angiology 脉管学. composition cardiovascular system 心血管系统 lymphatic system 淋巴系统
TRANSCRIPT
Angiology 脉管学
Angiology 脉管学Composition Cardiovascular system
心血管系统 Lymphatic system
淋巴系统
The cardiovascular system 心血管系统
Organization Heart 心
A muscle pump to maintain the flow of blood.
Consist of four chambers (right and left atria, right and left ventricles).
Artery (A) 动脉 carry blood away from the heart. Veins (V) 静脉 carry blood back to the heart Capillary (Cap) 毛细血管 microscopic vessels, the area of exch
ange between blood and tissue fluid.
The cardiovascular system 心血管系统
Blood circulation Systemic circulation 体循环 l
eft ventricle→aorta and its branches→capillaries of body→superior and inferior vena cava→right atrium
Pulmonary circulation 肺循环 right ventricle→pulmonary A→ capillaries of lung → pulmonary V →left atrium
The cardiovascular system 心血管系统
Vascular anastomosis 血管吻合
Anastomosis between A Anastomosis between V Arteriolovenular anastomosis
动静脉吻合 Collateral vessels 侧副管 Collateral circulation 侧支循环
The Heart
The heartPosition Lies within the pericardium in mid
dle mediastinum. Behind the body of sternum and 2t
h. to 6th. coastal cartilages. In front of 5th. to 8th. thoracic vert
ebrae. One third of it lies to the right of m
edian plan and 2/3 to the left.
Surfaces of the heart
Pyramidal in shape, somewhat larger than a closed fist.
One apex One base Two surface Three borders Four sulcuses
Formed by left ventricle Directed downwards, for
ward, and to the left Lies at the level of the 5th
left intercostal space, 1~2 cm medial to the left midclavicular line (9cm from the midline) .
Cardiac apex 心尖
Cardiac base 心底 Formed by the left
atrium and to a small extent by the right atrium.
Faces backward, upward and to the right.
Sternocostal surface 胸肋面
Formed mainly by the right atrium and right ventricle, and a lesser portion of its left is formed by the left auricle and ventricle.
Directed forwards and upwards.
Diaphragmatic surface 膈面 Formed the ventricles - c
hiefly the left ventricle. Directed backwards and d
ownwards, and rest upon the central tendon of the diaphragm.
Borders of the heart Right border 右缘
Vertical Formed entirely by right atrium
Left border 左缘 Round Mainly formed by the left ventricle
and partly by the left auricle
Inferior border 下缘 Horizontal Formed by the right ventricle and c
ardiac apex
Sulcuses of the heart
Coronary sulcus 冠状沟 (circular sulcus) which marks the division between atrium and ventricles, contains the trunks of the coronary vessels and completely encircles the heart.
Interatrial sulcus 房间沟 - separates the two atrium and is hidden by pulmonary trunk and aorta in front.
Sulcuses of the heart Anterior interventricular groove
前室间沟 Posterior interventricular groove
后室间沟 Mark the division between ventricle
s (which separates the R from the L ventricle)
Cardiac apical incisure 心尖切迹 Atrioventricular crux 房室交点
Chambers of the heart 心 腔
Chambers of the heart 心腔
Consists of four chambers Left and right atria
左、右心房 Left and right auricle
左、右心耳 Left and right ventricles
左、右心室
Right atrium 右心房 Three inlets
Orifice of superior vena cava 上腔静脉口
returns blood to the heart from the upper half of the body.
Orifice of inferior vena cava 下腔静脉口
returns blood to the heart from the lower half of the body.
Orifice of coronary sinus 冠状窦口
returns blood to the heart from the cardiac muscle.
One outlet - right atrioventricular orifice
右房室口
Right atrium 右心房 Crista terminalis 界嵴- vertical ridge
that from superior vena cave to inferior vena cave.
Sulcus terminalis 界沟- groove on exterior of heart that corresponds ( 一致 )to crista terminalis.
Two parts - separated externally by sulcus terminalis and internally by the crista terminalis. Atrium proper 固有心房 Sinus venarum cavarum 腔静脉窦
Right atrium 右心房 Atrium proper 固有心房
In front of the ridge Pectinate muscles in wall
Sinus venarum cavarum 腔静脉窦 Smooth walls Fossa ovalis 卵圆窝- an oval
depression, a remnant of the fetal foramen ovale, on the lower part of interatrial septum, the most common location of atrial septal defects (ASD)- 房间隔缺损 .
Right ventricle 右心室
One inlet - right atrioventricular orifice 右房室口
One outlet - orifice of pulmonary trunk 肺动脉口
Right ventricle 右心室 Supraventricular crest 室上嵴
(a muscular ridge between right atrioventricular orifice and orifice of pulmonary trunk )
Two parts Inflow tract 流入道 Outflow tract 流出道
Right ventricle 右心室 Inflow tract
Trabeculae carneae 肉柱 irregularly arranged bundles of myocardium.
Septomarginal trabecula 隔缘肉柱- extends from interventricular septum to base of anterior papillary muscle, contains right bundle branch.
Papillary muscles 乳头肌 Conical-shaped Three: anterior, posterior
and septal.
Right ventricle 右心室
Outflow tract —Conus arteriosus 动脉圆锥 Cone-shape , smooth area leadi
ng upward to orifice of pulmonary trunk
Pumps blood through pulmonary orifice to pulmonary trunk.
Tricuspid valve 三尖瓣 Guards right atrioventricular orifice Three triangular cusps:
anterior, posterior and septal Base of cusps are attached to fi
brous ring surrounding the atrioventricular orifice.
To their free edges and ventricular surfaces are attached chordae tendineae 腱索 , which connect the cusps to the papillary muscles.
Tricuspid valve 三尖瓣
Tricuspid complex 三尖瓣复合体
Tricuspid ring 三尖瓣环 Tricuspid valve 三尖瓣 Chordae tendineae 腱索 Papillary muscles 乳头肌
Function of tricuspid complex Open during diastole to allow blood to enter ventricles from atria
Closed during systole to prevent regurgitation of blood into atria
Valve of pulmonary trunk 肺动脉瓣
three semilunar cusps which guards the orifice of pulmonary trunk
Function of pulmonary valves
Opening during systole( 心脏收缩 ) , with cusps pressed toward wall of vessel as blood is forced upward.
Closed during diastole( 心脏舒张 ) Ventricular pressure drops in dia
stole. Floating together of valve cusps,
with free borders meeting, thus closing the valve.
Left atrium 左心房 Four inlets - four orifices of pulmonary veins 肺静脉口 One outlet - left atrioventricular orifice 左房室口
Left ventricle 左心室 One inlet
left atrioventricular orifice 左房室口
One outlet - aortic orifice 主动脉口 Two parts - divided by anterior cusps
of mitral valve. Inflow tract - rough walls Outflow tract
Aortic vestibule 主动脉前庭 Smooth area leading to aortic orific
e
Mitral valve 二尖瓣 Guards left atrioventricular orifice Two triangular cusps - anterior a
nd posterior with commissural cusps between them.
Mitral complex 二尖瓣复合体
Mitral ring 二尖瓣环 Mitral valve 二尖瓣 Chordae tendineae 腱索 Papillary muscles 乳头肌
Function of mitral complex Open during diastole to allow blood to enter ventricles from atria
Closed during systole to prevent regurgitation of blood into atria
Aortic valve 主动脉瓣 Guards the aortic orifice Three semilunar cusps (right, le
ft and posterior) Aortic sinus 主动脉窦 – bulges i
n aortic wall at level of valve that correspond to cusps. Right - contains opening of
right coronary artery. Left - contains opening of le
ft coronary artery. Posterior - no opening
Function of aortic valves
Opening during systole, with cusps pressed toward wall of vessel as blood is forced upward
Closed during diastole Ventricular pressure drops in diastole Floating together of valve cusps, with
free borders meeting, thus closing the valve
Structures of the heart
Walls of heart Endocardium 心内膜
Inner coat of the heart wall Continuous with the valve flaps
Myocardium 心肌 Arranged spirally Attached to fibrous rings surrouding t
he four orifices of heart The walls of left ventricle are about th
ree times thicker than that of right Epicardium 心外膜
Outer Visceral layer of serous pericardium
Structures of the heart
Interatrial septum 房间隔 Located between right and left atria Contains fossa ovalis
Interventricular septum 室间隔 Located between right and left ventri
cles Has upper membranous part Has thick lower muscular part
Atrioventricular septum 房室隔
Membranous part of interventricular septum
Fibrous skeleton of heart 纤维骨骼
Fibrous rings that surround the atrioventricular, pulmonary, and aortic orifices.
Left and right fibrous trigones.
Conduction system of heart 心传导系统
Conduction system of heart 心传导系统Composed of specialized myocardial cells.
Sinuatrial node 窦房结 Internodal tract 结间束 Atrioventricular node 房室结 Atrioventricular bundle 房室束 Right and left bundle branches 左、右束支 Purkinje network 普肯野氏纤维网
Conduction system of heart 心传导系统
Sinuatrial node 窦房结 Called the pacemaker cell. Loc
ated at the upper part of the sul
cus terminalis close to the supe
rior vena cava, under the epicar
dium.
Conduction system of heart 心传导系统Atrioventricular node (AV node) 房室结
Located in the lower part of interatri
al septum, near orifice of coronary sinus and base of tricuspid valve.
Under the endocardium Lower part related to membranous
part of interventricular septum.
Conduction system of heart 心传导系统Atrioventricular bundle (AV bundle)
房室束 Passes forward through right fibr
ous trigone to reach inferior border of membranous part.
Divides into right and left bundle branches at upper border of muscular part of interve ntricular septum.
Conduction system of heart 心传导系统 Right and left bundle branches
左、右束支 Right bundle branch - passes dow
n on right side of interventricular septum to reach the septomarginal trabecular and into the base of anterior papillary muscle. Here it becomes continuous with the fibers of Purkinje fibres.
Left bundle branch - passes down on left side of interventricular septum beneath the endocardium. It usually divides into two branches, which eventually become continuous with the Purkinje fibers.
Purkinje network 普肯野氏纤维网 continuous with myocardium.
★ 心传导系统
Sinatrial node
Atrioventricular node
Atrioventricular bundle
Right and left bundle branches
Purkinje network
Arterial supply of the heartLeft coronary artery 左冠状动脉 Course
Arises from left aortic sinus Runs between pulmonary trunk and left au
ricle into coronary sulcus. Branches
Anterior interventricular branch 前室间支- runs downward in anterior interventricular groove around inferior margin of heart to posterior interventricular groove.
Circumflex branch 旋支- travels to left in coronary sulcus to posterior aspect.
Distribution - supplies left atrium and ventricle, lesser portion of anterior wall of right ventricle, and anterior 2/3 of interventricular septum.
Arterial supply of the heartRight coronary artery 右冠状动脉 Course
Arises from the right aortic sinus Runs forward between right auricle and pulmo
nary trunk into coronary sulcus. Branches
Right marginal branch 右缘支- travels along inferior border.
Posteror interventricular branch 后室间支 travels downward in posterior interventricular groove, it anastomosises near the apex with the anterior interventricular branch of the left coronary artery.
Distribution: supplies right atrium and ventricle, posterioinferior 1/3 of interventricular septum, posterior wall of left ventricle, the sinuatrial node and atrioventricular node.
Stent in an artery
Precutaneous translaminal coronary angioplasty (PTCA)
Coronary artery bypass grafting (CABG)
Venous drainage of the heart
Coronary sinus 冠状窦 Lies in posterior part of coronary
sulcus. Carries most of venous blood fr
om myocardium to right atrium. Tributaries
Great cardiac vein 心大静脉 Middle cardiac vein 心中静脉 Small cardiac vein 心小静脉
Venous drainage of heart
Anterior cardiac veins 心前静脉- 3~4 small vessels, drain into right atrium.
Smallest cardiac veins 心最小静脉- drain into all chambers, mainly atria.
Pericardium 心包 Fibrous pericardium 纤维心包
Attached to central tendon of diaphragm inferiorly
Blends with outer coat of great vessels superiorly
Serous pericardium 浆膜心包 Visceral layer (epicardium) Parietal layer
Pericardial cavity 心包腔 Potential space between visceral and
parietal layes. Contains film of pericardium fluid as a
lubricant to facilitate cardiac movements.
Pericardium 心包
Pericardium sinus Formed by reflection of serous peric
ardium. Transverse sinus of pericardium
心包横窦 Posterior to ascending aorta and pul
monary trunk Anterior to superior vena cava and le
ft atrium.
Pericardium sinus
Oblique sinus of pericardium 心包斜窦- cul-de-sac( 死胡同 ), posterior to heart, bounded by pulmonary veins on either side.
Anterior inferior sinus of pericardium 心包前下窦
Surface markings of heart
R. superior point - lies on the upper border of right third costal cartilage ±1.2cm from the margin of sternum
R. inferior point - lies on the sixth sternocostal joint
L. superior point - lies on lower border of left second costal cartilage ±1.2cm from sternal margin
Cardiac apex - in the fifth left intercostal space 7~9cm from the midline