Heart and Pericardium

Prof. Dr. Selda Önderoğlu

Prof. Dr. H. Selçuk Sürücü

heart

muscular organPumps blood to body.Shape:conicalApex is directed downwards

location

location:thoracic cavityMiddle mediastinum

Weight:250-300 gr. In the adult

• Right and left:mediastinal surfaces of the lungs

• inferior: Diaphragm

• Anterior:: Sternum, costal cartilages,remains of thymus gland and partially lungs

• Posterior:Oesophagus

relations

General shape

Apex Base 4 surfacesFour borders

Apex: directed anterior,inferior and to the left, Base:faces posteriorly and to the right

Apex

L ventricleForward,

downward&to the left

Prof. Dr. H. Selçuk Sürücü

Base

L & R atriaFaces posteriorly

Prof. Dr. H. Selçuk Sürücü

Diaphragmatic (inf) surface

L ventricle

Prof. Dr. H. Selçuk Sürücü

Sternocostal (ant) surface

R atriumR ventricleL ventricle

Prof. Dr. H. Selçuk Sürücü

+ v brachiocephalica

Inf border

R ventricleL ventricle

Sup border

L atrium, roots of great

vessels

Right and left borders

Right border, Right atrium.

Left border, left ventricle,left auricle.

Surface projections of borders

Apex:5th intercostal space 9 cm from midline 2nd left costal cartilage 1 cm from sternum3rd right costal cartilage 1cm from sternum6th right costal cartilage 1cm from sternum

Prof. Dr. H. Selçuk Sürücü

“ coronary sulcus”,between atria and ventricles.

“anterior interventricular sulcus”,

between ventricules

• “posterior interventricular sulcus”,

between ventricles

External features

R atriumV cava sup&infCoronary sinusPectinate mmSinus venorum(sinus of venae cavae)Terminal crestInteratrial septumForamen ovaleFossa ovalisLimbus fossa ovalisAuricle (ant.to crest)

Tricuspid valve(bw.R atr.&R vent.)

Prof. Dr. H. Selçuk Sürücü

R ventricle

Cusps of tricuspid valve/R atrioventricular valve (at sup wall)(ant.+post.+septal)

Interventricular septum (septal wall)

Membranous part muscular partAtrioventricular part ( bw. R atr&L ventr.)

Pro.

R ventricle

Trabeculae carneaPapillary mm(ant+post+septal)Septomarginal trabecule (moderator band)Conus arteriosus (infundibulum)Supraventricular crestOpening of pulmonary trunk(has 3 semilunar cusps- R+L+Ant)

L atrium

Pulmonary vv openings (4 in number)Valve of foramen ovaleDuring development prevents blood from L atr. to R atr)AuricleMitral valve/L atrioventricular valve(Ant+post cusps)

Prof. Dr. H. Selçuk Sürücü

L ventricleCusps of mitral valve/L

atrioventricular valve(Ant+post cusps)

Papillary mm(ant+post)Chordae tendineaeTrabecula carneae

Aortic openingAortic valve ( R+L+post semilunar cusps)(each cusp has lunule,nodule,sinus)

Arteries of heart

Right coronary artery (R marginal br &Post interventricular br)

Left coronary artery(Circumflex br+Ant interventricular br)

R&L coronary aa- Both Exit from bulbus aorta

Prof. Dr. H. Selçuk Sürücü

Veins of heartcoronary sinus-receives great,middle,small&post. Cardiac v)

Least cardiac vv (venae cordis minimae-Thebasian vv)-directly into chambers

Anterior right ventricular vvRight marginal v

Great cardiac v

Ant interventricular vL coronary v

Small cardiac v

R coronary v

Middle cardiac v

Post interventricular v

Innervation of heart

SympPsymp

Together They form the cardiac plexus

Sympathetics

Sup cervical cardiac n (from sup. Cerv. Gang.)

Middle cervical cardiac n br(from middle cerv.gang.)

Inf cervical cardiac n (from cervicothoracic (stellate)gang.

Thoracic cardiac brrs (T 1-4)

Parasympathetics

(vagus nerve (CN X)

Sup cervical cardiac brr

inferior cervical cardiac brr

Thoracic cardiac brr ( of vagus n.)

Lymphatics of heart

R inf tracheabronchial lymph nodes

Layers of heart

Endocardium:innermost layerMyocardium: middle layer, muscular layer,striated,under control of autonomic nervous systemPericardium: outermost layer, like a sac

Myocardium Atrial

VentricularConducting system

Striated-special typeUnder autonomic nervous system controlAtrial muscle fibers: 2 layers (inner-each atrium, outer- two atria together)Ventricular muscle fibers- has complex structure, no distinct layers- vortex

Myocardium

Prof. Dr. H. Selçuk Sürücü

Skeleton of heart

R & L fibrous rings (around mitral&tricuspid valves

R & L fibrous trigones

Around aortic & pulmonary

valvesProf. Dr. H. Selçuk Sürücü

Conducting system of heart- specialised myocardial fibers

SA nodeat terminal crestAV node, at interaatrial septumAV bundle, pars membranaceaR & L bundle branchesPurkinje fibers

Pericardium

Fibrous pericardiumSerous pericardium

Parietal layerVisceral layer (epicardium)

“pericardial cavity ” “liquor pericardii”

Pericardial sinuses-of the pericardial cavity

Oblique sinusBw.Left atrium- Pulmonary vvLike the letter “j”, inverted

Transverse sinus superior v.c.&leftatrium-

pulmonary trunk&ascending aorta two ends open

nerves of pericardium

Phrenic n –parietal pericardium (afferent)

vagusSympathetic trunk

Aorta

ascending aorta

Arch of aorta

descending aorta