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Cardiovascular system
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 HEART
Basis cordis
Apex cordis
Facies sternocostalis (ant.)
Facies diaphragmatica (post.)
Margo acutus (dexter)
Margo obtusus (sinister)
= facies pulmonalis
1 2
3 4
5 6
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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
A
S
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
7 8
9 10
11 12
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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.)
LEFT VENTRICLE MORPHOLOGY OF HEART WALL
ENDOCARDIUM
MYOCARDIUM (muscular layer, conductive systém of heart)
EPICARDIUM (pericardium serosum - lamina visceralis )
PERICARDIUM (fibrosum et serosum – lamina parietalis)
ENDOCARDIUM Wider in the atria
Wider in left portion of the heart
Background of valves
SYSTOLE
DIASTOLE
Heart valves
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15 16
17 18
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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
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
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21 22
23 24
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CONDUCTIVE SYSTEM OF THE HEART
crus dextrum
Purkyně´s fibres
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
Cardiostimulation
v. cephalica
5 cm
detail of the electrode
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27 28
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PERICARDIUM
Pericardium fibrosum
Pericardium serosum
lamina parietalis
lamina visceralis (epicardium)
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
Epicardium
Subepicardial tissue
PERICARDIUM
Cavum pericardii
Liquor pericardii
Porta arteriarum =
vagina serosa arteriarum
(aorta, tr.pulmonalis)
Porta venarum
(vv.cavae, vv.pulmonales)
sinus transversus pericardii
sinus obliquus pericardii
Sinus transversus pericardii et sinus obliquus pericardii
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33 34
35 36
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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. circumflexus
facies sternocostalis
facies diaphragmatica
a. coronaria cordis sin. a. coronaria cordis dx.
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
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39 40
41 42
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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 systém 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
AUSCULTATION POINTS
valva aortae
valva tricuspidalis
valva trunci pulmonalis
valva bicuspidalis
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 Distantia
mediodextra
4-4,5 cm
Distantia
mediosinistra
8-9 cm
Heart transverse diameter
= DMd+DMs
Less than 15 cm
Longitudo
Angle - 450
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45 46
47 48
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Arteriae
(terminales, collaterales)
Arteriolae
Vasa capillaria (7-15 µm)
Venulae
Venae
Anastomoses
Vasa (vessels)
ARTERY VEIN
tunica intima
(endotel, elastin)
tunica media
(muscular)
tunica externa
(adventicia)
vasa vasorum
MORPHOLOGY OF THE WALL
valvulae
venosae
Jan Janský: 1873-1921. r. 1907 – aglutination of erythrocytes
Karl Landsteiner : (Wien) r. 1901 - A,B,O.
Alfr. Decastello, Adriano Sturli : r.1902 - AB
TRUNCUS PULMONALIS
arteria pulmonalis dx. et sin. (angle 1800)
vv. pulmonales dextrae et sinistrae (sup. et inf.)
lig. arteriosum (ductus arteriosus)
AORTA
L4 (bifurcatio aortae)
AORTAASCENDENS
ARCUS AORTAE
AORTA DESCENDENS
Aorta thoracica
Aorta abdominalis
Th3
2. art. sternocostalisdx. AORTAASCENDENS Arteria coronaria cordis dx. et sin.
Bulbus aortae
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ARCUS AORTAE
truncus brachiocephalicus (art. sternoclavicularis dx.)
arteria carotis communis sin.
arteria subclavia sin.
AORTA THORACICA
Th3
Th11-12
AORTA ABDOMINALIS
Th11-12 diaphragm
L4 bifurcatio aortae
A. CAROTIS COMMUNIS
A. carotis interna et externa
Trigonum caroticum
Glomus caroticum (chemoreceptor)
C4
a. laryngea sup.
r. cricothyroideus
rr. glandulares
(r. infrahyoideus)
(r. sternocleidomastoideus)
ARTERIA THYROIDEA SUP.
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ARTERIA CAROTIS EXTERNA
Ventral branches:
a. thyroidea sup.
a. lingualis
a. facialis
Dorsal branches:
a. occipitalis
a. auricularis post.
Medial branches:
a. pharyngea asc.
Lateral branches:
a. sternocleidomastoidea
Terminal branches:
a. maxillaris
a. temporalis spf.
Béclard´s angle
Trigonum Pirogowi
ARTERIA LINGUALIS
r. suprahyoideus
a. sublingualis
rr. dorsales linguae
a. profunda linguae
ARTERIA FACIALIS
a. palatina ascendens,r. tonsillaris
a. submentalis, rr. glandulares
a. labialis sup. et inf.
(circulus arteriosus oris)
a. alaris nasi
a. angularis
ARTERIA PHARYNGEA ASC.
rr. pharyngei
a. meningea post. (foramen jugulare)
a. tympanica inf. (canaliculus tympanicus)
ARTERIA OCCIPITALIS rr. musculares (r. sternocleidom.)
r. auricularis
r. mastoideus
rr. occipitales
rr. musculares
rr. glandulares
r. auricularis
a. stylomastoidea
- a. tympanica post.
- rr. mastoidei
- r. stapedialis
r. occipitalis
A. STERNOCLEIDOMASTOIDEA
A. AURICULARIS POST.
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rr. parotidei
a. transversa faciei
rr. auriculares ant.
a. zygomaticoorbitalis
a. temporalis media
r. frontalis
r. parietalis
ARTERIA TEMPORALIS SUPERFICIALIS A. MAXILLARIS Pars mandibularis
a. meningea media
a. alveolaris inf.
r. mylohyoideus
rr. dentales
rr. gingivales
a. mentalis
a. auricularis prof.
a. tympanica ant.
pars mandibularis
pars pterygoidea
pars pterygopalatina
A. MAXILLARIS
Pars pterygoidea
a. masseterica
aa. temporales prof.
rr. pterygoidei
a. bucalis
a. infraorbitalis
a. alveolaris sup. post.
a. palatina descendens
a. canalis pterygoidei
a. sphenopalatina
A. MAXILLARIS - pars pterygopalatina
Fissura scalenorum
Pars intrascalenica (med.)
Pars interscalenica (post.)
Pars extrascalenica (lat.)
ARTERIA SUBCLAVIA
Sulcus a. subclaviae
cupula pleurae
costa prima
Pars intrascalenica:
a. vertebralis
a. thoracica interna
tr. thyreocervicalis
Pars interscalenica:
tr. costocervicalis
Pars extrascalenica:
a. transversa colli
ARTERIA SUBCLAVIA
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69 70
71 72
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rr. spinales
rr. musculares
a. basilaris
aa. cerebripost.
ARTERIA VERTEBRALIS
a. musculophrenica
a. epigastrica sup.
aa. intercostales ant.
(rr. perforantes, rr. mammarii)
a. pericardiacophrenica
rr. mediastinales
(aa. thymicae, rr. bronchiales,
rr. sternales)
ARTERIA THORACICAINTERNA
A. pericardiacophrenica
a. thyroidea inf.
a. cervicalis ascendens
a. cervicalis spf.
a. suprascapularis
TRUNCUS THYREOCERVICALIS
a. cervicalis prof.
a. intercostalis suprema
TRUNCUS COSTOCERVICALIS ARTERIA TRANSVERSA COLLI
r. ascendens (superficialis)
r. descendens (profundus)
= a. dorsalis scapulae
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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.
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