Anatomy of the Heart PDF

Session Objectives: 1. Describe the layers of the pericardium, especially with respect to cardiac tamponade 2. Describe landmark external anatomic features of the heart chambers 3. Describe landmark internal anatomic features of the heart chambers 4. Describe the vessels that supply/drain the ch...

Session Objectives: 1. Describe the layers of the pericardium, especially with respect to cardiac tamponade 2. Describe landmark external anatomic features of the heart chambers 3. Describe landmark internal anatomic features of the heart chambers 4. Describe the vessels that supply/drain the chambers 5. Describe the structures comprising the cardiac conduction system (e.g., from SA node to anterior papillary muscles), including fibrous cardiac skeleton. 6. Name & identify the major coronary arteries/cardiac veins, and their connections to the conduction system Notes The number on the left upper corner of each slide corresponds to the specific session objective. The corresponding session objective is also located in the “notes” section of each slide In the recorded video, each session objective is followed by MCQs. The examples of physiology and pathology are primarily intended to illustrate the application of anatomy, rather than for exam testing. They will be helpful for your future clinical practice and for taking any exams with clinical vignettes. If you prefer my PowerPoints without any clinical correlations, please email me. Heart Overview Great veins and arteries at the base Pointed tip is apex Sits between two pleural cavities in the mediastinum Located retrosternally. Martini Fundamentals of A&P, 11 ed. Pearson Martini Fundamentals of A&P, 11 ed. Pearson Heart Overview The heart is situated in the anterior part of the mediastinum, immediately posterior to the sternum Surrounded by pericardial sac Thieme Atlas of Anatomy, 4th ed. Martini Fundamentals of A&P, 11 ed. Pearson 1. Layers of the Heart Pericarditis Heart: endocardium, myocardium, epicardium Pericardial Effusion Pericardium: Surrounds the heart Pericardial cavity: Between parietal and visceral layers Cardiac Tamponade Moore’s Clinically Oriented Anatomy, 9e Martini Fundamentals of A&P, 11 ed. Pearson 1. Pericardium Blood supply: Pericardiophrenic arteries Pericardiophrenic veins Innervation: Phrenic nerve (C3-C5) Moore’s Clinically Oriented Anatomy, 9e Test Your knowledge Session Objectives: 1. Describe the layers of the pericardium, especially with respect to cardiac tamponade 2. Describe landmark external anatomic features of the heart chambers 3. Describe landmark internal anatomic features of the heart chambers 4. Describe the vessels that supply/drain the chambers 5. Describe the structures comprising the cardiac conduction system (e.g., from SA node to anterior papillary muscles), including fibrous cardiac skeleton. 6. Name & identify the major coronary arteries/cardiac veins, and their connections to the conduction system 2. Cardiac Surfaces Gray's Anatomy for Students, 5th ed. Moore’s Clinically Oriented Anatomy, 9th edition 2. Surface Anatomy of Anterior Heart Great veins and arteries at the base Pointed tip is apex Sulci: Anterior interventricular sulcus Posterior interventricular sulcus Right and left coronary sulci Martini Fundamentals of A&P, 11 ed. Pearson Test Your knowledge Session Objectives: 1. Describe the layers of the pericardium, especially with respect to cardiac tamponade 2. Describe landmark external anatomic features of the heart chambers 3. Describe landmark internal anatomic features of the heart chambers 4. Describe the vessels that supply/drain the chambers 5. Describe the structures comprising the cardiac conduction system (e.g., from SA node to anterior papillary muscles), including fibrous cardiac skeleton. 6. Name & identify the major coronary arteries/cardiac veins, and their connections to the conduction system 3. Heart Chambers Pulmonary embolism our chambers of the heart § Right atrium Receives blood from the systemic circuit § Right ventricle Pumps blood into the pulmonary circuit § Left atrium Receives blood from the pulmonary circuit § Left ventricle Pumps blood into the systemic circuit Moore’s Clinically Oriented Anatomy, 9e 14 3. Heart Connective Tissue Physically support cardiac muscle fibers Add strength and prevent overexpansion of the heart Provide elasticity that helps return the heart to its original size and shape after contraction Martini Fundamentals of A&P, 11 ed. Pearson 3. Cardiac Skeleton Calcification Four bands around heart valves & bases of pulmonary trunk and aorta Stabilize valves Electrically insulate ventricular cells from atrial cells Membranous interatrial/ interventricular septa https://tr.pinterest.com/sabrinaricks/ Gray's Anatomy for Students, 5th ed.  Physiology 3. Right Atrium Receives blood from: Superior vena cava Inferior vena cava Coronary sinus Blood from the right atrium passes to the right ventricle through the right atrioventricular (AV) valve Right atrial appendage (right auricle) is a pouch-like projection Martini Fundamentals of A&P, 11 ed. Pearson Martini Fundamentals of A&P, 11 ed. Pearson  3. Right Atrium Atrial Septal Defect Foramen ovale Connects the two atria At birth forms fossa ovalis Pectinate muscles Contain prominent muscular ridges On anterior atrial wall & inner surfaces of right auricle Crista terminalis The interior of the right atrium is divided into two continuous spaces. Moore’s Clinically Oriented Anatomy, 9e 3. Right Ventricle Myocardial Infarction Papillary muscles: Anterior, posterior, and septal Trabeculae carneae Muscular ridges on the internal surface of the right (and left) ventricle Includes moderator band (septomarginal trabeculae) Ridge contains part of the conducting system Conus arteriosus Gray's Anatomy for Students, 5th ed. 3. Left Atrium Atrial fibrillation Receives blood from pulmonary veins Blood from the left atrium passes to the left ventricle through the left atrioventricular (AV) valve The left atrial appendage (left auricle) is a pouch-like projection from the main body of the left atrium Moore’s Clinically Oriented Anatomy, 9e Gray's Anatomy for Students, 5th ed. 3. Left Ventricle Hypertrophic Cardiomyopathy Holds the same volume as the right ventricle Is larger; thicker and more powerful Receives blood from the left atrium through mitral valve Ejects blood to aorta Martini Fundamentals of A&P, 11 ed. Pearson Moore’s Clinically Oriented Anatomy, 9e 3. Left Ventricle Dilated Cardiomyopathy Similar internally to right ventricle but does not have moderator band Contains anterior and posterior papillary muscles Gray's Anatomy for Students, 5th ed.  Rheumatic fever à carditis 3. Heart Valves Mitral valve prolapse Two pairs of one-way valves prevent backflow during contraction Atrioventricular (AV) valves Between atria and ventricles Blood pressure closes valve cusps during ventricular contraction Free edges attach to chordae tendineae from papillary muscles of the ventricle Papillary muscles tense chordae tendineae --> valves won't swing into atria https://www.geeksforgeeks.org/cardiac-cycle-phase-diagram/ Moore’s Clinically Oriented Anatomy, 9e https://www.geeksforgeeks.org/cardiac-cycle-phase-diagram/  Mitral/tricuspid stenosis 3. Heart Valves Atrioventricular (AV) valves Tricuspid: Opening from the right atrium to the right ventricle Has three cusps Mitral (bicuspid): Opening from the left atrium to the left ventricle Has two cusps Note: Papillary muscles are in both ventricles. They tense up the chordae tendineae to prevent the AV valves from prolapsing into the atria during ventricular contraction. Martini Fundamentals of A&P, 11 ed. Pearson  3. Heart Valves Aortic/pulmonary regurgitation Atrioventricular (AV) valves When ventricles are relaxed: AV valves are open Semilunar valves are closed Martini Fundamentals of A&P, 11 ed. Pearson Moore’s Clinically Oriented Anatomy, 9e 3. Heart Valves Semilunar valves Pulmonary and aortic valves Prevent backflow from the pulmonary trunk and aorta into ventricles Have no muscular support Three cusps support like a tripod Have sinuses above the valves Gray's Anatomy for Students, 5th ed. 3. Heart Valves Mitral/tricuspid regurgitation Semilunar valves Aortic/pulmonary stenosis When ventricles are contracting: AV valves are closed Semilunar valves are open Martini Fundamentals of A&P, 11 ed. Pearson Moore’s Clinically Oriented Anatomy, 9e  CVS: PCP 3. Heart Valves Auscultation areas S1: closure of the mitral and tricuspid valves at the beginning of ventricular contraction (systole) S2: closure of the aortic and pulmonary valves at the end of ventricular contraction (beginning of diastole). Grant’s Atlas of Anatomy, 16 ed Test Your knowledge Session Objectives: 1. Describe the layers of the pericardium, especially with respect to cardiac tamponade 2. Describe landmark external anatomic features of the heart chambers 3. Describe landmark internal anatomic features of the heart chambers 4. Describe the vessels that supply/drain the chambers 5. Describe the structures comprising the cardiac conduction system (e.g., from SA node to anterior papillary muscles), including fibrous cardiac skeleton. 6. Name & identify the major coronary arteries/cardiac veins, and their connections to the conduction system 4. Major Blood Vessels Martini Fundamentals of A&P, 11 ed. Pearson 4. Heart Blood Flow Physiology Right-sided vs left-sided heart failure Isovolumetric Relaxation Isovolumetric Contraction Moore’s Clinically Oriented Anatomy, 9e Test Your knowledge Session Objectives: 1. Describe the layers of the pericardium, especially with respect to cardiac tamponade 2. Describe landmark external anatomic features of the heart chambers 3. Describe landmark internal anatomic features of the heart chambers 4. Describe the vessels that supply/drain the chambers 5. Describe the structures comprising the cardiac conduction system (e.g., from SA node to anterior papillary muscles), including fibrous cardiac skeleton. 6. Name & identify the major coronary arteries/cardiac veins, and their connections to the conduction system 5. The Conducting System A system of specialized cardiac muscle cells Initiates and distributes electrical impulses that stimulate contraction Automaticity Cardiac muscle tissue contracts automatically Martini Fundamentals of A&P, 11 ed. Pearson 5. The Conducting System Tachycardia The Sinoatrial (SA) Node In posterior wall of right atrium Contains pacemaker cells SA node generates 60–100 action potentials per minute Connected to AV node by internodal pathways Begins atrial activation Moore’s Clinically Oriented Anatomy, 9e 5. The Conducting System Bradycardia The Atrioventricular (AV) Node On the floor of the right atrium Receives impulse from SA node Delays impulse Atrial contraction begins AV node generates 40–60 action potentials per minute Moore’s Clinically Oriented Anatomy, 9e 5. The Conducting System Bundle Branch Block The AV Bundle In the septum Carries impulse to left and right bundle branches Which conduct to Purkinje fibers And to the moderator band Which conducts to papillary muscles Pacemaker generates 20-40 action potentials per minute Moore’s Clinically Oriented Anatomy, 9e 5. The Conducting System Ventricular Tachycardia/Fibrillation Purkinje Fibers Distribute impulse through ventricles Atrial contraction is completed Ventricular contraction begins Test Your knowledge Session Objectives: 1. Describe the layers of the pericardium, especially with respect to cardiac tamponade 2. Describe landmark external anatomic features of the heart chambers 3. Describe landmark internal anatomic features of the heart chambers 4. Describe the vessels that supply/drain the chambers 5. Describe the structures comprising the cardiac conduction system (e.g., from SA node to anterior papillary muscles), including fibrous cardiac skeleton. 6. Name & identify the major coronary arteries/cardiac veins, and their connections to the conduction system 6. Coronary Arteries Coronary artery bypass graft Originate at aortic sinuses Coronary angioplasty High blood pressure, elastic rebound forces blood through coronary arteries between contractions Martini Fundamentals of A&P, 11 ed. Pearson Martini Fundamentals of A&P, 11 ed. Pearson Martini Fundamentals of A&P, 11 ed. Pearson 6. Coronary Arteries Right Coronary Artery Supplies blood to: Thieme Atlas of Anatomy, 4th ed. Right atrium Ventricles (mainly right) Cells of SA and AV nodes Marginal arteries (surface of the right ventricle) Posterior interventricular artery Patrick J. Lynch and Mikael Häggström, 6. Coronary Arteries Left Coronary Artery Supplies blood to: Thieme Atlas of Anatomy, 4th ed. Ventricles (mainly left) Left atrium Interventricular septum Branches of Left Coronary Artery: Anterior interventricular artery (LAD) Circumflex artery Left marginal artery Patrick J. Lynch and Mikael Häggström,  Myocardial infarction 6. Coronary Arteries Imaging Moore’s Clinically Oriented Anatomy, 9e  Angina Pectoris 6. Coronary Arteries Imaging Moore’s Clinically Oriented Anatomy, 9e 6. The Cardiac Veins Great cardiac vein Drains blood from the area of the anterior interventricular artery into the coronary sinus Small cardiac vein Drains right atrium and ventricle Anterior cardiac veins Empty into the right atrium Posterior cardiac (ventricular) and middle cardiac veins: Empty into the coronary sinus Martini Fundamentals of A&P, 11 ed. Pearson  Contact Info [email protected] Melbourne Campus, Hall C, Room 244 48