Cardiovascular System PDF

Cardiovascular system DR. SEPIDEH HASSANPOUR EASTERN MEDITERRANEAN UNIVERSITY FACULTY OF DENTISTRY 11/1/2024 11/1/2024 2  The cardiovasculare system The heart :The heart acts as a double-sided pump that establishes blood pressure within the...

Cardiovascular system DR. SEPIDEH HASSANPOUR EASTERN MEDITERRANEAN UNIVERSITY FACULTY OF DENTISTRY 11/1/2024 11/1/2024 2  The cardiovasculare system The heart :The heart acts as a double-sided pump that establishes blood pressure within the pulmonary and systemic circuits. Blood vessels: passageways for the blood to be distributed throughout the body to exchange materials to and from the lungs and tissues. Blood: liquid connective tissue that transports dissolved and suspended materials. 11/1/2024 3  Types of Blood Vessels Arteries: Carry blood away from heart. Veins: Carry blood to heart. Capillaries: Networks between arteries 11/1/2024 4  Heart Location Superior surface of diaphragm 1/3 of it located at the right side of the midsternal line and 2/3 Left of the midsternal line Anterior to the vertebral column, posterior to the sternum ✓ The average weight of the human heart is 290-350 gr. 11/1/2024 5 11/1/2024 6 11/1/2024 7  Mediastinum The mediastinum is the central compartment of the thoracic cavity, located between the two pleural sacs. It contains most of the thoracic organs, and acts as a duct for structures passage the thorax into the abdomen. 11/1/2024 8 Boundaries of Mediastainum Superior:superior thoracic apertur Inferior: Diaphragma Anterior: Sternum and costal cartilage 1-5 Posterior: Body of thoracic vertebrae Lateral: Parietal Pleura of each lung (pulmo) 11/1/2024 9 Anatomicaly, the mediastinum is divided into two parts by an imaginary line that runs from the sternal angle to the T4 vertebrae: 11/1/2024 10 11/1/2024 11  superior mediastinum – extends upwards, terminating at the superior thoracic aperture. The superior mediastinum is bordered by the following thoracic structures: Superior – Thoracic inlet. Inferior – Continuous with the inferior mediastinum at the level of the sternal angle. Anterior – Manubrium of the sternum. Posterior – Vertebral bodies of T1-4. Lateral – Pleurae of the lungs. Contents (FROM BEHIND FORWARD): 1.Esophagus 2.Trachea 3.Arch of aorta & its 3 branches: brachiocephalic, left common carotid & left subclavian arteries 4.Right & left brachiocephalic veins & superior vena cava 5.Thymus gland 11/1/2024 12  OTHER CONTENTS: Nerves: 1.Right & left vagus 2.Right & left phrenic 3.Right & left sympathetic trunks 4.Left recurrent laryngeal Lymphatic structures: 1.Thoracic duct 2.Lymph nodes 11/1/2024 13 11/1/2024 14 Anterior mediastinum The anterior mediastinum contains no major structures. It accommodates loose connective tissue, fat, some lymphatic vessels, lymph nodes and branches of the internal thoracic vessels. In infants and children, the thymus extends inferiorly into the anterior mediastinum. However, the thymus recedes during puberty and is mostly replaced by adipose tissue in the adult. 11/1/2024 15  The middle mediastinum is bordered by the following thoracic structures: Anterior: Anterior margin of the pericardium. Posterior: Posterior border of the pericardium. Laterally: Mediastinal pleura of the lungs. Superiorly: Imaginary line extending between the sternal angle and the T4 vertebrae. Inferiorly: Superior surface of the diaphragm. 11/1/2024 16  Contents The Middle Mediastinum Is The Largest Subdivision Of The Inferior Mediastinum. It Contains Several Important Organs, Vessels, Nerves And Lymphatic Structures. organs the middle mediastinum contains the heart, and its protective sheath, the pericardium. it also contains the tracheal bifurcation and the left and right main bronchi. vessels the middle mediastinum is associated with the origins of the great vessels that run to and from the heart: ascending aorta – the first part of the aorta, which arises from the aortic orifice. it moves upwards, exiting the fibrous pericardium and entering the superior mediastinum – where it then becomes the aortic arch. the ascending aorta gives rise to two branches; the left and right coronary arteries. pulmonary trunk – gives rise to the left and right pulmonary arteries. the trunk itself is relatively short and wide, allowing a large volume of blood to pass through it. superior vena cava – returns deoxygenated blood from the upper half of the body. it is formed by the right and left brachiocephalic veins. 11/1/2024 17  Middle Mediastinum 1.Pericardium & heart 2.Arteries: ascending aorta, pulmonary 3.trunk 4.Veins: lower half of superior vena cava, terminations of inferior vena cava & pulmonary veins 5.Nerves: phrenic 6.Lymph nodes 11/1/2024 18  The posterior mediastinum is bordered by the following thoracic structures: Lateral: Mediastinal pleura (part of the parietal pleural membrane). Anterior: Pericardium. Posterior: T5-T12 vertebrae. Roof: Imaginary line extending between the sternal angle (the angle formed by the junction of the sternal body and manubrium) and the T4 vertebrae. Floor: Diaphragm. 11/1/2024 19  posterior mediastinum CONTENTS: 1. Esophagus (most anterior structure) 2. Thoracic duct 3. Right & left vagus 4. Descending aorta 5. Azygos & hemiazygos veins 6. Right & left sympathetic trunks & their branches (splanchnic nerves) 7. Lymph nodes 11/1/2024 20 11/1/2024 21  Surface anatomy Landmarks Surface anatomy: The muscles and bony structure of the upper trunk provide important landmarks for physical examination, visible beneath the skin. 11/1/2024 22 Bony Landmarks in Thorax ❑Clavicles. ❑ Jugular notch of the sternum. ❑ Sternal angle (of Louis).Articulation between the manubrium and sternal body. The sternal angle serves as the location for the articulation of rib 2 with the sternum at the T4–T5 vertebral level. ❑ Xiphoid process. process lies at the level of the T9 vertebral body. ❑ Costal margins. Formed by costal cartilages 7–10. 11/1/2024 23 11/1/2024 24  pericardium A double-layered membrane called the pericardium surround heart like a sack. 11/1/2024 25  Layers of the Pericardium ✓External layer: fibrous pericardium ✓Internal layer: serous pericardium Visceral and parietal layers are continuous with each other where the great vessels enter and leave the heart 11/1/2024 26  Fibrous Pericardium Continuous with the central tendon of the diaphragm, the fibrous pericardium is made of tough connective tissue and is relatively non- distensible. Its rigid structure prevents rapid overfilling of the heart. 11/1/2024 27 11/1/2024 28  Serous Pericardium Enclosed within the fibrous pericardium, the serous pericardium is itself divided into two layers: the outer parietal layer that lines the internal surface of the fibrous pericardium and the internal visceral layer that forms the outer layer of the heart (also known as the epicardium). Each layer is made up of a single sheet of epithelial cells, known as mesothelium. 11/1/2024 29  Found between the outer and inner serous layers is the pericardial cavity, which contains a small amount of lubricating serous fluid. The serous fluid serves to minimize the friction generated by the heart as it contracts. 11/1/2024 30  Fibrous pericardium serous pericardium parietal layer visceral layer(epicardium) Function of the pericardium 1. Fixes the heart 2. Prevents overfilling 3. Lubrication 4. Protection from infection 11/1/2024 31  Innervation Of Pericardıum Phrenic nerve: Innervates fibrous pericardium and parietal layer of serous pericardium. Visceral layer of serous pericardium: Does NOT contain nerve endings. 11/1/2024 32  Clinical note Cardiac tamponade Extensive pericardial effusion leads to cardiac tamponade, in which the excess fluid in the pericardial cavity limits the expansion of the heart during cardiac filling. Stab wounds, perforation of the myocardium, or bleeding into the pericardial cavity after a cardiac operation are causes of hemopericardium, which may also lead to cardiac tamponade. The fibrous pericardium is tough and inelastic, therefore it will not expand. Due to the failure of circulation, cardiac tamponade might be lethal if not treated. 11/1/2024 33  Clinical note Pericardiocentesis Performed for the drainage of the fluid within the pericardial cavity Needle is inserted through the 5th or 6th intercostal space to the left of sternum (bare area of the pericardium) or through the infrasternal angle 11/1/2024 34 11/1/2024 35  External Surface of the heart Atrium Ventricle Auricle Interventricular sulcus Atrioventricular sulcus Major Veins Superior Vena Cava Inferior Vena Cava Pulmonary Veins Major Arteries Aorta Pulmonary Trunk 11/1/2024 36  all vessels which they are taking the blood away from the heart known as artery. all vessels which they are bringing the blood into the heart known as vein. 11/1/2024 37  Surface of the heart The heart has been described by many texts as “a pyramid which has fallen over”. 1. Sternocostal (anterior) surface 2. Diaphragmatic surface 3. Right pulmonary surface 4. Left pulmonary surface 5. Base 11/1/2024 38 Base of the heart Sternocostal Diaphragmatic surface The left atrium, Mostly of the right ventricle Anatomical position A small portion of the right Left ventricle and a small atrium portion of the right ventricle The proximal parts of the great veins The apex of the heart is formed by the part of the left ventricle 11/1/2024 39 11/1/2024 40 Right pulmonary surface Right atrium. Left pulmonary surface Left ventricle. 11/1/2024 41  Sulci of the heart the heart is a hollow structure. on the interior, it is divided into four chambers. these divisions create grooves on the external surface of the heart, these are known as sulci. the coronary sulcus (or atrioventricular groove) runs transversely around the heart, it represents the wall dividing the atria from the ventricles. the sinus contains important vasculature, such as the right coronary artery. the anterior and posterior interventricular sulci can be found running vertically on their respective sides of the heart. they represent the wall separating the ventricles. /2024 42  External Grooves (sulci ) of the heart 11/1/2024 43  Margins or borders of the heart The heart has 4 border(margin) : Right margin Left margin superior margin inferior margin 11/1/2024 44  Right margin of the heart Inferior (acute) margin of the heart Left margin of the heart Superior margin of the heart 11/1/2024 45  Radiological evaluation of the heart 11/1/2024 46 11/1/2024 47 11/1/2024 48 11/1/2024 49 11/1/2024 50  Have a nice day 11/1/2024 51