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  • This episode of Real Engineering is brought to you by Skillshare, home to over 16,000

  • classes that could teach you a new life skill.

  • By the time we reach our 80s, our hearts have beat over 3.3 billion times and and have pumped

  • 250 million litres of blood around the body, enough blood to fill 100 olympic sized pools.

  • Just 3 weeks after conception the first muscle cells of the heart begin to contract and don't

  • stop until the moment we die.

  • It is quite frankly a marvel that our hearts can last so long.

  • Pick up a stress ball and see how many times you can squeeze it before arm starts to cramp

  • and tire.

  • Unlike skeletal muscle, cardiac muscle has much higher numbers of mitochondria, which

  • provide the vital energy needed for contractions, and a rich supply of oxygenated blood, it

  • never has to worry about the build of lactic acid from working when deprived of oxygen.

  • But just because they do not fatigue does not mean they are invincible.

  • Heart disease is one of the leading causes of death in the world, as we grow older some

  • parts of the heart can deteriorate and cause some problems, but we have developed some

  • incredible technology that has extended our lives.

  • One of the most common implants in the world being pacemakers, small implantable devices

  • that help keep our hearts beating when our natural systems need some help.

  • Before seeing how they are implanted and how they work, let's first see how our own bodies

  • have been engineered by nature to keep our blood flowing.

  • The heart has two sides separated by an inner wall called the septum.

  • The right side of the heart, which on this diagram is on the left, pumps blood to the

  • lungs where it is oxygenated and then travels back to the heart where it is pumped by the

  • left side to the rest of the body.

  • The walls of the left side are much thicker and stronger because of it has to pump blood

  • around the entire body, whereas the right side just has to pump it to the lungs and

  • back.

  • The heart consists of 4 chambers the left and right ventricles and the left and right

  • atria, the atria and ventricles are separated by valves.

  • At the start of the heart beat all 4 chambers are relaxed and the valves are open.

  • Blood flows into the heart from large veins and the heart reaches max capacity.

  • Just here there are a bundle of cells called the Sinoatrial node that are capable of producing

  • a electric impulse that will travel through the heart and cause it to contract in a specific

  • order.

  • First the impulse travel to the AV node located here, where it triggers both atria to contract,

  • squeezing blood out of the atria into the left and right ventricles.

  • The electric impulse has now travelled down through the heart to fibres located in the

  • ventricle walls that now cause them to contract, as the pressure rises it forces these valves

  • to shut and prevents blood from flowing backwards.

  • You can see each of these stages on the classic electrocardiogram.

  • The first little bump is the atria contracting, followed by the spike of the stronger ventricles

  • contracting and finally there is another little bump as ventricles recover.

  • For most, this sequence of events goes unnoticed thousands of times a day.

  • But some may need a little help controlling their heart beat.

  • sometimes the Sinoatrial node's ability to set the correct pace breaks down, leading

  • to slower heartbeats or long pauses between heartbeats.

  • There are a range of reasons why you may need help and this is why the incredible pacemaker

  • was invented.

  • And as with most medical inventions it started as an incredibly dangerous and scary device.

  • The first being invented by Albert S Hyman in the 1930s.

  • It consisted of a hand cranked spring motor, which would store the hand crank rotation

  • as potential energy in a spring.

  • This spring motor then drove a generator, with these large U-Shaped magnets providing

  • the magnetic flux needed to generate a direct current voltage.

  • The current was then pulsed by a rotating interrupter disk with four conducting pads

  • which intermittently made contact with a brush which supplied this huge needle electrode.

  • Amazingly this little machine was portable, but it proved ineffective due to the low voltage

  • output.

  • His work was ultimately abandoned, but other researchers recognised its potential after

  • the second world war.

  • A method of inducing hypothermia by cooling the heart until it stopped beating to allow

  • it to be worked on during surgery was being investigated, but upon rewarming it was found

  • that the heart needed help with controlling heart rate as metabolic function recovered.

  • And John A. Hopps developed this device for the job, delivering impulses at the desired

  • rate through paddles that were placed inside the chest cavity during surgery near the Sinoatrial

  • Node.

  • The potential of using such a device on patients suffering from heart defects at normal temperatures

  • was soon realised, but repeated applications of high voltages cause muscle pain and twitches,

  • along with burns.

  • Making it unsuitable for extended use.

  • What we needed was an implantable device.

  • Hopps developed a catheter electrode, which removed the need for open chest surgeries

  • by passing the electrodes through the subclavian vein and into the heart.

  • On halloween night 1957 a power outage struck a minneapolis hospital, leaving several young

  • patients without pacing from the mains powered pacemakers, killing one of the children and

  • pushing famed heart surgeon Dr. C Walton Lillehei to request the hospitals technician Earl Bakken

  • to develop a battery powered pacemaker.

  • He returned with this device, a wearable pacemaker powered by mercury batteries that would launch

  • Earl Bakken's company Medtronic into the fortune 500.

  • This was a revolutionary device, but the need to pass the wires through the skin was a constant

  • infection risk.

  • What was needed was a fully implantable device and with continual improvements to transistors

  • allowing for the miniaturization of circuitry, and improvements to batteries this was soon

  • realised.

  • This was the first ever fully implantable pacemaker, created and implanted in Sweden

  • to save Arne Larsson's life.

  • With a rechargeable nickel-cadmium battery, which was charged through this induction coil

  • overnight about once a month.

  • It utilized some of the first silicon transistors imported into Sweden, allowing it to use less

  • energy over older Germanium transistors.

  • All this was encapsulated in a biocompatible epoxy resin.

  • Arne Larsson survived to 86, with his pacemaker being replaced a total of 25 times over the

  • course of his life, as the technology improved incrementally.

  • [5] Current generation pacemakers are now smaller

  • and more reliable than ever.

  • Medtronic have even developed the world's smallest pacemaker which is implanted directly

  • into the right ventricle without any cables, and eliminating the need for the pacemaker

  • to be implanted under the skin, which can lead to discomfort.

  • Over 700,000 pacemakers are implanted worldwide every year.

  • [2] These devices help people live healthier, happier lives and have advanced so far that

  • many can practically forget that they suffer from heart disease.

  • This subject is something I spent 4 years studying to work with, and have worked in

  • the medical device industry in the past with Medtronic.

  • I am however completely self taught in illustration and animation.

  • I designed this logo over 3 years, and today I am happy to unveil the new updated version

  • which someone who actually knows what they are doing designed.

  • I essentially just traced a gear tooth and attempted to make it look like the font I

  • was using, with no real design experience.

  • I may have fared better with making look professional if I watch some of these skillshare classes

  • on logo design first.

  • They teach simple things about shape, type and colour, which I just had no idea about

  • at the time.

  • Something as simple as fixing the symmetry of height and width of my logo has done wonders,

  • and that's the type of thing this course will teach you.

  • These days you can teach yourself pretty much any skill online and Skillshare is a fantastic

  • place to do it.

  • With professional and understandable classes, that follow a clear learning curve, you can

  • dive in and start learning how to do the work you love.

  • . A Premium Membership begins around $10 a month

  • for unlimited access to all courses, but the first 1000 people to sign up with this link

  • will get their first 2 months for free.

  • So ask yourself right now.

  • What skill have you been putting off learning.

  • What project have you been dreaming of completing, but you aren't sure if you have the skills

  • to do it.

  • Why not start right now and sign up to Skillshare using the link below to get your first 2 months

  • free.

  • You have nothing to lose and a valuable life skill to gain.

  • As usual thanks for watching and thank you to all my Patreon supporters.

  • If you would like to see more from me, the links to my twitter, facebook, discord server,

  • subreddit and instagram pages are below.

This episode of Real Engineering is brought to you by Skillshare, home to over 16,000

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Cyborg Hearts 人类如何将心脏计算机化(Cyborg Hearts - How Humans Computerised The Heart)

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    joey joey 發佈於 2021 年 06 月 02 日
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