ANATOMY OF CARDIOVASCULER 1

CHODIDJAH

The Heart

Location Thorax between the lungs Superior surface of diaphragm Left of the midline Anterior to the vertebral column, posterior to

the sternum

The Heart: Coverings

Pericardium A superficial fibrous pericardiumA deep two-layer serous pericardium The parietal layer lines the internal surface of the fibrous

pericardium The visceral layer or epicardium lines the surface of the heart

Serous fluid fills the space between the layers of pericardium

The Heart: Heart Wall

Three layers Epicardium This serous membrane of smooth outer surface of heart

Outside layerThis layer is the parietal pericardiumConnective tissue layer

MyocardiumMiddle layercomposed of cardiac muscle cellresponsibility for heart contracting

EndocardiumInner layerEndothelium

The Heart: Chambers

Four chambers Atria

Right atrium Left atrium

Ventricles Right ventricle Left ventricle

External Heart: Major Vessels of the Heart

Vessels returning blood to the heart include:1. Superior and inferior venae cavae2. Right and left pulmonary veins

Vessels conveying blood away from the heart include:1. Pulmonary trunk, which splits into right and left

pulmonary arteries2. Ascending aorta (three branches)

a. Brachiocephalicb. Left common carotidc. Subclavian arteries

External Heart: Posterior View

Anatomy of Heart: Frontal Section

Atria of the Heart

Atria are the receiving chambers of the heart Each atrium has a protruding auricle Pectinate muscles mark atrial walls Blood enters right atria from superior and inferior

venae cavae and coronary sinus Blood enters left atria from pulmonary veins

Right Atria has inferior vein cava ( valve of inferior vein cava) superior vein cava sinus coronarius osteum (valve of osteum sinus coronarius) cordis minimi veins Pectinati mucle terminalis cristae= tuberculum intervenosum Ovalis fossa Limbus of ovalis fossa Right atrio ventricularis osteum (tricuspidalis) Right Auricula .

Ventricles of the Heart

Right Ventricle has: Pulmonalis trunk (semilunair valve) Papilaris anterior muscle and papillaris posterior

muscle Chorda tendenea Trabecula carnae.

Left ventricle has: Base of the aorta ( posterior, dextra and sinistra

semilunair valve) Left atrioventriculair osteum ( bicuspidalis =

mitralis ) Papilaris muscle Chorda tendenea Trabecula carnaeRight ventricle pumps blood into the pulmonary trunkLeft ventricle pumps blood into the aorta

Coronary Circulation

Blood in the heart chambers does not nourish the myocardium

The heart has its own nourishing circulatory system Coronary arteries Cardiac veins Blood empties into the right atrium via the

coronary sinus

Coronary Circulation

Branches of ascendens aorta : Right coronary artery Left coronary arteryBranches of Right coronary artery marginalis arteries posterior descendens arteries Supplies blood to the right ventricle . right atrium SA

node and AV node.

Branches of left coronary arteria: circumflex branch anterior descendens arteryLeft coronary arteries: Supplies blood to the left

ventricle and left atrium

circumflex branch supplies blood to lateral side and back of the heart

anterior descendens artery supplies blood to the font of the left side of the heart

Veins : great cardiac vein ( vena cordis magna), posterior vein to left ( Vena posterior ventriculi sinistri), coronary sinus ( Sinus coronarius), and middle cardiac vein ( Vena cordis media) cordis minimi vein ( cardiaca minimi vein) dexter atria oblique atrii sinistri vein Cardiaca anterior vein dexter atria

The Heart: Valves

Four valves Atrioventricular valves between atria and ventricles

Bicuspid valve (left)Tricuspid valve (right)

Semilunar valves between ventricle and arteryPulmonary semilunar valveAortic semilunar valve

The Heart: Valves

Valves open as blood is pumped through Close to prevent backflow

The Heart: Associated Great Vessels Aorta

Leaves left ventricle Pulmonary arteries

Leave right ventricle Vena cava

Enters right atrium Pulmonary veins (four)

Enter left atrium

Pathway of Blood Through the Heart and Lungs

Right atrium tricuspid valve right ventricle Right ventricle pulmonary semilunar valve

pulmonary arteries lungs Lungs pulmonary veins left atrium Left atrium bicuspid valve left ventricle Left ventricle aortic semilunar valve aorta Aorta systemic circulation

Cardiac Pathology

= Inadequate blood = Angina Pectoris

Branches of the aorta

Glomus caroticus and Sinus caroticus Glomus caroticus

( carotid body): Is a small cluster of

chemoreceptors and supporting cells located near the bifurcation of the carotid artery, that monitors changes in the oxygen content of the blood and help control respiratory activity

They release a variety of neurotransmitter .

Sinus caroticus is the dilated area to the bifurcation of the common carotid at the level of the superior border of thyrod cartilage

Pulmonary circuitThe blood pathway between the right side of the heart, to the lungs, and back to the left side of the heart.

Systemic circuitThe pathway between the left and right sides of the heart.

Pathway of Blood Through the Heart and Lungs

Right atrium tricuspid valve right ventricle Right ventricle pulmonary semilunar valve

pulmonary arteries lungs Lungs pulmonary veins left atrium Left atrium bicuspid valve left ventricle Left ventricle aortic semilunar valve aorta Aorta systemic circulation

Blood Circulation

Coronary Circulation: Arterial Supply

Flow Chart of Fetal Circulation

Congenital Heart Disease

Atrial Septal Defect (ASD) Ventricular Septal Defect (VSD) Atrioventricular Septal Defect (AV Canal) Patent Ductus Arteriosus (PDA)

ASD VSD

Complete AVSD

Pulmonary Stenosis Aortic Stenosis

Coartation of the Aorta

The Heart: Conduction System

Sinoatrial node (right atrium) Pacemaker

Atrioventricular node (junction of r&l atria and ventricles)Atrioventricular bundle (Bundle of His)Bundle branches (right and left)Purkinje fibers

Impulse passes from atria to ventricles via the atrioventricular bundle (bundle of His) AV bundle splits into two pathways in the interventricular

septum (bundle branches)1. Bundle branches carry the impulse toward the apex of

the heart2. Purkinje fibers carry the impulse to the heart apex and

ventricular walls

Extrinsic Innervation of the Heart Heart is stimulated by

the sympathetic cardioacceleratory center

Heart is inhibited by the parasympathetic cardioinhibitory center

Sympathetic nervous system (SNS) stimulation is activated by stress, anxiety, or exercise

Parasympathetic nervous system (PNS) stimulation is mediated by acetylcholine and opposes the SNS

Lokasi proyeksi katub. Jantung:Katub Aorta : ICS II kanan, linea sternalisKatub. Pulmonal : ICS II kiri , linea sternalisKatub. Trikuspid : ICS IV-V linea sternalis kanan- kiriKatub. Mitral : ICS V linea Midclavicularis, 2 cm ke

medial . ( Apex )

BATAS BATAS jantung

BATAS KANAN:ICS V ( cartilago costa VI) Linea sternalis kananBATAS ATAS:ICS II Linea parasternalis kiriBATAS KIRI BAWAH ( APEX CORDIS )ICS V 1- 2 cm disebelah medial linea midclavicularis.PINGGANG JANTUNG:ICS III linea parasternalis kiri.

The Vascular System

Taking blood to the tissues and back Arteries Arterioles Capillaries Venules Veins

The Vascular System

RETICULAR VEIN