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15 - Pericardium & Heart.ppt

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15 - Pericardium & Heart.ppt

  1. 1. SEMINAR -BY MORESHWAR PAWAR AND LUBAINA RAMPURAWALA
  2. 2. Heart Hollow muscular organ, acts as a double pump Conical in shape Slightly larger than the clenched fist Lies free within the pericardium Connected superiorly to the large vessels
  3. 3. Heart cont’d Has 4 chambers: two atria superiorly and two ventricles inferiorly, separated from each other by atrioventricular and interventricular grooves Atria act as the receiving chambers and the ventricles as the pumping chambers Right side of the heart contains deoxygenated blood & left side contains oxygenated blood
  4. 4. External Features: Surfaces The heart has: Sternocostal (Anterior) surface Diaphragmatic (Inferior) surface Base (Posterior surface) Apex
  5. 5. Sternocostal Surface Formed mainly by the right atrium and the right ventricle separated by vertical atrioventricular groove The anterior interventricular groove separates the right ventricle from the left ventricle
  6. 6. Diaphragmatic Surface Formed mainly by the right and left ventricles separated by posterior interventricular groove, and a small part of the right atrium, into which the inferior vena cava opens
  7. 7. Base (Posterior Surface) Formed mainly by the left atrium, into which open the 4 pulmonary veins Quadrilateral in shape Lies opposite the apex Faces posteriorly, superiorly and toward the right shoulder
  8. 8. Apex Formed by left ventricle Directed downward, forward and to the left Located posterior to the left 5th intercostal space, 7-9 cm from the median plane and just medial to the left midclavicular line Position varies slightly with the person’s position and the phase of respiration Is the point of maximal pulsation of the heart (the apex beat can be seen as well as palpated)
  9. 9. Borders of the Heart The heart has 4 borders: Right: Formed by the right atrium Left: Formed by the left auricle above and the left ventricle below Inferior: Formed mainly by the right ventricle, and the apex of the left ventricle Superior border is where great vessels enter or leave the heart. Formed by right and left auricles and superior part of right & left ventricle
  10. 10. Surface Projection of the Heart
  11. 11. Blood Supply of the Heart
  12. 12. Arterial Supply Supplied by right & left coronary arteries Coronary arteries arise from the ascending aorta immediately above the aortic valves Coronary arteries and their branches are distributed over the surface of the heart lying within the subepicardial connective tissue
  13. 13. Right Coronary Artery Arises from anterior sinus of ascending aorta Runs between the pulmonary trunk and right auricle Runs in the atrioventricular groove At the inferior border of the heart turns posteriorly in the atrioventricular groove Anastomoses with the left coronary artery in the posterior interventricular groove
  14. 14. Right Coronary Artery: Branches Right conus artery Anterior ventricular branches: 2-3 in number, largest is the marginal branch Posterior ventricular branches, gives a branch to atrioventricular node Posterior interventricular artery Atrial branches, & artery of the sinuatrial node which also supplies atria
  15. 15. Left Coronary Artery Larger than the right Supplies major part of the heart Arises from the left posterior aortic sinus Runs between the pulmonary trunk and left auricle Runs in the atrioventricular groove Divides into anterior interventricular & circumflex branches
  16. 16. Left Coronary Artery: Branches Anterior interventricular artery, gives a small conus artery Circumflex artery, gives: Left marginal Anterior ventricular Posterior ventricular Atrial branches
  17. 17. Variations in Coronary Arteries In 35% of individuals, the sinuatrial artery arises from left coronary artery In most of the individuals (90%), the posterior interventricular artery is a branch of right coronary artery (Right Dominance). In 10% of the individuals, it arises from circumflex branch of left coronary artery (Left Dominance)
  18. 18. Coronary Artery Anastomoses Though anastomoses do exist between the terminal branches of the right and left coronary arteries, but these are not large enough to compensate for any sudden blockage of a large branch. A sudden blockage of the larger branches results in myocardial infarction.
  19. 19. Venous Drainage cont’d Anterior cardiac veins drain directly into the right atrium Vena cordis minimi (Thebesian veins) open directly into heart chambers
  20. 20. Venous Drainage Most of the blood drains into the right atrium through the coronary sinus, which:  Lies in the posterior part of the atrioventricular sulcus  Is continuation of the great cardiac vein  Opens into the right atrium to the left of the inferior vena cava Tributaries:  Small cardiac vein  Middle cardiac vein  Posterior vein of the left ventricle  Oblique vein of the left atrium

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