ける
臓器重量 (kg)
血液量酸素消費量
(mL/min) 組織100g当り(mL/100g·min) (mL/min) 組織100g当り(mL/100g·min)
骨格筋 31.0 840 2.7 50 0.2
皮膚 3.6 462 12.8 12 0.3
肝臓 2.6 1500 75.7 51 2.0
脳 1.4 750 54.0 46 3.3
腎臓 0.3 1260 420.0 18 6.0
心臓 0.3 250 84.0 29 9.7
『生理学展望 14版』（丸善株式会社）より

心臓のポンプ機能
Richard E. Klabunde 『Cardiovascular
Physiology Concepts, 2nd Ed.』
（Wolter Kluwer Health）より

心臓は興奮する
http://thevirtualheart.org/HHindex.html

心電図 (ECG)
Gan-Xin Yan et al. Circulation. 2004;110:1036-1041
50 mV
50 mV

Richard E. Klabunde 『Cardiovascular
Physiology Concepts, 2nd Ed.』
（Wolter Kluwer Health）より
心電図 (ECG)

電気的興奮が収縮力に変換される仕組み
筋小胞体
(Ca2+ 1 mM)
収縮フィラメント
Na+ 140, K+ 5, Ca2+ 2 (mM)
Na+ 10, K+ 150, Ca2+ 0
電位依存性
Na+チャネル
電位依存性
Ca2+チャネル電位依存性
K+チャネル
Na+-K+ ポンプ
Ca2+ ポンプ
ATP
Ca2+依存性
Ca2+放出チャネル

電位依存性
Na+チャネル
電位依存性
Ca2+チャネル
電位依存性
K+チャネル
Na+-K+ ポンプ
Ca2+依存性
Ca2+放出チャネル

Richard E. Klabunde 『Cardiovascular
Physiology Concepts, 2nd Ed.』
（Wolter Kluwer Health）より
心周期

心臓ペースメーカー
洞(房)結節
結節間伝導路
房室結節
ヒス束
Purukinje系
マウスの洞房結節細胞
20?m
『生理学展望 14版』（丸善株式会社）より

心室筋と洞房結節における活動電位の違い
mV
200 ms
IK1
IKr
IKs
INa
ICaL
pA
0
-40
-80
40
mV
ICaL
IKr
pA
200 ms

ペースメーカー電位
m
V
200 ms
Dr. Dario DiFrancesco
Funny current (If); 1980
分子実態： HCN4 チャネル
野間昭典先生
Sustained inward current (Ist); 1997
分子実態：不明
Dr. Edward G. Lakatta
Calcium clock; 2001
分子実態： Na+ - Ca2+ 交換体、リアノジン受容体

? 心臓は休まず拍動し続ける事で、絶えず全身に血液
を送っている。
? 心筋は収縮フィラメントが整列した横紋筋で、強い収
縮力を有する。
? 洞房結節 → 刺激伝導系 → 心室の順で興奮が心
臓全体に広がる。
? 興奮-収縮連関により、心臓は規則的に収縮している。
まとめ

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心臓の働きとその异常（１）

1. 心臓の働きとその异常（１）心臓の形態と機能平成28年 5月9日医学部薬理学講座岡本洋介前にあるプリントと出席カードを一枚ずつ取って行って下さい．

2. ? なぜ心臓は拍動するのか？ ? どうやって心臓は拍動するのか？心臓は拍動する臓器である

3. BioDigital https://www.biodigital.com/

4. 心臓の颁罢画像

5. 心臓は血液を全身に届ける人は、1分間に ? ５リットルの空気を呼吸し ? ５リットルの血液を拍出する

6. 脂肪酸＋ H2O ＋ O2 グルコース＋ H2O ＋ O2 ATP ATPATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATP ATPβ酸化クエン酸回路電子伝達系

7. 心臓は血液を全身に届ける臓器重量 (kg) 血液量酸素消費量 (mL/min) 組織100g当り(mL/100g·min) (mL/min) 組織100g当り(mL/100g·min) 骨格筋 31.0 840 2.7 50 0.2 皮膚 3.6 462 12.8 12 0.3 肝臓 2.6 1500 75.7 51 2.0 脳 1.4 750 54.0 46 3.3 腎臓 0.3 1260 420.0 18 6.0 心臓 0.3 250 84.0 29 9.7 『生理学展望 14版』（丸善株式会社）より

8. 心臓のポンプ機能 http://www.ms.is.ritsumei.ac.jp/profile/staff/ijiri/index.html HeartSim

9. 心臓のポンプ機能 Richard E. Klabunde 『Cardiovascular Physiology Concepts, 2nd Ed.』（Wolter Kluwer Health）より

10. ? 心臓は拍動し続けなければいけない心停止、即ち、個体死

11. 心臓は興奮する http://thevirtualheart.org/HHindex.html

12. 心臓は興奮する Kyoto Model 秋田大学医学部細胞生理学講座

13. 心電図 (ECG) Gan-Xin Yan et al. Circulation. 2004;110:1036-1041 50 mV 50 mV

14. Richard E. Klabunde 『Cardiovascular Physiology Concepts, 2nd Ed.』（Wolter Kluwer Health）より心電図 (ECG)

19. 電気的興奮が収縮力に変換される仕組み筋小胞体 (Ca2+ 1 mM) 収縮フィラメント Na+ 140, K+ 5, Ca2+ 2 (mM) Na+ 10, K+ 150, Ca2+ 0 電位依存性 Na+チャネル電位依存性 Ca2+チャネル電位依存性 K+チャネル Na+-K+ ポンプ Ca2+ ポンプ ATP Ca2+依存性 Ca2+放出チャネル

20. 電位依存性 Na+チャネル電位依存性 Ca2+チャネル電位依存性 K+チャネル Na+-K+ ポンプ Ca2+依存性 Ca2+放出チャネル

21. 興奮-収縮連関 Kyoto Model 秋田大学医学部細胞生理学講座

22. Richard E. Klabunde 『Cardiovascular Physiology Concepts, 2nd Ed.』（Wolter Kluwer Health）より心周期

23. 心臓ペースメーカー

24. 心臓ペースメーカー洞(房)結節結節間伝導路房室結節ヒス束 Purukinje系マウスの洞房結節細胞 20?m 『生理学展望 14版』（丸善株式会社）より

25. 心臓ペースメーカー Kyoto Model 秋田大学医学部細胞生理学講座

26. 心室筋と洞房結節における活動電位の違い mV 200 ms IK1 IKr IKs INa ICaL pA 0 -40 -80 40 mV ICaL IKr pA 200 ms

27. ペースメーカー電位 m V 200 ms Dr. Dario DiFrancesco Funny current (If); 1980 分子実態： HCN4 チャネル野間昭典先生 Sustained inward current (Ist); 1997 分子実態：不明 Dr. Edward G. Lakatta Calcium clock; 2001 分子実態： Na+ - Ca2+ 交換体、リアノジン受容体

28. ? 心臓は休まず拍動し続ける事で、絶えず全身に血液を送っている。 ? 心筋は収縮フィラメントが整列した横紋筋で、強い収縮力を有する。 ? 洞房結節 → 刺激伝導系 → 心室の順で興奮が心臓全体に広がる。 ? 興奮-収縮連関により、心臓は規則的に収縮している。まとめ

Editor's Notes

#6: 一分间の拍出量、一分间の呼吸量、础罢笔、各臓器への血液量　など、血圧の高いところから低いところへ、生物はものすごく燃费が悪い
#7: 脂质、炭水化物、
#8: 特殊循环、各臓器は础罢笔を使って、それぞれ特有の働きをしている。
#9: 心臓も、全身に血液を送る、という特有の働きがある。どうやって、全身に血液を送り出しているのだろうか？
#10: 心臓も、全身に血液を送る、という特有の働きがある。どうやって、全身に血液を送り出しているのだろうか？
#14: Wedge preparation, 微分波形
#16: 体には火力発电所も原子力発电所もない。础罢笔がある。どうやって、础罢笔を使って、电気兴奋をポンプ机能に変换するのか？
#17: 体には火力発电所も原子力発电所もない。础罢笔がある。どうやって、础罢笔を使って、电気兴奋をポンプ机能に変换するのか？
#18: 体には火力発电所も原子力発电所もない。础罢笔がある。どうやって、础罢笔を使って、电気兴奋をポンプ机能に変换するのか？
#19: 体には火力発电所も原子力発电所もない。础罢笔がある。どうやって、础罢笔を使って、电気兴奋をポンプ机能に変换するのか？
#20: 電気的興奮が力学的収縮に変換される仕組み。Na-Kポンプによって、膜電位は-80 mVに維持されている。

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心臓の働きとその异常（１）

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心臓の働きとその异常（１）

Editor's Notes