Transcript Anterior & Posterior View

Anatomical and Physiological
Substantiations of Surgical
Interventions on Lungs & Heart
Lungs Anterior-Medial View
Borders of Lungs & Pleura
Anterior View
Borders of Lungs & Pleura
Posterior View
Right Lung Gate & Root
Left Lung Gate & Root
Lung Roots
 Note the gross
difference between
right and left roots.
 On the right, the
upper and middle
bronchi are spread
apart by the artery;
on the left, they are
pressed together.
Borders of Lung & Pleura
Left Side View
Borders of Lungs & Pleura
Right Side View
Nomenclature of the Lungs and Bronchi
Segmental Bronchi
Note that on the left the apical and posterior
bronchi arise from a single stem, as do the anterior
basal and medial basal.
Lung Acinus as Structural Unit
Lung Regional Lymphatic Nodes
Subdivisions of Mediastinum
Anterior Mediastinum Organs
Posterior Pericardial Wall,
Oblique & Transverse Sinuses
Pericardium is Removed, Roots of
Great Vessels
Heart (General anterior view)
Heart (Anterior & Posterior View)
Radiograph of Chest
 T1-body of the first
thoracic vertebra
 C-clavicle
 RA-right atrium
 SVC-superior vena cava
 IVC-inferior vena cava
 A-»aortic knob»
 PT-pulmonary trunk
 LAA-left auricular
appendage
 LV-left ventricle
Heart Valves
 Auscultation points are the areas where sounds
from each of the heart's valves may be heard
most distinctly through a stethoscope. They do
not represent the location of the valves
projected on the surface of the chest, although
for the tricuspid and pulmonary valves location
and sound are quite close. Aortic and mitral
valves are deep in the chest and their sounds
are heard best at the points where the direction
of blood flow is closer to the chest wall. Aortic
(A) and Pulmonary (P) areas are in the second
interspace to the right and left of the sternal
border. The Tricuspid area (T) is near the left
sternal border in the 5th or 6th interspace. The
Mitral valve (M) is heard best near the apex of
the heart in the 5th intercostal space in the
midclavicular line.
Heart Auscultation Points
Heart Arterial Supply
Coronary Arteries
Types of Heart Blood Supplying
Cardiac Veins
Heart Conducting System
 The Sinu-atrial (SA) Node in the wall of the right atrium near the
upper end of the sulcus terminalis and extending over the front
of the opening of the superior vena cava. The SA Node is the
"pacemaker" of the heart because it initiates cardiac muscle
contraction and determines the heart rate. It is supplied by the
sinus node artery, usually a branch of the right coronary artery.
 Contraction spreads through the atrial wall until it reaches the
Atrio-ventricular (AV) Node in the right atrial side of the
interatrial septum just above the opening of the Coronary sinus.
After a brief delay contraction passes to the ventricles. The AV
Node is usually supplied by the distal right coronary artery.
 The A V Bundle (B) passes from the AV Node in the
membranous part of the interventricular septum and divides into
right and left Bundle Branches on either side of the muscular
part of the septum.
 The right Bundle Branch travels down the septum to the
anterior wall of the ventricle, enters the base of the anterior
papillary muscle, and excitation spreads to the right ventricular
wall.
 The left Bundle Branch is a thin, broad band which usually
divides into two divisions which enter papillary muscles and
excitation of the muscular walls of the left ventricle occurs.
 Damage to the conducting system (often by
compromised blood supply as in coronary
artery disease) leads to disturbances of cardiac
muscle contraction. Damage to the AV Node
results in "heart block" as the atrial excitation
wave does not reach the ventricles which begin
to contract independently at their own rate
which is slower than that of the atria. Damage
to one of the branches results in "bundle branch
block" in which excitation goes down the
unaffected branch to cause systole of that
ventricle. The impulse then spreads to the other
ventricle producing later asynchronous
contraction.
Aorto-coronary Shunting
Thank You for Attention