PART 1: THE HEART AND PERICARDIUM

Heart Anatomy Size, Location, and Orientation Enclosed in the mediastinum Base (posteriorsuperior portion) and Apex (inferioranterior portion)

Heart Anatomy Coverings Pericardium protects the heart anchors the heart to surrounding structures such as the diaphragm and the great vessels prevents overfilling of the heart with blood

Heart Anatomy Coverings pericardial cavity contains a film of serous fluid pericarditis: inflammation of the pericardium which may lead to adhesions between the layers or the buildup of fluid in the pericardial cavity (cardiac tamponade)

Heart Anatomy Heart Wall Epicardium Myocardium bulk of the heart consisting mainly of cardiac muscle Endocardium

Heart Anatomy Heart Wall Endocardium simple squamous epithelium and a thin CT layer that lines the heart chambers and valves and is continuous with the endothelial lining of the blood vessels

Heart Anatomy Chambers Atria Features  small, thin-walled chambers Functions  receiving chambers for blood returning to the heart from the circulation  push the blood into the adjacent ventricles.

Heart Anatomy Chambers Atria Receive blood from  right side  Superior and Inferior Vena Cava  Coronary Sinus (draining the myocardium)  left side  Pulmonary Veins

Heart Anatomy Chambers Ventricles Features  make up most of the mass of the heart  the walls of the left ventricle are 3X thicker than those of the right

Heart Anatomy Chambers Ventricles Functions  discharging chambers of the heart  propel blood to Pulmonary Trunk (right ventricle), Aorta (left ventricle)

Heart Anatomy Pathway of Blood Through the Heart Pulmonary Circuit functions strictly as gas exchange the right side of the heart is the pulmonary circuit pump this is a short, low-pressure circuit

Heart Anatomy Pathway of Blood Through the Heart Systemic Circuit ofunctions as both gas and nutrient exchange othe left side of the heart is the systemic circuit pump othis is a long, high-resistance pathway through the entire body

Heart Anatomy Heart Valves These enforce the one-way flow of blood through the heart The valves open and close in response to differences in blood pressure on their two sides

Heart Anatomy Heart Valves Atrioventricular Valves the valves close when the ventricular pressure increases and forces blood against the valve flaps Tricuspid (right side) Bicuspid (Mitral) (left side)

Heart Anatomy Heart Valves Semilunar Valves located between the ventricles and the large arteries these open when the pressure produced by the contracting ventricle exceeds that in the artery and close when the arterial pressure exceeds the pressure produced by the relaxing ventricle Pulmonary (right side) Aortic (left side)

Coronary Circulation Coronary Arteries the coronary arteries arise from the base of the aorta and actively deliver blood only when the heart is relaxed the heart is 0.5% of body weight and receives 5% of the body's blood supply (most to the left ventricle)

CORONARY CIRCULATION Heart is supplied by TWO CORONARY arteries: 1- Right coronary artery---(RCA) 2- Left coronary artery---(LCA) These coronary arteries arise at the root of the aorta. 21

Coronary artery & their branches LCA---- -Lt Anterior Descending (LAD) -Marginal Artery -Circumflex Artery RCA Marginal Artery -Posterior descending branch 22

Left coronary artery (LCA) –Divides in Anterior Descending (LAD) Circumflex artery LAD--- Supplies anterior and apical parts of heart,and Anterior 2/3 rd of interventricular septum. Circumflex branch-- supplies the lateral and posterior surface of heart. 23

Right coronary artery(RCA) supplies: Right ventricle Part of interventricular septum (posterior 1/3 rd ) Inferior part of left ventricle AV Node 24

Diagram of coronary circulation 25

Venous return of Heart Most of the venous blood return to heart occurs through the coronary sinus and anterior cardiac veins, which drain into the right atrium 26

Applied Aspect THE C A D. 29

PART 2: THE BREAST

Breast Anatomy Breast Made up of milk-producing glands Supported and attached to the chest wall by ligaments Rests on pectoralis major muscle Three major hormones affect the breast Estrogen, progesterone, and prolactin

Breast Anatomy Breast contains lobes Fat covers the lobes and shapes the breast Lobules fill each lobe Sacs at the end of lobules produce milk Ducts deliver milk to the nipple

Regional Lymph Nodes for Breast Axillary lymph nodes Located in the underarm to the collarbone Include interpectoral or Rotter nodes Internal mammary (parasternal) lymph nodes Tucked under the sternum

Regional Lymph Nodes for Breast Infraclavicular (subclavicular) lymph nodes In the deltopectoral groove Supraclavicular lymph nodes Above the collarbone

Regional Lymph Nodes for Breast A: Pectoralis major muscle B: Axillary lymph nodes level I C: Axillary lymph nodes level II D: Axillary lymph nodes level III E: Supraclavicular lymph nodes F: Internal mammary lymph nodes

What area does the base of the breast cover? Extends from lateral border of sternum to midaxillary line From 2 nd to 6 th ribs Small part may extend towards the axilla – the axillary tail

What two muscles does the breast overly? Pectoralis major Serratus anterior

What separates the breast from the underlying muscle? Retromammary space A potential space filled with loose connective tissue

How is the breast attached to the skin that overlies it? Suspensory ligaments of Cooper Helps support the lobules of the breast

On what line does the nipple lie? Mammary ridge/milk line From the anterior axillary fold to the groin Supernumerary nipples can be occur along this line Also axillary breasts

How is the breast divided for descriptive purposes? Quadrants

What glands are found on the areola? Sebaceous (Montgomery) glands Secrete oily substance following pregnancy Oily substance protects the nipple from irritation

How many lobules are in the breast? How are they separated? lobules of glandular tissue Separated by suspensory ligaments of Cooper

Describe the drainage of milk from a lobule? Each lobule drains into a lactiferous duct Each lactiferous duct opens on the nipple

What arteries supply the breast? Medial mammary – From internal thoracic (mammary)/anterior intercostal Lateral mammary – From lateral thoracic artery & posterior intercostals

What is the nerve supply to the breast? T4-6 intercostal nerves

What different areas do the lymphatics of the breast drain to? Axillary nodes Parasternal nodes Contralateral breast Subdiaphragmatic/hepatic nodes Interpectoral (rotter’s) nodes

What changes does the breast go through during pregnancy? (6) Lengthening and branching of ducts Development of secretory alveoli Vascularity increases Nipples enlarge Areola becomes more prominent Lobular structure more prominent

What effect do progesterone and oestrogen have on breast tissue? Progesterone – lobular development (growth) Oestrogen – ductal growth Combined – suppress lactation

THE END THANK YOU QUESTIONS?