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Cardiovascular system
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
Sulcus coronarius
Sulcus interventricularis ant.
Sulcus interventricularis post.
Auricula dextra et sinistra
Incisura apicis cordis
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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.
VALVATRICUSPIDALIS
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 LEFT VENTRICLE
Ostium atrioventriculare sin.
Valva bicuspidalis - mitralis
M. papillaris ant. et post.
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Ostium aortae
Valva aortae (bulbus aortae)
Sinus aortae dx.
(a. coronaria cordis dx.)
Sinus aortae sin.
(a. coronaria cordis sin.)
ENDOCARDIUM Wider in the atria
Wider in left portion of the heart
Background of valves
SYSTOLE
DIASTOLE
Heart valves Cardiac skeleton
Anulus fibrosus dexter
Anulus fibrosus sinister
Anulus aorticus
Anulus trunci pulmonalis
Conus ligament
Trigonum fibrosum dextrum
Trigonum fibrosumsinistrum
Pars membranacea septi cordis
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
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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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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.
■ 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 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
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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
Arteriae
(terminales, collaterales)
Arteriolae
Vasa capillaria (7-15 µm)
Venulae
Venae
Anastomoses
Vasa (vessels)
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)
AORTA ASCENDENS
ARCUS AORTAE
AORTA DESCENDENS
Aorta thoracica
Aorta abdominalis
Th3
2. art. sternocostalis dx.
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AORTA ASCENDENS Arteria coronaria cordis dx. et sin.
Bulbus aortae
ARCUS AORTAE
truncus brachiocephalicus (art. sternoclavicularis dx.)
arteria carotis communis sin.
arteria subclavia sin.
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.
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
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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.
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
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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
rr. spinales
rr. musculares
a. basilaris
aa. cerebri post.
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 THORACICA INTERNA
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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
Parietal branches
aa. intercostales post. (VAN)
a. subcostalis
a. phrenica sup.
Visceral branches:
rr. bronchiales
rr. oesophagei
rr. pericardiaci
AORTA THORACICA
AORTA ABDOMINALIS
Parietal branches
a. phrenica inf.
(a. suprarenalis sup.)
4 aa. lumbales
a. sacralis mediana
(a. lumbalis ima,
rr. sacrales)
Visceral branches - paired
a. suprarenalis media
a. renalis
r. uretericus
a. suprarenalis inf.
rr. praepelvici
r. retropelvicus
a. testicularis (a. ovarica)
rr. ureterici
(r. tubarius)
AORTA ABDOMINALIS
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AORTA ABDOMINALIS
Visceral branches – unpaired
truncus coeliacus Th12
a. mesenterica sup. L1
a. mesenterica inf. L3
TRUNCUS COELIACUS
a. gastrica sin.
a. hepatica communis
a. hepatica propria
a. gastrica dx.
r. dexter (a. cystica)
r. sinister
a. gastroduodenalis
a. gastroepiploica dx.
a. pancreaticoduodenalis. sup.
a. lienalis
rr. pancreatici
a. gastroepiploica sin.
aa. gastricae breves
rr. lienales
ARTERIA LIENALIS ARTERIA MESENTERICA SUP.
a. pancreaticoduodenalis inf.
aa. jejunales et ilei (10-18)
a. ileocolica
a. colica dx.
a. colica media
a. colica sinistra
aa. sigmoideae
a. rectalis sup.
anastomosis magna
(Halleri)
ARTERIA MESENTERICA INFERIOR ARTERIA ILIACA COMMUNIS
(bifurcatio aortae L4)
A. iliaca externa
A. iliaca interna
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Parietal branches
a. Iliolumbalis
a. sacralis lat.
a. obturatoria
(r. pubicus - corona mortis)
a. glutaea sup.
a. glutaea inf.
a. pudenda interna
ARTERIA ILIACA INTERNA
a. rectalis inf.
a. perinealis – rr. scrotales post.
(rr.labiales post.)
a. penis (a. clitoridis)
a. profunda penis (clitoridis)
a. dorsalis penis (clitoridis)
ARTERIA PUDENDA INTERNA
Visceral branches
aa. vesicales sup.
(a. umbilicalis)
a. vesicalis inf.
a. rectalis media
♂ a. ductus deferentis
♀ a. uterina
ARTERIA ILIACA INTERNA ARTERIA UTERINA
r. uretericus
a. vaginalis ant. et post.
rr. uterini
r. tubarius
r. ovaricus
a. epigastrica inf.
r. pubicus (corona mortis)
a. cremasterica
(a. ligamenti teretis)
a. circumflexa ilium profunda
ARTERIA ILIACA EXTERNA
v. cava superior
v. cava inferior
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Vena cava superior Venae brachiocephalicae
Angulus venosus dx. a sin.
Vena jugularis interna
• INTRACRANIAL TRIBUTARIES
(region supplied by a. carotis interna)
• EXTRACRANIAL TRIBUTARIES
(region supplied by a. carotis externa)
Intracranial tributaries
venae cerebri
venae emissariae
venae diploicae
venae ophtalmicae
Anterior (separately, from stem…)
• v. facialis
• v. lingualis
• v. thyroidea superior
• v. thyroidea media
Medial (separately)
• v. pharyngea (plexus pharyngeus)
Posterior (vena jugularus externa)
• v. auricularus posterior
• v. occipitalis
Stem (vena retromandibularis)
• v. temporalis superficialis
• v. maxillaris (plexus pterygoideus)
Extracranial tributaries
Žíly hloubky obličeje
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Vena jugularis anterior Venae pharyngeae
(plexus pharyngeus)
VENA CAVA SUPERIOR
Vena subclavia
v. cava inferior
v. iliaca comm. sin.v. iliaca comm. dx.
v. iliaca ext.
v. iliaca int.
LE
pelvis
abdomen
L4-5
Vena iliacae (comm., externae et internae)
Parietal and visceral tributaries (plexuses)
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v. hemiazygos accessoria
v. lumbalis asc. dx.
vv. lumbales
v. subcostalis dx.
v. azygos
v. hemiazygos
Th 4
Th 7-9
Cavo-caval anastomoses
VENA CAVA INFERIOR
Vena portae
Porto-caval anastomoses Fetal blood
circulation
Lymphatic system
■ lympha 1,5-2l/day
■ lymphatic vessels (vasa lymphatica)
■ lymphatic nodes (nodi lymphatici)
■ lymphaatic organs
capillaries (vasa lymphocapillaria)
Lymphatic net (rete lymphocapillare)
collector vessels(collectores lymphatici)
trunks (trunci lymphatici)
tonsillae
spleen
thymus
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vas afferens
vas efferens
tr. subclavius sin.
tr. intestinalis
tr.lumbalis
dx.
tr. jugularis
sin.
tr. bronchomediast. sin.
tr. lumbalis sin.
ductus thoracicus
L1-2
Hlavní mízní kmeny
tr. jugularis
dx.
tr. subclavius dx.
tr. bronchomediast. dx.
ductus lymphaticus dx.
● nodi lymphatici occipitales
● nodi lymphatici retroauriculares
● nodi lymphatici parotidei
● nodi lymphatici submandibulares
● nodi lymphatici submentales
● nodi lymphatici retropharyngei
nll. cervicales superficiales
nll. cervicales profundi
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• superficiales
alongside vena jugularis externa
• profundi
alongside vena jugularis interna
alongside nervus accesorius
alongside arteria transversa coli
(supraclavicular)
• anteriores
superficial - alongside vena jugularis anterior
deep – around larynx, trachea, thyroid gland
Nodi lymphatici cervicales
● superficial collectors
anterior
lateral
medial
● deep collectors
n.l. cubitales superf.
n.l. cubitales prof.
n.l. axillares
Lymphatic vessels of the
upper extremity
n.l. axillares
● n.l. laterales (brachiales)
● n.l. subscapulares
● n.l. pectorales
(n.l. interpectorales)
● n.l. centrales
● n.l. apicales
truncus subclavius
Funkce uzliny
Lymphatic vessels of the thorax
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Lymphatic nodes of the
abdominal cavity
nodi lymphatici iliaci comm.
nodi lymphatici lumbales
parietal
visceral from paired organs
truncus lumbalis dx. et sin.
nodi lymphatici coeliaci
Lymphatic nodes of the unpaired organs
• gastrici
• gastroepiploici
• hepatici
• pancreaticoduodenales
• pancreatici
• lienales
• mesenterici
• ileocolici
• colici
• mesenterici inferiores
truncus intestinalis
Lymphatic vessels of the pelvis
• nodi lymphatici iliaci externi
• nodi lymphatici iliaci interni
parietal - sacrales
visceral - paravesicales
parauterini
paravaginales
(paraprostatici)
pararectales
n.l. poplitei prof.
n.l. inguinales prof.
n.l. poplitei superf.
n.l. inguinales superf.
● superficial collectors
posterior
lateral
medial
● deep collectors
Lymphatic vessels of the
lower extremity
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