SISTEM KARDIOVASKULER

DEPARTMENT OF ANATOMYHASANUDDIN UNIVERSITY

DINDING THORAX

Dibentuk oleh : kulit fascia / otot Tulang

Terdapat glandula mammae.

• LOKALISASI : antara Costa II – Costa VI, di medial tepi sternum, dilateral mencapai Linea axillaris

• Struktur : kelenjar, fat dan jaringan ikat

MAMMA

OTOT-OTOT DINDING THORAX

• M. Serratus posterior superior

• M. Serratus posterior inferior

• M. Intercostalis Externus• M. Intercostalis Internus• M. Subcostalis• M. Transversus thoracalis

SKELETON DINDING THORAX

• Ventral : - Sternum - Costae I – XII• Dorsal :

Vertebra Thoracalis I – XII

LINEA PADA DINDING THORAX

Linea mediana anterior (ventralis) Linea sternalis Linea mammilaris (=linea

medioclavicularis) Linea parasternalis Linea axillaris

• LINEA MEDIANA VENTRALIS (ANTERIOR)

Garis tegak yang membagi sternum menjadi 2 bagian yang simetris

• LINEA STERNALIS

Garis yang sejajar dengan Line mediana anterior yang melalui tepi sternum

• LINEA MAMMILARIS

Garis yang melalui papilla mammae atau garis yang sejajar dengan Linea mediana anaterior yang melalui pertengahan clavicula

• LINEA PARASTERNALIS

Garis yang terletak ditengah-tengah antara Linea mediana anterior dan Linea mammilaris

• LINEA AXILLARISGaris yang ditarik mulai dari lipatan ketiak

(axilla) anterior medialis posterior

MEDIASTINUM

• MEDIASTINUM SUPERIUS

• MEDIASTINUM INFERIUS :

MEDIASTINUM ANTERIUSMEDIASTINUM MEDIUMMEDIASTINUM POSTERIUS

THE CONDUCTING SYSTEM

• nodus sinuatrialis (= keith-flack)

• nodus atrioventricularis (= aschoff-tawara)

• fasciculus atrioventricularis

COR(=Cordis, kardia ,jantung)

• Organ muscular

• Bentuk “conus”, sebesar kepalan tinju

LETAK• Diantara ke-2

pulmo• Di atas

diaphragma• Menempati

mediastinum medius

Location in Thorax

Pericardium Serous membrane

lining the pericardial cavity

Analogous to a fist in a balloon

Subdivided into visceral and parietal pericardium

Visceral layer (brown arrow) is the outer layer of the heart itself – a.k.a. the epicardium

Parietal layer (red arrow) lines the inner portion of the pericardial sac and is deep to a meshwork of collagen fibers that stabilize the position of the heart

Pericardium Space btwn the visceral &

parietal layers is the pericardial cavity. Normally contains 10-

20mL of pericardial fluid secreted by the membranes

A variety of pathogens may infect the pericardium, causing pericarditis.

Pericardial irritation and inflammation results in an in pericardial fluid production which limits the movement of the heart. Known as cardiac tamponade.

MORFOLOGI COR

• Basis cordis• Facies sternocostalis• Facies sinister • Facies diaphragmatica

Posisi :• Basis di cranial• Apex di caudal• 2/3 bagian di kiri linea

medianaSumbu cordis :• Dari basis ke apex• Miring dari craniodorsal

ke caudoventral

APEX CORDIS•Bagian ventriculus sinister

•Letak :Ruang intercostalis 5 kiri

9 cm dari linea mediana

2 jari medial linea medioclavicularis sinistra

BASIS CORDIS

• Di cranialis : arah craniodorsal kanan

• Dibentuk oleh: - Sebagian atrium sinistra dan

dextra - Bagian proximal: Pembuluh darah

besar

Cor dewasa: Ukuran : p = 12 cm,

L = 8-9 cm, T = 6 cm Berat : Pria: 280-340

gr , Wanita= 230-280 gr

Dinding 3 lapis: Epicardium (luar) Myocardium

(tengah) Endocardium

(dalam)

Gross Anatomy of Heart: Frontal Section

Figure 18.4e

BAGIAN-BAGIAN COR

• atrium dextra• atrium sinister• ventriculus dexter• ventriculus sinister

ATRIUM DEXTER• lebih besar dari sinister• dinding tipis• 2 bagian : Sinus

venorum & auricula dextra

• Terdapat auricula dexter

Bermuara :- Vena cava superior- Vena cava inferior- Sinus coronaries

Blood Flow back to the Heart

Blood high in CO2 and low in O2 arrives at the RA from 3 vessels: Superior Vena Cava

• Drains head, upper torso, and arms

Inferior Vena Cava • Drains abdomen,

pelvis, and legs Coronary Sinus

• Drains coronary circulation

AURICULA DEXTRA: Bentuk kantong Permukaan dalam kasar akibat

tonjolan serabut otot-otot (MUSCULI PECTINATI)

ATRIUM SINISTER

Terdapat auricula sinistra

Bermuara vena pulmonalis

Sisa FORAMEN OVALE(FOSSA OVALIS)

Antara Atrium Sinister & Dextra

Terdapat SEPTUM INTERATRIORUM (=septum atriorum)

VENTRICULUS DEXTER• Ostium atrioventriculare

dexter dengan 3 katup (VALVULA TRICUSPIDALIS)

• Chordae tendinae• Trabeculae carnae• M. papillaris• Terdpt pangkal A.

Pulmonalis

Valves Semilunar Valves:

• Pulmonary Semilunar Valve• Prevents backflow of blood from pulmonary artery into

RV

• Aortic semilunar valve• Prevents backflow of blood from aorta into LV

VENTRICULUS SINISTER

• membentuk apex cordis• dinding 3 x lebih tebal• Ostium Atrioventriculare sinister 2

katup (VALVULA BICUSPIDALIS = VALVULA MITRALIS)

• Chordae tendinae• Trabeculae carnae• M. papillaris

Atria have thin flaccid walls corresponding to their light workload. Why is it light?

Right and left atria are separated by the interatrial septum.

RA and both auricles exhibit internal ridges of myocardium called pectinate muscles.

The thick interventricular septum separates the LV and RV.

LV is 2-4x as thick as the RV because of its large workload.

Both ventricles exhibit internal muscular ridges known as trabeculae carneae

LV

RV

SEPTUM

AORTA AORTA ASCENDENS:

mempercabangkan a.coronaria sinistra dan a.coronaria dextra

ARCUS AORTA AORTA DESCENDENS (=AORTA

THORACALIS) Melanjutkan diri menjadi ARTERI

ABDOMINALIS

Aorta ascendens

Arcus aortaAorta descendens

Arteri Anonyma

a.Carotis communis sinistra

a.Subclavia sinistra

a.Coronaria dextraa.Coronaria sinistra

ARCUS AORTA

a. anonyma (=truncus brachiocephalicus)

a. carotis communis sinistra a. subclavia sinistra

A. ANONYMA

BERCABANG MENJADI:

A. CAROTIS COMMUNIS DEXTRA A.SUBCLAVIA DEXTRA

CIRCULASI SISTEMIK ALIRAN DARAH ARTERI : dinding otot polos,

berdenyut VENA : dinding tipis, valvula COR – AORTA – ARTERI – ARTERIOLE

– CAPILER – JARINGAN capiler – venule – vena – vena

cava superior et inferior-cor

VENTRICULUS SINISTER

Aorta ascendens – arcus aortae – aorta descendens (= aorta thoracalis ) – aorta abdominalis – arteria iliaca communis – a.iliaca interna-a.ilica externa – a.femoralis – a.poplitea – a.tibialis anterior – a.tibialis posterior – a.dorsalis pedis

ALIRAN DARAH VENA :

EXTREMITAS INFERIOR : vena saphena magna-v.saphena parva – v.femoralis – v.iliaca – vena cava inferior

EXTREMITAS SUPERIOR : v.cephalica, v.ulnaris-v.radialis – v.brachialis – v.axillaris-v.subclavia

CIRCULASI PULMONAL ventriculus dexter arteria pulmonalis pulmo vena pulmonalis atrium sinistrum Pergantian Karbon dioksida dengan

Oksigen ( darah – eritrosit )

Basic Pathway of Blood Flow

SVC

IVC

CS

Right Atrium

Tricuspid Valve

Right Ventricle

Pulmonary Semilunar

Valve

Pulmonary Trunk

Pulmonary Arteries

Pulmonary Capillaries

Pulmonary Veins

Left AtriumBicuspid

Valve

Left Ventricle

Aorta

Aortic Semilunar Valve

Systemic Capillaries

CIRCULASI CORONER

vascularisasi myocardium a.coronaria dextra et sinistra v.cordis sinus coronarius atrium dextrum

Coronary Circulation Why does the heart require a prodigious

amt of O2 and nutrients? Cardiac muscle is not nourished to any

extent by the blood flowing thru its chambers, so it has its own network of arteries, capillaries, and veins – the coronary circulation

5% of circulating blood is delivered to the heart

After the aorta emerges from the LV it gives off 2 branches, the left & right coronary arteries

The coronary circulation has many anastomoses – where 2 arteries come together and combine their blood flow. What is the advantage to this?

Blockage of coronary arteries causes ischemia – a loss of blood flow. Temporary and reversible ischemia produces a sense of pain known as angina pectoris. Prolonged coronary blockage can lead to myocardial cell death - a myocardial infarction (a.k.a., heart attack or coronary)

After blood passes thru the coronary capillaries, it enters coronary veins which combine to form the coronary sinus which empties into the RA

a.Coronaria dextra a.Coronaria sinistra

Vena cordisSinus coronarius