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Dr.pardeep Kumar

Heart. Dr.pardeep Kumar. The Truth About Your Heart. Heart: Heart is a hollow, muscular organ, situated in the middle Mediastinum. It is enclosed within the pericardium. Measurements Length - 12 cm (Apex to Base) Width - 6 cm (Anterior Posterior)

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Dr.pardeep Kumar

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  1. Heart Dr.pardeep Kumar The Truth About Your Heart

  2. Heart: • Heart is a hollow, muscular organ, situated in the middle Mediastinum. • It is enclosed within the pericardium. Measurements • Length - 12 cm (Apex to Base) • Width - 6 cm (Anterior Posterior) • Widest transverse diameter – 8 – 9 cm • Weight – • Male 300g • Female - 250g Dr. Pardeep Kumar

  3. Position • It lies obliquely behind the sternum, so that 1/3 lies to the right & 2/3 to the left of the median plain Dr. Pardeep Kumar

  4. External Features of the Heart -The Human heart has 4 Chambers. These are the • Rt. Atrium • Lt Atrium • Rt. Ventricles • Lt Ventricles. • -The Atria are separated from the ventricles by a circular Atrioventricular or Coronary sulcus & lies above & behind the Ventricles. Dr. Pardeep Kumar

  5. -The Ventricles are separated from each other by an interventricular groove, which is sub divided into Anterior & Posterior part • -The upper part of each atrium has an Appendage called the Auricles Dr. Pardeep Kumar

  6. For practical purposes, the heart may be considered to have an apex, base, 4 borders & 2 surfaces • Borders of the Heart Dr. Pardeep Kumar

  7. Apex, Base & Surfaces of the Heart Dr. Pardeep Kumar

  8. Relations Post Surface (Base) • pericardium • Rt pulmonary veins • esophagus • aorta • These separate it from (TV5-8 or TV6-9) The 4 pulmonary veins open into the Lt Atrium The SVC opens into sup part IVC opens into inferior part of RV Dr. Pardeep Kumar

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  12. Anatomical Position This is the specimen of the heart with great vessels • Apex is directed downwards, forwards & to the left & lies in the left 5th intercostal space 9 cm from the midline • Base lies posteriorly & is directed backwards & to the right • Sternocostalis surface is directed forwards, upwards & to the left • Inferior or diaphragmatic surface is direced downwards & slightly backwards Dr. Pardeep Kumar

  13. Valves of Heart Have 2 pairs of Valves • 2 Semi lunar valves • Pulmonary valves [3 cusps] • Aortic valves[3 cusps] • 2 Atrio ventricular valves • Rt Atrio ventricular valve/ Tricuspid valve[3 cusps] • Lt Atrio ventricular valve/ Mitral valve/ Bicuspid valve[2 cusps] Dr. Pardeep Kumar

  14. Valves are made up of following components • Fibrous ring to which cusps are attached • Cusps are flat & project into ventricle cavity • Cusps are folds of endocardium • Cusps have • Attached & free margin • Atrial & ventricular surface • Atrial surface - Is smooth • Ventricular surface - Is rough & irregular due to attachment of chordate tendinae Dr. Pardeep Kumar

  15. Chordae tendenae • They are cord like strands of connective tissue that connect the free margin of Mitral & Tricuspid valves to the papillary muscles Papillary muscles • They are conical muscular projections formed by myocardium enclosed by endocardium that connect the ventricular wall with the chordate tendinae •  One papillary muscle is connected to halves of two cusps Dr. Pardeep Kumar

  16. Tricuspid valve Guards the Rt. Atrioventricular opening • 3 cusps • Anterior, Posterior or inferior & septal • 3 papillary muscle • Anterior is largest • Posterior smaller & irregular • Septal Dr. Pardeep Kumar

  17. Mitral valve Guards the Lt. Atrioventricular orifice • 2 cusps • Anterior/Aortic cusp & posterior cusp • It admits two fingers Dr. Pardeep Kumar

  18. Semilunar valves • Pulmonary valve guards the Pulmonary opening • Aortic valve guards the Aortic opening  3 cusps • Attached to vessels wall directly & has no fibrous cap Dr. Pardeep Kumar

  19. Right Atrium • It forms the base of the heart, anterior surface of the heart, & Rt. Border • Extends from the orifice of the SVC behind the 3rd costal cartilage to the orifice of IVC behind the 6th Rt. Costal cartilage External Features • Upper end is prolongated to the left to form Rt. Auricle • Shallow vertical groove called sulcus terminalis run along the Rt. Border of Atrium extending between SVC & IVC. Dr. Pardeep Kumar

  20. Internal Features It is divided into 3 parts • Smooth posterior part/Sinus Venarum • Rough Anterior part/ pectinate part including the auricle • Septal wall Dr. Pardeep Kumar

  21. Smooth posterior part/Sinus Venarum It has opening for SVC, IVC, Coronary sinus & venae cordis minimi • SVC opens at upper end • IVC opens at lower end • Coronary sinus opens between the opening of IVC & tricuspid valve • Venae cordis minimi present in the walls of all 4 chambers they open into Rt. Autrium through small foramina (Foramen venarum minimarum) Dr. Pardeep Kumar

  22. Rough Anterior part/ pectinate part • It is a series of transverse muscular ridges called pectinate muscle. • They arise from crista terminalis & run forward & downward towards Atrioventricular orifice giving appearance of teeth of comb Septal wall • Fossa Ovalis – It is an oval depression above & to the left of the opening of inferior vena cava • The margin of the fossa ovalis is called annulus ovalis Dr. Pardeep Kumar

  23. Right Ventricle • It is a Triangular chamber. • It forms inferior surface, large part of anterior surface, inferior border of heart Dr. Pardeep Kumar

  24. Right Ventricle Internal Features • It has two parts • The inflowing part is rough due to presence of muscular ridges called trabeculae Cornae • The out flowing part is smooth & forms the upper conical part of Rt. Ventricle which gives rise to pulmonary trunk • This two part is separated by muscular ridge called supraventricular crest (infundibulo ventricular crest) Dr. Pardeep Kumar

  25. Inflowing Part • The interior of inflowing part shows trabeculae carnaea or muscular ridges of three types • Ridges/ fixed elevations • Bridges having two fixed ends with free centre • Pillars/papillary muscles with one end attached to ventricular wall & the other end connected to cusps of tricuspid valve by chordate tendinae • The wall of Rt ventricle is thinner than that of left ventricle in ratio 1:3 Dr. Pardeep Kumar

  26. Outflowing part • It is conical, smooth walled & truncated • It is directed upwards, backwards & to the left • The apex of the infundibulum presents pulmonary orifice Dr. Pardeep Kumar

  27. Left Autrim • It is situated posteriorly • Its appendages Lt. Auricle projects upwards & medially • It contributes to form 2/3rd of the base of the heart Dr. Pardeep Kumar

  28. Left Autrim Features • Anterior wall of Atrium is formed by interatrial septum • Two pulmonary veins opens into atrium on each side of the posterior wall • The greater part of the interior of Atrium is smooth • In Auricle, Musculi Pectinati are present which forms the reticulum • The septal wall show fossa lunate corresponding to fossa ovales of Rt. Atrium Dr. Pardeep Kumar

  29. Left Ventricle • It contributes to form apex of heart, Lt. Border, 2/3 of inferior surface of heart, Anterior surface Interior of Heart • Divided into 2 parts • Upper Smooth part • Gives origin to Asecding Aorta Dr. Pardeep Kumar

  30. Left Ventricle • Lower rough part • Consists of Trabeculae Carnae • Consists of 2 orifices • Aortic orifice guarded by aortic valve • Lt. Atrioventricular guarded by Bicuspid valve • They are 2 papillary muscles - Anterior & Posterior Dr. Pardeep Kumar

  31. Interartial septum • It intervenes between right & left Atria • It is placed obliquely so that the right atrium lies in front & to the Rt. Side • The septum is indicated externally by the interatrial groove Dr. Pardeep Kumar

  32. Interventricular Septum • It is placed obliquely backwards & to the Rt. & presents a convexity towards the right ventricle • It is indicated externally by anterior & posterior interventricular groove • The walls of two ventricles are joined by interventricular septum • consists of 2 parts: • 1. Membranous part – Anterior inferior part • 2. Muscular part – Posterior superior part Dr. Pardeep Kumar

  33. Heart: Conducting System • Definition - Intrinsic system of the Heart where specialized cells in the myocardium initiate & conduct cardiac impulse to cause rhythmical contraction of the Heart muscle  Components of conducting system • SA node • AV node • AV bundle (of His) – R & L terminal branches • Purkinje fibres Dr. Pardeep Kumar

  34. Sino-Atrial Node • Found in upper part of sulcus terminalis just to the Rt of opening of SVC • Site of initiation of cardiac impulses  pacemaker • Cardiac impulses spread through Arial myocardium to reach the AV node • Generates impulse at the rate of 70/min Dr. Pardeep Kumar

  35. Atrio-Ventricular Node • Found in lower & dorsal part of atrial septum just above attachment of septal cusp of tricuspid valve • links atrium & ventricle • impulses are then conducted to AV bundle • Generates impulse at the rate of 60/ min Dr. Pardeep Kumar

  36. Atrio-Ventricular Bundle (of His) • arise from AV node • divides into Rt & Lt branches Purkinje Plexus • These are found in the subendocardial regions of the ventricles Dr. Pardeep Kumar

  37. Blood Supply Dr. Pardeep Kumar

  38. Heart: Blood Supply • The arterial supply of the heart is provided by the Rt & Lt coronary artery • Both arteries run in Coronary sulcus Dr. Pardeep Kumar

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  42. Venous Drainage • coronary sinus receives most of the venous drainage of the heart  opens into RA most of the blood returned via • great cardiac vein-accompanies anterior interventricular artery • middle cardia vein-accompanies posterior interventricular artery • small cardiac vein-accompanies marginal branch of Rt coronary art • the rest of the blood is returned via ant cardiac vein • small veins that open directly into the heart chambers Dr. Pardeep Kumar

  43. Pericardium • It is a fibroserous sac that encloses the heart & the roots of the great vessels & situated in the middle Mediastinum Layers of Pericardium • Outer Fibrous Pericardium • Inner Double-Layered Serous Pericardium • It has outer parietal layer which fuse with fibrous pericardium • Inner visceral layers are continuous with the heart • These two layers are continuous with each other at the roots of the great vessels Dr. Pardeep Kumar

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  45. Pericardial Cavity • potential space between the parietal & visceral layers • Contains serous fluid for lubrication during beating of the heart Dr. Pardeep Kumar

  46. Contents of Pericardium • Heart • Lower part of SVC • Terminal parts of IVC • Terminal parts of Pulmonary vein • Pulmonary trunk • Ascending trunk Dr. Pardeep Kumar

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