ANATDMY 27 lecture # : Date : Lecturer : Maher Hadidi
Pericardium A double-walled fibroserous conical-shaped sac, within middle mediastinum. Enclose the heart and roots of its large vessels. Vagus nerves nternal thoracic A. ericardiophrenic A. '" '.., > - '' ''~ - -----.. <.. (: 36
Parts: 1. Fibrous pericardium 2. Serous pericardium Fibrous pericardium Conical-shaped sac. Base: Attached inferior to central tendon of diaphragm. Apex: Attached superior to roots of large vessels. ~ Prevent overextension of the heart. Pericardium Apex Base 1 Fibrous Pericardium (Outer) :,. ::;,;:1'1 2 CiFrJ'I"... 1...,...,J-.. 1 r:..;:,..,'; /~.:.. I Myocardiu~ ' ' ; ; ~ ' ' Endocardium! _j icardial cavity (pmential) ~Wall 37?
Serous pericardium Complete sac invaginated by heart. Has 2 layers: Parietal layerc: lines fibrous pericardium. Visceral layer",,,,~ covers the heart (Epicardium). Pericardia! cavity: A potential space between 2 serous layers. Pericardium Apex 1 Fibrous Pericardium (Outer) ''i" c'~;dium : / ' - ocardium J,icardial cavity (pote1tial) ~Wall 38 3
Contents of pericardium Roots of large vessels: 1. Heart and its arteries, veins and nerves. 2. 3. 4. 5. 6. Ascending aorta. Pulmonary trunk. Lower 2cm of SVC. Terminal 2cm of IVC. Terminal part of the 4 pulmonary veins. Superior vena cava Fibrous pericardium. 40
Heart Pyramidal-shaped muscular organ. About the size of the person's own fist. 1 Apex: directed forward, downward, and to the left. Located at the left 5th intercostal SPace about 9cm from -the midline. Form by left ventricle Base: directed posteriorly, form by left atrium.. to aortic arch. -Give 2 coronaries. Pericardium----- Righ! corona~ A. trunk 43 1
Chambers of heart Form of 4 chambers: 2 atrium above. 2 ventricles below. Atriums are separated from inside by interatrial septum. Ventricles are separated from inside by interventricular septum. Interventricular septum Pulmonarj vein Sp rirrg e2"(llir12 44
Grooves of the heart Externally, atriums are separated from ventricles by the circular coronary sulcus (groove). Also ventricles are separated by the c-. shaped anterior IV sulcus: and posterior IV sulcus.. Coronary sulcus cp~onary artcr)' cardiac vein Wall of the heart Form of 3 layers: Endocardium~- lining. Myocardiumqwall. Epicardiumcqcovering. Right coronary Anterior a~!e'y 45
Borders of the Heart Due to rotation of the heart 90 to the left, the right side becomes anterior and \eft side posterior. Has 3 borders: Right: l\ ;\ Ascending Form by right H Aorta. ' atrium.... Inferior: l\ Form by right ventricle. Left: a: Form by left ventricle. 1~ n ji Pulmonary Trunk =---- Left auricle Apex ~------ -~--- ~" -,_ c,~., r:::'~ ~ ".,.)l/,1. ~- 46
Surface of the heart Has 3 surfaces 1. Anterior surf. 2. Inferior surf. 3. Base. Ascending Anterior Right coronary (Sternocostal). Right atrium Form by Right ventricle Right atrium. Right ventricle Ligamentum arteriosum trunk cardiac vein interventricjlar groove ventricle 47
Inferior surface of the heart (Diaphragmatic surface) Form by right and left ventricles. Left pulmonary A. Superior vena cava Rt. sup. pulmonary v. Right pulmonary A. Right pulmonary Veins Right atrium Sulcus terminalis Left ventric\e. Inferior vena cava 48
Base of the heart Directed posterior, opposite the apex. Form by left atrium. Left pulmonary A. Rt. sup. pulmonary v. rtic arch.----superior vena cava _.Right pulmonary A. Lt. inf. pulmonary v. Right pulmonary Veins Right atrium Sulcus terminalis Left ventricle Inferior vena cava 49
From body above diaphragm,, Right Venous side: Superior vena cava_ 1; Right pulmonary arteries [.:~..;~: :. to right lung ;It!-< ~.:.~--< ' \ Right pulmonary veins\~,' from right lung ~ : Right atriu Interatrial septum Inferior vena cava. From body below diaphragm Right ventricle-, To head and neck+ upper Limbs Outflow part ~,~J Left Arterial side: --nortic arch ortic valve Left pulmonary veins from right lung Left atrium Interventricular septum 50 7
Interior of right Atrium Receives venous blood from whole body by SVC from upper 1/2. IVC from lower 1/2. Coronary sinus (coronary vein) from the heart itself. Send blood to right ventricle by Tricuspid valve. Has 2 walls: Anterior wall, rough Posterior wall, smooth limbus fossa ovalis Crista terminalis. Pectinate muscles Fossa ovalis i Valve of coronary sinus Arch of aorta.. Right auricle (reserve part) Tricuspid valve ventricle 51