PERICARDIUM

PERICARDIUM

Layers:

1. FIBROUS PERICARDIUM

2. SEROUS PERICARDIUM
A. PARIETAL LAYER
B. VISCERAL LAYER
(EPICARDIUM)
 PERICARDIUM

Arterial Supply:
1. Musculophrenic Artery – from Internal Thoracic Artery
2. Bronchial, Esophageal & Superior Phrenic Arteries –
from Descending Thoracic Aorta
3. Coronary Artery

Venous Drainage:
1. Pericardiophrenic Vein
2. Azygos Venous System
 PERICARDIUM

Nerve Supply:
1. Phrenic Nerves – 60 – 70% sensory
2. Vagus Nerves
3. Sympathetic Trunk - vasomotor
THE HEART
 HEART

Layers:
1. ENDOCARDIUM - endothelium
endothelial connective tissue

2. MYOCARDIUM - striated
involuntary cardiac muscle

3. EPICARDIUM - external
layer (mesothelium)
visceral layer of serous
pericardium
 HEART

FIBROUS CARDIAC SKELETON

- keeps AV and SL valves patent
- attachments for leaflets & cusps of valves
- attachment of myocardium
- electrical insulator
 HEART

Parts:
APEX - inferolateral part of LV

APEX BEAT – located behind 5th

left ICS & 9 cms from
median plane

BASE - posterior aspect formed

by left atrium
- receives the pulmonary
veins, SVC & IVC
 HEART
3. SURFACES
a. Diaphragmatic Surface (Inferior)
– left ventricle
b. Sternocostal Surface (Anterior)
- right ventricle
c. Pulmonary Surface (Left)
– left ventricle

4. BORDERS
a. Right Border – Rt. Atrium bet. SVC
& IVC
b. Inferior Border – Right Ventricle
c. Left Border – Left Ventricle &
Left auricle
d. Superior Border – Rt. & Lt. Atria &
auricles
 CARDIAC CHAMBERS

A. RIGHT ATRIUM
- receives venous blood from
SVC, IVC & CS
- “Auricle” increases capacity
Parts:
1. Sinus Venarum
thin-walled posterior part
opening of SVC, IVC & CS
2. Pectinate muscles
rough muscular ant wall
3. Right Atrioventricular Orifice
 CARDIAC CHAMBERS

Anatomic Features of Left Atrium:

SULCUS TERMINALIS
CRISTAL TERMINALIS
INTERATRIAL SYSTEM – Fossa Ovalis
 CARDIAC CHAMBERS

B. RIGHT VENTRICLE
- largest part of ant. surface
- small part of diaphragmatic
surface
- mainly forms the inferior
border

CONUS ARTERIOSUS
TRABECULAE CARNAE
 CARDIAC CHAMBERS

C. LEFT ATRIUM
- forms the base of the heart
- smooth inner wall with
smaller auricle
- posterior part receives the
4 pulmonary veins
- slightly thicker wall than
the right atrium
 CARDIAC CHAMBERS

D. LEFT VENTRICLE
- forms the cardiac apex &
all of pulmonary surface
- forms most of diaphragmatic
surface
- walls 2x thicker than the
right ventricle
- trabeculae carnae finer &
more numerous
- conical cavity is much longer
- larger papillary muscles
 CARDIAC VALVES

A. TRICUSPID VALVE
guards the left AV orifice
anterior, posterior & septal
cusps

Features:
Chordae Tendinae
Papillary Muscles
Interventricular Septum
Septomarginal Trabeculae
(Moderator Band)
 CARDIAC VALVES

B. PULMONARY VALVE
(SEMILUNAR)
- at level w/ 3rd L costal cart
- anterior, right & left cusps
**Pulmonary Sinus

C. MITRAL VALVE (BICUSPID)

- at level w/ 4th L costal cart
- anterior & posterior cusps

D. AORTIC VALVE
- at level w/ 3rd L ICS
- has three cusps
 CORONARY CIRCULATION

ARTERIAL SUPPLY:

RIGHT & LEFT CORONARY

ARTERIES
- first branches of aorta
- supply the epicardium &
myocardium
- from the ascending aorta
just above the aortic valve
 CORONARY CIRCULATION

RIGHT CORONARY ARTERY

- runs thru the AV groove
Branches:
1. SINOATRIAL NODAL BRANCH
2. RIGHT MARGINAL BRANCH
3. AV NODAL BRANCH
4. POSTERIOR IV BRANCH
Areas Supplied:
1. Right Atrium
2. Most of Right Ventricle
3. Part of SA Node & AV Node
 CORONARY CIRCULATION
LEFT CORONARY ARTERY
- passes between the L auricle
& pulmonary trunk in the
coronary groove
Branches:
CIRCUMFLEX BRANCH
=> Left Marginal Artery
- supplies the left ventricle
ANT. INTERVENTRICULAR Br.
- runs along IV groove to apex
- anastomosis with the
Post. IV branch
- gives off Diagonal Branch –
anterior surface
 CORONARY CIRCULATION

AREAS SUPPLIED BY THE LEFT CORONARY ARTERY

1. Left Atrium
2. Most of Left Ventricle
3. Part of Right Ventricle
4. Most of Interventricular Septum
5. SinoAtrial Node in 40% of cases
 CORONARY CIRCULATION

VENOUS DRAINAGE
CORONARY SINUS
Tributaries:
1. GREAT CARDIAC VEIN
(Anterior IV Vein)
2. MIDDLE CARDIAC VEIN
(Posterior IV Vein)
3. SMALL CARDIAC VEIN
4. LEFT POST VENTRICULAR
VEIN
5. LEFT MARGINAL VEIN
 CARDIAC CONDUCTING SYSTEM

SINOATRIAL NODE (Cardiac Pacemaker)

- located in the epicardium b/w SVC & Right Atrium
- 70 beats/min
- triggers contraction of both atria
- controlled by the Autonomic Nervous System
(Cardiac Plexus)

Sympathetics - increases cardiac rate

Parasympathetics – decreases cardiac rate
 CARDIAC CONDUCTING SYSTEM

ATRIOVENTRICULAR NODE
- located at posteroinferior region of Interatrial septum
near opening of coronary sinus
- follows a myogenic conduction
- AV Bundles  Right & Left Bundles
- Purkinje Fibers (Subendocardial Branches)