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Department of Anatomy
Heart
MUDr. Marek Joukal, Ph.D.
HEART (COR)
VESSELS (VASA)
BLOOD (SANGUIS)
CARDIOVASCULAR SYSTEM COMPOSITION
SYSTEMIC BLOOD CIRCULATION
PULMONAR BLOOD CURCULATION
PORTAL BLOOD CIRCULATION
COR (HEART)
2/3 left, 1/3 right270-320 g
HEART DIVISION
Septum cordis (interatriale, interventriculare)
Septum atrioventriculare dx., sin.
Ostium atrioventriculare dx., sin.
Valva tricuspidalis
Valva bicuspidalis
Atrium dx. et sin.
Ventriculus dx. et sin.
Vena cava sup. et inf.
Truncus pulmonalis
Vv. pulmonales
Aorta
SURFACE OF THE HEART
Basis cordis
Apex cordis
Facies sternocostalis (ant.)
Facies diaphragmatica (post.)
Margo acutus (dexter)
Margo obtusus (sinister)
= facies pulmonalis
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Sulcus coronarius
Sulcus interventricularis ant.
Sulcus interventricularis post.
Auricula dextra et sinistra
Incisura apicis cordis
Ostium v. cavae sup.
Ostium v. cavae inf.
(valvula v. cavae inf.)
Ostium sinus coronarii
(valvula sinus coronarii)
Torus intervenosus
Crista terminalis
(sinus venarum cavarum,
auricula dextra, mm. pectinati)
Septum interatriale
(fossa ovalis)
Valva tricuspidalis
RIGHT ATRIUM
Septum atrioventriculare dx.
(ostium atrioventriculare dx.,
valva tricuspidalis)
ant. post.sept.
VALVA TRICUSPIDALIS
AS
P
Cuspis anterior, septalis, posterior
Chordae tendineae
Musculi papillares
anterior, parvi - posterior, septales
RIGHT VENTRICLE
Pars trabecularis
Pars glabra
Crista supraventricularis
Ostium atrioventriculare dextrum
Valva tricuspidalis
Trabecula septomarginalis
Musculi papillares
RIGHT VENTRICLE
Pars glabra (conus arteriosus)
Ostium trunci pulmonalis
Valva trunci pulmonalis
Auricula sinistra (musculi pectinati)
Ostia venarum pulmonalium
Septum interatriale
(fossa ovalis)
Ostium atrioventriculare sin.
(valva bicuspidalis)
LEFT ATRIUM
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LEFT VENTRICLE
Ostium atrioventriculare sin.
Valva bicuspidalis - mitralis
M. papillaris ant. et post.
Ostium aortae
Valva aortae (bulbus aortae)
Sinus aortae dx.
(a. coronaria cordis dx.)
Sinus aortae sin.
(a. coronaria cordis sin.)
MORPHOLOGY OF HEART WALL
ENDOCARDIUM
MYOCARDIUM (muscular layer, conductive systém of heart)
EPICARDIUM (pericardium serosum - lamina visceralis )
PERICARDIUM (fibrosum et serosum – lamina parietalis)
ENDOCARDIUM Thicker in the atria
Thicker in left portion of the heart
Background of valves
Cardiac skeleton
Anulus fibrosus dexter
Anulus fibrosus sinister
Anulus aorticus
Anulus trunci pulmonalis
Conus ligament
Trigonum fibrosum dextrum
Trigonum fibrosum sinistrum
Pars membranacea septi cordis
SYSTOLE
DIASTOLE
Heart valves
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MYOCARDIUM OF THE ATRIA
fasciculus interauricularis
horizontalis
fasciculus interauricularis
verticalis
MYOCARDIUM OF THE VENTRICLES
vortex cordis
Superficial layer of myocardium
Middle layer of myocardium Deep layer of myocardium
Trabeculae carnae
Mm. papillares
Intercalar discs
CONDUCTIVE SYSTEM OF THE HEART
crus dextrum
Purkyně´s fibres
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1. Internodal connections
dorsal (Thorel)
middle (Wenckenbach)
ventral (James, Bachnan)
Accesory fibres of the conductive system
2. Mahaim´s paraspecific fibers
(divided fasciculus atriovent.)
3. Kent´s fibers (circular)
4. By pass tractus
PERICARDIUM
Pericardium fibrosum
Pericardium serosum
Lamina parietalis
Lamina visceralis (epicardium)
PERICARDIUM
Basis pericardii - facies diaphragmatica
(ligg. phrenicopericardiaca)
Cupula pericardii
(aorta, v. cava sup.,tr. pulmonalis)
Pars sternalis
(ligg. sternopericardiaca)
Partes laterales
(vasa pericardiacophrenica,
n. phrenicus)
Pars dorsalis
Porta arteriarum =
vagina serosa arteriarum
(aorta, tr.pulmonalis)
Porta venarum
(vv.cavae, vv.pulmonales)
sinus transversus pericardii
sinus obliquus pericardii
Coronary arteries
Arteria coronaria cordis dextra
r. coni arteriosi
r. nodi sinuatrialis
r. nodi atrioventricularis
rr. atriales dx.
rr. ventriculares dx.
r. marginalis dx.
r. interventricularis post.
Arteria coronaria cordis sinistra
r. interventricularis ant.
r. coni arteriosi
r. lateralis
rr. interventriculares septales
r. circumflexus
r. marginalis sin.
rr. atriales
r. nodi sinuatrialis
r. nodi atriovetricularis
facies sternocostalis
facies diaphragmatica
a. coronaria cordis sin. a. coronaria cordis dx.
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Coronarography (a. coronaria cordis sin.) Coronarography (a. coronaria cordis dx.)
■ 40%
vv. cordis ant.
vv. cordis minimae
■ 60%
sinus coronarius
v. cordis magna
v. cordis media
v. cordis parva
v. obliqua atrii sin.
v. post. ventriculi sin.
VENAE CORDIS
Plexus cardiacus spf.
(ganglion cardiacum)
Plexus cardiacus prof.
Plexus coronarius dx. et sin.
Nn. accelerantes
(sympaticus, nn. cardiaci)
Nn. retardantes
(parasympaticus, rr. cardiaci
n. vagi)
Innervation of the heart
Lymphatic system of the heart Lymphatic plexuses: subendocardial
myocardial
subepicardial
Truncus lymphaticus anterior sinister
(r. interventricularis a. coronariae cordis sin.)
Truncus lymphaticus posterior
(r. circumflexus a. coronariae cordis sin.)
Truncus lymphaticus anterior dexter
(a. coronaria cordis dx.)
Nodus lymphaticus praeaorticus
Nodus lymphaticus retroaorticus
valva
aortae
valva
tricuspidalis
valva trunci pulmonalis
valva bicuspidalis
AUSCULTATION POINTS
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1. V. brachiocephalica dx.
2. V. cava sup.
3. Atrium dx.
4. V. cava inf.
5. Arcus aortae
6. Truncus pulmonalis
7. Auricula sin.
8. Ventriculus sin.
NATIVE X-RAY OF THE CHEST References:
Putz, R. (2008):
Atlas of Human Anatomy Sobotta. Elsevier Books.
Keith L. Moore, Arthur F. Dalley (2005):
Clinically Oriented Anatomy. Williams and Wilkins.
Platzer, W., Kahle, W., Leonhardt H. (1992):
Locomotor system. Georg Thieme Verlag, Stuttgart,
New York, 4th edition.
Čihák, R. (1987):
Anatomie 1. Avicenum, Zdravotnické nakladatelství.
Netter, F. H. (1997):
Interactive Atlas of Clinical Anatomy. Novartis, USA.