心脏、血管系统.ppt

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,The Heart and,Angiology,同济大学医学院 解剖教研室,孙红斌,Composition,Cardiovascular system,心血管系统,Lymphatic system,淋巴系统,The cardiovascular system,Organization,Heart,心,A muscle pump to maintain the flow of blood,Consist of four chambers(right and left atria,right and left ventricles),Artery,动脉,a.,carry blood away from the heart,Veins,静脉,v.,carry blood back to the heart,Capillary,毛细血管,microscopic vessels,the area of exchange between blood and tissue fluid,Blood circulation,Systemic circulation,体循环,left ventricleaorta and its branchescapillaries of bodysuperior and inferior vena cavaright atrium,Pulmonary circulation,肺循环,right ventriclepulmonary a.capillaries of lungpulmonary v.right atrium,Vascular,anastomosis,血管吻合,Anastomosis,between a.,Anastomosis,between v.,Arteriolovenular,anastomosis,动静脉吻合,Collateral vessels,侧副管,Circulation,侧支循环,Rectal venous plexus,Position,Lies within the pericardium in middle,mediastinum,Behind the body of sternum and coastal cartilages 2 to 6,In front of thoracic vertebrae 5 to 8,A third of it lies to the right of median plan and 2/3 to the left,External characteristics,a hollow muscular organ,pyramidal in shape,somewhat larger than a closed fist;consists of four,chanbers,(right and left atria,right and left ventricles),Cardiac apex,is formed by left ventricle and is directed downwards and forwards to the left.It lies at the level of the fifth left,intercostal,space,12cm medial to the left,midclavicular,line(9cm from the midline),Cardiac base,is formed by the left atrium and to a small extent by the right atrium.It faces backward,upward and to the right,Two surface,Sternocostal,surface,is formed mainly by the right atrium and right ventricle,and a lesser portion of its left is formed by the left auricle and ventricle.It is directed forwards and upwards,Diaphragmatic surface,is formed the ventricles,chiefly the left ventricle,directed backwards and downwards,and rest upon the central tendon of the diaphragm,Three borders,Right border,vertical,is formed entirely by right atrium,Left border,round,is mainly formed by the left ventricle and partly by the left auricle,Inferior border,horizontal,is formed by the right ventricle and cardiac apex,Four grooves,Coronary,sulcus,冠状沟,(circular,sulcus,)which marks the division between atria and ventricles,contains the trunks of the coronary vessels and completely encircles the heart,Interatrial,sulcus,房间沟,separates the two atria and is hidden by pulmonary trunk and aorta in front,Interventricular,grooves,室间沟,anterior and posterior,mark the division between ventricles(which separates the RV from the LV),the two grooves extend from the base of the ventricular potion to a notch called:the,cardiac apical,incisure,心尖切迹,Atrioventricular,crux,房室交点,a junction of the posterior,interventricular,groove and coronary,sulcus,Chambers of the heart,Right atrium,右心房,(RA),Three inlets,Orifice of superior vena cava,上腔静脉口,returns blood to the heart from the upper half of the bodyOrifice of inferior vena cava,下腔静脉口,returns blood to the heart from the lower half of the body,Orifice of,coronar,sinus,冠状窦口,returns blood to the heart from the cardiac muscle,One,outle,right,atrioventricular,orifice,右房室口,Crista,terminalis,界嵴,vertical ridge,thatjfrom,superior vena cave to inferior vena cave,Sulcus,terminalis,界沟,groove on exterior of heart that corresponds to,crista,terminalis,Two parts,separated externally by,sulcus,terminalis,and internally by the,crista,terminalis,Atrium proper,固有心房,In front of the ridge,Pectinate,muscles in wall,Right auricle,右心耳,a small conical muscular pouch,projects to the left from the root of superior vena cava,pectinate,muscles in wall,Sinus,venarum,cavarum,腔静脉窦,Lies posterior to the ridge,Smooth walls,Fossa,ovalis,卵圆窝,an oval depression,a remnant of the fetal foramen,ovale,on the lower part of,interatrial,septum,the most common location of,atrial,septal,defects(ASD),Limbus,fossae,ovalis,卵圆窝缘,prominent margin of,fossa,ovalis,Torus,aortious,主动脉隆凸,Right ventricle,(RV),右心室,Receives deoxygenated blood from right atrium through right,atrioventricular,orifice,One inlet,right,artrioventricular,orifice,右房室口,One outlet,orifice of pulmonary trunk,肺动脉口,Two parts,divided by the,supraventricular,crest,室上嵴,a muscular ridge between right,atrioventricular,orifice and orifice of pulmonary trunk,Inflow tract,rough walls,Trabeculae,carneae,肉柱,irregularly arranged bundles of myocardium,Septomarginal,trabecula,隔缘肉柱,extends from,interventricular,septum to base of anterior papillary muscle,contains right bundle branch,Papillary muscles,乳头肌,conical-shaped,anterior,posterior and,septal,Out flow tract,Conus,arteriosus,动脉圆锥,cone-shaped,smooth area leading upward to orifice of pulmonary trunk,Pumps blood through pulmonary orifice to pulmonary trunk,Left atrium(LA),左心房,Left auricle,左心耳,projecting to the right,pectinate,muscles in wall,Four inlets,four,orifices of pulmonary veins,肺静脉口,open through the posterior wall,One outlet,left,atrioventricular,orifice,左房室口,blood leaves through left,atrioventricular,orifice to left ventricle,Left ventricle(LV),左心室,Has wall three times thicker than that of right ventricle,One inlet,left,atrioventricular,orifice,左房室口,One outlet,aortic orifice,主动脉口,Two parts,divided by anterior cusps of,mitral,valve,Inflow tract,rough walls,Outflow tract,aortic vestibule,主动脉前庭,smooth area leading to aortic orifice,Valves,Tricuspid valve,三尖瓣,Guards right,atrioventricular,orifice,Three triangular cusps:anterior,posterior and,septal,the base of cusps are attached to fibrous ring surrounding the,atrioventricular,orifice,Chordae,tendineae,腱索,fine,white,connective tissue cords,attach margin of cusps to,papillary muscles,乳头肌,Mitral,valve,二尖瓣,Guards left,atrioventricular,orifice,Two triangular cusps,anterior and posterior with commissural cusps between them(,posteromedial,and,anterolateral,commissures,),Similar structures to those of right,Similar functions for right and left,atriventricular,valves,Open during diastole to allow blood to enter ventricles from atria,Closed during systole to prevent regurgitation of blood into atria,Valve of pulmonary trunk,肺动脉瓣,Guards the orifice of pulmonary trunk,Has three,semilunar,cusps each with free border that has central,nodules of,semilunar,valve,半月瓣小结,Aorti,vavle,主动脉瓣,Guards the aortic orifice,Three,semilunar,cusps(right,left and post),Three aortic sinuses bulges in aortic wall at level of valve that correspond to cusps,Right,contains opening of right coronary artery,Left,contains opening of left coronary artery,Posterior,no opening,Similar functions for pulmonary and aortic valves,Opening during systole,with cusps pressed toward wall of vessel as blood is forced upward,Closed during diastole,Ventricular pressure drops in diastole,Floating together of valve cusps,with free borders meeting,thus closing the valve,Structure of the heart,Walls of heart,Endocardium,心内膜inner coat of the heart wall,and continuous with the valve flaps,Myocardium,心肌,Arranged spirally,Attached to fibrous rings,surrouding,the four orifices of heart,Epicardium,心外膜,serous membrane(visceral pericardium),Interatrial,septum,房间隔,Located between right and left atria,Contains,fossa,ovalis,andlimbus,Interventricular,septum,室间隔,Located between right and left ventricles,Has upper membranous part,Has thick lower muscular part,Fibrous skeleton,纤维骨骼,Fibrous rings that surround the,atrioventricular,pulmonary,and aortic orifices,Left and right fibrous,trigons,Conduction system of heart,心传导系,Consists of specialized myocardial cells,Sinuatrial,node,窦房结,(SA node),Called the pacemaker cell(P cell),Located at the junction of right atrium and superior vena cava,upper part of the,sulcus,terminalis,under the,epicardium,Atrioventricular,node,房室结,(AV node),Located in the lower part of,interatrial,septum just above the orifice of coronary sinus,under the,endocardium,Lower part related to membranous part of,interventricular,septum,Atrioventricular,bundle,房室束,(AV bundle),Passes forward through right fibrous,trigon,to reach inferior border of membranous part,Divides into right and left bundle branches at upper border of muscular part of,interventricular,septum,Right and left bundle branches,左、右束支,Right bundle branch,passes down on right side of,interventricular,septum to reach the,septomarginal,trabecular,and into the base of anterior papillary muscle.Here it becomes continuous with the fibers of Purkinje,fibres,Left bundle branch,passes down on left side of,interventricular,septum beneath the,endocardium,.It usually divides into two branches,which eventually become continuous with the Purkinje fibers,Purkinje fibers,普肯野氏纤维,continuous with myocardium,Arterial supply,Left coronary artery,左冠状动脉,Arises from left aortic sinus,Runs between pulmonary trunk and left auricle into coronary,sulcus,Branches,Anterior,interventricular,branch,前室间支,travels downward in anterior,interventricular,groove around inferior margin of heart to posterior,interventricular,groove,Circumflex branch,旋支,travels to left in coronary,sulcus,to posterior aspect,Distribution,supplies left atrium and ventricle,lesser portion of anterior wall of right ventricle,and anterior 2/3 of,interventricular,septum,Right coronary artery,右冠状动脉,Arises from the right aortic sinus,Runs forward between right auricle and pulmonary trunk into coronary,sulcus,Branches,Right marginal branch,右缘支,travels along inferior,bord,Posteror,interventricular,branch,后室间支,travels downward in posterior,interventricular,groove,it,anastomosises,near the apex with the,anteriorinterventricular,branch of the left coronary artery,Distribution:supplies right atrium and ventricle,posterior 1/3 of,interventricular,septum,posterior wall of left ventricle,the,sinuatrial,node and,atrioventricular,node,Venous drainage,Coronary sinus,冠状窦,Located in posterior part of coronary sinus,Carries most of venous blood from myocardium to right atrium,Tributaries,Great cardiac vein,心大静脉,Middle cardiac vein,心中静脉,Small cardiac vein,心小静脉,Anterior cardiac veins,心前静脉,34 small vessels,drain into right atrium,Smallest cardiac veins,心最小静脉,drain into all chambers,mainly atria,Pericardium,心包,Fibrous pericardium,纤维心包,Attached to central tendon of diaphragm inferiorly,Blends with outer coat of great vessels superiorly,Serous pericardium,浆膜心包,Visceral pericardium(,epicardium,),Parietal pericardium,Pericardial cavity,心包腔,Potential space between visceral and parietal pericardium,Contains film of pericardium fluid,Pericardium sinus,Transverse sinus of pericardium,心包横窦,posterior to ascending aorta and pulmonary trunk,anterior to superior vena cava and left atrium.,Oblique sinus of pericardium,心包斜窦,cul-de-sac,posterior to heart,bounded by pulmonary veins on either side,Surface markings of heart,Right border,corresponds to a line running from the upper border of right third costal cartilage 1.2cm from the margin of sternum,downwards to sixth,sternocostal,joint,Apex,in the fifth left,intercostal,space 79cm from the midline,Left border,represented by a line running from apex upwards and medially to a point on lower border of left second costal cartilage 1.2cm from,sternal,margin,Lower border,represented by a line joint the lower end of right border to apex,Dissection of the heart,The Arteries,Characteristics,Symmetry,对称,In the trunk of the body consist parietal and visceral branches,壁支和脏支,Shortest possible course,Run on flexor surfaces,Usually do not pass directly through muscles,avoiding compression,Together with the veins and nerves in a sheath of fascia to form neurovascular bundle,血管神经束,Arteries of pulmonary circulation,肺循环的动脉,Pulmonary trunk,肺动脉干,Arises from right ventricle,Runs up,back,and to the left,Bifurcates inferior to aortic arch into right and left pulmonary arteries,one for each lung,Arteries of systemic circulation,体循环的动脉,Aorta,主动脉,Ascending aorta,升主动脉,Aortic arch,主动脉弓,Brachiocephalic,trunk,头臂干,right common carotid a.,右颈总动脉,right,subclavian,a.,右锁骨下动脉,Left common carotid a.,左颈总动脉,Left,subclavian,a.,左锁骨下动脉,Descending aorta,降主动脉,Thoracic aorta,胸主动脉,Abdominal aorta,腹主动脉,Arteries of head and neck,Common carotid a.,颈总动脉,External carotid a.,颈外动脉,Internal carotid a.,颈内动脉,Subclavian,a.,锁骨下动脉,Arteries of upper limb,Axillary,a.,腋动脉,Brachial a.,肱动脉,Radial a.,桡动脉,Ulnar,a.,尺动脉,Superficial,palmar,arch,掌浅弓,deep,palmar,arc,掌深弓,Thoracic aorta,胸主动脉,Parietal branches,壁支,Nine pairs posterior intercostals arteries,肋间后动脉,One pair,subcostal,肋下动脉,Visceral branches,脏支,Abdominal aorta,腹主动脉,Visceral branches,脏支,Paired branches,Middle suprarenal artery,肾上腺中动脉,Renal artery,肾动脉,Testicular(ovarian)artery,睾丸（卵巢）动脉,Unpaired branches,Celiac trunk,腹腔干,Superior mesenteric a.,肠系膜上动脉,Inferior mesenteric a.,肠系膜下动脉,Parietal branches,Arteries of pelvis,Common iliac a.,髂总动脉,Internal iliac a.,髂内动脉,External iliac a.,髂外动脉,Arteries of lower limb,Femoral a.,股动脉,Popliteal,a.,腘动脉,Posterior,tibial,a.,胫后动脉,Anterior,tibial,a.,胫前动脉,dorsal a.of foot,足背动脉,The Veins,静脉,General feature,Thin walls,larger lumens,venous valves,venous plexus,venous,rete,Two sets,Superficial vein,Deep veins,Special structures:,sinuses of,dura,mater,硬脑膜窦,diploic,veins,板障静脉,Venous valve,Diploic,veins,Sinuses of,dura,mater,Superior vena cava and its tributaries,Veins of head and neck,Internal jugular vein,External jugular vein,Brachiocephalic,vein:venous angle,Veins of upper limb,Deep vein:have the same names as their companion arteries,Superficial veins:,cephalic v.,头静脉,basilica v.,贵要静脉,median,cubital,v.,肘正中静脉,Veins of thorax,Superior vena cava,上腔静脉,Azygos,v.,奇静脉,Hemiazygos,v.,半奇静脉,accessory,hemiazygos,v.,副半奇静脉,Veins of vertebral column,椎静脉丛,Inferior vena cava system,Veins of lower limb,Deep vein:have the same names as their companion arteries,Superficial veins:,great,saphenous,v.,大隐静脉,small,saphenous,小隐静脉,Veins of pelvis,Internal iliac v.,髂内静脉,External iliac v.,髂外静脉,Common iliac v.,髂总静脉,Inferior vena cava and its tributaries,Hepatic portal v.,The Lymphatic System,Heart,Artery,Capillaries,Vein,Cell,Tissue fluid,Lymphatic capillary,Lymphatic vessel,Lymphatic node,Lymphatic trunk,Lymphatic duct,Composition,Lymphatic vessel,Lymphatic capillary,Lymphatic vessels:two sets,superficial and deep,Lymphatic trunks:nine,Lymphatic ducts:,thoracic duct,right lymphatic duck,Lymphatic organ,Lymphatic nodes,Tonsil,spleen,thymus,Lymphatic tissue,Lymphatic capillary,Lymphatic node,Afferent vessels,Afferent vessels,Thoracic duct,Right lymphatic duck,Lymphatic vessels,