Cardiovascular System Lecture 1 PDF

Cardiovascular system lecture 1 Mo Anatomy CVS ANATOMY Pericardium & External features of the heart Pericardium & External features of the heart...

Cardiovascular system lecture 1 Mo Anatomy CVS ANATOMY Pericardium & External features of the heart Pericardium & External features of the heart heart Definition Muscular pump that keeps circulation going on. Size about the size of individual’s hand’s fist. Site It lies in the middle mediastinum. Shape conical in shape  It is surrounded by a fibro-serous sac called pericardium, which Covering surrounds the heart & proximal part of its great vessels. Features & structure of the heart 1) Right atrium, 2) Right ventricle, 4 chambers 3) Left atrium, 4) Left ventricle. 1) atrioventricular, 4 grooves 2) anterior & posterior Interventricular 3) inter atrial. DR. ME Page | 1 CVS ANATOMY Pericardium & External features of the heart  Directed downwards, forwards and to the left. Apex  It is formed by the left ventricle.  lies at the level of left 5th intercostal space 3.5 inch from midline.  It is formed by the 2 atria, mainly left atrium.  It is directed backwards. Base  Lies opposite middle thoracic vertebrae (5-8).  Bounded inferiorly by coronary sulcus, which lodges the coronary sinus.  Formed by: RA, RV and LV.  The 2 ventricles are separated by anterior Sternocostal interventricular groove, which lodges: surface  Anterior interventricular artery  Great cardiac vein.  The coronary groove lodges right coronary artery  Formed by the 2-ventricles, mainly left ventricle. 4 Surfaces  it rests on diaphragm.  Separated from base of heart by coronary sulcus. Diaphragmatic  The 2-ventricles are separated by posterior surface interventricular groove which lodges:  Posterior interventricular artery  Middle cardiac vein. Right surface Right auricle Left surface Left auricle & left ventricle. DR. ME Page | 2 CVS ANATOMY Pericardium & External features of the heart  Upper border: Formed by the two atria  Right border: Consists of the right atrium 4 Borders  Lower border: Composed of the right ventricle and left ventricle  Left border: Includes the left ventricle and left auricle DR. ME Page | 3 CVS ANATOMY Pericardium & External features of the heart Surface anatomy of Heart Point Location Lower border of the 2nd left costal cartilage, 1.5 inches from the median plane Point 1 Upper border of the right 3rd costal cartilage, 1 inch from the median plane Point 2 Upper border of the right 6th costal cartilage, 1 inch from its junction with the sternum Point 3 Apex at the left 5th intercostal space, 3.5 inches from the median plane Point 4 Surface anatomy of the valves Valve Location Left 3rd sternocostal junction Pulmonary Left 3rd intercostal space, just left of the sternum Aortic Left 4th sternocostal junction Mitral 4th intercostal space near the midline Tricuspid DR. ME Page | 4 CVS ANATOMY Pericardium & External features of the heart pericardium  Formed of: Structure  Outer fibrous layer  Inner serous sac (Parietal, visceral)  Mainly supplied by pericardiophrenic and musculophrenic arteries, branches of internal thoracic artery. Arterial  Pericardial branches of bronchial, esophageal and superior phrenic arteries Blood supply  Visceral layer of the serous pericardium is supplied by the branches of the coronary arteries.  Veins are tributaries of azygos system. Venous  Pericardiophrenic veins also drain into the internal thoracic vein.  The fibrous pericardium and the parietal layer of the serous pericardium are supplied by the phrenic nerves. Nerve supply  The visceral layer of the serous pericardium is innervated by (autonomic fibers) branches of the sympathetic trunks and the vagus nerves. Feature Transverse Pericardial Sinus Oblique Pericardial Sinus Lies anterior to the superior vena cava and posterior to the ascending Location Lies posterior to the heart in the pericardial sac aorta and pulmonary trunk  Anterior: Back of the left atrium  Anterior: Pulmonary trunk & ascending aorta  Posterior: Fibrous pericardium & posterior mediastinum  Posterior: SVC & upper part of the two atria Boundaries (esophagus & descending aorta)  Above: Right pulmonary artery  Left: Two left pulmonary veins  Below: the two atria, mainly the left atrium  Right: Two right pulmonary veins & IVC DR. ME Page | 5 CVS ANATOMY Pericardium & External features of the heart DR. ME Page | 6 CVS ANATOMY Pericardium & External features of the heart Applied Anatomy Pericarditis Inflammation of the pericardium. Pericardial Accumulation of excess fluid within the Effusion pericardial sac. Constrictive Abnormal thickening of the pericardium that Pericarditis compresses the heart, impairing its function. A procedure involving the aspiration or Pericardial Tap removal of fluid from the pericardial cavity. Bare Area of Region not covered by the pleura, located in the Heart the left 4th to 6th parasternal area. DR. ME Page | 7 CVS ANATOMY Pericardium & External features of the heart Great vessels Great Vessel Origin (beginning) Termination Branches/Tributaries a) Right coronary artery (from the Begins at the aortic orifice of the left ventricle Ascending right aortic sinus) behind the left margin of the sternum at the Becomes the arch of the aorta Aorta b) Left coronary artery (from the left level of the left 3rd intercostal space aortic sinus) From the upper end of the infundibulum of the Ends in the concavity of the aortic arch Pulmonary a) Right Pulmonary Artery right ventricle behind the sternal end of the opposite the sternal end of the left 2nd Artery b) Left Pulmonary Artery left 3rd costal cartilage costal cartilage At the lower border of the right 1st costal a) Right and left brachiocephalic veins Superior Vena In the right atrium opposite the right cartilage by the union of right and left b) The azygos vein (at the level of the Cava (SVC) 3rd costal cartilage brachiocephalic veins right 2nd costal cartilage) Right Pulmonary Artery Left Pulmonary Artery Longer Shorter Artery divides at the hilum into 2 branches Artery divides at the hilum into 2 branches a) Smaller branch to the superior lobe a) One branch to the superior lobe b) Larger branch to the middle and inferior lobes of the right lung b) The other branch to the inferior lobe of the left lung --------- Attached to the aortic arch by ligamentum arteriosum DR. 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