Anatomy of Internal Structures of Heart Students PDF

Anatomy of Internal Structures of Heart Dr. Rana Aly Elbeshbeishy Professor, Anatomy Department, RAKCOMS, RAKMHSU MBBS, MSc, PhD (Anatomy), Faculty of Medicine, ASU, Egypt MHPE Ottawa U, Canada Rana.aly@rakmh...

Anatomy of Internal Structures of Heart Dr. Rana Aly Elbeshbeishy Professor, Anatomy Department, RAKCOMS, RAKMHSU MBBS, MSc, PhD (Anatomy), Faculty of Medicine, ASU, Egypt MHPE Ottawa U, Canada [email protected] Office- 209, First Floor, Ext. 262  Learning Outcomes - List the parts of the heart. - Describe the internal features of heart chambers and its Clinical correlations. - Compare and contrast the left versus the right heart anatomically. - Name and describe the anatomy of heart valves, moderator bands, & myocardium. - Describe the surface anatomy of heart valves and points of auscultation.  Blood flow through the Chambers of the Heart: Poly Fated blood Overview vein pulmonary 6 6 Heart is divided into 2 halves; right (for deoxygenated 2 blood) & left (for oxygenated Carryoxygnatedbloo miskg agitated 1 1 yrii.it blood) halves. 111 Heart is formed of 4 chambers 5 3 separated by septa. 2 4 Heart is rotated to the LT  so that RT atrium & RT p 0 4 5 ventricle are present anterior 3 to LT atrium & LT ventricle. 1 netians ftp.t.at monguaugnoing  as Right Atrium: Internal Anatomy (Ant. view) SVC item pox Receives blood from the whole body. Has a small extension; Right auricle. atrium Has 2 parts; smooth and rough T.fi eeE.EEEf separated externally by sulcus terminalis. Openings of the Right Atrium 1. Inferior vena cava (IVC) opening. 2. Superior vena cava (SVC) opening. 3. Coronary sinus opening. L 4. Anterior cardiac veins openings. 5. Venae cordis minimi openings. aggaganggame cardiac The smallish 6. Tricuspid orifice (Right atrio- Ficcorific.e ventricular) opening.  Right Atrium: Internal Anatomy (Ant. view) Pectinate muscle Sinus Venarum smooth IiEEtn rough, internal aspect of internal aspect of atrium auricle a border Iliff Crista Terminalis Corresponds to sulcus terminalis; image separates rough from smooth aspects Fossa Ovalis depression on inter-atrial septum; derived 00 Opening of the coronary sinus 9 Tatshaped from foramen ovale; has margin termed and its valve limbus of fossa ovalis depression 0 Five oriitive Opening of the IVC and its valve Clinical correlation: Atrial Septal Defects (ASD) can arise to non- closure of foramen ovale; these small ASDs are common and called usually asymptomatic; larger ASDs → associated with enlarged The smooth area right side of heart; → may lead to pulmonary hypertension sinus venarum  Right Ventricle: Internal Anatomy (Ant. view) - receives blood from right Pulmonary Valve atrium & pumps it to lungs - guards pulmonary orifice. via pulmonary trunk - formed of 3 semilunar cusps - divided into 2 parts: A) Rough inflowing part: S contains trabeculae carneae & 3 papillary muscles. P B) Smooth outflowing part: infundibulum EE nn - Cavity is crescent in cross section Tricuspid Valve - lies between RT atrium & RT Ventricle. A -3 cusps; guards RT atrioventricular opening he pocketed  Af Right Ventricle: Internal Anatomy (Ant. view) on Cusps of the Pulmonary Valve Anterior, Right, Left Conus arteriosus (infundibulum) of S eptifi F smooth aspect leading to pulmonary valve Moderator Band casp Posterior (Septomarginal Trabecula) Cusps of Tricuspid Valve Connects anterior papillary muscle to 1 motors Interventricular septum (IV) (electrical Anterior, Posterior, Septal communication) Trabeculae carneae Ft Rough (irregular muscle ridges, internal aspect of ventricle Papillary Muscles Ainterior Anterior, Posterior, Septal (attached to corresponding cusp ventricular wall); papillary muscles bind the anterior, posterior and septal cusps via chordae tendinae  oxygenated blood through pulmonary vein Left Atrium: Internal Anatomy (Left lateral view) Receives blood from lungs. Has a small extension; Left auricle. Mostly smooth; only auricle is rough Note: test in -Pulmonary veins drain into t.hr smooth part of left atrium -Left auricle lined internally Fits with rough pectinate muscle valve of -Superior aspect of the Mitral Value (bicuspid) valve -Valve of the foramen ovale in interatrial septum  z.ir EsI - receives blood from Lt Left Ventricle: Internal Anatomy (Left lat. view) all tough excep atrium & pumps it to Whole body via Aorta a way test - Has 2 parts: Rough & Smooth (Vestibule) Cusps of - Resembles Rt ventricle but its wall is 3 times thicker Aortic Valve a - Cavity is circular in cross section Ant. Papillary Muscle bound to anterior cusp of mitral valve via chordae tendinae Aortic Vestibule internet smooth wall leading to aortic valve Mitral (bicuspid) Valve Trabeculae carneae Post. Papillary Muscle regerged rough, internal aspect of ventricle Bound to posterior cusp of mitral valve via chordae tendinae or prey  Chambers of the Heart in Section Through IV Septum Note: visit aortic -Thickness in left vs. right ventricle wall Left Atint RA Finn -Muscular part vs. Membranous part of Interventricular (IV) Septum LA smoth LA RV RA LV y interesting aurictipart LV RV main 1s Clinical correlation: capillarymuscle Membranous IV septum common site of ventricular septal defects (VSDs)  Pre-natal circulation: Right to Left shunts (Pulm. To Systemic) LA Oxygenated blood derived from RA mother (umbilical veins) LV RV bypasses liver  enters heart  blood bypasses right side/pulmonary circuit via 1) Foramen ovale (shunt b/w right and left atria) 2) Ductus Arteriosus (shunt b/w pulmonary trunk and if aorta) Post-natal circulation: Lungs functional, now responsible for blood oxygenation; umbilical vein and liver shunt occludes; the two right-to-left circulatory shunts also occlude: 1) Foramen ovale is closed off depression termed fossa ovalis 2) Ductus arteriosus occludes leaving Ligamentum arteriosum  The Cardiac Skeleton (Conceptual) I This fibrous, elastic skeleton biased Tricuspi -supports the structure/patency of the AV valves (tricuspid, mitral) and the semilunar valves (aortic, pulmonary) -provides attachment sites for cardiac muscle -is inert and thus forms electrical plane separating chambers of heart  Anterior The Valves Viewed From Above Left Right oooo Posterior Pulmonary Valve thebranch Aortic Valve the only Aorta from ascending both value should be opened to illing my Tricuspid Valve the.TT lf Mitral Valve confracted Diastole: Systole: -Tricuspid and Mitral Valves Open -Tricuspid and Mitral Valves Close (Papillary muscles relax) (Papillary muscles contract) -Ventricles Fill -Ventricles Contract -Pulmonary and Aortic Valves Close -Pulmonary and Aortic Valves Open  Cusps of Heart Valves, Viewed From Above Anterior Pulmonary Valve: Anterior Semilunar Cusp Left Right Right Semilunar Cusp Posterior Aortic Valve: Left Semilunar Right Semilunar Cusp Cusp Posterior Semilunar Cusp Left Semilunar Tricuspid Valve: Cusp Ant. Cusp Septal Cusp Mitral Valve: Post. Cusp Ant. Cusp LCA Post. Cusp RCA Section of Heart Revealing Aortic Valve: Note Right and Left Semilunar Cusps Associated Openings for RCA and LCA; Spaces above cusps are called aortic sinuses; when valve is Right Post. Left Cusp Cusp closed, blood backflows into sinuses and enter coronary arteries Cusp Auscultation of Heart Valves Aortic Valve: 2nd Rt intercostal space, to the right of sternal border Pulmonary Valve: 2nd Lt intercostal space, to the left of sternal border Tricuspid Valve: left sternal border near 5th or 6th intercostal spaces Mitral Valve: 5th intercostal space, left side, approximately in midclavicular line  Auscultation of Heart Valves 2nd RT intercostal space 2nd LT intercostal space of 0ᵗʰ Angle the oval is where the glue P A i 3rd space O 3rd costal cartilage 4thcostalcartilage Fth M T space 4th space 4th costal cartilage RT ½ of lower end of sternum apex of heart (5th LT space 3.5 inches from midline)  AHL lately poster II To Clinical Correlation allow blood to flow 81 1 dilation Valve disease again resistance incompetence (insufficiency) or Stenosis (narrowing of orifice) Jaggargetprolaps very narrow a and Mitral valve disease: can be stenosis incompetence, ane – Mitral valve stenosis: congenital or acquired m tiheartsee causingRheumat – Most common cause for acquired mitral valve stenosis → Rheumatic fever. for reggerge Aortic valve disease: happenstance both aortic stenosis and aortic regurgitation (backflow), can produce marked heart failure. because of – Aortic valve stenosis: most common cardiac valve disease Lensis Causes: » atherosclerosis → calcification of valve leaflets. » postinflammatory or postrheumatic conditions