Pericardium & Heart Flashcards
Septum transversum is
Undivided part of Lateral mesoderm
Septum transversum contributes to →
- Central tendon of diaphragm
- Connective tissue of liver
- Fibrous Pericardium
Pericardium is;
FibroSerous Sac
Fibrous sac of pericardium is adherent to
Central tendon of diaphragm
Fibrous sac is derived from;
Septum transversum
Serous sac; derived from
Parietal layer → from Parietal layer of Lateral mesoderm
Visceral layer → from Splanchnic layer of Lateral mesoderm
Nerve supplying the Fibrous and Parietal layer of Pericardium;
Phrenic nerve
The pain in Pericarditis is mediated by Phrenic Nerve,
And referred pain to Tip of the Shoulder
Visceral layer of pericardium is supplied by (nerve)
Autonomic nervous system
Spaces in the Pericardium;
Transverse sinus and Oblique sinus
Boundaries of Transverse sinus;
Anteriorly -
Posteriorly -
Below -
Anteriorly - Pulmonary Trunk and Ascending Aorta
Posteriorly - Superior vena cava
Below - Left atrium
Boundaries of Oblique sinus;
Anteriorly -
Posteriorly -
On either side -
Anteriorly - Left atrium
Posteriorly - Parietal Pericardium
On either side - 2 Pairs of Pulmonary veins
Chamber of Heart which is in relation for both Transverse and Oblique sinus
Left atrium
Posterior surface of heart is formed by;
Right atrium 1/3
Left atrium 2/3
Diaphragmatic surface of heart is formed by;
Left ventricle 2/3
Right ventricle 1/3
Anterior surface of heart is formed by;
- Right Ventricle 2/3
- Left Ventricle 1/3
- Right atrium
- Right auricle
- Left auricle
Right Border of heart formed by;
Right atrium
Left Border of heart formed by;
Left Ventricle - Mainly
Left atrium appendages - Slightly
Coronary arteries derived from
Aortic sinus
Left coronary artery arise from
Left posterior aortic sinus
Right coronary artery arise from
Anterior aortic sinus
Non coronary sinus is
Right Posterior Aortic Sinus
Branches of RCA;
- Right Conus Artery
- SA Nodal Artery
- Right Marginal Artery / Acute Marginal Artery
- PIVA → Septal branch
Right Conus Artery Supplies;
Infundibulum of Right Ventricle
Other name for Right Conus Artery;
3rd Coronary Artery
When it arise from Aortic sinus, then it is called as 3rd Coronary Artery
What is Annulus of Vieussens
Is Anastomosis between Left Conus Artery and Right Conus Artery
LCA → left conus artery
RCA → right conus artery
SA Nodal artery is a branch of;
In 65% → branch of RCA
In 35% → branch of LCX
SA node supplies;
It ascends between Aorta and Right Auricle, turns laterally and goes to SVC opening → SA NODE
Other name for Right Marginal Artery;
Acute Marginal Artery
Follows inferior border upto Apex
PIVA supplies;
And its Branch;
Diaphragmatic Surface of RV/LV
Septal branch → supplies Post. 1/3 of IV Septum
Inverted course of Septal Branch (of PIVA) supplies;
AV Node
Branches of LCA;
AIVA and LCX
Septal branch of AIVA Supplies;
Anterior 2/3 of Interventricular septum
LCX anastomoses at Crux with
RCA
Branches of LCX
- Supplies LA and LV
- Left marginal artery / Obtuse marginal artery
- SA Nodal artery in 35%
- Atrial branch / Kugal’s artery
How Kugal’s anastomosis formed;
Kugal’s artery / Atrial branch of LCX anastomosis with Atrial branch of RCA
In Left Dominance, PIVA arise from
LCX
In left dominance entire ventricle and entire Ventricular septum is supplied by LCA
In majority of cases PIVA arise from
RCA then it is called as Right Dominance
If Two PIVA arise from RCA and LCX, is called
Balanced dominance
The only part of Conducting system not supplied by RCA;
Right Bundle Branch
It is supplied by only LCA
Location of SA Node;
- Junction of SVC opening into Right atrium
- Junction of Post. Smooth wall and Ant. Rough wall of Right atrium
- Upper end of Crista terminalis
Location of AV node;
In Triangle of Koch
Right Bundle Branch is present in;
Moderator band / Supramarginal Trabeculae (Right ventricle)
Majority of blood from the heart is drained by
Coronary sinus
Coronary sinus; Derived from
Left horn of Sinus Venosus
Coronary sinus drains into
Posterior wall of Right atrium
Opening of Coronary sinus is Guarded by
Thebesian’s valve
Tributaries of Coronary Sinus;
- Great Cardiac Vein
- Middle Cardiac Vein
- Small Cardiac Vein
- Posterior vein of LV
- Oblique vein of RA
Vein accompanying the AIVA and LCX artery
Great Cardiac Vein accompanies AIVA and LCX artery.
Vein accompanying the PIVA;
Middle Cardiac vein accompanies PIVA
Vein accompanying the Right Coronary Artery;
Small Cardiac Vein
Vein which open directly into Anterior wall of Right Atrium
Anterior Cardiac Vein
Which has Larger Diameter;
RCA / LCA
LCA > RCA
Posterior Part of Right Atrium is;
Derived from
Smooth part
Derived from Sinus venosus
Anterior part of Right Atrium is
Derived from
Rough part
Derived from Primitive antrum
Crista terminalis is present between
Between Anterior (Rough) and Posterior (Smooth) Part of Right Atrium
Eustachian valve guards
IVC Opening
Valve guarding opening of Coronary Sinus
Thebesian valve
Boundaries of Triangle of Koch;
Base of Septal Leaflet
Tendon of Todaro
Coronary Sinus opening
Triangle of Koch Contains
AV Node
Fossa ovalis derived from
Septum primum,
Floor of Fossa Ovalis is formed by Septum Primum
Limbus Fossa Ovalis derived from;
Septum secundum
Right Ventricle is divided into
Two Parts;
- Inflow (Rough) - receives blood from Right Atrium
- Outflow (Smooth) - also called as Conus (infundibulum) carried blood to Pulmonary trunk