Anatomy of the heart- lecture 1 Flashcards
What structures are contained within the lung root
- Pulmonary artery
- Main bronchus
- pulmonary veins - 2 for each lung
- Pulmonary lymphatic vessels
- Bronchopulmonary lympho nodes
- Autonomic motor nerves
- Pulmonary visceral afferents
Where is the heart located
middle mediastinum
Where are the phrenic nerves found in relation to the heart
Descend down lateral borders of the pericardium
There are two nerves found in the middle pericardium how can we find these
- Vagus nerve - Posterior to hilum
- Phrenic nerve - anterior to Hilum
What are the layers of the pericardium
- Fibrous pericardium
- Serous pericardium
- Parietal serous layer
- Visceral serous layer - this is the Epicardium
What is between the two serous layers
Pericardial cavity/sac
- Secretes serous fluid
- To reduce surface tension and lubricate the heart
What pathology can airse in the pericardial cavity
Haemopericardium - heart fills with blood
- Can put pressure on the heart and prevent contraction
- Can lead to cardiam tamponade - preventing normal beats
What is the treatment for fluid in the pericaridal space
Pericaridocentesis
- Draining fluid
- Needle inserted via infrasternal angle and directed superior-posteriorly, aspirating continously
- Below the costal cartilages
What is the transverse pericardial Sinus
- A channel between the posterior left and right sides of the pericardial cavity
- Posterior to the ascending aorta and pulmonary trunk
- Anterior to the SVC
- Can put fingers behind the 2 vessels
What is the significance of the transverse percardial sinus
Surgical importance
- Cardiopulmonary bypass
- Isolate the two vessels and tie them off
What are the Great vessels of the heart
What are the clinically important surfaces of the heart
- Anterior (Sternocostal) Surface
- Base (Posterior) Surface
- Inferior (Diaphragmatic) Surface
What are the cinically important borders of the heart
- Right border - Right atrium
- Left (lateral) Border - Left ventricle
- Inferior border - Right ventricle
- Superior border - Great vessels
What is the apex
Clinically the most lateral and inferior aspect of the heart
- Located in left side, 5th intercostal space midclavicular line
What is the anterior surface anatomy of the heart
2 nerves in the superior mediastinum
- Vagus - most medial
- Phrenic- most lateral
What are the main veins form the heart
- Internal jugular vein - drians head and neck - left and right
- Subclavian vein - upper limb drainage
- these two form the Brachiocephalic vein - on the Right
- Brachiocephlic vien on left is a branch of the SVC
- Pulmonary veins - brings oxygenated blood back to the heart into the left atrium -4 pulmonary veins - 2 on each side
- the Two brachiocephalic veins come together to form superior vena cava
What are the main ateries of the heart
- Pulmonary arteries - Deoxygenated blood to the lungs
- Aorta
- Ascending aorta
- Arch of aorta
- Descending Aorta
What are the branches of the arch of aorta
- Brachiocephalic Trunk - Bifurcates into common carotic and right subclavian
- Left common carotid - head and neck
- Left subclavian artery - left upper limb
What are auricles
Extension of the Atria - allow atria to fill with more blood
- Right Auricle = extension of right atrium
- Left auricle = Extension of left atrim
What are the grooves in the heart
- Right side = coronory groove for coronary artery
- Left side = anterior intraventricular groove
- Boundary between left and right ventricles
- where anterior intra-ventricular artery - Left anterior descending
What the bas eof the heart mostly composed of
Left atrium
What is the anatomy of the posterior side of the heart
What is the coronory sinus
- Short Vein - located in the atrioventricular groove
- Recieves blood from most of the cardiac veins and drains into the Right atrium
- Border between the base and inferior surface of the heart
what are the posterior grooves in the heart
-
Posterior intra-ventricular groove -
* This is where the intra-ventricular artery lies - Branch of right coronary artery -
Intra-arterial Groove
* Visualised only from base and no artery lies here -
Atrio-ventricular groove - transvere groove
* Between the atria and ventricle - this is where the coronary arteriy lies transversle
What does the Azygous vein drain and where does it drain into
- Drains - posterior inter-costal veins
- Drains into - superior vena cava
what are the first branches off the Ascending aorta
Coronary arteries
What is the first branch of the Arch of aorta
Brachiocephalic trunk
What are the branches off of the right coronory artery
- Anterior - right marginal artery
- Posterior intraventricular artery
What are the branches of the left coronary artery
- anterior intraventricular artery- left anterior descedning
- Left marginal branch
- Circumference artery - branches from left mariginal
- Lateral branch - from left anterior descending
What is the coronary sinus
Vein at the back of the heart that drains deoxygenated blood from cardiac veins into right atrium
What are the septums of the heart
- intra-atrial septum - between left and right atrium
- Intraventricular septum - between left and right atrium
What are the type of septal defects in the heart
- Atrial-septal defect
- Intra-ventricular septal defect
- mixing of oxygenated and deoxygenated blood can cause hypoxaemia
What are the 3 openings into the right atrium
- superior vena cava
- inferior vena cava
- Coronary sinus
Describe the anatomy of the interior of the right atirum
- Muscular Texture - muscular bands
- Smooth area - posterior wall of atrium
-
Crista terminalis - line that separates the two texture
3. Oval fossa - in the smooth muscle posterior wall - Embryological reminant
Describe the Tricuspid valves
- 3 cusps - names according to anatomical position
- Anterior cusp
- Posterior cusp
- Septal cusp - directly toward the intraventricular septum
Describe the pulmonary vavle
- Anterior cusp
- Left Cusp
- Right Cusp
Describe the Bicuspid vavle
- anterior
- Posterior cusp
Describe the Aortic vavle
- Right Cusp
- Left Cusp
- Posterior Cusp
- Ostia - 2 right and left sinues for coronary ateries
What is the leaflet design and which cusps have these
- Tricuspid
- Bisbuspid
- Connected by papillary muscle to walls of ventricules
- Leaflet is connected to PM by chordae tendineae/ Tendonous cords
- prevent vavles from being pulled back into atirum
What are semi-lunar vavles
- Aortic vavle
- Pulmonary vavle
- Half-moon shaped
Describe the interior of the ventricle anatomy
- Papillary muscle
- Valves
- Fibrous skeleton
- Moderator bands
Describe the fibrous bands
- Shortcut for electricle activity reaching anterior cusp of tricuspid valve
- why? because its positioned further away - needs short-cut to allow it to contract at the same time as other cusps
Whats the function of the fibrous skeleton
- Links the vavles
- Gives structural integritiy
- Allows abit of solid tissue valves to anchor on to
- Allows electricle conduction through heart
Describe the interior of the left atrium
- Foamen ovale - Remenant of formen ovale valve
- Cusps of mitral vavle
- Left auricle opening
- Bilateral opening of superior and inferior pulmonary veins
What are all the auscultatory sites on the thorax
