The anatomy of the Heartby : Azril Habibi, dr

Approximately the size of your fistLocation : Mid MediastinumApex rests on diaphragmTwo-Thirds Left of the midlineAnterior to the sternum, posterior to the vertebra column

Located

Mediastinum

Part of mediastinum

Apertura thoracis Superior 1. Mediastinum Superior Apertura thoracis Inferior 2. Mediastinum Medialis 3. Mediastinum Anterior 4. Mediastinum Posterior1423

Mediastinum

Superior: Arcus aorta a. anonyma a. Carotis communis sin a. Subclavia sinistra v. brachiochepalica sin/ dex Trachea oesophagus tymus Media : Jantung dan pericardium aorta ascendens bifurcatio trachealis a.v. pulmonalis Nn. phrenicus

Posterior : N.vagus dextra Oesophagus aorta descendens v. hemiazygos v. azygosAnterior :- Sebagian Thymus - Nn limphatici

Coverings of the Heart: AnatomyPericardium a double-walled sac around the heart composed of:A superficial fibrous pericardiumA deep two-layer serous pericardiumThe parietal layer lines the internal surface of the fibrous pericardiumThe visceral layer or epicardium lines the surface of the heartThey are separated by the fluid-filled pericardial cavity 10-20 ml

Pericardium & Heart WallPericardium

Pericardial cavityepicardium

Cardiac ChambersRight Atrium- Receives de-oxygenated blood from Superior vena cava (head and upper body) and Inferior vena cava (legs and lower torso)- Tricuspid Valve anulus- Limbus Fossa Ovalis- Coronary sinus

Left Atrium- Receives oxygenated blood from the Four pulmonary vein- Mitral valve anulus

Between Right atrium and Left atrium are separated by Septum interatriale

Right Ventricle- Receives de-oxygenated blood from right atrium- The tricuspid valve, which separates the right atrium from the right ventricle- anterior papillary muscles, posterior papillary muscles and septum- Moderator band (trabecula septomarginal)

Left ventricle- receives oxygenated blood from left atrium- Mitral valve separates the left atrium and the left ventricle- anterior an posterior papillary muscles

Cardiac Chambers

Heart AnatomyHeart Valves Atrioventricular Valves Tricuspid valve (right side) : located between right atrium and right ventricleConsist of 3 valve leaflet : Anterior leaflet, posterior leaflet and septal leaflet Bicuspid (Mitral) (left side) : located between left atrium and left ventricleConsist of 2 valve leaflet : anterior mitral leaflet and posterior mitral leaflet

Heart AnatomyHeart Valves Semilunar Valves located between the ventricles and the great arteries Pulmonary valve (right side) Aortic valve (left side) : right coronary cuspid, left coronary cuspid and non coronary cuspid

Heart ValvesFigure 18.8a, b

Heart ValvesFigure 18.8c, d

Operation of Atrioventricular Valves

Operation of Semilunar Valves

Vessels returning blood to the heart include:Superior and inferior venae cavaeRight and left pulmonary veinsVessels conveying blood away from the heart include:Pulmonary trunk, which splits into right and left pulmonary arteriesAscending aorta (three branches) brachiocephalic, left common carotid, and subclavian arteriesExternal Heart: Major Vessels of the Heart (Anterior View)

Arteries - right coronary artery - left coronary artery : circumflex, LAD Veins small cardiac, anterior cardiac, and great cardiac veinsExternal Heart: Vessels that Supply/Drain the Heart (Anterior View)

External Heart: Anterior ViewFigure 18.4b

Connected Aorta with Pulmonary Trunk

In prenatal, the pulmonal drainage is not perfect yet. There is a ductus arteriosus which connected the aorta with pulmonary trunk. After birth, the ductus will be closed and being a fibrous tissue that we called lig. Arteriosum Botalli

Arcus AortaLig. Arteriosum BotalliTruncus PulmonalisBCA

Vessels returning blood to the heart include:Right and left pulmonary veinsSuperior and inferior venae cavaeVessels conveying blood away from the heart include:AortaRight and left pulmonary arteriesExternal Heart: Major Vessels of the Heart (Posterior View)

Arteries right coronary artery (in right atrioventricular groove) and the posterior interventricular artery (in posterior interventricular groove)Veins great cardiac vein, posterior vein to left ventricle, coronary sinus, and middle cardiac veinExternal Heart: Vessels that Supply/Drain the Heart (Posterior View)

External Heart: Posterior ViewFigure 18.4d

Coronary Circulation Coronary Arteries left main coronary artery left anterior descending artery: serves the interventricular septum and anterior walls of both ventricles circumflex artery: serves the left atrium and posterior wall of the left ventricle

Coronary Circulation Coronary Arteries Right main coronary artery posterior descending artery: serves the posterior walls of both ventricles marginal artery: lateral wall of the right side of the heartCardiac Veins follow arteries and join at the Coronary Sinus which empties blood into the right atrium

Blood Flow Through Heart

Heart Physiology: Sequence of ExcitationFigure 18.14a

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