1. MEDIASTINUM & CARDIOVASCULAR SYSTEM
Though My Heart Is Torn © 2011 by Karen Mathison Schmidt
Kaan Yücel M.D., Ph.D.
Friday

2. crucial organ of the human body
.HEART
(1)7.3 million
Trapezoidal in A-P dimensions
Tipped-over pyramid in 3-D
crucial organ of the human body
30%

3. well- oxygenated (arterial) blood
Right heart (Suction)
poorly- oxygenated(venous) blood
from the body
superior vena cava & inferior vena cava
right atrium right ventricle
pulmonary arteries
lungs
Left heart (Pumping)
well- oxygenated (arterial) blood
from the lungs
pulmonary veins
left atrium left ventricle
aorta
the body

4. The four chambers of the heart
right and left atria & right and left ventricles
Atrium – plural atria
Ventricles
Discharging chambers
Receiving chambers
cardiac cycle
Ventricular filling (diastole)
Ventricular emptying (systole)
Blood pressure
mm/Hg

5. The fibrous skeleton of the heart
Keeps the orifices of the AV & semilunar valves patent
prevents them from being overly distended by an increased volume of blood.
Provides attachments for the valves & myocardium.
Forms an electrical «insulator»
separating impulses of the atria & ventricles  they contract independently
surrounding and providing passage for the initial part of the AV bundle

6. Sulci/Grooves in the heart
coronary sulcus (atrioventricular groove)
between atrium & ventricles
anterior & posterior interventricular (IV) sulci (grooves)
between right and left ventricles

7. apex located inferiorly & base located superiorly
Apex & base of the heart
apex located inferiorly & base located superiorly
Apex projects forward, downward and to the left
Base faces in a posterior direction

8. The four surfaces of the heart
Anterior (sternocostal) surface
mostly of right ventricle
some of the right atrium on the right
some of the left ventricle on the left
Diaphragmatic (inferior) surface
formed mainly by the left ventricle
partly by the right ventricle
related to central tendon of diaphragm.
Right pulmonary surface
formed by the right atrium.
Left pulmonary surface
left ventricle & a portion of left atrium.

9. 2.RIGHT ATRIUM forms the right border of the heart
Receives venous blood from the SVC, IVC, and coronary sinus.
Through the right atrioventricular orifice,
discharges the poorly oxygenated blood it has received
into the right ventricle.

10. 3.RIGHT VENTRICLE
forms
largest part of the anterior surface of the heart
a small part of the diaphragmatic surface
almost the entire inferior border of the heart.

11. muscular and membranous parts
interventricular septum (IVS)
obliquely placed partition between the right and left ventricles, forming part of the walls of each
muscular and membranous parts
Bulges into the cavity of the right ventricle.
Superiorly and posteriorly, a thin membrane, forms the much smaller membranous part of the IVS.

12. 4.LEFT ATRIUM forms most of the base of the heart
right and left pulmonary veins enter here.
Tubular, muscular left auricle,
Its wall trabeculated with pectinate muscles.
A semilunar depression in the interatrial septum
Floor of the oval fossa
surrounding ridge
Valve of the oval fossa

13. Compared to the right ventricle
5.LEFT VENTRICLE
forms the apex of the heart, left (pulmonary) surface & border, most of the diaphragmatic surface.
Compared to the right ventricle
Walls 2-3 times thicker
Trabeculae carneae finer and more numerous
Cavity longer
Anterior & posterior papillary muscles larger

14. aortic valve
semilunar valve
between the left ventricle & ascending aorta
obliquely placed.

15. double-leaflet mitral valve
Guards the left AV orifice.
Has two cusps, anterior and posterior.

16. 6. SEMILUNAR VALVES
Semilunar cusps of the pulmonary valve anterior-right-left
Seminular cusps of the aortic valve posterior-right-left
concave when viewed superiorly
no tendinous cords to support

17. 7. VASCULATURE OF THE HEART
coronary arteries & cardiac veins
embedded in fat
course across the surface of the heart just deep to the epicardium.

18. Arterial Supply of the Heart
coronary arteries
first branches of the aorta
supply the myocardium and epicardium
Anastomoses between the branches of the coronary arteries exist, which enables the development of the collateral circulation.

19. 8. STIMULATING, CONDUCTING, & REGULATING SYSTEMS OF HEART
1. sinuatrial (SA) node
initiates the heartbeat & coordinates contractions of the four heart chambers
2.atrioventricular (AV) node
3.bundles
highly specialized conducting fibers for conducting impulses rapidly to different areas of the heart
Propagation of the impluse
Simultaneous contraction of the cardiac striated muscle cells

20. sinuatrial (SA) node pacemaker of the heart
@junction of the SVC & right atrium
near to the superior end of the sulcus terminalis

21. sinuatrial (SA) node pacemaker of the heart
stimulated by sympathetic division of the autonomic nervous system to accelerate the heart rate
inhibited by parasympathetic division
to return to or approach its basal rate.

22. atrioventricular (AV) node
a smaller collection of nodal tissue than the SA node
in the posteroinferior region of the interatrial septum
near the opening of the coronary sinus

23. JOURNEY OF THE SIGNAL Generated @ SA node
Passed through the walls of the right atrium
Propageted by the cardiac muscle
Signal passed from SA node to AV node
Distributed to the ventricles through the AV bundle

24. BUNDLES passes from the AV node
AV bundle
the only bridge between the atrial and ventricular myocardium
passes from the AV node
through the fibrous skeleton of the heart and along the membranous part of the IVS.
@ junction of membranous & muscular parts of the IVS
divides into : right bundle & left bundle.

25. BUNDLES
right and left bundles
proceed on each side of the muscular IVS deep to the endocardium
then ramify into
subendocardial branches (Purkinje fibers)
extend into the walls of the respective ventricles.

26. Innervation of the Heart
autonomic nervous system, cardiac plexus
Cardiac plexus
posterior to the ascending aorta and bifurcation of the pulmonary trunk

27. Innervation of the Heart Parasympathetic supply
autonomic nervous system, cardiac plexus
Parasympathetic supply
presynaptic fibers of the vagus nerves
Slows the heart rate
Reduces the force of the contraction
Constricts the coronary arteries saving energy

28. Innervation of the Heart
sympathetic supply
presynaptic fibers
cell bodies in the intermediolateral cell columns (IMLs) of the superior 5 or 6 thoracic segments
postsynaptic sympathetic fibers
cell bodies in the cervical and superior thoracic paravertebral ganglia of the sympathetic trunks.
causes increased heart rate
increased impulse conduction, increased force of contraction,
increased blood flow through the coronary vessels increased activity.

29. a closed sac with two layers
11. PERICARDIUM
fibroserous membrane, covers the heart & beginning of its great vessels
a closed sac with two layers
fibrous pericardium
serous pericardium
parietal layer
visceral layer –heart & great vessels .

30. fibrous pericardium
continuous superiorly w/ tunica adventitia of the great vessels & w/pretracheal layer of deep cervical fascia
Continuous inferiorly w/ central tendon of the diaphragm
Attached anteriorly to the sternum by sternopericardial ligaments
Site of continuity pericardiacophrenic ligament
Inner surface lined by parietal layer of the serous pericardium
Protects the heart against sudden overfilling.

31. pericardial cavity potential space between opposing layers of the
parietal & visceral layers of serous pericardium
contains a thin film of fluid : pericardial fluid
enables the heart to move and beat in a frictionless environment.

32. right & left brachiocephalic veins
12. GREAT VESSELS
right & left brachiocephalic veins
formed by the union of
internal jugular & subclavian veins
posterior to the sternoclavicular (SC) joints.
brachiocephalic veins unite to form the SVC.
@ inferior border of the 1st right costal cartilage
shunt blood from the head, neck, & upper limbs right atrium.

33. superior vena cava (SVC)
Returns blood from all structures superior to the diaphragm
except the lungs & heart.
Passes inferiorly and ends by entering right atrium of the heart.

34. ascending aorta begins at the aortic orifice.
only branches coronary arteries, arising from the aortic sinuses.
ascending aorta

35. Arch of the aorta (Aortic arch)
curved continuation of the ascending aorta
begins posterior to the 2nd right sternocostal (SC) joint at the level of the sternal angle.
ligamentum arteriosum remnant of the fetal ductus arteriosus
root of the left pulmonary artery inferior surface of the arch of the aorta
The usual branches of the arch
brachiocephalic trunk
left common carotid artery
left subclavian artery.

36. brachiocephalic trunk
first and largest branch of the arch of the aorta
arises posterior to the manubrium.
ascends superolaterally
divides into right common carotid & right subclavian arteries.

37. left common carotId artery
second branch of the arch of the aorta
arises
posterior to the manubrium,
slightly posterior and to the left of the brachiocephalic trunk.

38. left subclavian artery
third branch of the arch of the aorta
arises from the posterior part of the arch
posterior to left common carotid artery.
ascends lateral to trachea & left common carotid artery.
Leaves the thorax and enters the root of the neck.

39. monitor changes in blood pressure
CAROTID BODY
CN IX
CN X
responsible for detecting changes in blood chemistry, primarily oxygen content
CAROTID SINUS
monitor changes in blood pressure
CN IX

40. Abdominal aorta

41. Abdominal aorta

42. External iliac artery
Femoral artery

43. Anterior tibial artery Posterior tibial artery
Popliteal artery
Anterior tibial artery
Posterior tibial artery

44. Anterior tibial artery
Dorsal pedis artery

48. U Superficial