CARDIOVASCULAR SYSTEMBERNARD SM HUTABARAT;dr,PAK

FACULTY OF MEDICINE – UPHLIPPO VILLAGE KARAWACI

DEFINITION

CARDIOVASCULAR SYSTEM : ORGANS WHICH FUNCTION IS RELATED TO BLOOD CIRCULATION.

CONSISTS OF : CONSISTS OF :

1.COR ( HEART ) 2.VASA SANGUINEA ( BLOOD VESSELS )

EMBRYOLOGIA SYSTEMA CARDIOVASCULARIA

CVS IS THE 1ST FUNCTIONING SYSTEM IN THE BODY ; BEGINS TO DEVELOP IN THE 3RD WEEK OF GESTATION ( CARNEGIE STAGES 9 – 23 )DAY 18 : MESODERM SPLANCHNICUS

BLOOD ISLANDS ( ANGIOCYST ) DAY 19: COALESCENCE

A PAIR OF ENDOTHELIAL HEART TUBES CEPHALOCAUDAL & LATERAL FOLDING DAY 21 : PRIMARY ( PRIMITIVE ) HEART TUBE

DIFFERENCIATION OF HEART TUBE

PRIMARY HEART TUBE

SINUS VENOSUS PRIMORDIAL ATRIUM VENTRICLE BULBUS CORDIS

V. UMBILICALIS V. VITELLINA V. CARDINALIS COMMUNIS ( CHORION ) ( YOLK SAC ) ( EMBRYO )

SYSTEMA PORTA SYSTEMA CAVA ( VCS & VCI )

ENDOCARDIAL ( PRIMARY HEART ) TUBE

TRUNCUS ARTERIOSUS

BULBUS CORDIS VENTRICLE

INTRAPERICARDIAL (BULBOVENTRICULARIS)

ATRIUM ELONGATIOSINUS VENOSUS

FORMATION OF THE HEART LOOPDAY 23-28 : ELONGATIO PARS BULBOVENTRICULARIS FIXATED BY SURROUNDING TISSU TISSUES PERICARDIAL CAVITY VENTRAL ,CAUDAL

& SLIGHTLY TO THE RIGHT

SULCUS BULBOVENTRICULARIS

PLICA BULBOVENTRICULARIS

BULBOVENTRICULAR LOOPTRUNCUS ARTERIOSUS

BULBUS AORTAE & PARTS OF THE ASCENDING AORTAE

SULCUS BULBOVENTRICULARIS

PLICA BULBOVENTRICULARIS

VENTRICLE

CONUS CORDIS OUTFLOW TRACTS OF RV & LV

PARTITION OF ATRIUM

DAY 28 : SEPTUM PRIMUM ABSORBTION SEPTUM SECUNDUM FORAMEN PRIMUM ENDOCARDIAL CUSHION

SEPTUM SECUNDUM

FORAMEN OVALE ATRIUM DEXTRA ATRIUM SINISTRA

SEPTUM PRIMUMVENTRICLE DEXTRA VENTRICLE SINSITRA

PARTITIONING OF OUTFLOW TRACTSOUTFLOW TRACTS COMPOSED OF BULBUS CORDIS AND TRUNCUS ARTERIOSUSWEEK 5 : TWO PAIRS OF SWELLING GROW FROM THE WALL OF THE OUTLOW TRACT :1. TRUNCUS SWELLINGS : AT PERIPHERE. ( PERIPHERAL TRUNCUS SWELLING )

1.1. RIGHT SUPERIOR ( RSTS ) : GROWS DISTALLY TO THE LEFT

1.2. LEFT INFERIOR ( LITS ) : GROWS DISTALLY TO THE RIGHT2. CONUS SWELLINGS : DISTALLY ( CENTRAL TRUNCUS SWELLING )

2.1. RIGHT DORSAL ( RDCS ) 2.2. LEFT VENTRAL ( LVCS )

RSTS CONTINUES WITH RDCS ; LITS CONTINUES WITH LVCS

SEPTUM AORTICOPULMONALIS ( AORTICO-PULMONARY SEPTUM )

ROTATION OF SEPTUM AORTICOPULMONALE SEPTUM AORTICOPULMONALEPARTITIONING OF OUTFLOW TRACTS ACHIEVED BYROTATION OF THE SEPTUM AORTICOPULMONARY.FIXED POINT : SULCUS BULBOVENTRICULARIS.ROTATION CONSISTS OF :1. ROTATION OF PERIPHERAL BULBAR ORIFICE ( ORIFICE CONNECTED TO TRUNCUS ARTERIOSUS ): 1.1. FIRST ROTATION : 180º CCWR 1.2. SECOND ROTATION ( WEEK 5 – 8 ) : 150º CWR 2. ROTATION OF CENTRAL BULBAR ORIFICE ( AT THE BORDER OF BULBUS & VENTRICLE ) 2.1. FIRST ROTATION : 90º CWR 2.2. SECOND ROTATION : 45º CCWRTHE RESULT OF THE ROTATION IS SEPTUM AORTICO-PULMONALE BECOME SPIRAL FORM ; THENCE :1. AORTA ORIGINATED FROM LV2. A. PULMONALIS ORIGINATED FROM RV

CIRCULATIO FOETALIS ( FETAL CIRCULATION )

PARTICIPATING COMPONENTS : * DUCTUS ARTERIOSUS BOTALLI * ATRIUM SINISTRA * CRISTA DIVIDENS AMOROSO (CAUDAL MARGIN OF SEPTUM SECUNDUM) * FORAMEN OVALE * ATRIUM DEXTRA * VALVULA VENAE CAVAE INFERIORIS EUSTACHII * V. CAVA INFERIOR * DUCTUS VENOSUS ARANTII ( HEPAR BY PASS )

* V. UMBILICALIS PLACENTA* AA. UMBILICALES

.

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CHANGES AFTER BIRTH

MALFORMATIO CONGENITALIA

1.ABNORMALITIES OF THE CARDIAC SEPTUM: 1.1. PATENT ( PERSISTENT ) OF THE OVAL FORAMEN. * PROBE PATENCY OF THE OVAL FORAMEN. 1.2. VENTRICULAR SEPTAL DEFECT ( VSD )2. ABNORMALITIES OF TRUNCUS AND CONUS : TETRALOGY FALLOT ( BLUE BABY ) : 2.1. PULMONARY STENOSIS ( PS ) 2.2. VSD 2.3. OVER RIDING AORTAE 2.4. RIGHT VENTRICULAR HYPERTROPHY ( RVH )3 ABNORMALITY OF THE DUCT. PATENT ( PERSISTENT ) DUCTUS ARTERIOSUS BOTALLI.4. ABNORMALITY OF THE ROTATION TRANSPOSITION OF THE GREAT VESSELS

MALFORMATIO CONGENITALIAPERSISTENT FOR. OVALE V S D TETRALOGY FALLOT

PERSISTENT DUCTUS ARTERIOSUS TRANSPOSITION OF THE GREAT VESSELS ( P D A ) ( T G V )

VASAE SANGUINEAE ( BLOOD VESSELS )

DEFINITION.

VASAE SANGUINEAE ( BLOOD VESSELS ) ARE VESSELS THAT CIRCULATE BLOOD TO AND FROM THE HEART.

CONSISTS OF :

1. ARTERIA ( A, ARTERY )

2. CAPILLARIA ( CAPILLARY ) 3. VENA ( V ,VEIN )

DIFFERENCES BETWEEN ARTERIA AND VENA

ARTERIA DISTINCTIONS VENA

THICKER WALL THINNER

SMALLER DIAMETRE LARGER

+ MUSCULAR LAYER -

+ PULSE -ACTIVELY BLOOD STREAM PASSIVELY

PROXIMAL TO DISTAL STREAM DIRECTION DISTAL TO PROXIMAL

- VALVES +EMPTY, INTACT LUMEN (AFTER DEATH) COLLAPS,CLOTTING

OXYGENATED BLOOD CONTENT DEOXYGENATED

RAMUS BRANCHES TRIBUTARIA

MAIN ARTERIES OF THE BODY

AORTA (LV, LOWER BORDER CARTIL.COSTAE III ) AA. CORONARIAE CORDES

AORTA ASCENDENSA. ANONYMA

ARCUS AORTAE A.CAR.COMMUNIS DEXT. A.CAR COMMUNIS SIN

AORTA THORACALIS

A. SUBLAVIA DEXTRA A. SUBLAVIA SIN

AORTA ABDOMINALIS

A. ILIACA COMMUNIS ( L 4 )

AA. ILIACAE EXT. ET INT.(ARTIC.SACRO-ILIACA )

AA COELIACA,MESENTERICAE,RENALES ET LUMBALES

MAIN VEINS OF THE BODY VV.JUGULARIS INTERNA ET SUBCLAVIA

TRIBUTARIAE PARTES SUPERIOR

VV. BRACHIOCEPHALICA DEXTRA ET SINISTRA V. CAVA SUPERIOR

V. CAVA SUPERIOR (CARTIL.COSTAE I - III )

TRIBUTARIAE THORACALES

HIATUS VCI ( DIAPHRAGMA; T 8 )

TRIBUTARIAE ABDOMINALES

V. CAVA INFERIOR ( VCI, L 5 )

TRIBUTARIAE PELVICAE

VV. ILIACAE EXTERNA ET INTERNA (V. HYPOGASTRICA)

LOCATION FOR PALPATING PULSES

A.TEMPORALIS SUPERFICIALIS

A. CAROTIS COMMUNIS/EXTERNA

A. BRACHIALIS

A. RADIALIS

A. FEMORALIS

A. POPLITEA

A. TIBIALIS POSTERIOR

A. DORSALIS PEDIS

CORSIZE : FISTFUL HAND

RIGHT DORSOCRANIALLY

AXIS CORDIS

LOCATION : MEDIASTINUM MEDIUS

FIXATION OF THE HEART : VISCERAL ORGANS &THE GREAT CARDIAC VESSELS

LEFT VENTROCAUDALLY

POSITION : OBLIQUE, ACCORDINGLY TO AXISCORDIS ( AXIS OF THE HEART).

AXIS CORDIS : IMAGINARY AXIS OF THE HEART DRAWN OBLIQUELY FROM BASIS CORDIS ( BASE OF THE HEART ) TO APEX CORDIS

ASYMMETRICAL POSITION OF THE HEART ( ⅔ LEFT AND ⅓ RIGHT SIDE )

MEDIASTINUMTHE PART OF C AVUM THORACIS BETWEEN PULMONES DEXTRA ET SINISTRA( RIGHT AND LEFT LUNGS )

ANGULUS STERNALIS LUDOVIGI ( ANGLE OF LUDWIG )

1.MEDIASTINUM SUPERIOR

IMAGINARY PLANE

2. MEDIASTINUM INFERIUS :

2.1. MEDIAST. ANTERIUS

2.2. MEDIAST. MEDIUS

2.3. MEDIAST.POSTERIUS

BORDERS OF MEDIASTINUM::1.LATERAL : PLEURA MEDIASTINALIS2.DORSAL : VERTT. THORACALES &COLLUM COSTAE3.VENTRAL : STERNUM4.KAUDAL : DIAPHRAGMA5.KRANIAL : APERTURA THORACIS SUPERIOR

MEDIASTINUM SUPERIUSCONTENTS :

1. THYMUS

CORPUS ADIPOSUM RETROSTERNALE / JUGULARE

4. UNIT OF 4 PARALLEL STRUCTURES :

4.1. TRACHEA

4.2. OESOPHAGUS

4.3. N. RECURRENS SIN.

4.4. DUCTUS THORACICUS

2. VV. ANONYMAE DEXTRA ET SINISTRA

3. V. CAVA SUPERIOR

COVER OF THE HEART OUTER LAYER, DETACHED EASILY

PERICARDIUM ;

1. PARIETALE

-----CAVUM PERICARDII----

2. VISCERALE

INNER LAYER, ATTACHED FIRMLY TO THE HEART

EXTERNAL PARTS OF THE HEARTBASIS CORDIS (BASE OF THE HEART)

GREAT CARDIAC VESSELS

FACIES ANTERIOR CORDIS

( ANTERIOR SURFACE OF THE HEART )MARGO OBTUSUS CORDIS

FACIES POSTERIOR CORDIS

SULCI CORDIS :

1. SULCUS CORONARIUS CORDIS

2. SULCI LONGITUDINALES ANT.ET POST (SULCI INTERVENTRICC.ANT.ET POST)

MARGO ANTERIOR CORDIS (MARGO ACUTUS )

APEX CORDIS (TOP OF THE HEART)

ICTUS CORDIS

THE GREAT CARDIAC VESSELS

5. AORTA

1. V. CAVA SUPERIOR

3. A. PUMONALIS

4. VV. PULMONALES

2. V. CAVA INFERIOR

SULCI CORDES 1.SULCUS CORONARIUS CORDIS

1.1. AA. CORONARIAE CORDES

1.2.SINUS CORONARIUS

2.SULCUS LONGIT.ANT.CORDIS:

2.1. R.DESC.ANT.A.COR.CORD.SIN

2.2.. V.CORDIS MAGNA .

3.2. V. CORDIS MEDIA

3.1. R.DESC.POST.A.COR.CORD.DEXTRA

3.SULCUS LONGITUDINALIS ( INTERVENTRICULARE ) POSTERIOR CORDIS

INTERNAL PARTS OF THE HEARTFOUR CHAMBERS :1.RIGHT ATRIA(ATRIUM DEXT) 3. LEFT ATRIA 1.1.OSTIUM VCS OSTT. VV. PULM. .1.2. OST. SINUS CORON OST. AV SINISTRA 1.2. OSTIUM VCI OSTIUM AV DEXTRA VALV. BICUSPIDALIS

4. LEFT VENTRICLE VALVULA TRICUSPIDALIS OSTIUM AORTAE TRABECULAE CARNEAE CHORDA TENDINEA M. PAPILLARIS OST. A. PULMONALIS SEPTUM INTERVENTRIC. 2.RIGHT VENTRICLE(VENTRIC.DEXTRA)

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PROYEKSI ORIFICIAE CARDIACAE

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VASCULARISATIO CORDES1. AA. CORONARIAE CORDES DEXTRA ET SINISTRA.

2. Vv. CORDES

3. CIRCULATIO COLLATERALES :3.1. CARDIACA3.1. EXTRA CARDIACA.

VASCULARIZATION OF THE HEART1.A. CORONARIA CORDIS DEXTRA ( AVN TAWARA, LA, FASCIC.AV HIS, VENTRICLE WALL & SEPT.VENTRIC.) 1.1. R.DESC.POST. A. CORON.CORD. DEXTRA 1.2. R.TRANSVERSA A. CORON.CORD. DEXTRA 1.2. R. MARGINALIS A. CORON. CORD. DEXTRA 2. A. CORONARIA CORDIS SINISTRA

( PARS ANT.SEPT.VENTRIC., NEARBY RV & FACIES ANTERIOR LV ) 2.1. R. DESC. ANT. A.CORON.CORD. SIN

.

2.2. R. CIRCUMFLEXA A. CORONARIA SIN

VENAE CORDES

*SINUS CORONARIUS

1. V. CORDIS MAGNA*

2. V. CORDIS PARVA*

4. V. OBLIQ. ATRII SINISTRI MARSHALLI*

5. V. POSTERIOR VENTRICULI SIN.*

6. V. CORDIS ANTERIOR.

7. V. CORDIS MINIMAE THEBESII

3. V. CORDIS MEDIA*

CIRCULATIO SANGUINEA1. CIRCULATIO PULMONALIS ( CIRCULATIO MINOR ) ATRIUM DEXTRA OSTIUM ATRIOVENTRIC.DEXTRA

( VALVULA TRICUSPIDALIS) VENTRICLE DEXTRA

A.PULMONALIS CAPILLARIAE PULMONALES

VV.PULMONALES ATRIUM SINISTRA

2. CIRCULATIO SYSTEMICA ( CIRCULATIO MAJOR ) ATRIUM SINISTRA OSTIUM ATRIOVENTRICULARE

SINISTRA ( VALVULA BICUSPIDALIS ) VENTRICLE

SINISTRA AORTA SELURUH TUBUH.

ATRIUM DEXTRA VCI ET VCS

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CIRCULATIO SANGUINEA

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INNERVATIO CORDIS1. TRUNCUS SYMPHATICUS

1.1. NN. CARDIACI SUP. ET MED.1.2. NN. CARDIACI T2-3

2. N. VAGUS

1&2 : PLEXUS CARDIACUS • PLEXUS CARDIACUS SUPERF : DI BAGIAN KAUDAL

ARCUS AORTAE, ANTERIOR TERHADAP A.PULM. BERISI GGL. CARDIACUM WRISBERGI.

• PLEXUS CARDIACUS PROF.DI DEPAN PERCABANG. A.PULM, DORSALTERHADAP AORTA.

N.VAGUS : BRADYCARDIASYMPHATICUS : TACHYCARDIA

SOURCES

1. The Cardiovascular System: The Heart Embryology Atlas ; Partition of Bulbus Cordis and Truncus Arteriosus

2. Dawn A. Tamarkin, Ph.D; University of Wisconsin Anatomy2. John A. McNulty, Ph.D.Professor , LOYOLA

UNIVERSITY MEDICAL CENTER ; Cell Biology, Neurobiology and Anatomy

3. Langman, Jan : Medical Embryology5. Peerves et al : Life : The Scientific Biology6. UNSW : Embryology