Basics of Anatomy Physiology & Pathology

Soumya Ranjan Parida

All Anatomy Descriptions

Basic Medical Terminologies

•Medial , Lateral, Median •Transverse , longitudinal•Ventral/ Anterior , Dorsal/ Posterior

•Cephalad / Superior , Caudad/ Inferior

•Proximal, Distal

Position of the Heart

Mediastinum

Transverse section through thorax

Approaches

1. Sternotomy

2. Rt. Ant. Tho

3. Lt. Ant. Tho

4. Lt. Post. Tho

5. Rt. Post. Tho

Surfaces of Heart

Lateral

surface

Anterior surface

Inferior surface

Posterior surface

Heart Anatomy

Brachiocephalic Trunk

Left Common Carotid Artery

Left Subclavian Artery

Right Coronary Artery

Left Coronary Artery

Left Anterior Descending Artery

Circumflex Branch

Right= Anterior , Left = Posterior

Heart : Blood Flow

Layers of Heart

Function of Heart: Salient Features

•Blood flows in series•Atria : reservoir , Ventricles: pump•Two atria as one, Two ventricles as one•Valves prevent regurgitation•RV dispensable

•Handles blood but cannot use it DIRECTLY•Receives its ‘pay’ through coronary arteries•Blood Supply = Work = BP X HR

Coronary Circulation Facts

•250ml blood per minute•Extracts all oxygen even at rest•Myocardium can not store oxygen

•Hence Increase in Demand = increase in supply

Position: LAD,D – anterior; PD, PLV – Inferior; OM – PosteriorNon accessible : LM, LCx, S , intramyocardial vessels

Heart: as seen through median sternotomy

Coronaries shaded black are difficult/ impossible to see

Left Chest

• Structures: Lt heart Aorta ,LSCA Lt lung• Approach to: + mitral valve Lt coronaries

Right Chest

•Structures: Right lung, RSCA •Approach to: + mitral valve, RA, SVC

Layers of heart/ Blood vessels

Terminologies•Ischemia•Angina•Infarction•Arteriosclerosis / Atherosclerosis•Risk factors•% stenosis , critical/ sub total / total•Proximal block• ---- Equivalent : angina , LM

Atherosclerosis

•Generalised , affects all vessels •proximal vessels>> distal vessels•Cause: not known , risk factors :

known •Surgery treats blocks not the

disease

F∞ R4

Vessel, site, severity