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Heart and mediastinum. Mediastinum What is the mediastinum? The region between the lungs, extending from the thoracic inlet to the diaphragm.

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Presentation on theme: "Heart and mediastinum. Mediastinum What is the mediastinum? The region between the lungs, extending from the thoracic inlet to the diaphragm."— Presentation transcript:

1 Heart and mediastinum

2 Mediastinum

3 What is the mediastinum? The region between the lungs, extending from the thoracic inlet to the diaphragm

4 Label… Rib 1 Sternal angle @ T4/5 Diaphragm Superior mediastinum Posterior mediastinum Middle mediastinum Anterior mediastinum

5 Contents of the mediastinum Superior Thymus, trachea, oesophagus, aortic arch, SVC, thoracic duct, phrenic & vagus nerves Anterior Lymph nodes, thymus (in children), internal thoracic vessels Middle Pericardium, heart, ascending aorta, tracheal bifurcation, pulmonary artery, SVC Posterior Thoracic part of the descending aorta, azygous vein, splanchnic nerves, sympathetic chain, oesophagus and thoracic duct

6 Heart

7 Label… Pulmonary trunk Pulmonary artery Arch of the aorta SVC IVC RA RV LV Apex

8 What are the three layers of pericardium? Fibrous pericardium – what are its attachments? Parietal layer of the serous pericardium Visceral layer of the serous pericardium What can be used to clamp arterial outflow during cardiac surgery? Transverse pericardial sinus = a passage between two sites of reflected serous pericardium, separating the arteries from the veins

9 What is the function of the fibrous skeleton? Prevents free conduction of electrical signals from the atria to the ventricles → AVN only route for signal conduction Also provides structure and support for the heart → it is an attachment point for the AV valves Mitral valve Tricuspid valve

10 Atrioventricular valves Name the AV valves. Where are they located? How are they anchored to the ventricle wall? What may be the consequences of damage to the papillary muscles? Mitral (left ventricle) and tricuspid (right ventricle). Located between the atria and the ventricles By tendons (chordae tendineae), which are attached to papillary muscles Valve incompetence and cardiac murmur → mitral/tricuspid regurgitation

11 Semilunar valves Name the semilunar valves. Where are they located? During systole the cusps are pushed TOWARD the vessel walls During diastole blood catches in the pockets and CLOSES the valve RPRP A LPLP P RARA LALA Anterior Posterior Pulmonary valve Aortic valve What happens to the valve cusps during systole/diastole? Aortic (left ventricle) and pulmonary (right ventricle). Located between the ventricles and the aorta/PT

12 Coronary arteries Circumflex artery -Left atrium and ventricle -Continues as posterior intraventricular in 40% -Provides AV nodal branch in 20% Posterior interventricular artery -Posterior ⅓ of septum -AVN in 80% Anterior interventricular artery -R & L ventricles -Majority of septum anterior ⅔ -AVN in 20% SAN artery -SAN -R & L atria -65% from RCA,35% from circumflex RCA LCA RCA is dominant (gives off PIVA) in 60% LCA is dominant in 40% RCA is dominant (gives off PIVA) in 60% LCA is dominant in 40%

13 Label...

14 What is the surface anatomy of the heart borders? 3 rd R CC 2 nd L CC 6 th R CC 5 th L ICS midclavicular line

15 Where would you auscultate for the valves? Mitral  5 th left ICS MCL Tricuspid  4/5 th left ICS Pulmonary  2 nd left ICS Aortic  2 nd right ICS

16 Thanks! Feel free to email us at ami.mason@warwick.ac.uk or Annabel.fothergill@warwick.ac.uk if you have any questions!ami.mason@warwick.ac.ukAnnabel.fothergill@warwick.ac.uk


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