Transcript SO_cyprus_heart_pericardium_14-15_30

Heart and Pericardium
Prof. Dr. Selda Önderoğlu
Prof. Dr. H. Selçuk Sürücü
heart
muscular organ
Pumps blood to body.
Shape:conical
Apex is directed downwards
location
location:thoracic cavity
Middle mediastinum
Weight:250-300 gr.
In the adult
relations
• Right and left:mediastinal
surfaces of the lungs
• inferior: Diaphragm
• Anterior:: Sternum,
costal cartilages,remains
of thymus gland and
partially lungs
• Posterior:Oesophagus
General shape
Apex
Base
4 surfaces
Four borders
Apex: directed
anterior,inferior and to
the left,
Base:faces posteriorly
and to the right
Apex
L ventricle
Forward,
downward&to the
left
Prof. Dr. H. Selçuk Sürücü
Base
L & R atria
Faces
posteriorly
Prof. Dr. H. Selçuk Sürücü
Diaphragmatic
(inf) surface
L ventricle
Prof. Dr. H. Selçuk Sürücü
Sternocostal (ant)
surface
R atrium
R ventricle
L ventricle
Prof. Dr. H. Selçuk Sürücü
+ v brachiocephalica
Inf border
R ventricle
L 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
sternum
3rd right costal
cartilage 1cm from
sternum
6th right costal
cartilage 1cm from
sternum
Prof. Dr. H. Selçuk Sürücü
External features
“ coronary sulcus”,
between atria and
ventricles.
“anterior interventricular
sulcus”,
between ventricules
•
“posterior interventricular
sulcus”,
between ventricles
R atrium
V cava sup&inf
Coronary sinus
Pectinate mm
Sinus venorum
(sinus of venae cavae)
Terminal crest
Interatrial septum
Foramen ovale
Fossa ovalis
Limbus fossa
ovalis
Auricle (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)
Pro.
Membranous part
muscular part
Atrioventricular
part ( bw. R atr&L
ventr.)
R ventricle
Trabeculae carnea
Papillary mm
(ant+post+septal)
Septomarginal
trabecule
(moderator band)
Conus arteriosus
(infundibulum)
Supraventricular
crest
Opening of
pulmonary trunk
(has 3 semilunar cuspsR+L+Ant)
L atrium
Pulmonary vv openings
(4 in number)
Valve of foramen ovale
During development
prevents blood from L atr. to
R atr)
Auricle
Mitral valve/
L atrioventricular valve
(Ant+post cusps)
Prof. Dr. H. Selçuk Sürücü
L ventricle
Cusps of mitral valve/L
atrioventricular valve
(Ant+post cusps)
Papillary mm(ant+post)
Chordae tendineae
Trabecula carneae
Aortic opening
Aortic valve ( R+L+post
semilunar cusps)
(each cusp has
lunule,nodule,
sinus)
Arteries of heart
R&L coronary aa- Both Exit from bulbus aorta
Right coronary artery
(R marginal br &Post interventricular br)
Left coronary artery
(Circumflex br+Ant interventricular br)
Prof. Dr. H. Selçuk Sürücü
Veins of heart
coronary sinus-receives great,middle,small&post. Cardiac v)
Least cardiac vv (venae cordis minimae-Thebasian vv)directly into chambers
Anterior right ventricular vv
Right marginal v
Great cardiac v
Ant interventricular v
L coronary v
Small cardiac v
R coronary v
Middle cardiac v
Post interventricular v
Innervation of heart
Symp
Psymp
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 layer
Myocardium: middle layer, muscular
layer,striated,under control of autonomic
nervous system
Pericardium: outermost layer, like a sac
Myocardium
Atrial
Ventricular
Conducting system
Striated-special type
Under autonomic nervous system control
Atrial 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
Prof.
Dr. H. Selçuk Sürücü
valves
Conducting system of
heart- specialised
myocardial fibers
SA node
at terminal crest
AV node,
at interaatrial
septum
AV bundle, pars
membranacea
R & L bundle
branches
Purkinje fibers
Pericardium
Fibrous pericardium
Serous pericardium
Parietal layer
Visceral layer (epicardium)
“pericardial cavity ”
“liquor pericardii”
Pericardial
sinuses-of the
pericardial cavity
Oblique sinus
Bw.Left atrium- Pulmonary vv
Like the letter “j”, inverted
Transverse sinus
superior v.c.&leftatriumpulmonary trunk&ascending
aorta
two ends open
nerves of pericardium
Phrenic n –parietal
pericardium (afferent)
vagus
Sympathetic trunk
Aorta
ascending aorta
Arch of aorta
descending aorta