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Dr.Maher AL-Hadidi School of Medicine University of Jordan Spring 2019

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Dr.Maher AL-Hadidi School of Medicine University of Jordan Spring 2019 Pericardium & HEART Dr.Maher AL-Hadidi School of Medicine University of Jordan Spring 2019 Spring 2019 Dr,Maher AL-Hadidi , University of Jordan 1 [Type here] Pericardium A double-walled fibroserous conical-shaped sac, inside middle mediastinum. Enclose the heart and roots of its large vessels. PericardiumVagus nerves Pericardium Pericardium SVC Pericardiophrenic A. Pericardiophrenic V. MusculophRt.renic Pericardiophrenic vessels branches Base [Type here] Diaphragm Diaphragm 2 Pericardium – Sagittal section Parts: 1 1. Fibrous pericardium. (outer) 2. Serous pericardium. 2 Fibrous pericardium (Inner) Conical-shaped fibrous sac. Base: Attached to central tendon of diaphragm. Layers . Apex: Attached to roots of large of heart vessels. Wall Prevent overextension of the Base heart. (potential) [Type here] Serous pericardium Complete serous sac invaginated by 1 the heart. Like pleura by the lung. (outer) 2 layers: 2 Parietal layer lines fibrous pericardium. (Inner) Visceral layer covers the heart as (Epicardium). Layers of heart Pericardial cavity: Wall A potential space between 2 serous Base layers. (potential) [Type here] Contents of pericardium: Superior vena cava Contents: Ascending Aorta Arch of aorta 1. Heart and all arteries, Transverse sinus Pulmonary veins and nerves. (separates arteries Artery from veins) 2 3 2. All Ascending aorta. 4 8 Left pulmonary 3. All Pulmonary Artery. 7 Right pulmonary vs. 9 6 4. Last 2cm of SVC. 1 5. Last 2cm of IVC. Serous pericardium + Oblique sinus 5 6. First part of the 4 diaphragm Fibrous pericardium pulmonary veins. Inferior vena cava 7. Transverse sinus. Thoracic aorta 8. Oblique sinus. Dr. Maher Hadidi, University of Jordan Heart Pyramidal-shaped muscular organ. SVC About the size of the person’s own fist. Ligamentum arteriosum Ascending aorta Apex: -Inside pericardium. -From aortic valveto aortic arch. Directed downward , forward and to the left. -Give 2 coronaries. th Pericardium Located at the left 5 intercostal space Right coronary A. Anterior interventricular A. about 9cm from midline. Form by the left ventricle. Ant. Interventricular groove Base: Directed posteriorly , form by left atrium. Spring 2019 Dr. Maher Hadidi, University of Jordan Chambers of heart Form of 4 chambers: 2 atriums above. 2 ventricles below. Atriums separated from inside by the interatrial septum. Ventricles separated from inside by the interventricular septum. Spring 2019 Dr. Maher Hadidi, University of Jordan Borders of the Heart Due to the rotation of the heart 45° to the left, the right side becomes anterior and the left side becomes posterior. Has 3 borders: Right: Right atrium. Left: left ventricle. Inferior: Right ventricle. Surfaces of the heart 1. Anterior surface. 2. Inferior surface. 3. Base. Anterior (Sternocostal) Form by Right ventricle. Right atrium. Inferior surface of the heart (Diaphragmatic surface) Form mainly by left ventricle and right ventricle. Lt. sup. pulmonary v. Left auricle Left atrium Lt. inf. Pulmonary v. Left ventricle 10 Right ventricle Base of the heart Directed posterior , opposite the apex. Form by left atrium. Interior of right Atrium Receives venous blood from the whole body by: Arch of aorta 1. SVC from upper ½ 2. IVC from lower ½ 3. Coronary sinus (coronary vein) from SVC Right auricle (reserve part) the heart itself. Tricuspid valve Send blood to right ventricle by Tricuspid Limbus fossa ovalis valve. Crista terminalis Right Has 2 walls: ventricle Anterior wall, rough. Pectinate muscles - Pectinate muscles - Crista terminalis Fossaovalis Posterior wall , smooth IVC Valve of IVC 12 Coronarysinus -Fossa ovalis Valve of coronarysinus -SA Node Interior of right Ventricle -1 Receives blood by Tricupsid valve. Send blood to both lungs via Pulmonary valve. Wall thicker than right atrium. Blood inflow part is rough and outflow part is smooth Pulmonarry valve Septomarginal band (moderator band) Corda tendineae (spongelike appearance) Interior of right Ventricle -2 Has 2 walls: Anterior wall (inflow part). Rough with a network of projecting cardiac muscle bundles. E.g. Trabeculae carnea. Septomarginal band. Pulmonarry valve Papillary muscles. Posterior wall, (outflow part). Smooth in part. E.g. Septomarginal band (moderator band) Infundibulum of pulmonary artery. Corda tendineae 14 Left Atrium Form base of the heart. Receive blood by: 4 pulmonary veins. (Reverse part) Send blood by : Bicuspid valve to the left ventricle. Right Pulmonary Ant. Wall: Rough, especially its veins auricle. Left atrium Post. Wall: Smooth. APEX Left Ventricle Main chamber of the heart. Form apex of the heart. Receive blood by: Bicupsid valve. Aortic vestibule (smooth) Send blood by : Aortic valve. Anterior cusp of bicuspid valve Has thicker wall. Ant. Wall (I.V septum) : Smooth in part. -Aortic vestibule. Post. Wall: Rough. Left atrium -Trabeculae carnae. -Papillary muscles. (coronary vein)16 Posterior cusp 18 Cardiac conduction System A network of a modified cardiac muscle fibers specialized in conduction only. SAN Left atrium It is autorhythmic , it constantly initiates and coordinates atrial and ventricular AVN muscle contraction. Insulated from myocardium by a sheath of connective tissue Establishes a unidirectional pathway of Left ventricle excitation signals and contraction. AV bundle Papillary muscle Organized into 4 basic components: Right and left bundle branches 20 Purkinje fibers Apex.
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