anatomi sistem kardiovaskular
DESCRIPTION
Anatomi Sistem KardiovaskularTRANSCRIPT
Dr. I Gusti Ayu Widianti, M.Biomed
ANATOMY DEPARTMENTUDAYANA UNIVERSITY
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Cardiovascular system
Circulatory System
The heart (cor) System of blood vessel System of lymphatics
Heart disease Malignant neoplasms Cerebrovascular diseases, Chronic obstructive pulmonary
disease Pneumonia and influenza Accidents Diabetes mellitus Suicide, nephritis, chronic liver
disease, etc etc
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National Health Statistics, 1999
The heart: Coronary artery disease → ischemic heart disease → myocardial infarction The blood vessels: → atherosclerosis → hypertension varicose vein
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The general design
Two major components: The heart and system of blood vessels
Major functions: Transport of oxygen and nutrients Transport of CO2 and waste products
Two major divisions Major or systemic circulation Lesser or pulmonary circulation
Oxygenated blood (O2 & nutrients)
Deoxygenated blood (CO2 & waste products)
Systemic circulation
Pulmonary circulation
Oxygenated blood Deoxygenated blood
RV LA
RA LV
RA=right atrium, LA=left atrium, RV=right ventricle, LV=left ventricle
Lungs
Heart
Whole body
Heart
Veins Arteries
Venules Arterioles
Capillaries
Circulation
Venules=very small veins; arterioles=very small arteries
Aorta Vena cava
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OVERVIEW OF THE CARDIOVASCULAR SYSTEM
The Heart
A four-chamber, powerful, muscular pump Divided into two halves: left heart & right
heart.
Left heart: left atrium & left ventricle Receives oxygenated blood (“arterial blood“)
from the lungs Distributes it to the whole body.
Right heart: right atrium & right ventricle Receives deoxygenated blood (“venous
blood”) from the whole body, sends it to the lungs.
The walls of the left ventricle is the thickest.
Is the central compartment of the thoracic cavity
It does not contain the lungs Extends :
› from the superior thoracic aperture to the diaphragm inferiorly
› From the sternum and costal cartilages anteriorly to the bodies of the thoracic vertebrae posteriorly
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MEDIASTINUM:MEDIASTINUM:1. The superior mediastinum : extends
inferiorly from the superior thoracic aperture to the horizontal plane (transverse thoracic plane), contains:◦ Superior venae cava◦ Brachiocephalic veins◦ Arc of aorta◦ Thoracic duct◦ Trachea◦ Esophagus◦ Thymus◦ Vagus nerve◦ Left recurrent laryngeal nerve◦ Phrenic nerve
2. The inferior mediastinum2. The inferior mediastinum: : between the transverse thoracic plane between the transverse thoracic plane and the diaphragmand the diaphragm
The anterior mediastinum contains: remnants of the thymus, lymph nodes, fat and connective tissue
The middle mediastinum contains: the pericardium, heart, roots of the great vessels, arch of azygos vein and main bronchi
The posterior mediastinum contains the esophagus, thoracic aorta, azygos and hemiazygos veins, thoracic duct, vagus nerve, sympathetic trunks and splanchnic nerves
MIDDLE MEDIASTINUMMIDDLE MEDIASTINUMBoundaries: left and right pleural cavities, diaphragm, anterior and posterior leaves of fibrous
pericardium, and superior aspect of the left and right
pulmonary arteries
Contents: Heart and pericardium Roots of the great vessels Arch of azygos vein Main bronchi
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HEART
The wall consist of three layers: Epicardium: a thin external layer
(mesothelium) formed by the visceral layer of serous pericardium
Myocardium : a thick middle layer composed of cardiac muscle
Endocardium: a thin internal layer (endothelium and subendothelial connective tissue) or lining membrane of the heart that also covers its valves
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PERICARDIUM
Double-walled fibroserous sac, encloses the heart and the roots of its great vessels
Pericardial cavity:
The potential space between the opposing layers of the parietal and visceral of serous pericardium. It normally contains a thin film of serous fluid that enables the heart to move and beat in a frictionless environment
Transverse pericardial sinus : Posterior aorta & pulmonary trunk Anterior SVC
Oblique pericardial sinus SCV, IVC and pulmonary veins
EXTERNAL HEART STRUCTURE Boundaries: Apex of the heart apex beat Base of the heart----the heart’s posterior
aspect Four surfaces of the heart Four borders of the heart
Apex of the heart:
Is formed by the left inferolateral part of the left ventricle
Is located posterior to the left 5th intercostal space in adults, usually 9 cm from the median plane
Is where maximal pulsation of the heart (apex beat).
Base of the heart:
Is the heart’s posterior aspect (opposite the apex) as it lies in the thorax
Is formed mainly by the left atrium , with a lesser contribution by the right atrium
Faces posteriorly toward the bodies of vertebrae T6 through T9
Extends superiorly to the bifurcation of the pulmonary trunk and inferiorly to the coronary groove (sulcus)
Four surfaces of the heart:
Anterior (sternocostal) surface, formed mainly by the right ventricle
Diaphragma (inferior) surface, formed mainly by the left ventricle and partly by the right ventricle, is related to the central tendon of the diaphragm
Left pulmonary surface, formed mainly by the left ventricle, it formed the cardiac impreeion of the left lung
Right pulmonary surface, formed mainly by the right atrium
Four borders of the heart:
Right border (vertical, slightly convex), formed by the right atrium and extending between the SVC and IVC
Inferior borders (nearly horizontal), formed mainly by the right ventricle and only slightly by the left venricle
Left borders (oblique, nearly vertical) formed mainly by the left ventricle and slightly by the left auricle
Superior borders, formed by the right and left atria and auricles in an anteriorly view, ascending aorta and pulmonary thrunk emerge from the superior border, and the SVC enter its right side.
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Heart
Divisions: Four chambers: - right and left atria - right and left ventricles The right atrium: superior & inferior
vena cava coronary sinus The right ventricle: the largest portion
of the anterior (sternocostal) surface
Coronary arteries (RCA and LCA): › The first branches of the aorta› Arises from the corresponding aortic
sinuses at the proximal part of the ascending aorta, just superior to aortic valve
› Supply the myocardium and epicardium Coronary arteries: supply both the atria
and ventricles, however the atrial branches are usually small
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The heart is drained mainly by veins that empty into the coronary sinus and partly by small anterior cardiac veins that empty directly into the right atrium and the other chambers (smallest cardiac veins)
SA node: pacemaker of the heart, is located anterolaterally just deep to the epicardium at the junction of the SVC and right atrium
AV node is smaller collection of nodal tissue located in the posteroinferior region of the interatrial septum near the opening of the coronary sinus.
◦The impuls SA node : conducted to cardiac m. fibers in the atria, causing them to contract.
◦The impuls spreads by myogenic conduction that rapidly transmits the impuls from the SA node to the AV node.
◦From the AV node through the AV bundle and the right and left bundle branches (on each side of the IV septum) to supply subendocardial branches to the papillary m. and the wall of the ventricle
A-V node (atrioventricular node)Conduction through the atrial wall
Sinoatrial node (sinus node)
A-V bundle (bundle of His)
Right & left branches
Purkinje fibers
INNERVATION OF HEART :INNERVATION OF HEART :Autonomic nerve fibers (from
superficial & deep cardiac plexuses)◦sympathetic :
sympathetic stimulation : increase HR & contraction (tachycardia), dilatasi coronary a.
◦Parasympathetic : parasympathetic stimulation : slow HR, reduces
heart beat (bradycardia), constric coronary a. , saving energy
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Two most common sites: In the side of the neck: carotid pulse by
palpating the common carotid artery At the wrist: radial pulse by palpating
the radial artery
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Lymphatic plexuses Lymphatics Lymph nodes Aggregations of lymphoid tissue Circulating lymphocytes
The ground plan of lymphatic The ground plan of lymphatic drainagedrainage
Right lymphatic duct (ductus lymphaticus dexter):
The right halves of head, neck and thorax, and the right upper limb
Left lymphatic duct = The thoracic duct (ductus lymphaticus sinister):
The remainder of the bodyBoth duct eventually open into the
corresponding subclavian veins (venous angles)