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The Middle Mediastinum:The Middle Mediastinum:
Pericardium & HeartPericardium & Heart
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MediastinumMediastinum
• The space between 2 lungs
Sup.: thoracic inlet
Inf.: diaphragm
Ant.: sternum & 2-6 CC
Post.: thoracic vertebrae
By Imaginary line By Imaginary line superior & inferior mediastina superior & inferior mediastina
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DivisionsDivisions
Superior: Ant.: manubrium
Post.: T1-T4
Sup.: ?? Inf.: ??
Inferior:Ant.: sternal body
Post.: T5-T12
Sup.: ?? Inf.: ??
2 divisions by imaginary line: sternal angle T4-T5
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3 parts:
Ant.: from sternum heart covering
(pericardium)
Middle: heart & pericardium
Post.: post. to heart
Inferior MediastinumInferior Mediastinum
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PericardiumPericardium
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PericardiumPericardium
• Covering fibroserous sac of 2 layers of tissues that encloses the heart
• Outer: fibrous (fibrous pericardium)
• Inner: serous (serous pericardium)
• Fxn.: 1. Protection 2. Lubrication (friction)
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Fibrous PericardiumFibrous Pericardium
• Strong single layer
• Attached:
Ant.: sternum (sternopericardial lig.)
Inf.: diaphragm (central tendon)
Sup.: fuse to great vessels (t. adventitia)
• Sensory innervations by phrenic nerve
(very sensitive)
What are the cervical spinal segments of the phrenic nerve origin?
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Serous PericardiumSerous Pericardium
• 2 layers of mesothelial cells that are continuous with each other
• Outer (Parietal):
lines over fibrous pericardium
reflects around the roots of large vessels
to become continuous with
• Inner (Visceral):
closely attached to the heart
Epicardium (outer heart layer)
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• Sup & Inf mediastinum
• Inf middle:
pericardium & heart
Fibrous: Protection
Serous: Lubrication
visceral epicardium
ReviewReview
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HeartHeartRead Your Textbook For DetailsRead Your Textbook For Details
• 3 layers
• 4 chambers
• 3 borders
(examining X-ray)
• 3 surfaces
• Apex & Root
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Heart SurfacesHeart Surfaces
1. Anterior (sternocostal):
Rt. Atrium, Rt. V., Lf. V., ant. intervent. groove
2. Inferior (diaphragmatic):
Rt. & Lf. V’s, & post. interventricular groove
3. Posterior:
Lf. Atrium
Base of the heart
4. Apex:
part of Lf. V. (lf. 5th intercostal space, 9 cm from ??)
5. Root:
origin of great vessels
(aorta, pulmonary trunk, SVC)
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Inferior Surface
Posterior Surface
Anterior Surface
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Site for posterior surface of the heart (Base)
Site for inferior surface of the heart (Diaphragmatic)
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Right AtriumRight Atrium
- Receives deO2 bld. From the body
- Forms Rt. Border of the heart
- Composed of:smooth walled chamber &rough out pouch (auricle)
Rough = pectinate muscle
- Border between:crista terminalis
Outside:sulcus terminalis
- Atrial septum (fetal remnants): Fossa ovalis Anulus ovalis
Read Your Textbook For More Details
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Openings of Rt. AtriumOpenings of Rt. Atrium1. SVC:
bld. from upper body
2. IVC:
bld. From lower body / larger
3. A-V orifice:
Ant. to IVC
Guarded by tricuspid valve
4. Coronary Sinus:
Between IVC & A-V orifice
Bld form heart wall
5. ant. cardiac veins
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Rt. VentricleRt. Ventricle
Crescent shaped from inside (cross-section)
3 muscular projections:
1. Papillary muscles:
Finger-like projections
Attach the cusps of A-V valve via Chordae tendineae
2. Moderator band:
inf. septal wall base of ant. Papillary muscle
contains nervous bundle to Rt. Ventricular wall
3. Trabeculae carneae:
prominent muscular ridges
Read Your Textbook For More Details
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OpeningsOpenings
• A-V orifice:guarded by tricuspid valve
• Pulmonary opening:smooth funnel-shaped wall (infundibulum)
infundibulum = conus arteriosus
guarded by pulmonary valve
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Lf. AtriumLf. Atrium• Most of the posterior wall
• Small lf. Auricle (muscular ridges)
• Usually 4 openings for P. V.& 1 for mitral valve
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Left VentricleLeft Ventricle
• Wall 3x thicker than Rt. V.
• Circular in cross-section
• 2 large papillary m. (groups)
• Aortic vestibule:
smooth surface inf. to
aortic valve
No moderator bandNo moderator band
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Heart PositionHeart Position
• Behind the sternum & slightly to the left
strong sounds = left to the sternum
• Dextrocardia:
The heart is on the right side of the chest
heart sounds = right to the sternum
- 1 in 12,000