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Anatomy Cardiovascular system

Research · August 2020

DOI: 10.13140/RG.2.2.34574.79683

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Ahmed Nady Ramadan

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Assignmment of
Anatomy
Ahmed Nady Ramadan Mohamed
ID: 191070096
Faculty Of Medicine in Beni Suef NUB
5/5/20
 1- Coronary arteries

Define:
Coronary arteries supply blood to the heart muscle. Like all other tissues in the body,
the heart muscle needs oxygen-rich blood to function. The coronary arteries wrap
around the outside of the heart. The 2 main coronary arteries are the left main and
right coronary arteries.

Importance:
Since coronary arteries
deliver blood to the heart muscle,
any coronary artery disorder or
disease can have serious
implications by reducing the flow
of oxygen and nutrients to the
heart muscle. This can lead to a
heart attack and possibly death.
Atherosclerosis (a buildup of
plaque in the inner lining of an
artery causing it to narrow or
become blocked) is the most
common cause of heart disease.

References:
 Johns Hopkins medicine <Health Home< Conditions and Diseases<Anatomy and Function of the Coronary
Arteries
 2- Conductive system of the heart

Define:
The cardiac conduction system is a network of specialized cardiac muscle cells
that initiate and transmit the electrical impulses responsible for the coordinated
contractions of each cardiac cycle. These special cells are able to generate an action
potential on their own (self-excitation) and pass it on to other nearby cells
(conduction), including cardiomyocytes.

The parts of the heart conduction system can

be divided into those that generate action
potentials (nodal tissue) and those that conduct
them (conducting fibers). Although all parts
have the ability to generate action potentials
and thus heart contractions, the sinoatrial
(SA) node is the primary impulse initiator and
regulator in a healthy heart.

References:
 Assadi, R., & Motabar, A. (2018). Conduction System of the Heart: Overview, Gross
Anatomy, Natural Variants. Retrieved from
https://emedicine.medscape.com/article/1922987-overview#a1
 3- Valves of the heart

About:
The heart has four valves - one for each
chamber of the heart. The valves keep blood
moving through the heart in the right
direction.

The mitral valve and tricuspid valve are

located between the atria (upper heart
chambers) and the ventricles (lower heart
chambers).

The aortic valve and pulmonic valve are

located between the ventricles and the major
blood vessels leaving the heart.

Mitral Valve

The mitral valve has only two leaflets; the aortic, pulmonic and tricuspid valves have
three. The leaflets are attached to and supported by a ring of tough, fibrous tissue called
the annulus. The annulus helps to maintain the proper shape of the valve.

The leaflets of the mitral and tricuspid valves are also supported by:

• Chordae tendineae: tough, fibrous strings. These are similar to the strings
supporting a parachute.
• Papillary muscles: part of the inside walls of the ventricles.

References:

 Cleveland clinic- Health Library / Articles - 17067-heart-valves / Appointments 800.659.7822

 4- Sinuses of the serous pericardium

Abstract:

The Sinuses of Pericardium lie between the

parietal and visceral layers of serous
pericardium and are 2 in number:
1. Transverse sinus.
2. Oblique sinus.

They’re created because of the reflection of

visceral layer of serous pericardium around
great vessels of the heart.

The visceral pericardium (epicardium) at the

roots of great blood vessels is arranged into
tubes:

• arterial tube
• venous tube.

The arterial tube encloses the

ascending aorta and pulmonary trunk
(arterial end of the heart tube).

The venous tube encloses the

superior and inferior vena cava and 4
pulmonary veins (venous end of the
heart tube).

References:
 K. L. Moore, A. F. Dalley, A. M. R. Agur: Clinically Oriented Anatomy, 7th edition, Lippincott Williams & Wilkins
(2014), p. 128-133
 5- Papillary muscle of the right ventricle

Location:
The three right ventricular papillary muscles
originate in ventricular wall, and attach to
anterior, posterior and septal leaflets of the
tricuspid valve via chordae tendinae. The
three papillary muscles of the right ventricle
have highly variable anatomy with the
anterior papillary muscle usually being the
most prominent. The anterior and septal
papillary muscles are connected by the
moderator band. The septal papillary muscle
itself is normally the least prominent and can
often not be distinguished from the
ventricular wall.

Function:
Prevent prolapse of the tricuspid valve
leaflets during ventricular systole.

Importance in cardiovascular diseases:

Tricuspid regurgitation can be the result of papillary dysfunction or chordate rupture.

Importance in device delivery:

The papillary muscles and sub-valvular apparatus of the tricuspid can complicate the
implantation of pacing leads into the right ventricular apex.

References:
 Jurcut, R., Haugaa, K., & La Gerche, A. (2018). The Right Ventricle: From Bench to Bedside. Biomed Research
International, 2018, 1-3. doi: 10.1155/2018/2868437
 6- Inter atrium septum & inter ventricular septum

A. inter ventricular septum

1. Define:
The stout wall that separates the lower chambers
(the ventricles) of the heart from one another. A
hole in the interventricular septum is termed a
ventricular septal defect (VSD).
2. Location:
Medial wall of the left ventricle. This is the wall that
borders septum between the left and right ventricle.

3. Function:
Contributes to the pumping function of the left ventricle.

4. Importance in cardiovascular diseases:

Ventricular septal defects

B. Inter atrium septum

1. Location:
Wall that separates right from left atrium.

2. Importance in cardiovascular
diseases:
Atrial septal defects (e.g., patent foramen ovale).

3. Importance in device delivery:

Pacing site for reducing interatrial conduction
delay, transseptal puncture for left heart
ablations.

References:
 Gray's Anatomy: The Anatomical Basis of Clinical Practice, 39th ed. (2005)
 Pillitteri, Adele (2010). "Maternal & Child Health Nursing: Care of the Childbearing & Childrearing Family".
Lippincott Williams & Wilkins.
 7- Coronary venous sinus

Mechanism:
The coronary sinus serves as the primary collector of cardiac venous blood and is located in the
atrioventricular groove on the diaphragmatic surface of the heart.

The coronary sinus

➢ Is the largest cardiac vein in terms of
diameter.

➢ Various landmarks have been described as

the location of the coronary sinus origin,
including where the oblique vein of the left
atrium meets the great cardiac vein and at
the valve of Vieussens.

➢ It empties directly into the right atrium

near the conjunction of the interventricular
and coronary grooves (also known as the crux cordis area), located on the inferior region of
the right atrial septum between the inferior vena cava and tricuspid valve.

➢ The atrial orifice can be partially covered by a Thebesian valve, although the anatomy of this
valve is highly variable.

References:
 Hutchins G, Moore G, Hatton E (1986) Arterial-venous relationships in the human left
ventricular myocardium, Anatomic basis for countercurrent regulation of blood flow.
Circulation 74:1195-1202
 Truex R, Angulo A (1952) Comparative study of the arterial and venous systems of the
ventricular myocardium with special reference to the coronary sinus. Anat Rec 113:467-491
 8- Superior mediastinum

Define:
The superior mediastinum is the region sandwiched between the pleural sac on each side above an
imaginary line from the angle of Louis in front to the fourth/fifth thoracic intervertebral disc
behind. Its important contents are the oesophagus, trachea, great veins, aortic arch and its
branches, the vagus, phrenic and left recurrent laryngeal nerves, the upper part of the thoracic
duct and the thymus gland.

Boundaries
➢ superiorly: thoracic inlet.
➢ inferiorly: thoracic plane.
➢ laterally: mediastinal pleura.
➢ anteriorly: manubrium of the sternum.
➢ posteriorly: bodies of upper four thoracic
vertebrae.

References:
 RETROSTERNAL DISLOCATION OF THE CLAVICLE
o Kennedy John C., The Bone & Joint Journal, 1949
 Thoracic Defects: Cleft Sternum and Poland Syndrome
o PracticeUpdate, 2010
 The surgical anatomy of the blood supply to the femoral head
 9- Arch of the aorta

The arch of the aorta begins at the level of the upper border of the second
sternocostal articulation of the right side, and runs at first upward, backward, and to
the left in front of the trachea;
it is then directed backward on
the left side of the trachea and
finally passes downward on the
left side of the body of the
fourth thoracic vertebra, at the
lower border of which it
becomes continuous with the
descending aorta. It thus forms
two curvatures: one with its
convexity upward, the other
with its convexity forward and
to the left. Its upper border is
usually about 2.5 cm. below the
superior border to the
manubrium sterni.

References:
 Singh, V. (2011). Anatomy of abdomen and lower limb. London: Elsevier Health Sciences APAC.
 Joshi, S. D., Joshi, S. S., & Athavale, S. A. (2010). Origins of the coronary arteries and their significance.
Clinics (Sao Paulo, Brazil), 65(1), 79–84.
 10- Posterior mediastinum

Define:
The Posterior Mediastinum is an irregular triangular space running parallel with the vertebral
column; it is bounded in front by the pericardium above, and by the posterior surface of the
diaphragm below, behind by the vertebral column from the
lower border of the fourth to the twelfth thoracic vertebra, and
on either side by the mediastinal pleura. It contains the thoracic
part of the descending aorta, the azygos and the two hemiazygos
veins, the vagus and splanchnic nerves, the esophagus, the
thoracic duct, and some lymph glands.

Borders:
The posterior mediastinum is bordered by the following thoracic
structures:

➢ Lateral: Mediastinal pleura (part of the parietal pleural

membrane).
➢ Anterior: Pericardium.
➢ Posterior: T5-T12 vertebrae.
➢ Roof: Imaginary line extending between the sternal angle
(the angle formed by the junction of the sternal body and
manubrium) and the T4 vertebrae.
➢ Floor: Diaphragm.

References:
 Amanda Segal, ... Kim R Geisinger, in Orell and Sterrett's Fine Needle Aspiration Cytology (Fifth Edition), 2012
 Wai-Kuen Ng, in Comprehensive Cytopathology (Third Edition), 2008

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