heart and pericardium prof. dr. selda Önderoğlu prof. dr. h. selçuk sürücü
TRANSCRIPT
Heart and Pericardium
Prof. Dr. Selda Önderoğlu
Prof. Dr. H. Selçuk Sürücü
heart
muscular organPumps blood to body.Shape:conicalApex is directed downwards
location
location:thoracic cavityMiddle mediastinum
Weight:250-300 gr. In the adult
• Right and left:mediastinal surfaces of the lungs
• inferior: Diaphragm
• Anterior:: Sternum, costal cartilages,remains of thymus gland and partially lungs
• Posterior:Oesophagus
relations
General shape
Apex Base 4 surfacesFour borders
Apex: directed anterior,inferior and to the left, Base:faces posteriorly and to the right
Apex
L ventricleForward,
downward&to the left
Prof. Dr. H. Selçuk Sürücü
Base
L & R atriaFaces posteriorly
Prof. Dr. H. Selçuk Sürücü
Diaphragmatic (inf) surface
L ventricle
Prof. Dr. H. Selçuk Sürücü
Sternocostal (ant) surface
R atriumR ventricleL ventricle
Prof. Dr. H. Selçuk Sürücü
+ v brachiocephalica
Inf border
R ventricleL ventricle
Sup border
L atrium, roots of great
vessels
Right and left borders
Right border, Right atrium.
Left border, left ventricle,left auricle.
Surface projections of borders
Apex:5th intercostal space 9 cm from midline 2nd left costal cartilage 1 cm from sternum3rd right costal cartilage 1cm from sternum6th right costal cartilage 1cm from sternum
Prof. Dr. H. Selçuk Sürücü
“ coronary sulcus”,between atria and ventricles.
“anterior interventricular sulcus”,
between ventricules
• “posterior interventricular sulcus”,
between ventricles
External features
R atriumV cava sup&infCoronary sinusPectinate mmSinus venorum(sinus of venae cavae)Terminal crestInteratrial septumForamen ovaleFossa ovalisLimbus fossa ovalisAuricle (ant.to crest)
Tricuspid valve(bw.R atr.&R vent.)
Prof. Dr. H. Selçuk Sürücü
R ventricle
Cusps of tricuspid valve/R atrioventricular valve (at sup wall)(ant.+post.+septal)
Interventricular septum (septal wall)
Membranous part muscular partAtrioventricular part ( bw. R atr&L ventr.)
Pro.
R ventricle
Trabeculae carneaPapillary mm(ant+post+septal)Septomarginal trabecule (moderator band)Conus arteriosus (infundibulum)Supraventricular crestOpening of pulmonary trunk(has 3 semilunar cusps- R+L+Ant)
L atrium
Pulmonary vv openings (4 in number)Valve of foramen ovaleDuring development prevents blood from L atr. to R atr)AuricleMitral valve/L atrioventricular valve(Ant+post cusps)
Prof. Dr. H. Selçuk Sürücü
L ventricleCusps of mitral valve/L
atrioventricular valve(Ant+post cusps)
Papillary mm(ant+post)Chordae tendineaeTrabecula carneae
Aortic openingAortic valve ( R+L+post semilunar cusps)(each cusp has lunule,nodule,sinus)
Arteries of heart
Right coronary artery (R marginal br &Post interventricular br)
Left coronary artery(Circumflex br+Ant interventricular br)
R&L coronary aa- Both Exit from bulbus aorta
Prof. Dr. H. Selçuk Sürücü
Veins of heartcoronary sinus-receives great,middle,small&post. Cardiac v)
Least cardiac vv (venae cordis minimae-Thebasian vv)-directly into chambers
Anterior right ventricular vvRight marginal v
Great cardiac v
Ant interventricular vL coronary v
Small cardiac v
R coronary v
Middle cardiac v
Post interventricular v
Innervation of heart
SympPsymp
Together They form the cardiac plexus
Sympathetics
Sup cervical cardiac n (from sup. Cerv. Gang.)
Middle cervical cardiac n br(from middle cerv.gang.)
Inf cervical cardiac n (from cervicothoracic (stellate)gang.
Thoracic cardiac brrs (T 1-4)
Parasympathetics
(vagus nerve (CN X)
Sup cervical cardiac brr
inferior cervical cardiac brr
Thoracic cardiac brr ( of vagus n.)
Lymphatics of heart
R inf tracheabronchial lymph nodes
Layers of heart
Endocardium:innermost layerMyocardium: middle layer, muscular layer,striated,under control of autonomic nervous systemPericardium: outermost layer, like a sac
Myocardium Atrial
VentricularConducting system
Striated-special typeUnder autonomic nervous system controlAtrial muscle fibers: 2 layers (inner-each atrium, outer- two atria together)Ventricular muscle fibers- has complex structure, no distinct layers- vortex
Myocardium
Prof. Dr. H. Selçuk Sürücü
Skeleton of heart
R & L fibrous rings (around mitral&tricuspid valves
R & L fibrous trigones
Around aortic & pulmonary
valvesProf. Dr. H. Selçuk Sürücü
Conducting system of heart- specialised myocardial fibers
SA nodeat terminal crestAV node, at interaatrial septumAV bundle, pars membranaceaR & L bundle branchesPurkinje fibers
Pericardium
Fibrous pericardiumSerous pericardium
Parietal layerVisceral layer (epicardium)
“pericardial cavity ” “liquor pericardii”
Pericardial sinuses-of the pericardial cavity
Oblique sinusBw.Left atrium- Pulmonary vvLike the letter “j”, inverted
Transverse sinus superior v.c.&leftatrium-
pulmonary trunk&ascending aorta two ends open
nerves of pericardium
Phrenic n –parietal pericardium (afferent)
vagusSympathetic trunk
Aorta
ascending aorta
Arch of aorta
descending aorta