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PERICARDIUMPERICARDIUM
PERICARDIUMPERICARDIUM
Layers:Layers:
1. FIBROUS PERICARDIUM1. FIBROUS PERICARDIUM
2. SEROUS PERICARDIUM2. SEROUS PERICARDIUMA. PARIETAL LAYERA. PARIETAL LAYERB. VISCERAL LAYER B. VISCERAL LAYER (EPICARDIUM)(EPICARDIUM)
PERICARDIUMPERICARDIUM
Arterial Supply:Arterial Supply:1. Musculophrenic Artery – from Internal Thoracic Artery1. Musculophrenic Artery – from Internal Thoracic Artery2. Bronchial, Esophageal & Superior Phrenic Arteries – 2. Bronchial, Esophageal & Superior Phrenic Arteries –
from Descending Thoracic Aortafrom Descending Thoracic Aorta3. Coronary Artery3. Coronary Artery
Venous Drainage:Venous Drainage:1. Pericardiophrenic Vein1. Pericardiophrenic Vein2. Azygos Venous System2. Azygos Venous System
PERICARDIUMPERICARDIUM
Nerve Supply:Nerve Supply:1. Phrenic Nerves – 60 – 70% sensory1. Phrenic Nerves – 60 – 70% sensory2. Vagus Nerves2. Vagus Nerves3. Sympathetic Trunk - vasomotor3. Sympathetic Trunk - vasomotor
THE HEARTTHE HEART
HEARTHEART
Layers:Layers:
1. ENDOCARDIUM - 1. ENDOCARDIUM - endotheliumendothelium
endothelial connective endothelial connective tissuetissue
2. MYOCARDIUM - striated 2. MYOCARDIUM - striated involuntary cardiac muscleinvoluntary cardiac muscle
3. EPICARDIUM - external 3. EPICARDIUM - external layer (mesothelium)layer (mesothelium)
visceral layer of serous visceral layer of serous pericardiumpericardium
HEARTHEART
FIBROUS CARDIAC SKELETONFIBROUS CARDIAC SKELETON- keeps AV and SL valves patent- keeps AV and SL valves patent- attachments for leaflets & cusps of valves- attachments for leaflets & cusps of valves- attachment of myocardium- attachment of myocardium- electrical insulator- electrical insulator
HEARTHEART
Parts:Parts:
APEXAPEX - inferolateral part - inferolateral part of LVof LV
APEX BEAT – located behind 5APEX BEAT – located behind 5thth left ICS & 9 cms fromleft ICS & 9 cms from
median planemedian plane
BASEBASE - posterior aspect - posterior aspect formed formed by left atrium by left atrium
- receives the pulmonary - receives the pulmonary veins, SVC & IVCveins, SVC & IVC
HEARTHEART
3. SURFACES3. SURFACESa. Diaphragmatic Surface (Inferior)a. Diaphragmatic Surface (Inferior)
– – left ventricleleft ventricleb. Sternocostal Surface (Anterior) b. Sternocostal Surface (Anterior)
- right ventricle- right ventriclec. Pulmonary Surface (Left)c. Pulmonary Surface (Left) – – left ventricleleft ventricle
4. BORDERS4. BORDERSa. Right Border – Rt. Atrium bet. a. Right Border – Rt. Atrium bet.
SVC & IVCSVC & IVCb. Inferior Borderb. Inferior Border – Right – Right
VentricleVentriclec. Left Borderc. Left Border – Left Ventricle – Left Ventricle
& Left auricle& Left auricled. Superior Border – Rt. & Lt. Atria & d. Superior Border – Rt. & Lt. Atria &
auriclesauricles
CARDIAC CHAMBERSCARDIAC CHAMBERS
A. RIGHT ATRIUMA. RIGHT ATRIUM- receives venous blood from - receives venous blood from
SVC, IVC & CSSVC, IVC & CS- “Auricle” increases capacity- “Auricle” increases capacity
Parts:Parts:1. Sinus Venarum 1. Sinus Venarum
thin-walled posterior thin-walled posterior partpart
opening of SVC, IVC & opening of SVC, IVC & CSCS
2. Pectinate muscles2. Pectinate musclesrough muscular ant rough muscular ant
wallwall
3. Right Atrioventricular 3. Right Atrioventricular OrificeOrifice
CARDIAC CHAMBERSCARDIAC CHAMBERS
Anatomic Features of Left Atrium:Anatomic Features of Left Atrium:
SULCUS TERMINALISSULCUS TERMINALISCRISTAL TERMINALISCRISTAL TERMINALISINTERATRIAL SYSTEM – Fossa OvalisINTERATRIAL SYSTEM – Fossa Ovalis
CARDIAC CHAMBERSCARDIAC CHAMBERS
B. RIGHT VENTRICLEB. RIGHT VENTRICLE
- largest part of ant. - largest part of ant. surfacesurface- small part of - small part of diaphragmaticdiaphragmatic
surfacesurface- mainly forms the inferior- mainly forms the inferior
borderborder
CONUS ARTERIOSUSCONUS ARTERIOSUSTRABECULAE CARNAETRABECULAE CARNAE
CARDIAC CHAMBERSCARDIAC CHAMBERS
C. LEFT ATRIUMC. LEFT ATRIUM
- forms the base of the - forms the base of the heartheart
- smooth inner wall with- smooth inner wall withsmaller smaller
auricleauricle
- posterior part receives - posterior part receives thethe
4 pulmonary veins4 pulmonary veins
- slightly thicker wall than - slightly thicker wall than the right atriumthe right atrium
CARDIAC CHAMBERSCARDIAC CHAMBERS
D. LEFT VENTRICLED. LEFT VENTRICLE- forms the cardiac apex & - forms the cardiac apex &
all of pulmonary all of pulmonary surfacesurface- forms most of diaphragmatic- forms most of diaphragmatic
surfacesurface- walls 2x thicker than the- walls 2x thicker than the
right ventricleright ventricle- trabeculae carnae finer &- trabeculae carnae finer &
more numerousmore numerous- conical cavity is much longer- conical cavity is much longer- larger papillary muscles- larger papillary muscles
CARDIAC VALVESCARDIAC VALVES
A. TRICUSPID VALVEA. TRICUSPID VALVE
guards the left AV orificeguards the left AV orifice
anterior, posterior & septal anterior, posterior & septal cuspscusps
Features:Features:
Chordae TendinaeChordae Tendinae
Papillary MusclesPapillary Muscles
Interventricular SeptumInterventricular Septum
Septomarginal Septomarginal Trabeculae (Moderator Trabeculae (Moderator Band)Band)
CARDIAC VALVESCARDIAC VALVES
B. PULMONARY VALVE B. PULMONARY VALVE (SEMILUNAR)(SEMILUNAR)- at level w/ 3- at level w/ 3rdrd L costal L costal cartcart- anterior, right & left - anterior, right & left cuspscusps
**Pulmonary Sinus**Pulmonary Sinus
C. MITRAL VALVE (BICUSPID)C. MITRAL VALVE (BICUSPID)- at level w/ 4- at level w/ 4thth L costal L costal cart cart - anterior & posterior cusps- anterior & posterior cusps
D. AORTIC VALVED. AORTIC VALVE- at level w/ 3- at level w/ 3rdrd L ICS L ICS- has three cusps- has three cusps
CORONARY CIRCULATIONCORONARY CIRCULATION
ARTERIAL SUPPLY:ARTERIAL SUPPLY:
RIGHT & LEFT CORONARY RIGHT & LEFT CORONARY ARTERIESARTERIES- first branches of aorta- first branches of aorta- supply the epicardium & - supply the epicardium &
myocardiummyocardium- from the ascending aorta - from the ascending aorta just above the aortic just above the aortic valvevalve
CORONARY CIRCULATIONCORONARY CIRCULATION
RIGHT CORONARY ARTERYRIGHT CORONARY ARTERY- runs thru the AV groove- runs thru the AV groove
Branches:Branches:1. SINOATRIAL NODAL 1. SINOATRIAL NODAL
BRANCHBRANCH2. RIGHT MARGINAL BRANCH2. RIGHT MARGINAL BRANCH3. AV NODAL BRANCH3. AV NODAL BRANCH4. POSTERIOR IV BRANCH4. POSTERIOR IV BRANCH
Areas Supplied:Areas Supplied:1. Right Atrium1. Right Atrium2. Most of Right Ventricle2. Most of Right Ventricle3. Part of SA Node & AV Node3. Part of SA Node & AV Node
CORONARY CIRCULATIONCORONARY CIRCULATION
LEFT CORONARY ARTERYLEFT CORONARY ARTERY- passes between the L - passes between the L auricle auricle & pulmonary trunk in the& pulmonary trunk in the
coronary coronary groovegroove
Branches:Branches:CIRCUMFLEX BRANCH CIRCUMFLEX BRANCH
=> Left Marginal Artery => Left Marginal Artery - supplies the left ventricle- supplies the left ventricle
ANT. INTERVENTRICULAR Br. ANT. INTERVENTRICULAR Br. - runs along IV groove to - runs along IV groove to apexapex- anastomosis with the - anastomosis with the
Post. IV branchPost. IV branch- gives off Diagonal Branch – - gives off Diagonal Branch –
anterior surfaceanterior surface
CORONARY CIRCULATIONCORONARY CIRCULATION
AREAS SUPPLIED BY THE LEFT CORONARY ARTERYAREAS SUPPLIED BY THE LEFT CORONARY ARTERY1. Left Atrium1. Left Atrium2. Most of Left Ventricle2. Most of Left Ventricle3. Part of Right Ventricle3. Part of Right Ventricle4. Most of Interventricular Septum4. Most of Interventricular Septum5. SinoAtrial Node in 40% of cases5. SinoAtrial Node in 40% of cases
CORONARY CIRCULATIONCORONARY CIRCULATION
VENOUS DRAINAGEVENOUS DRAINAGE
CORONARY SINUSCORONARY SINUS
Tributaries:Tributaries:1. GREAT CARDIAC VEIN 1. GREAT CARDIAC VEIN (Anterior IV Vein)(Anterior IV Vein)2. MIDDLE CARDIAC VEIN 2. MIDDLE CARDIAC VEIN (Posterior IV Vein)(Posterior IV Vein)3. SMALL CARDIAC VEIN3. SMALL CARDIAC VEIN4. LEFT POST 4. LEFT POST VENTRICULAR VENTRICULAR VEINVEIN5. LEFT MARGINAL VEIN5. LEFT MARGINAL VEIN
CARDIAC CONDUCTING SYSTEMCARDIAC CONDUCTING SYSTEM
SINOATRIAL NODE (Cardiac Pacemaker)SINOATRIAL NODE (Cardiac Pacemaker)- located in the epicardium b/w SVC & Right - located in the epicardium b/w SVC & Right
AtriumAtrium- 70 beats/min- 70 beats/min- triggers contraction of both atria- triggers contraction of both atria- controlled by the Autonomic Nervous System- controlled by the Autonomic Nervous System
(Cardiac Plexus) (Cardiac Plexus)
Sympathetics - increases cardiac rateSympathetics - increases cardiac rateParasympathetics – decreases cardiac rateParasympathetics – decreases cardiac rate
CARDIAC CONDUCTING SYSTEMCARDIAC CONDUCTING SYSTEM
ATRIOVENTRICULAR NODEATRIOVENTRICULAR NODE- located at posteroinferior region of Interatrial - located at posteroinferior region of Interatrial
septumseptum near opening of coronary sinusnear opening of coronary sinus
- follows a myogenic conduction- follows a myogenic conduction- AV Bundles - AV Bundles Right & Left Bundles Right & Left Bundles- Purkinje Fibers (Subendocardial Branches)- Purkinje Fibers (Subendocardial Branches)
