Summary
samenvatting van HAP
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comprehensive summary of the course HAP. including anatomy & physiology. This course is also given on other studies at vu, so can also be used in other studies.
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Anatomy heartPosition of the heart: In the 5th intercostal space parasternal on the right and midclavicular (in the
middle of the clavicular) on the left. Sternal angle is where the heart begins.
What is the mediastinum: room between the lungs, and vertebrae and sternum. There is a superior
part and inferior part (with anterior, middle and posterior).
Superior got: thymus, nerves ((vagal on both sides, left recurrent laryngeal to the larynx, phrenic
nerves (to breath for diaphragm) sympathetic trunk (fight or flight along
the vertebrae)), thoracic duct with lymph.
Posterior got: vessels, oesophagus, thoracic duct and nerve. So no trachea
because has split up into longs!
Pericardium: pericardial cavity = visceral (inside wall) and parietal (outside
wall). Pericardial cavity has air in between the walls, to provide less friction. If there is fluid > cardiac
tamponade. Transition from visceral to parietal = transverse sinus (used in surgery because no
damage to the tissue) & oblique sinus.
Structure of the heart:
>>RA: inferior and superior vena cava, coronary sinus (vein, all
the blood collected from the heart self), interatrial septum
(oval fossa), crista terminalis (ridge
between smooth muscle and
muscle wall)
<<RV: tricuspid valve. Chordae
tendinea (to prevent collapse when pressure drops), papillary muscles,
pulmonary valve (to prevent the blood to go back into RV) and
pulmonary trunk.
LA: also an ovale fossa.
LV: mitrale, bicuspid valve. Very muscular and membranous.
Ascending aorta.
Semilunar valves from aorta and pulmonary do not need muscles
to prevent collapse. So not like the mitral and the tricuspid which
are supported with chordea.
Heart skeleton makes sure that the signals go only to the right place and does not spread all along
the heart. The small whole in the skeleton is for the bundle of
his, that makes sure there is a pause in between the
contractions.
Conduction system: First of the SA is pacemaker for the atria.
AV node delay a bit, to bundle of His, which go to branches
and purkinje fibres.
Thickness heart wall = left is very thick. Infraction on the right
place can therefore take time, bc LV takes pare of RV contraction.
Blood supply heart self: from aorta 2 coronary artery, the LAD and right. Venous drainage is vena
cardiac magna.
, Atherosclerosis, problematic when in coronary artery. Then tissue die in the heart muscle. Called
myocardial infarction. Fixed by stend, or bypass.
Systole = contraction of the ventricles
Diastole = if the heart is relaxed.
Anatomy Embryology Heart
Cyanotic new-born = lips are blue, fingertips swollen. Sign of bad heart.
Forming straight heart tube: 2 myocardial tubes, fuse together to form one tube.
Forming primitive heart:
1. Looping > atrium migrates cranial.
2. Rotation > right atrium and ventricle rotate to ventral.
Forming fetal heart:
Septation atria: done by septum primum (blue line) and secundum (green line)>.
Via pressure of breathing, septum’s close. Called oval fossa.
ASD (whole in heart), mix the blood flow
Ventricles separation: Muscular septum in the middle to divide the ventricles. To develop
separation to aorta and pulmonary trunk. Develop of spiral shaped septum, to make 2
outflow tracts.
If this goes wrong, aorta and pulmonary grow together, mixed blood.
Tetralogy of Fallot: pulmonary stenosis (1, narrowing), VSD (2, right also
to aorta) this leads to 3, overriding aorta, so harder worker RV, 4, leading to
enlarged RV.
Remodelling aorta and veins:
Sinus venosus where all veins come together, most disappear. Third arch
become aorta.
Development smooth walled atrium, sinus venosus goes into RA,
becoming 3 or 4 holes, depends on the incorporation of the
pulmonary veins.
Post-natal changes:
Ductus venosus is bypass live from the mother to the heart. In the
heart become mixed blood, into the ductus arteriosus to bypass the lungs.
1. Umbilical vein > Round ligament of the liver
2. ductus venosus > Ligamentum venosum
3. foramen ovale > Oval fossa
4. ductus arteriosus (Botalli) > Ligamentum arteriosum
5. Umbilical arteries > Medial umbilical ligaments*
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