心脏解剖学.ppt

心脏解剖 整体观 心脏功能 Cardiac Orientation If one considered the chest a cube, then the heart is located in its own cube within the large cube. The heart is pointing downwards, to the left, and anterior. Usually about 45 degree in each direction, but there are considerable individual variations. Cardiac Orientation AP AP位： *右侧心房、心室遮盖住大部分左侧的心房、心室 *TV、MV部分展开 *上腔静脉、主动脉、肺动脉自右向左排开 左前斜位450 LAO位： *两侧心房、心室完全展开 *TV、MV完全展开 *肺动脉、主动脉、上腔静脉自前向后排开 右前斜300 RA RA+RV LA+LV+AO LA+LV+AO+PA+RV Myocardial Anatomy Dissection – Anterior View Superior Aspect of the Heart Right Atrial Anatomy Cardiac chambers Cardiac Valves RAA - Pectinate Muscle and Thin Wall Right Appendage Crista Terminalis Right Atrial Anatomy Thebesian Flap/Valve Thebesian Flap/Valve Right Atrial Anatomy Koch三角 在右心房的冠状窦口前内缘、三尖瓣隔侧尖附着缘和Todaro腱之间的三角区，称Koch三角。Todaro腱为下腔静脉口前方心内膜下可触摸到的一个腱性结构，它向前经房室隔附着于中心纤维体（右纤维三角），向后与下腔静脉瓣相延续。Koch三角的前部心内膜深面为房室结，其尖对着膜性室间隔的房室部。此三角为心内直视手术中的重要标志，用以指示房室结的位置所在，以防术中损伤。此外，在行心导管检查时，在此三角区过分刺激，可引起心率失常 Right Atrial Anatomy Right and Left Atrial Anatomy LA+LV+AO Left Atrial Wall Left Appendage Left Atrium Left Atrium Left Atrial Anatomy Left Atrial Anatomy Cardiac Venous Anatomy Left Atrium Eso Vagus Nerve Venous structures Coronary Sinus Coronary Sinus Coronary Sinus Right Ventricular Anatomy Right Ventricular Anatomy Right Ventricular Anatomy Left Ventricle Anatomy Septal Anatomy Triangle of Koch Transverse Pericardial Sinus S.Y. Ho et al./Cardiovascular Research 54(2002)325-336 Right Left * S.Y. Ho etal./Cardiovascular Research 54(2002)325-336 S.Y. Ho etal./Cardiovascular Research 54(2002)325-336 Coronary Sinus (CS) – Great Cardiac Vein (GCV) Vein (Ligament) of Marshall (VOM or LOM) Left and Right Superior and Inferior Pulmonary Veins (RSPV, RIPV, LSPV, LIPV) Superior Vena Cava (SVC) Inferior Vena Cava (IVC) Pulmonary artery (PA) Middle Cardiac Vein (MCV) Posterior Descending Artery (PDA) Fluoroscopy and MRI views of the Pulmonary veins Cardiac Venous Anatomy * Ho et al. Vagaries of the Vagus Nerv