CARDIOVASCULAR SYSTEM Arteries Veins Capillaries HEART Adult 240 – 320 g Newborn 20 – 30 g •COR •Atrium cordis •Ventriculus cordis • • • • • • • • • • • •Septum interatriale •Septum interventriculare •COR • •Atrium dextrum •- vena cava sup. et inf. •Ventriculus dexter •- truncus pulmonalis •Atrium sinistrum •vv. pulmonales dextrae et • sinistrae •Ventriculus sinister •- aorta • •Basis, apex •Facies sternocostalis (anterior) •Facies diaphragmatica (inferior) •Facies pulmonalis dx. et sin. •Margo dexter (acutus) et sinister (obtusus) •Sulcus coronarius, sulcus interventricularis ant. et post. •Auricula dextra et sinistra •ATRIUM DEXTRUM • •Septum interatriale – fossa ovalis •Ostium v. cavae sup. •Ostium v. cavae inf. – • valvula v. cavae inf. •Ostium sinus coronarii •Tuberculum intervenosum •(sinus venarum cavarum) •Crista terminalis •Auricula dextra – • musculi pectinati •Ostium atrioventriculare •dextrum - valva tricuspidalis • • •VENTRICULUS DEXTER •Pars trabecularis - trabeculae carneae •Crista supraventricularis, trabecula septomarginalis •Ostium atrioventriculare dextrum, valva tricuspidalis •– cuspis ant., septalis, post. •Musculi papillares (anterior, septalis, posterior) •Chordae tendineae • •VENTRICULUS DEXTER •Pars glabra – conus arteriosus •Ostium trunci pulmonalis – valva trunci pulmonalis – • valvula semilunaris ant., dx., sin. – lunula, nodulus, sinus •ATRIUM SINISTRUM • •Ostia venarum pulmonalium •Septum interatriale – • fossa ovalis •Auricula sinistra – •musculi pectinati •Ostium atrioventriculare sin. •VENTRICULUS SINISTER •Ostium atrioventriculare sin.– valva bicuspidalis (mitralis) – •cuspis ant. et post. – m. papillaris ant. et post. – chordae •tendineae •Ostium aortae – valva aortae – valvula semilunaris dx., sin. •et post. – lunula, nodulus, sinus aortae dx. et sin. – arteriae •coronariae, bulbus aortae •SYSTOLE •DIASTOLE •Endocardium, myocardium, pericardium • •SKELETON OF THE HEART •Anulus fibrosus dexter, sinister, aorticus, trunci pulmonalis •Trigonum fibrosum dextrum et sinistrum •Pars membranacea septi cordis •MYOCARDIUM • •Mm. pectinati •Trabeculae carneae, mm. papillares •Vortex cordis • •CONDUCTING SYSTEM (Complexus stimulans cordis) •Nodus sinuatrialis (Bachmann interatrial, anterior, middle and •posterior internodal tracts) •Nodus atrioventricularis (accessory AV connections – Kent •fibres) •Fasciculus atrioventricularis (His) – crus dextrum et sinistrum •Rami subendocardiales - Purkinje fibers infmi normalECG2 Normal 180px-ECGcolor Normal ECG Myocardial infarction ECG pacemaker Artificial pacemaker •PERICARDIUM FIBROSUM •- basis •- cupula •- pars sternalis, •- partes laterales •- pars dorsalis • •Ligg. pericardiacophrenica •Ligg. sternopericardiaca •A. et v. pericardiacophrenica •N. phrenicus •PERICARDIUM SEROSUM •- lamina parietalis •- lamina visceralis (epicardium) •- cavitas pericardii – liquor pericardii • •Porta arteriarum – sinus transversus pericardii •Porta venarum – sinus obliquus pericardii • A. coronaria cordis dx. - rr. atriales • - rr. ventriculares • - r. marginalis dx. • - r. coni arteriosi • - r. nodi sinuatrialis • - r. nodi atrioventricularis • - r. interventricularis post. • A. coronaria cordis sin. - r. interventricularis ant. (LAD) • - r. circumflexus •Dominance of RCA • • 67% •Dominance of LCA • 15% •Codominance • 18% coronary-thrombosis-2-PU Illustration of a normal artery with normal blood flow and an artery with plaque buildup. Figure A shows an overview of the heart and coronary artery. Figure B shows a cross-section of the coronary artery with plaque buildup and a blood clot. Angina pectoris Myocardial infarction Coronary thrombosis with heart wire •Venae cordis •1. Sinus coronarius cordis • a) v. cordis magna • b) v. cordis media • c) v. cordis parva • d) v. obliqua atrii sinistri • e) v. posterior ventriculi sinistri •2. Vv. cordis anteriores •3. Vv. cordis minimae •Lymphatics: •Truncus lymphaticus • anterior sinister + • truncus lymph. post. – • nodus lymph. retroaorticus •Truncus lymph. ant. dx. – • nodus lymph. praeaorticus • •Nerves: •Plexus cardiacus spf. • (ganglion cardiacum) •Plexus cardiacus prof. •Plexus coronarius dx. et sin. • •Nn. cardiaci (symp.) •– accelerantes •Rr. cardiaci (parasymp.) • – retardantes • •Sites of auscultation: http://www.stethographics.com/heart/images/sites.jpg •Heart shadow: 1.V. brachiocephalica dx. 5. Arcus aortae 2.V. cava sup. 6. Truncus pulmonalis 3.Atrium dx. 7. Auricula sin. 4.V. cava inf. 8. Ventriculus sin. •Distantia •mediodextra • •Distantia •mediosinistra • •Transverse •line = DMd+DMs • •Length • •Gradient • •Area •Coronary angiography – left coronary artery •Right anterior oblique projection •Left anterior oblique projection •Coronary angiography – right coronary artery •Left anterior oblique projection •Illustrations were copied from: •Atlas der Anatomie des Menschen/Sobotta. •Putz,R., und Pabst,R. 20. Auflage. München: •Urban & Schwarzenberg, 1993 •Netter: Interactive Atlas of Human Anatomy. •Windows Version 2.0 •Čihák R: Anatomie 2 (Splanchnologia). Avicenum, •zdravotnické nakladatelství, Praha, 1988. http://devblog.winniepalmerhospital.com/wp-content/uploads/2013/02/lisa_cooper-dietitian_cardiac_re habilitation-heart_healthy_diet-miranda_schultz-orlando_health-e1361284875836.jpg