心脏基础解剖幻灯片.pptVIP

心脏基础解剖及血液循环 宋书波 心脏外形 循环特点 1、下腔静脉的血经卵圆孔到左心房，而上腔静脉的血经房室孔到右心室的原因是，下腔静脉射进的血直对卵圆孔，而上腔静脉射进的血直对房室孔。 2、头、颈、上肢部分供应的血含氧及营养丰富，使其发育快；而盆、腹部及下肢供应的血相对含氧低及营养少，故其发育较慢。 出生后血液循环的变化 胎儿出生以后： 1、脐带被剪断，胎盘血供应中断。 2、肺开始呼吸。 造成胎儿血循环发生一系列变化： 1、脐动脉大部分分化成为膀胱外侧韧带。 2、脐静脉退化形成肝圆韧带。 3、肝的静脉导管闭锁成为静脉韧带。 4、动脉导管退化闭锁成为动脉韧带。 5、卵圆孔关闭。 心的神经 心的体表投影 血液循环 胎儿血液循环 生后血液循环 Thanks for your attention ! 心脏heart位于胸腔的纵隔内，膈肌中心腱的上方，夹在两侧胸膜囊之间。 The heart is suspended within the thorax by arteries and veins. Two thirds of the heart is located to the left of the mid-sternal line while one third lies to the right of the sternum. The base is located at the 2nd-3rd intercostal space while the apex is located at the 5th intercostal space. The base is tilted backwards posterior , while the apex is tilted forward anterior . Due to forward tilt - PMI point of maximal impulse is located at the apex. “Right and left” references the patient’s right or left side. RA receives unoxygenated blood from the body through superior vena cava SVC and inferior vena cava IVC , and from the heart muscle through the coronary sinus CS LA receives oxygenated blood from the lungs though the pulmonary veins The triangle of Koch has become vitally important in performing transcatheter ablations. Koch’s triangle is defined posteriorly by the os of the coronary sinus. The apex of the triangle is defined anteriorly by the His bundle. The tendon of Todaro and the tricuspid valve annulus comprise the other two sides of the triangle. Fast pathway along Tendon of Todaro, Slow pathway along tricuspid valve annulus Papillary Muscle – Cone shaped muscular pillars, which prevent the valves from reopening into the atrial. The papillary muscles of the right ventricle comprise: Small, cone-shaped muscles projecting from the walls of the lower heart chambers the ventricles to which are attached fibrous cords chordae tendineae stretching up to the flaps of the valves between upper and lower chambers. When the ventricles fill with blood and contr