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Transcript of HEART ANATOMY DR. EMAD ABU ALRUB AAUJ. HEART ANATOMY Approximately the size of your fist Wt. =...
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HEART ANATOMY
DR. EMAD ABU ALRUB
AAUJ
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HEART ANATOMYApproximately the size of your fistWt. = 250-300 gramsLocationIn the mediastinum between the lungsSuperior surface of diaphragm⅔’s of it lies to the left of the midsternal line
Anterior to the vertebral column, posterior to the sternum
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HEART ANATOMY
Figure 18.1
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COVERINGS OF THE HEARTPericardium – a double-walled sac around the
heart Composed of:
A superficial fibrous pericardiumA deep two-layer serous pericardium
The parietal layer lines the internal surface of the fibrous pericardium
The visceral layer or epicardium lines the surface of the heart
They are separated by the fluid-filled pericardial cavity called the pericardial cavity
Protects and anchors the heartPrevents overfilling of the heart with bloodAllows for the heart to work in a relatively friction-free environment
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PERICARDIAL LAYERS OF THE HEART
Figure 18.2
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LAYERS OF THE HEART WALL
Epicardium – visceral pericardium
Myocardium – cardiac muscle layer forming the bulk of the heart
Endocardium – endothelial layer of the inner myocardial surface
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HEART ANATOMYExternal markings Apex - pointed inferior regionBase - upper regionCoronary sulcusIndentation that separates atria from ventricles
Anterior and posterior interventricular sulcusSeparates right and left ventricles
Internal divisionsAtria (superior) and ventricles (inferior)Interventricular and interatrial septa
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ATRIA OF THE HEARTAtria - receiving chambers of the heartReceive venous blood returning to heartSeparated by an interatrial septum (wall)Foramen ovale - opening in interatrial septum in fetus
Fossa ovalis - remnant of foramen ovaleEach atrium has a protruding auriclePectinate muscles mark atrial wallsPump blood into ventricles Blood enters right atria from superior and
inferior venae cavae and coronary sinusBlood enters left atria from pulmonary veins
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GROSS ANATOMY OF HEART: FRONTAL SECTION
Figure 18.4e
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VENTRICLES OF THE HEARTVentricles are the discharging chambers of the
heartPapillary muscles and trabeculae carneae
muscles mark ventricular wallsSeparated by an interventricular septumContains components of the conduction system
Right ventricle pumps blood into the pulmonary trunk
Left ventricle pumps blood into the aortaThicker myocardium due to greater work load
Pulmonary circulation supplied by right ventricle is a much low pressure system requiring less energy output by ventricle
Systemic circulation supplied by left ventricle is a higher pressure system and thus requires more forceful contractions
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EXTERNAL HEART: ANTERIOR VIEW
Figure 18.4b
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STRUCTURE OF HEART WALLLeft ventricle –
three times thicker than right
Exerts more pumping force
Flattens right ventricle into a crescent shape
Figure 18.7
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HEART VALVES
Heart valves ensure unidirectional blood flow through the heart
Composed of an endocardium with a connective tissue core
Two major typesAtrioventricular valvesSemilunar valvesAtrioventricular (AV) valves lie between the atria
and the ventriclesR-AV valve = tricuspid valveL-AV valve = bicuspid or mitral valveAV valves prevent backflow of blood into the atria
when ventricles contractChordae tendineae anchor AV valves to papillary
muscles of ventricle wallPrevent prolapse of valve back into atrium
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SEMILUNAR HEART VALVES
Semilunar valves prevent backflow of blood into the ventricles
Have no chordae tendinae attachments
Aortic semilunar valve lies between the left ventricle and the aorta
Pulmonary semilunar valve lies between the right ventricle and pulmonary trunk
Heart sounds (“lub-dup”) due to valves closing
“Lub” - closing of atrioventricular valves“Dub”- closing of semilunar valves
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FIBROUS SKELETONSurrounds all four valvesComposed of dense connective tissue
FunctionsAnchors valve cuspsPrevents overdilation of valve openings
Main point of insertion for cardiac muscle
Blocks direct spread of electrical impulses
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HEART VALVES
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CONDUCTING SYSTEM
Cardiac muscle tissue has intrinsic ability to:
Generate and conduct impulsesSignal these cells to contract rhythmically
Conducting system A series of specialized cardiac muscle cells
Sinoatrial (SA) node sets the inherent rate of contraction
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CONDUCTING SYSTEM
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INNERVATIONHeart rate is altered
by external controls
Nerves to the heart include:
Visceral sensory fibersParasympathetic branches of the vagus nerve
Sympathetic fibers – from cervical and upper thoracic chain ganglia
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EXTERNAL HEART: POSTERIOR VIEW
Figure 18.4d
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MAJOR VESSELS OF THE HEARTVessels returning blood to the heart
include:Superior and inferior venae cavae
Open into the right atriumReturn deoxygenated blood from body cells
Coronary sinusOpens into the right atriumReturns deoxygenated blood from heart muscle (coronary veins)
Right and left pulmonary veinsOpen into the left atriumReturn oxygenated blood from lungs
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MAJOR VESSELS OF THE HEART Vessels conveying blood away from the heart
include:Pulmonary trunkCarries deoxygenated blood from right ventricle to lungs
Splits into right and left pulmonary arteriesAscending aortaCarries oxygenated blood away from left ventricle to body organs
Three major branchesBrachiocephalicLeft common carotid, Left subclavian artery
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BLOOD FLOW THROUGH THE HEART
Figure 18.6
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PATHWAY OF BLOOD THROUGH THE HEART AND LUNGS
Figure 18.5
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CORONARY CIRCULATIONThe functional blood supply to the heart muscle itself
R and L Coronary arteries are 1st branches off the ascending aorta
Coronary sinus (vein) empties into R. atriumCollateral routes ensure blood delivery
to heart even if major vessels are occluded
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CORONARY CIRCULATION - ARTERIESRight Coronary Artery Supplies blood to
Right atrium and posterior surface of both ventricles
Branches into theMarginal artery - extends across surface of R. ventricle
Posterior interventricular arteryFound in posterior interventricular sulcus
Left Coronary ArterySupplies blood to
Left atrium and left ventricleBranches into
Circumflex arteryAnterior interventricular artery
Found in anterior interventricular sulcusConnected with posterior interventricular artery via arterial anastomoses
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CORONARY CIRCULATION: ARTERIAL SUPPLY
Figure 18.7a
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CORONARY CIRCULATION - VEINSCoronary sinus - Vein that empties into right atriumReceives deoxygenated blood from:Great cardiac vein - on anterior surfacePosterior cardiac veinDrains area served by circumflex
Middle cardiac veinDrains area served by posterior interventricular artery
Small cardiac veinDrains blood from posterior surfaces of right atrium and ventricle
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CORONARY CIRCULATION: VENOUS SUPPLY
Figure 18.7b
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MICROSCOPIC ANATOMY OF HEART MUSCLECardiac muscle cellsShort, striated, branched, and interconnectedThe connective tissue endomysium acts as both
tendon and insertionIntercalated discs anchor cardiac cells together
and allow free passage of ionsHeart muscle behaves as a functional syncytiumMany mitochondria (25% of total volume)
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MICROSCOPIC ANATOMY OF HEART MUSCLE
Figure 18.11
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DISORDERS OF THE HEART
Coronary artery diseaseAtherosclerosis – fatty depositsArteriosclerosis - hardening of the arteries
Angina pectoris – chest painMyocardial infarction – blocked coronary artery
Silent ischemia – no pain or warning Fibrillation - irregular heart beat; may occur in either atria or ventricles