5.心臟解剖ppt課件

1、心臟解剖心臟解剖&心臟傳導(dǎo)系統(tǒng)心臟傳導(dǎo)系統(tǒng)1;.2 位于縱隔腔內(nèi)位于縱隔腔內(nèi) 左右肺之間左右肺之間 2/3 2/3 在中線左側(cè)在中線左側(cè) 方向：右后上左前下方向：右后上左前下Mid Line3概述：心房為薄壁，低壓心腔心房為薄壁，低壓心腔左右心房以房間隔分隔左右心房以房間隔分隔導(dǎo)管從右心房到左心房，需行房導(dǎo)管從右心房到左心房，需行房間隔穿刺術(shù)，經(jīng)卵圓窩通路進入間隔穿刺術(shù)，經(jīng)卵圓窩通路進入左心房左心房右心房：在右心室收縮期充盈在右心室收縮期充盈接受來自于接受來自于SVC，IVC，CS的血的血液液 靜脈血靜脈血4IVC右心房右心房5IVC右心房右心房6IVCTricuspid Valve

2、Annulus (TVA)7IVCRight Auricle (or)Right Atrial Appendage8IVC9 點點 CS竇口 His 束 邊緣邊緣 Todaro氏腱 三尖瓣環(huán)10IVC11 左心房 在左心室收縮期充盈 接受來自肺靜脈的血液 動脈血12肺靜脈肺靜脈1314151617 概述概述 左右心室間以室間隔相隔 分流入道和流出道 左心室左心室 接受來自左心房的血液 將血液泵入主動脈 (Ao)，至全身組織 左心室室壁厚于右心室 右心室右心室 接受來自右心房的血液 將血液泵入肺動脈18Viewed from above面面19右心室右心室20212223242526 心外膜心外

3、膜 最外層Outermost layer 薄層，漿膜Thin, serous membrane 心肌層心肌層Myocardium 中層Middle layer 工作心肌Working muscle of heart 心內(nèi)膜心內(nèi)膜Endocardium 最內(nèi)層Innermost layer Lines myocardium 心包心包Pericardium 心包腔Pericardial Sac 內(nèi)含少量漿膜液Small amount of liquid27 纖維骨架 分離心房和心室 為心臟瓣膜提供框架28 只允許血液從心房單向流向心室 三尖瓣連接 RA 和 RV 二尖瓣連接 LA和 LV 心室壓力

4、低于心房壓力時，房室瓣開放29 心臟收縮期心臟收縮期 30 心臟舒張期心臟舒張期31 肺動脈瓣：連接RV與PA 主動脈瓣：連接LV 與 AoPulmonic ValveAortic Valve3233 腱索腱索 腱索連接房室瓣和乳頭肌 乳頭肌乳頭肌 發(fā)自心內(nèi)膜,連接于腱索 作用作用 心室收縮迫使房室瓣關(guān)閉 乳頭肌收縮引起腱索緊張 預(yù)防血液從動脈逆向回流至心室心臟傳導(dǎo)系統(tǒng)心臟傳導(dǎo)系統(tǒng) Conduction System34;.35 竇房結(jié)（竇房結(jié)（SA Node） The hearts main Pacemaker Located near junction of RA and SVC Bach

5、mans Bundle conducts activation from SA node to LA 結(jié)間束（結(jié)間束（Internodal Tracts ） Conducts activation from SA node across atria 纖維骨架（纖維骨架（Fibrous Skeleton） barrier to conduction from atria to ventricles36 房室結(jié)房室結(jié)(AV node ) 位于三尖瓣上方，CS開口前方 激動從心房經(jīng)AV 傳導(dǎo)到His 束( bundle of His) Traffic Cop Secondary pacemaker

6、of the heart37 If the ventricles contract when the mitral and tricuspid valves are o p e n , b l o o d t e n d s t o g o backwards instead of forwards By delaying it 120 to 150 milliseconds, that allows the atria to empty and then the ventricles to contract against closed valves.38 希氏束（Bundle His） S

7、tart of Ventricular Conduction System Conducts impulses t hr ough s e p t u m t o bundle branches N o r m a l l y t h e s o l e electrical connection b e t w e e n a t r i a a n d ventricles39 束支（束支（Bundle Branches） Down Septum Wall Transmits impulses from the bundle of His to both ventricles 浦氏纖維網(wǎng)（

8、浦氏纖維網(wǎng)（Purkinje Fibers） Special cells of conduction throughout the ventricles Tertiary pacemaker of the heart 20-40 bpm40 These are like the Autobahn. Sinus node and AV node have speed limits of about about 25 mph Atrium and ventricular muscle is 70 or 75 mph His-Purkinje system is like the Autobahn

9、at 150 mph. It allows very rapid conduction down to the apex of the heart Large cells and allow contraction down to the apex so the heart squeezes apex back to base.41 SA Node Internodal Tracts and Bachmans Bundle AV Node Bundle of His Bundle Branches Purkinje Fibers42Cardiac Anatomy QuizPlease identify the following anatomic points.SA NodeBachmans BundleInternodal TractsAV NodeBundle of HisBundle BranchesPurkinje Fibers1.2.3.4.5.6.7.8. 9. 10.11.12.13.Superior Vena CavaOS of Superior Vena CavaRight AtriumOS of Inferior V