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‫أﺳﺎﺳﻴﺎ ت ﻓ ﺴﻴﻮﻟﻮﺟﻴﺎ اﻹﻧ ﺴﺎن‬

‫ﺑﻌ ﺔ‬
‫ﺒﻌ ﺔ اﻟ ﺴﺎ‬
‫اﻟﻄ‬
‫‪Dr l Saleh-Aljammal‬‬

‫ﻧﻈﺎم اﻟﻘﻠ ﺐ واﻷوﻋﻴ ﺔ اﻟﺪﻣﻮﻳ ﺔ‬

‫ﻣﺤﺎﺿﺮة‪1-‬‬

‫ﺛﻨﻴﻦ‪3202/11/72-‬‬
‫اﻹ‬
‫ﺷﺮﻳﺤ ﺔ ‪1‬‬
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‫ﻧﻈﺮة ﻋﺎﻣ ﺔ ﻋﲆ ﻧﻈﺎم اﻟﻘﻠ ﺐ واﻷوﻋﻴ ﺔ اﻟﺪﻣﻮﻳ ﺔ‬

‫•ﻧﻈﺎم اﻟﻘﻠ ﺐ واﻷوﻋﻴ ﺔ اﻟﺪﻣﻮﻳ ﺔ ﻣﻐﻠﻖ‬

‫ﻧﻈﺎم اﻟﻘﻠ ﺐ واﻷوﻋﻴ ﺔ اﻟﺪﻣﻮﻳ ﺔ‬

‫ﺑﻀﺦ اﻟﺪم إﱃ اﻷوﻋﻴ ﺔ اﻟﺪﻣﻮﻳ ﺔ‬‫•ﻳﻘﻮم اﻟﻘﻠ ﺐ‬

‫ﺘﺪوﻳﺮ اﻟﺪم إﱃ ﺟﻤﻴﻊ أﺟﺰاء اﻟﺠ ﺴﻢ‪،‬‬

‫ﺑ‬‫ﺗﻘﻮم اﻷوﻋﻴ ﺔ اﻟﺪﻣﻮﻳ ﺔ‬
‫•‬
‫وإﱃ ﺟﻤﻴﻊ اﻟﺨﻼﻳﺎ‬

‫•اﻟﻮﻇﺎﺋﻒ‪:‬ﺗﻮﺻﻴﻞ اﻷﻛ ﺴﺠﻴﻦ واﻟﻤﻮاد اﻟﻤﻐﺬﻳ ﺔ إﱃ ﺟﻤﻴﻊ ﺧﻼﻳﺎ‬

‫ﺑﻮن‬ ‫ﺛﺎﻧ ﻲ أﻛ ﺴﻴﺪ اﻟﻜﺮ‬‫اﻟﺠ ﺴﻢ‪ ،‬وﻧﻘﻞ اﻹﻧﺰﻳﻤﺎ ت واﻟﻬﺮﻣﻮﻧﺎ ت‪ ،‬وإزاﻟ ﺔ‬
‫ﺘﺠﺎ ت اﻟﻨﻔﺎﻳﺎ ت اﻷﺧﺮى ﻣﻦ اﻟﺨﻼﻳﺎ‪.‬‬‫وﻣﻨ‬

‫ﺑﺎﺳﻢ ‪Benjamin Cummings‬‬‫ﺘ ﻲﺗﻨﺸﺮ‬

‫ﺒﻊ واﻟﻨﺸﺮ ‪© 2003‬ﻣﺤﻔﻮﻇ ﺔ ﻟﺸﺮﻛ ﺔ ‪Pearson Education, Inc.‬واﻟ‬
‫ﺣﻘﻮق اﻟﻄ‬
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‫أ(ﺗﺸﺮﻳﺢ اﻟﻘﻠ ﺐ‬
‫‪1.‬اﻟﻤﻮﻗﻊ‬
‫ﺘﻴﻦ‬
‫ﺋ‬‫ﺑﻴﻦ اﻟﺮ‬‫ﺘﺠﻮﻳﻒ اﻟﺼﺪري •ﻓ ﻲ اﻟﻤﻨﺼﻒ‪،‬‬
‫•اﻟ‬

‫ﺑﺎﺳﻢ ‪Benjamin Cummings‬‬‫ﺘ ﻲﺗﻨﺸﺮ‬

‫ﺒﻊ واﻟﻨﺸﺮ ‪© 2003‬ﻣﺤﻔﻮﻇ ﺔ ﻟﺸﺮﻛ ﺔ ‪Pearson Education, Inc.‬واﻟ‬
‫ﺣﻘﻮق اﻟﻄ‬ ‫‪3‬‬
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‫‪2.‬اﻟﺤﺠﻢ‬

‫ﺒﺎ وأﻗﻞ ﻣﻦ رﻃﻞ واﺣﺪ‬

‫ﺒﻀ ﺔ اﻟﻴﺪﺗﻘﺮﻳ ً‬
‫ﺑﺤﺠﻢ ﻗ‬
‫•‬

‫‪~ 14‬ﺳﻢ ﻃﻮﻻً؛ ﻋﺮض ‪9‬ﺳﻢ‬

‫ﺘﻴﻦ‪،‬‬ ‫ﺋ‬‫•اﻟﻘﻠ ﺐ وﺳﻄ ﻲ ﻟﻠﺮ‬
‫ﺧﻠﻒ ﻋﻈﻢ اﻟﻘﺺ‪ ،‬وأﻣﺎم اﻟﻌﻤﻮد اﻟﻔﻘﺮي‪ ،‬وأﻋﲆ اﻟﺤﺠﺎ ب‬
‫اﻟﺤﺎﺟﺰ‪.‬‬

‫ﺒﻌﻴﺪة ‪ ،‬اﻟﻘﻤ ﺔ‪،‬ﺗﺸﻴﺮ إﱃ اﻟﻴ ﺴﺎر‪،‬‬‫ﺘﻪ اﻟ‬

‫•ﻧﻬﺎﻳ‬
‫ﺑ ﻲ اﻟﺨﺎﻣ ﺲ ‪.‬‬‫ﺘﻮى اﻟﻔﻀﺎء اﻟﻮر‬‫ﺘﻬ ﻲ ﻋﻨﺪ ﻣ ﺴ‬ ‫ﺗﻨ‬‫و‬
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‫ﺘﺄﻣﻮر اﻟﻠﻴﻔ ﻲ ‪-‬ﻛﻴ ﺲ ﻣﺼﻨﻮع‬

‫ﺘﺄﻣﻮر( )‪1‬اﻟ‬
‫ﺘﺄﻣﻮر )أو ﻛﻴ ﺲ اﻟ‬
‫‪3.‬أﻏﻄﻴ ﺔ اﻟﻘﻠ ﺐ أ( اﻟ‬

‫ﻣﻦ اﻟﻨ ﺴﻴﺞ اﻟﻀﺎم اﻟﻘﻮي‬

‫ﺘﺎﻣﻮر‬
‫ﺘﺎﻣﻮر اﻟﺠﺪاري ب‪ .‬اﻟ‬
‫ﺒﻘﺎ ت‪ :‬أ‪ .‬اﻟ‬
‫)‪2‬اﻟﻐﺸﺎء اﻟﻤﺼﻠ ﻲ ﻣﺰدوج اﻟﻄ‬

‫اﻟﺤﺸﻮي‪ .‬اﻟﻨﺨﺎ ب‬

‫ﻳﻐﻄ ﻲ اﻟﻘﻠ ﺐ‬

‫ﺒﻘﺎ ت اﻟﺠﺪارﻳ ﺔ واﻟﺤﺸﻮﻳ ﺔ‬

‫ﺑﻴﻦ اﻟﻄ‬‫ﺘﺎﻣﻮر‬
‫ب(ﻳﻤﻸ اﻟ ﺴﺎﺋﻞ اﻟﻤﺼﻠ ﻲﺗﺠﻮﻳﻒ اﻟ‬

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‫‪4.‬ﺟﺪار اﻟﻘﻠ ﺐ‬

‫ﺘﺄﻣﻮر اﻟﺤﺸﻮي (‬
‫أ( اﻟﻨﺨﺎ ب ) اﻟ‬
‫ﺒﻘ ﺔ اﻟﺨﺎرﺟﻴ ﺔ ﻣﻦ اﻟﻨ ﺴﻴﺞ اﻟﻀﺎم ﻋﲆﺳﻄﺢ اﻟﻘﻠ ﺐ‬
‫اﻟﻄ‬

‫ب( ﻋﻀﻠ ﺔ اﻟﻘﻠ ﺐ =ﺟﺪارﺳﻤﻴﻚ ﻟﻌﻀﻠ ﺔ اﻟﻘﻠ ﺐ‬

‫ج( اﻟﺸﻐﺎف –اﻟﻈﻬﺎرﻳ ﺔ اﻟﺪاﺧﻠﻴ ﺔ و‬

‫ﺑﻄﺎﻧ ﺔ اﻟﻨ ﺴﻴﺞ اﻟﻀﺎم ﻟﻠﻘﻠ ﺐ واﻟﺼﻤﺎﻣﺎ ت‬

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‫‪5.‬ﻏﺮف اﻟﻘﻠ ﺐ )‪(4‬‬

‫ﺒﻞ اﻟﺪم‬
‫ﺘﻘ‬‫•اﻷذﻳﻦ — )‪(R & L‬ﻳ ﺴ‬
‫ﺘﺪ ﻛﻞ أذﻳﻦ إﱃ ﺣﺠﺮة ﺧﺎرﺟﻴ ﺔ أﺻﻐﺮﺗ ﺴﻤﻰ اﻷذﻧﻴ ﺔ‬
‫ﻳﻤ‬

‫ﺒﻄﻴﻦ — )‪(R & L‬أدﻧﻰ ﻣﻦ اﻷذﻳﻨﻴﻦ‪ .‬ﻃﺮد اﻟﺪم ﻣﻦ اﻟﻘﻠ ﺐ‬

‫•اﻟ‬

‫ﺘﻢ ﻓﺼﻞ اﻟﻐﺮف اﻟﻤﻮﺟﻮدة ﻋﲆ اﻟﻴ ﺴﺎر ﻋﻦ اﻟﻐﺮف اﻟﻤﻮﺟﻮدة‬

‫•ﻳ‬
‫ﺑﻮاﺳﻄ ﺔ ﺣﺎﺟﺰ )ﺟﺪار ﻋﻀﻠ ﺔ اﻟﻘﻠ ﺐ(‪.‬‬‫ﻋﲆ اﻟﻴﻤﻴﻦ‬

‫ﺑﻴﻦ اﻷذﻳﻨﻴﻦ‬‫اﻟﺤﺎﺟﺰ‬
‫ﺒﻄﻴﻨﻴﻦ‬
‫ﺑﻴﻦ اﻟ‬‫اﻟﺤﺎﺟﺰ‬

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‫ﻫﻞﻳﻤﻜﻨﻚﺗ ﺴﻤﻴ ﺔ ﻛﻞ ﺟﺰء ﻣﺮﻗﻢ ﻣﻦ اﻟﻘﻠ ﺐ؟‬

‫‪3‬‬
‫‪1‬‬

‫‪2‬‬ ‫‪4‬‬
‫‪5‬‬

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‫‪ 6.‬ﺻﻤﺎﻣﺎ ت اﻟﻘﻠ ﺐ‬

‫ﺗﺠﺎه‬
‫ﺘﺪﻓﻖ ﻓ ﻲ ا‬
‫ﺑﺎﻟ‬‫ﺘ ﻲﺗ ﺴﻤﺢ ﻟﻠﺪم‬
‫أ( ﻫ ﻲ اﻟﻠﻮﺣﺎ ت اﻟ‬
‫واﺣﺪ ﻓﻘﻂ‬

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11
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‫ﺑﻄﻴﻦ؛‬
‫ﺑﻴﻦ ﻛﻞ أذﻳﻦ و‬
‫ﺒﻄﻴﻨﻴ ﺔ ‪(AV) -‬‬
‫ب( اﻟﺼﻤﺎﻣﺎ ت اﻷذﻳﻨﻴ ﺔ اﻟ‬
‫ﺒﻄﻴﻦ‬‫ﺘﺪﻓﻖ اﻟﺪم ﻣﻦ ﻛﻞ أذﻳﻦ إﱃ اﻟ‬ ‫ﺑ‬‫اﻟ ﺴﻤﺎح‬

‫ﺛﻲ‬
‫ﺛﻼ‬‫ﺘﺎﺟ ﻲ )اﻟﺠﺎﻧ ﺐ اﻷﻳ ﺴﺮ( •اﻟﺼﻤﺎم‬
‫ﺜﻨﺎﺋ ﻲ اﻟﺸﺮف‪/‬اﻟ‬
‫•اﻟﺼﻤﺎم اﻟ‬

‫اﻟﺸﺮﻓﺎ ت )اﻟﺠﺎﻧ ﺐ اﻷﻳﻤﻦ(‬

‫ﺋﻴ ﺴ ﻲ‪ .‬اﻟ ﺴﻤﺎح‬

‫ﺒﻄﻴﻦ وﺷﺮﻳﺎن اﻟﻘﻠ ﺐ اﻟﺮ‬
‫ﺑﻴﻦ اﻟ‬
‫ج( اﻟﺼﻤﺎﻣﺎ ت اﻟﻬﻼﻟﻴ ﺔ ‪-‬‬
‫ﺘﺎ ب‬
‫ﺋﻴ ﺴﻴ ﺔ؛ ‪3‬أﻋ‬
‫ﺒﺮ أﺣﺪ ﺷﺮاﻳﻴﻦ اﻟﻘﻠ ﺐ اﻟﺮ‬
‫ﺑﻄﻴﻦ ﻋ‬‫ﺘﺪﻓﻖ اﻟﺪم ﻣﻦ ﻛﻞ‬
‫ﺑ‬

‫ﺒﻄﻴﻦ‬
‫ﺑﻬﺮي )اﻟ‬
‫ﺋﻮي( واﻟﺼﻤﺎم اﻷ‬
‫ﺒﻄﻴﻦ اﻷﻳﻤﻦ واﻟﺠﺬع اﻟﺮ‬
‫ﺋﻮي )اﻟ‬
‫اﻟﺼﻤﺎم اﻟﺮ‬
‫ﺑﻬﺮ(‬
‫اﻷﻳ ﺴﺮ واﻷ‬

‫اﻟﺸﺮﻳﺤ ﺔ ‪12‬‬
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‫ﺑﻮاﺳﻄ ﺔ‬‫ﺒﻴ ﺖ ﺷﺮﻓﺎ ت اﻟﺼﻤﺎم ﻓ ﻲ ﻣﻜﺎﻧﻬﺎ‬

‫ﺜ‬‫ﺘﻢﺗ‬
‫د(ﻳ‬
‫ﺘ ﻲﺗﻨﺸﺄ ﻣﻦ اﻟﻌﻀﻼ ت‬
‫ﺗﺎر اﻟﻘﻠ ﺐ"( واﻟ‬
‫ﺗﺮﻳ ﺔ )"أو‬‫ﺒﺎل اﻟﻮ‬ ‫اﻟﺤ‬
‫ﺒﻄﻴﻦ‬‫ﺒﺎرزة ﻣﻦ داﺧﻞ ﺟﺪار اﻟ‬ ‫اﻟﺤﻠﻴﻤﻴ ﺔ اﻟ‬

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‫ﺒﺾ ﺟﺪار اﻟﺤﺠﺮةﻳﻜﻮن اﻟﺪم‬

‫ﻋﻨﺪﻣﺎﻳﻨﻘ‬
‫ﺘﻢ ﺿﺨﻬﺎ ﻣﻦ ﺧﻼل ﺻﻤﺎم‬
‫ﻳ‬

‫أيﺗﺪﻓﻖ ﻋﻜ ﺴ ﻲﻳﺰﻳﺪ اﻟﻀﻐﻂ ﻋﲆ اﻟﺸﺮﻓﺎ ت وﻳﻐﻠﻖ اﻟﺼﻤﺎﻣﺎ ت‬

‫ﺒﺾ‬ ‫ﺒﻄﻴﻦ؛ﺗﻨﻘ‬‫ﺒﺎض اﻟ‬ ‫ﺛﻨﺎء اﻧﻘ‬

‫ﺒﻄﻴﻨﻴ ﺔ أ‬
‫ﺗﻐﻠﻖ اﻟﺼﻤﺎﻣﺎ ت اﻷذﻳﻨﻴ ﺔ اﻟ‬
‫ﺘ ﻲﺗﻤﻨﻊ ﺷﺮﻓﺎ ت‬ ‫ﺗﺮﻳ ﺔ اﻟ‬
‫ﺒﺎل اﻟﻮ‬ ‫ﺘ ﺴﺤ ﺐ اﻟﺤ‬ ‫اﻟﻌﻀﻼ ت اﻟﺤﻠﻴﻤﻴ ﺔ أ ً‬
‫ﻳﻀﺎ ﻟ‬
‫اﻟﺼﻤﺎم ﻣﻦ اﻟ ﺴﻘﻮط ﻣﺮة أﺧﺮى إﱃ اﻷذﻳﻦ‬

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‫ﺑﺎ ت اﻟﻘﻠ ﺐ‬
‫و( ﺻﻮ ت ﺿﺮ‬
‫= "‪"lub‬ﻋﻨﺪ إﻏﻼق ﺻﻤﺎﻣﺎ ت ‪AV‬‬

‫)ﺻﻮ ت اﻟﻘﻠ ﺐ اﻷول( = "‪"dup‬ﻋﻨﺪﻣﺎﺗﻐﻠﻖ اﻟﺼﻤﺎﻣﺎ ت‬

‫ﺜﺎﻧ ﻲ‬
‫اﻟﻬﻼﻟﻴ ﺔ )ﺻﻮ ت اﻟﻘﻠ ﺐ اﻟ‬

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‫ز( أﻣﺮاض اﻟﺼﻤﺎﻣﺎ ت‬

‫• ﺻﻤﺎم ﻏﻴﺮ ﻛﻒءﻳﻤﻜﻦ أنﻳﺆدي إﱃ‬
‫ﺒﻴ ﺔ" وإﻋﺎدة ﺿﺦ‬
‫ُ ﺴﻤﻊ ﻋﲆ أﻧﻪ "ﻧﻔﺨ ﺔ ﻗﻠ‬
‫ﺘﺪﻓﻖ اﻟﻌﻜ ﺴ ﻲ‪،‬ﻳ‬
‫اﻟ‬
‫)ﻗﻠ ﺲ( ﻣﻦ ﻧﻔ ﺲ اﻟﺪم‬

‫ﺗﻀﻴﻴﻖ اﻟﺼﻤﺎمﻳﺰﻳﺪ ﻣﻦ اﻟﻌ ﺐء ﻋﲆ اﻟﻘﻠ ﺐ ﻟﻀﺦ اﻟﺪم‬

‫ﺘﻀﻴﻖ =‬
‫•اﻟ‬

‫ﺒﺪاﻟﻪ‬
‫ﺘ‬‫•اﻟﻌﻼج‪ :‬إﺻﻼح اﻟﺼﻤﺎم أو اﺳ‬

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‫ﺒﻄﻴﻦ اﻷﻳ ﺴﺮ إﱃ اﻟﺠﺰء‬

‫ﺑﻬﺮ اﻟﺪم اﻟﻤﺆﻛ ﺴﺞ ﻣﻦ اﻟ‬
‫•ﻳﺤﻤﻞ اﻟﺸﺮﻳﺎن اﻷ‬
‫اﻟﻌﻠﻮي واﻟ ﺴﻔﻠ ﻲ ﻣﻦ اﻟﺠ ﺴﻢ‬

‫ﺒﻄﻴﻦ اﻷﻳﻤﻦ إﱃ‬

‫ﺋﻮﻳ ﺔ ‪:‬ﺗﺤﻤﻞ اﻟﺪم ﻏﻴﺮ اﻟﻤﺆﻛ ﺴﺞ ﻣﻦ اﻟ‬
‫•اﻟﺸﺮاﻳﻴﻦ اﻟﺮ‬
‫ﺘﻴﻦ‬‫ﺋ‬‫اﻟﺮ‬

‫•اﻟﻮرﻳﺪ اﻷﺟﻮف‪:‬ﻳﺤﻤﻞ اﻟﺪم ﻏﻴﺮ اﻟﻤﺆﻛ ﺴﺞ ﻣﻦ اﻟﺠﺰء اﻟﻌﻠﻮي واﻟ ﺴﻔﻠ ﻲ‬

‫ﻣﻦ اﻟﺠ ﺴﻢ إﱃ اﻷذﻳﻦ اﻷﻳﻤﻦ‬

‫ﺋﻮﻳ ﺔ‪:‬ﺗﺤﻤﻞ اﻟﺪم اﻟﻤﺆﻛ ﺴﺞ‬

‫•اﻷوردة اﻟﺮ‬
‫ﺘﻴﻦ إﱃ اﻷذﻳﻦ اﻷﻳ ﺴﺮ‬
‫ﺋ‬‫ﻣﻦ اﻟﺮ‬

‫‪17‬‬
Machine Translated by Google

‫اﻟﺪاﺋﺮة اﻟﻨﻈﺎﻣﻴ ﺔ‬2.

18
Machine Translated by Google

‫ﺋﻮﻳ ﺔ‬
‫اﻟﺪاﺋﺮة اﻟﺮ‬3.

19
‫‪Machine Translated by Google‬‬

‫ﺘﺎﺟﻴ ﺔ‬
‫‪3.‬اﻟﺪاﺋﺮة اﻟ‬
‫ﺑﻪ ﻣﻦ‬‫ﺒﻜ ﺔ ﺧﺎﺻ ﺔ‬
‫ﺘﻠﻚ اﻟﻘﻠ ﺐ ﺷ‬ ‫•ﻳﻤ‬
‫ﺘ ﻲﺗﻐﺬي ﺧﻼﻳﺎ‬ ‫اﻷوﻋﻴ ﺔ اﻟﺪﻣﻮﻳ ﺔ اﻟ‬
‫ﻋﻀﻠ ﺔ اﻟﻘﻠ ﺐ‬

‫ﺘﺎﺟﻴ ﺔ‬
‫اﻟﺸﺮاﻳﻴﻦ واﻷوردة اﻟ‬
‫واﻟﺸﻌﻴﺮا ت اﻟﺪﻣﻮﻳ ﺔ‬
‫ﺒﺮ ﺣﺠﺮا ت اﻟﻘﻠ ﺐ ﻻ‬
‫ﺘﺪﻓﻖ ﻋ‬
‫•ﻣﻼﺣﻈ ﺔ‪ :‬اﻟﺪم اﻟﺬيﻳ‬
‫ﻳﻐﺬي ﻋﻀﻠ ﺔ اﻟﻘﻠ ﺐ‬

‫‪20‬‬