Learning Objectives Demonstrate the 4 chambers of the heart Name the vessels that enter or leave each chamber Name the valves of the heart and know where they are situated Describe the commonest pattern of distribution of the coronary arteries ID: 1048380
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1. Department of RadiologyCardiac anatomy
2. Learning ObjectivesDemonstrate the 4 chambers of the heartName the vessels that enter or leave each chamberName the valves of the heart and know where they are situatedDescribe the commonest pattern of distribution of the coronary arteriesDescribe the organisation and distribution of the pericardium
3. MediastinumCentral compartment of the thoracic cavity containing the heart
4. Mediastinum
5. Heart
6. Cardiac ChambersRVRALVLA
7. Cardiac Chambers
8. Fetal circulationOxygenated blood from placenta travels from umbilicus to liver in umbilical veinDrains into left portal vein and then through ductus venosus into IVCBlood enters RA and most bypasses RV through foramen ovale to left side of heartRV output (PA) mostly bypasses lungs by ductus arteriosus into descending aorta
9. Right VentricleRight AtriumLeft AtriumLeft Ventricle
10. Deoxygenated BloodDeoxygenated Blood
11. Oxygenated BloodOxygenated Blood
12. Right atrium2 components:Posterior to crista terminalisSmooth wallsDrains vena cavae
13. Right atrium2 components:Anterior to crista terminalisRidged walls (due to pectinate muscles)
14. Right atriumBlood returns from:SVCIVC (+ valve)Coronary sinus (+ valve)Numerous small openings (venae cordis minimae)
15. Right atriumSeparated from LA by interatrial septum:Fossa ovalis marks site of embryonic foramen ovale
16. Left atrium2 components:Posterior/inflowSmooth wallsReceives 4 pulmonary veins
17. Left atrium2 components:AnteriorContinuous with left auricleContains pectinate muscles
18. Ventricles
19. Ventricles – outputRV – pulmonary artery, LV - aortaAoPA
20. Features of the right ventriclePulmonary ValveOutflow valve from RV3 cuspsLt, Rt and anterior
21. Features of the right ventricleInfundibulum
22. Features of the right ventricleInfundibulumConus ateriosusDerived from bulbus conisSmooth walls
23. Features of the right ventricleInfundibulum
24. Features of the right ventricleProminent trabeculations(trabeculae carneae)Moderator bandConnects septum to anterior papillary muscleCarries right bundle branch of cardiac conduction system
25. Features of the right ventricleTrabeculationCoarse trabeculae carneae3 papillary muscles connect ventricular surface to free edges of tricuspid valve via chorda tendinaeAnterior, posterior and septal
26. Corda tendinae
27. Features of the right ventricleTricuspid ValveThree cusps/leafletsInflow RV from RAOpen in diastoleClosed in systole
28. Features of the right ventricle
29. Features of the right ventricle
30.
31. Features of the left ventricleAortic valveOutflow valve LVOpen in systoleClosed in diastole3 cuspsRight, left and posterior
32. Features of the left ventricleAortic vestibuleSmooth wallDerived from bulbus conis
33. Features of the left ventricleTrabeculation Fine trabeculae carneaePapillary musclesAnterior and posterior
34. Features of the left ventricleMitral valve LV inflow valveBicuspidAnterior and posterior cuspsClosed in systoleOpen in diastole
35. Left atrium and pulmonary veins
36. Aortic rootAortic Root CoronalLeft Ventricular Outflow Tract viewAortic insertion points – ‘Annulus’
37. Aortic rootSinus of Valsalva
38. Aorta arch
39. Aortic archInnominate arteryLeft subclavianarteryLeft common carotid artery
40. Above aortic arch (T3)Right brachiocephalic veinInnominate arteryTracheaLeft brachiocephalic vein
41. Aortic arch (T4)Superior vena cavaAortic arch
42. Ligamentum arteriosum- obliterated ductus arteriosum
43. Valves
44. Heart sounds1st heart sound (lub) = closure of AV valves at onset of systole2nd heart sound (dub) = closure of aortic and pulmonary valves as diastole commences
45. Aortic valve
46. RCALMSLCxLADRLLRAAAORTIC VALVEPULMONARY VALVECoronary arteriesP
47. Coronary arteries
48.
49. Right coronary artery – Runs in right AV groove
50. Right Coronary Artery
51. Right Coronary Artery
52. Right Coronary Artery
53. Posterior descending artery defines dominance
54. Left main coronary artery:Anterior descending (interventricular groove)Circumflex – AV groove
55. Left Coronary Artery
56. Left Coronary Artery
57. Left Coronary Artery
58. Left Coronary Artery
59. Pericardium – fibrous and serous layersOuter (parietal) and inner (visceral) layers of serous pericardium
60. PericardiumPericardium (Fibrous/Parietal & Visceral layers)Pericardial fatEpicardial fat
61. Pericardium
62. Reflections of the pericardiumSuperior: surrounds arteries, aorta and pulmonary trunkPosterior: surrounds pulmonary veins, SVC, IVCTransverse pericardial sinusOblique pericardial sinus
63. Sino-atrial node, cardiac pacemaker – in right atrium
64. Quiz
65. 1. Atrial septal defect is most likley to be due to incomplete closure of which structure?Foramen ovaleLigamentum arteriosiumDuctus arteriosusCoronary sinus
66. 1. Atrial septal defect is most likley to be due to incomplete closure of which structure?Foramen ovaleLigamentum arteriosiumDuctus arteriosusCoronary sinus
67. 2. Part of the right bundle branch of the AV bundle is carried by which structure?Pectinate musclesAnterior papillary muscle of left ventricleModerator bandCrista terminalis
68. 2. Part of the right bundle branch of the AV bundle is carried by which structure?Pectinate musclesAnterior papillary muscle of left ventricleModerator bandCrista terminalis
69. 3. Which statement about the valves of the heart is correct?Both pulmonary and aortic valves are bicuspid The chorda tendinae tether the AV valves to the pectinate muscles Chordae tendinae prevent eversion of the AV valvesThe 1st heart sound corresponds to closure of the aortic and pulmonary valves
70. 3. Which statement about the valves of the heart is correct?Both pulmonary and aortic valves are bicuspid The chorda tendinae tether the AV valves to the pectinate muscles Chordae tendinae prevent eversion of the AV valvesThe 1st heart sound corresponds to closure of the aortic and pulmonary valves
71. 4. Which statement about the left coronary artery is correct?It arises from the posterior aortic sinusIt gives rise to the left posterior descending coronary arteryIt gives rise to the left circumflex coronary arteryIt supplies the sino-atrial node
72. 4. Which statement about the left coronary artery is correct?It arises from the posterior aortic sinusIt gives rise to the left posterior descending coronary arteryIt gives rise to the left circumflex coronary arteryIt supplies the sino-atrial node
73. 5. Which statement about fetal circulation is correct?Oxygenated blood passes from the left portal vein to the IVC through the ductus venosusOxygenated blood from placenta travels to liver in umbilical arteriesBlood flows from left to right atrium through patent foramen ovaleDuctus arteriosus allows blood to bypass aorta to pulmonary artery
74. 5. Which statement about fetal circulation is correct?Oxygenated blood passes from the left portal vein to the IVC through the ductus venosusOxygenated blood from placenta travels to liver in umbilical arteriesBlood flows from left to right atrium through patent foramen ovaleDuctus arteriosus allows blood to bypass aorta to pulmonary artery
75. Any questions?