Cardiac Anatomysinoemedicalassociation.org/AP2/cardio/cardioanatomyx.pdfMediastinum • Superior –...
Transcript of Cardiac Anatomysinoemedicalassociation.org/AP2/cardio/cardioanatomyx.pdfMediastinum • Superior –...
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Cardiac Anatomyy
Great Website:http://info.med.yale.edu/intmed/cardio/i
maging/contents.html
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MediastinumMediastinum
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MediastinumMediastinum
• SuperiorAb l b t t l l d– Above plane between sternal angle and inferior border of T4 vertebral body
I f i• Inferior– Anterior– Middle– Posterior
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PericardiumPericardium
• PericardiumPericardium– Fibrous
Serous– Serous• Parietal layer• Visceral layerVisceral layer
• Phrenic NervesPhrenic Nerves
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Serous Pericardium (Parietal Layer)
Fibrous Pericardium
Serous Pericardium (Visceral Layer)
(Epicardium)
Subepicardium
Myocardium
Subendocardium
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PericardiumPericardium
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Innervation of HeartInnervation of Heart
• Sympathetic Nervous SystemSympathetic Nervous System– T1-T4
• “Cardiac accelerators”• Cardiac accelerators– Stellate ganglia (cervicothoracic ganglia) and
middle cervical gangliamiddle cervical ganglia– Distributed throughout the heart
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Innervation of HeartInnervation of Heart
• ParasympatheticParasympathetic– Originate in medulla oblongata
Vagus nerves– Vagus nerves– Much innervation to SA and AV nodes
Little innervation to ventricles– Little innervation to ventricles
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Conduction SystemConduction System• Sinoatrial Node
– Interatrial conduction pathways (SA to LA)– Internodal conduction pathways (SA to AV)
• Atrioventricular Node– Bundle of His
Bundle Branches• Bundle Branches– Left Bundle Branch
• Left anterior division• Left posterior division
– Right Bundle Branch
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AV ConductionAV Conduction
• AV node is situated on the right side ofAV node is situated on the right side of interatrial septum near the ostium of the coronary sinuscoronary sinus
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Conduction SystemConduction System
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SA Node
AnteriorInternodal
*
MiddleInternodal
*
PosteriorInternodal
*
Anterior interatrial myocardial band
Right Atrial
* Pathway* Pathway* Pathway* (Bachmann’s Bundle)
Left Atrium
Tracts*
Left AtriumAN Region N Region
NH RegionAV Node
Bundle of His
fRight Bundle Branch
Left Bundle Branch
Anterior Division
Posterior Division
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Cardiac ChambersCardiac Chambers
• Right AtriumRight Atrium• Left Atrium
Ri ht V t i l• Right Ventricle• Left Ventricle
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Right Atrium
• Vena Cavae– Superior– Inferior
• Eustachian valve• Crista terminalis (divides right atrium)
– Right atrial appendage (right auricle)• Trabeculated
– Smooth portion of atrium around vena cavae• Coronary Sinus (venous drainage of heart)• Fossa Ovalis
– Remnant of foramen ovale• Tricuspid Valve
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Base and Diaphragmatic Surfaces of Heart
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Right VentricleRight Ventricle
• Coarsely trabeculated inletCoarsely trabeculated inlet
S th tl t• Smooth outlet– Right ventricular outflow tract (RVOT)
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VentriclesVentricles
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Left AtriumLeft Atrium
• Pulmonary veins (4)Pulmonary veins (4)• Left atrial appendage
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Left VentricleLeft Ventricle
• Thick WallThick Wall• Anterior and Posterior Papillary Muscles
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VentriclesVentricles
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Cardiac AnatomyCardiac Anatomy
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Aortic ValveAortic Valve
• Separates left ventricle and aortaSeparates left ventricle and aorta• Located between (and on the same plane
as) the Mitral and Tricuspid valvesas) the Mitral and Tricuspid valves• Trileaflet (3 leaflets)• Right and Left Main Coronary Arteries
originate in sinuses behind valve leaflets• Sino-tubular junction
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Aortic ValveAortic Valve
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Cardiac AnatomyCardiac Anatomy
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Aortic ValveAortic Valve
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Mitral ValveMitral Valve
• Separates Left atrium from Left VentricleSeparates Left atrium from Left Ventricle• Two leaflets
A t i L fl t– Anterior Leaflet• Wide and short
Posterior Leaflet– Posterior Leaflet• Narrow and long
P ill l• Papillary muscles• Chordae tendinae
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Mitral ValveMitral Valve
A t iAnterior Leaflet
Posterior LeafletLeaflet
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Papillary MusclesPapillary Muscles
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Tricuspid ValveTricuspid Valve
• Separates Right atrium from RightSeparates Right atrium from Right ventricle
• 3 Leaflets• 3 Leaflets– Anterior leaflet
P t i l fl t– Posterior leaflet– Septal leaflet
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Pulmonary ValvePulmonary Valve
• Separates Right Ventricle from PulmonarySeparates Right Ventricle from Pulmonary artery
• 3 Cusps• 3 Cusps– Sinuses of Valsalva
L t d b hi d th l• Located behind the valve cusps
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Coronary ArteriesCoronary Arteries
• Right CoronaryRight Coronary– Dominance: In 85% of individuals the RCA supplies
the posterior descending artery (PDA) • Left Coronary
– Left anterior descending (LAD)• Diagonal
– Left circumflex• Obtuse marginal• Obtuse marginal
– Ramus intermedius (37%)
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Epicardial VesselPericardium (Epicardium)
Subepicardium
( p c d u )
p
Myocardium
Subendocardium
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Myocardial Segment AnatomyMyocardial Segment Anatomy
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Cardiac AnatomyCardiac Anatomy
With Corresponding Echo ViewsEcho Views
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The EndThe End