heart and pericardium prof. dr. selda Önderoğlu prof. dr. h. selçuk sürücü
TRANSCRIPT
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Heart and Pericardium
Prof. Dr. Selda Önderoğlu
Prof. Dr. H. Selçuk Sürücü
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heart
muscular organPumps blood to body.Shape:conicalApex is directed downwards
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location
location:thoracic cavityMiddle mediastinum
Weight:250-300 gr. In the adult
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• Right and left:mediastinal surfaces of the lungs
• inferior: Diaphragm
• Anterior:: Sternum, costal cartilages,remains of thymus gland and partially lungs
• Posterior:Oesophagus
relations
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General shape
Apex Base 4 surfacesFour borders
Apex: directed anterior,inferior and to the left, Base:faces posteriorly and to the right
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Apex
L ventricleForward,
downward&to the left
Prof. Dr. H. Selçuk Sürücü
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Base
L & R atriaFaces posteriorly
Prof. Dr. H. Selçuk Sürücü
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Diaphragmatic (inf) surface
L ventricle
Prof. Dr. H. Selçuk Sürücü
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Sternocostal (ant) surface
R atriumR ventricleL ventricle
Prof. Dr. H. Selçuk Sürücü
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+ v brachiocephalica
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Inf border
R ventricleL ventricle
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Sup border
L atrium, roots of great
vessels
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Right and left borders
Right border, Right atrium.
Left border, left ventricle,left auricle.
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Surface projections of borders
Apex:5th intercostal space 9 cm from midline 2nd left costal cartilage 1 cm from sternum3rd right costal cartilage 1cm from sternum6th right costal cartilage 1cm from sternum
Prof. Dr. H. Selçuk Sürücü
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“ coronary sulcus”,between atria and ventricles.
“anterior interventricular sulcus”,
between ventricules
• “posterior interventricular sulcus”,
between ventricles
External features
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R atriumV cava sup&infCoronary sinusPectinate mmSinus venorum(sinus of venae cavae)Terminal crestInteratrial septumForamen ovaleFossa ovalisLimbus fossa ovalisAuricle (ant.to crest)
Tricuspid valve(bw.R atr.&R vent.)
Prof. Dr. H. Selçuk Sürücü
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R ventricle
Cusps of tricuspid valve/R atrioventricular valve (at sup wall)(ant.+post.+septal)
Interventricular septum (septal wall)
Membranous part muscular partAtrioventricular part ( bw. R atr&L ventr.)
Pro.
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R ventricle
Trabeculae carneaPapillary mm(ant+post+septal)Septomarginal trabecule (moderator band)Conus arteriosus (infundibulum)Supraventricular crestOpening of pulmonary trunk(has 3 semilunar cusps- R+L+Ant)
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L atrium
Pulmonary vv openings (4 in number)Valve of foramen ovaleDuring development prevents blood from L atr. to R atr)AuricleMitral valve/L atrioventricular valve(Ant+post cusps)
Prof. Dr. H. Selçuk Sürücü
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L ventricleCusps of mitral valve/L
atrioventricular valve(Ant+post cusps)
Papillary mm(ant+post)Chordae tendineaeTrabecula carneae
Aortic openingAortic valve ( R+L+post semilunar cusps)(each cusp has lunule,nodule,sinus)
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Arteries of heart
Right coronary artery (R marginal br &Post interventricular br)
Left coronary artery(Circumflex br+Ant interventricular br)
R&L coronary aa- Both Exit from bulbus aorta
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Prof. Dr. H. Selçuk Sürücü
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Veins of heartcoronary sinus-receives great,middle,small&post. Cardiac v)
Least cardiac vv (venae cordis minimae-Thebasian vv)-directly into chambers
Anterior right ventricular vvRight marginal v
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Great cardiac v
Ant interventricular vL coronary v
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Small cardiac v
R coronary v
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Middle cardiac v
Post interventricular v
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Innervation of heart
SympPsymp
Together They form the cardiac plexus
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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)
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Parasympathetics
(vagus nerve (CN X)
Sup cervical cardiac brr
inferior cervical cardiac brr
Thoracic cardiac brr ( of vagus n.)
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Lymphatics of heart
R inf tracheabronchial lymph nodes
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Layers of heart
Endocardium:innermost layerMyocardium: middle layer, muscular layer,striated,under control of autonomic nervous systemPericardium: outermost layer, like a sac
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Myocardium Atrial
VentricularConducting system
Striated-special typeUnder autonomic nervous system controlAtrial muscle fibers: 2 layers (inner-each atrium, outer- two atria together)Ventricular muscle fibers- has complex structure, no distinct layers- vortex
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Myocardium
Prof. Dr. H. Selçuk Sürücü
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Skeleton of heart
R & L fibrous rings (around mitral&tricuspid valves
R & L fibrous trigones
Around aortic & pulmonary
valvesProf. Dr. H. Selçuk Sürücü
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Conducting system of heart- specialised myocardial fibers
SA nodeat terminal crestAV node, at interaatrial septumAV bundle, pars membranaceaR & L bundle branchesPurkinje fibers
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Pericardium
Fibrous pericardiumSerous pericardium
Parietal layerVisceral layer (epicardium)
“pericardial cavity ” “liquor pericardii”
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Pericardial sinuses-of the pericardial cavity
Oblique sinusBw.Left atrium- Pulmonary vvLike the letter “j”, inverted
Transverse sinus superior v.c.&leftatrium-
pulmonary trunk&ascending aorta two ends open
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nerves of pericardium
Phrenic n –parietal pericardium (afferent)
vagusSympathetic trunk
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Aorta
ascending aorta
Arch of aorta
descending aorta