Cardiac Anatomy and Physiology, Slides of Science education

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Cardiac Anatomy

and Physiology

Reporter: Dr. Christine Linda G. Amata Moderator: Dr. Francis P. Ferrer

PRAYER Dear Lord, Guide my mind and my hands and inspire me with words of comfort that I may help those in surgery. Encourage me in the trials and misery to which I am daily exposed. Grant that I may always use my power and influence for good, and let me use all my knowledge to safely protect those who need healing. In Jesus name, Amen.

OBJECTIVES:

1. Discuss and review on the gross anatomy of the heart
2. Discuss the coronary anatomy and physiology
3. Discuss the cardiac myocyte anatomy and function
4. Discuss the conduction system of the heart
5. Discuss and explain the cardiac cycle
6. Discuss the pressure-volume diagram
7. Discuss the different determinants of cardiac performance

Anatomy of the

Heart

● (^) Heart’s Skeleton ● (^) Borders ● (^) Layers of the Heart Wall ● (^) Valve Structure

Heart’s Skeleton ● (^) Annuli of the Valves ● (^) Aortic and Pulmonary Arterial Routes ● (^) Central Fibrous Body ● (^) Left and Right Fibrous Trigones

● Formed by Left Ventricle ● (^) Lies in the Left 5th Intercostal Space ● Slightly medial to Midclavicular/Nipple Line (~9 cm from midline) Base/Posterior Aspect ● (^) Left Atrium ● (^) Partly posterior Right Atrium Right (Acute) Border ● (^) SVC ● (^) Right Atrium ● IVC Left (Obtuse) Border ● (^) Left Ventricle BRS

MYOCARDIUM Interstitial Collagen Fiber Network

• provides structural support to myocardium Elastin - interwoven within the collagen matrix→flexibility and elasticity without compromising strength Consist of continuum of interconnecting cardiac muscle fibers

MYOCARDIUM

Left and Right Atria ● (^) 2 relatively thin sheets of myocardium ● (^) Oriented perpendicular to each other Right and Left Ventricles ● (^) Thicker walls than atria ( and 10mm) ● (^) 3 Muscle Layers: ○ (^) Interdigitating Deep Sinospiral ○ (^) Superficial Sinospiral ○ Superficial Bulbospiral

Pulmonic and Aortic Valves

● Trileaftlet structures located at RV (Pulmonic) and LV (Aortic) outlets ● (^) Operate passively with changes in hydraulic pressure from ejection ● (^) Sinuses of Valsalva - dilated segments in proximal aortic root located above each leaflet ● Eddy Currents - hydraulic flow vortices that assist with aortic valve closure when ejection ceases

Mitral Valve ● (^) Thin, flexible and strong valve that separates the LA from the LV ● (^) Oval, saddle-shaped structure containing two leaflets (anterior and posterior) What causes MV to open and close? Pressure gradient b/w LA and LV Chambers near the end of LV relaxation + LV Elastic Recoil → MV Open Retrograde blood flow toward the valve during LV Contraction → MV Close

CORONARY BLOOD SUPPLY ANATOMY AND PHYSIOLOGY

LCA ● Free wall of the LV ● Narrow strip of RV anteriorly ● Anterior ⅔ of ventricular septum ● Most of the LA

LAD ● “Anterior Interventricular Artery” ● Septal branches: Most of the Interventricular Septum