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GII PHU SINH L TR MM NON

GV: ThS. ThiHu PhEmail:[email protected]

CHNG5MU V TUN HON


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A- MUI. Chc nng v thnh phn ca mu

Mu l 1 cht lng mu lu thng trongh thng tun hon thc hin cc chc nng

quan trng.

1. Chc nng ca mu

- h hp

- dinh dng

- iu ho hot ng c quan

- o thi

- bo v

- iu ho nhit


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- Chc nng h hp: mu vn chuyn O2 t phi n cc t bo v CO2 t cc c quan n phi. Nh Hemoglobin (Hb) m mu vn chuyn c O2 v CO2

- Phn ng:

+ phi: Hb + O 2 -> HbO 2; HbCO 2 -> Hb + CO 2 + t bo: HbO 2 -> Hb + O 2; Hb + CO 2 -> HbCO 2

- Chc nng dinh dng: mu vn chuyn cccht DD c hp thu t ng tiu ho vn chuyn n cc m cung cp cho hot ng ca t bo.

+ Axit amin, glucose, axit bo, vitamin,


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- Chc nng iu ho hot ng cc c quan:

mu mang cht tit ca tuyn ni tit n cc c quan c tc dng kch thch hoc km hm hot ng cc c quan.

- Chc nng o thi: mu lu thng khp c th,ly cc cht cn b t t bo a n cc c quan

bi tit (thn, phi, tuyn m hi) bi tit rangoi.

- Chc nng bo v: T bo bch cu ca mu ckh nng tiu dit vi trng, ngoi ra trong mu cn

c cht khng th, khng c c tc dng bo v c th.


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- Chc nng iu ho nhit: mu c kh nng lm

tng, gim nhit c th nhanh chng (do mu ct nhit cao bc hi nhanh gim nhit khi nhit cao mu cha nhiu nhit chuyn n cc c

quan chng lnh khi nhit h)

+ Tri nng: gin mch, nhit chuyn ra ngoi

+ Tri lnh: co mch, chuyn nhit vo su trongc th gi nhit

2. Thnhphn ca mu


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Mu gm 2 thnh phn:

- Th v hnh : huyt tng

- Th hu hnh : hng cu, bch cu, tiu cu.


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2.1.Th v hnh

Huyt tng

L cht dch hi vng chim 50 - 60% th tch

mu gm: 90% nc; 1% mui; 7% P; 0,1% G;huyt tng tham gia qu trnh ng mu.

2.2.Th hu hnh

- hng cu,

- bch cu,

- tiu cu.


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Hng cu: L t bo hnh a lm 2 mt, khng c nhn

vn chuyn khng kh, dinh dng - S lng: khng n nh, thay i theo la tui, gii tnh,

tnh trng sc kho & mi trng sng:

+ ngi ln: Nam 4,2 tr/mm 3 mu; N 3,8 tr/mm 3 mu.

+ tr em thay i theo la tui.

- Thi gian sng: 100- 130 ngy, ti a 150 ngy. Hng

cu cht gan, lch.


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- Thnh phn v cu to: huyt cu t l thnh phn c

bn ca hng cu (hemoglobin mt protein kt hp vi st) chim 35% khi lng HC c tc dng lm cho mu

c mu . Ngoi ra trong HC cn cha nc.

- Chc nng: vn chuyn O2 & cht dinh dng n t

bo, thu CO 2 & cht cn b thi ra ngoi c th.


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- Qu trnh to HC: thi k bo thai c nhiu c

quan tham gia to HC nh: gan, lch, tu xng. Sau

khi sinh tu xng l c quan ch yu to hng cu

Bch cu: L nhng t bo c nhn, chuyn ng c,

khng c hnh dng nht nh bch cu c kh nng dichuyn c khp mi khe h ca t bo.

- S lng: ngi trng thnh (nam 7000/ mm3 mu;n 6200/ mm 3 mu) s lng BC tng khi b bnh nhim khun, gim khi b nhim c.


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C nhiu loi:

+ Khng ht: Lympho & Mono+ BC ht: BC a acid, BC a base, BC trung tnhBch cu sng: 2 4 ngy (lympho c th sng 100 ngy)

- Chc nng: bo v c th (BC c kh nng chng li cc

tc nhn gy nhim khun, nhim c cho c th, sn xut

ra khng th chng li tc nhn gy bnh.)

Bch cu c sinh ra cc tu xng, gan, lch.


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Tiu cu: L nhng t bo mu nh nht, khng nhn,

hnh a.

- S lng: 200000 400000/mm 3 mu. S lng tiu cu tng khi n nhiu tht, gim khi c th b nhim trng hoc

khi b chy mu.

- Thi giansng: 4-6 ngy.

- Chc nng: tham gia qu trnh ng mu, chng chy mu

khi b thng, khi phu thut.

- Tiu cu c sinh ra t tu xng


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Mu

T bo mu

Huyt tng

v

enzim

Cht sinh t mu

(axitamin, Ca 2+)

Ca2+

Huyt thanh

Khimung T mu

Hng cu

Bch cu

Tiu cu

ng mu


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II. Nhm mu

- ngi, theo h nhm mu

ABO, xp thnh 4 nhm:

A; B; AB; O.

- Trong :

+ nhm mu O chuyn cho, v nhm mu O khng c

khng nguyn trn HC khng gy ra s ngng kt.

+ nhm mu AB chuyn nhn, v nhm mu AB khngc khng th trn huyt tng khng gy ra s ngng kt.

Huyt tngca cc

nhm mu(nginhn)

Hng cu ca cc nhm mu ngi cho

O A B AB

O ( , )

A ( )

B ( )

AB (0)

Hng cu khng bkt dnh

Hng cu bkt dnh

O A B AB

gy kt dnh A

gy kt dnh B


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S tai bin sn khoa trong bt ng nhm mu Rhesus

- Theo h nhm mu Rh: Rh+, Rh- ( him)

III. c im mu tr em

1. c im s to mu.

- Thi k bo thai: gan, lch, tu xng tham gia to mu.

- Sau khi sinh: tu xng l c quan ch yu sinh ra cc t

bo mu.

- Tui dy th tr i: s to mu ch yu cc xng di,

xng dt, xng ct sng.


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- S to mu tr em tuy mnh nhng khng n nh,

do bt c nguyn nhn gy bnh no cng d nh

hng n s to mu, tr d b thiu mu nhng c kh

nng d hi phc.

- Khi thiu mu nng tr em d c phn ng nh gan,

lch, hch to ln.

2. c im mu tr em

Trong mu tr em:

- cht v c (huyt tng) tng t nh ngi ln,

- cht hu c thay i theo la tui.


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Hng cu: s lng thay i theo la tui.

- S sinh: 5-6 tr/mm 3 mu, sau 5- 7 ngy s lng HCgim cn 4- 4,5 tr/mm 3 mu.

- Tr < 1 tui: s lng HC cn 3,2- 3,5 tr/mm 3 mu (doc th ln nhanh, s to mu khng p ng kp nhu cu).

- Tr > 1tui: HC n nh dn.

- 3 tui: s lng HC khong > 4tr/mm 3 mu.

Bch cu: S lng thay i theo tui, nhn chung tr

cng nh s lng bch cu cng tng.

- S sinh: s lng BC rt caov thay i t 10000-

30000 /mm 3 mu.

- Thi k b m: 10000 20000/mm 3 mu.

- Thi k > 1 tui: s lng BC gim dn ri ging nh ngi ln 6000 8000 BC/mm 3 mu.


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Tiu cu: s lng t thay i.

- S sinh: 100000 400000/mm 3 mu.

- Thi k > 1 tui: s lng tiu cu t 150000

300000/mm 3 mu.

- tr < 6tui: d mc bnh thiu mu.

Mun trnh c bnh: cn cho tr n thc n cha nhiu cht st hnh thnh huyt cu t (hemoglobin). Nu thiu mu nng cn dng thm vitamin B12 kch

thch to mu.

B-TUN HON

- Chc nng tun hon rt

quan trng trong vic duy

tr s sng. B my tun

hon m bo s lu thng

mu trong c th.

- B my tun hon: tim &

mch mu (h mch).


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I. Tim

I. Cu to tim v v trTim nm trong lng ngc hi chch sang tri, cdng hnh nn ngc.


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1. Cu to tim

- Trng lng: ph thuc vo tng c th (thng

bng chnh nm tay ngi );

Nam = 267g, N = 240g.

- Tim c bao bc bi mng tim,

- Tim l mt c quan rng c cu to bi cc c tim v

m lin kt to thnh:

+ cc ngn tim (tm nh tri, tm tht tri, tm nh phi, tm tht phi)

+ cc van tim (van nh - tht, van ng mch )


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THO LUN 1. Ngn tim no c thnh c dy nht v ngn no c

thnh c mng nht?Tm tht tri c thnh c ln nht

Tm nh phi c thnh c mng nht 2. Ti sao much bm i mt chiu?

Gia tm nh & tm tht c van nh tht ng m t ng c

tc dng lm cho mu chy theo 1 chiu t tm nh -> tmtht. Gia tm tht (tri) vi ng mch ch & tm tht phi vi ng mch phi c van t chim (van bn nguyt).

2. Hot ng ca tim


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2. Hot ng ca tim

Hot ng ca tim c v nh 1 my bm, bm mu vo cc ng mch v ht mu v t tnh mch.Chu k hot ng tim gm 3 pha:

- Tm nh co: 0,1 giy

- Tm tht co: 0,3 giy

- Ton b tim gin: 0,4 giy Nhp tim trung bnh ca ngi ln: 70-75 ln/pht

2. Hot ng ca tim

Cc giai ontrong chu ktim( a: nh thu,b: tht thu,c: tm trngton b)


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3. c im tim ca tr em

Cu to tim tr em c bn ging ngi ln nhng cnhng c im khc:

- V tr nm cao hn, nm ngang, tim hnh trn ( s sinh), khi gn 1 tui tim nm t th cho nghing,4 tui c v tr nh ngi ln.

-Trng lng: tim tr s sinh chim 0,9% trng lng c th (ngi ln 0,5%)

- Hot ng ca tim cha n nh:

+ Nhp tim: tr 1 thng 120 140 ln/ pht

1 tui 100 130 ln/ pht.

2 5 tui: 90 120 ln/ pht.

> 6 tui: 80- 110 ln/ pht.

+ Mch p ca tim tr em nhanh hn ngi ln, tr cngnh mch p cng nhanh. Mch p ca tr d thay i

khi khc, st, s hi, gng sc...v vy khi kim tra mch p ca tr nn thc hin khi tr ng hoc nm yn.


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II. H mch

1. Cu to h mch Cc

mch Cu to Chc nng

Thnh mch Lngmch

S lp dy

ng mch

3 Dy Hp Dn mu t timn cc c quan

Tnh mch

3 Mng Rng cvan

Dn mu t ccc quan v tim

Maomch

1 Mng nht Hp nht Trao i cht


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2. S tun hon mu


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NG I CA MU TRONG H TUN HON

ng mch ch Mao mchcc c quan

Mao mch phi

VNG TUNHON LN

VNG TUNHON NH

Tnh mch

ng mch phi

Tnh mch phi

TM NH PHI

TM THT PHI

TM NH TRI

TM THT TRI

2.1. Vngtun hon ln

- Vng tun hon thc hin trao i cht & traoi kh khp ton b c th

- l vng tun hon m h mch dn mu ti

(giu O 2) t tm tht tri xung ng mch ch n khp c th qua mao mch theo tnh

mch v tm nh phi.


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2.2. Vngtun hon nh

- vng tun hon thc hin qu trnh trao i kh(xy ra phi).

- L vng tun hon em mu thm (cha CO 2)n phi thc hin trao i kh thnh mu ti

(cha O 2) ri tr v tim (tm nh tri) xung tm

tht tri vo ng mch.


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Huyt p

- Huyt p tm thu, huyt p tm trng?Huyt p thng c phn loi da trn huyt ptm thu v huyt p tm trng. Huyt p tm thul p lc mu trong lng mch trong khi tim p (huyt p trn/ ti a). Huyt p tm trng l plc mu trong khong thi gian gia hai ln p ca tim ( huyt p di/ti thiu)

Huyt p


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- Thi k thai nhi: cha phn chia vng tun honln nh ch mang chung nht l vng tun honnhau thai v phi cha hot ng.

- Khi a tr ra i, phi bt u hot ng, vngtun hon chnh thc hot ng v chia thnh vng

tun hon ln, vng tun hon nh.

2.3. Vngtun hon tr em

2.3. Vngtun hon tr em


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D-V SINH H TUN HON 1- Rnluyn tim mch chotr bng cch:

- Cho tr lao ng chn tay, tp th dc, hot dng vuichi va sc lm cho c tim dy hn, co gin tt hn.

- m bo cho thn kinh ca tr khng b kch thch qumnh, khng gy yu t bt ng , khng h do tr.

- To cho tr cuc sng thoi mi nhm gip h timmch hot ng tt.

2- Cn hng dn tr xoa bpc th mu lu thng d dng. Khng nn cho tr mc qun ocht qu, ma ng cn tm nc nng.

3- Quan tmn ch dinh dng ca tr.

4- T chc ch sinh hot ph hp la tui, to iu kin cho tr hot nh ni thong kh, khngkh trong lnh


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Ht chng ri!!!!!!!!!

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