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Anatomy and Physiology of The Heart
Anatomy and Physiology of The Heart
sinoatrial node (SA) Keith-Flack - present in the wall of the right atrium
(AD) near the orifice of the superior venae cavae (VCS)
atrioventricular node (AV) Aschoff-Tawara - located in the right atrium,
above the right atrioventricular orifice.
atrioventricular bundle Hiss - the only way of connection between the
atriums and ventricles. Leaves from the AV node,
crossing the
interventricular septum and divides into two branches: the left and
right which descending into respectively ventricles.
Purkinje network represent the ramification of bundle Hiss branches,
made the connection with adult myocardium and transmit contraction
impulses from top to bottom and from endocardium to epicardium.
Purkinje network isnt nerve impulse center (not produce automatism).
The epicardium
Epicardium represent the visceral leaf of the serous pericardium. The
pericardium is the fibrous sac which surrounding the heart and big vessels.It
is compound of two layers:
superficial - fibrous pericardium
deep - serous pericardium, consisting of two leafs: visceral (lining the heart
and big vessels) and parietal (lining the deep front of fibrous pericardium).
Internal configuration of the heart
Internal configuration of the heart reveals its tetracameral structure: right
and left atrium, right and left ventricle.
Atriums have thinner walls, smaller capacity, didnt have papillary muscles
and they are relatively cubical. Are separated by interatrial septum and both
communicate with homonymous ventricles by atrioventricular orifice.
Atrioventicular orifice presents funnel valves called cusps (bicuspid or mitral
valve at left orifice and tricuspid valve at right orifice), with peak oriented to
the ventricle and the base to the atrium. Peak continues with chordae
tendineae of papillary muscles in ventricle.
In the right atrium are opening orifices of the upper and lower vena cava,
coronary sinus and right atrioventricular orifice. In the left atrium are
opening orifices of the four pulmonary veins and the left atrioventricular
orifice.
Ventricles have thicker walls (due to pump function they perform), higher
capacity and pyramid form. Are separated by interventricular septum, which
has a muscular lower portion extended and an membranous upper portion
lower.
The internal surface of the ventricles is irregular due to the presence of the
projecting formations called the chordae tendineae (which are arranged in
the longitudinal axis of the heart and are subendocardial muscle) and
papillary muscles.
The tendineae chordae are attached to one end of the papillary muscle and
the other with the atrioventricular valves, preventing reflection of valves in
the atrium during ventricular systole. The base of ventricles is corresponding
with atrioventricular orifice on each side. Both ventricles present, near
atrioventricular orifice, an arterial orifice by leaving large vessels.
Arterial orifices are covered by three semilunar valves (sigmoid), the
"Swallow".
The vasculature of the heart is provided by two coronary arteries that
originate from the ascending aorta. Collaterals that are leaving are terminal
type (didnt mix with neighboring branches). If the blood flow stops through
these collaterals, the cardiac territory, due to lack of oxygen and nutrients, it
finally necrosis and appears heart failure. Venous blood is collected by veins
and finally arrive in the coronary sinus which opens into the right atrium.
Extrinsic innervation of the heart is double: sympathetic and
parasympathetic (nerve X). It come true through the agency of cardiac
plexus situated below the aortic arch.
Sympathetic fibers from the cervical sympathetic chain (originating in the
lateral medullary horns T1-T5) through the cervical cardiac nerves (upper,
middle and lower) and thoracic cardiac nerves (originating in marrow T4-T5
and synapse in thoracic ganglias).
Parasympathetic fibers comes from nerv X by the upper and lower
cervical cardiac branches.
The properties of the myocardium are:
Excitability
Rhythmicity
Conductivity
Contractility
Tonicity.