Lecture Anatomy week 1
PART 1
The heart is located in the anterior part of the mediastinum, immediately posterior to the sternum.
Para(sternal) = next to (sternal).
Posterior and superior mediastinum important to understand (EXAM QUESTION: know which
structure goes through what part of the mediastinum).
Organ systems
Function integumentary system: body temperature regulator, cell fluid maintenance, synthesis of
vitamin D and detection of stimuli.
Function skeletal system: shape, allows movement, makes blood cells, protects the organs and
stores minerals.
Function muscular system: contractibility and movement.
Function nervous system: controlling, regulating and communicating,
Function endocrine system: regulates all biological processes in the body.
Function lymphatic system: protection from illness-causing invaders.
Function digestive system: provides energy.
Explain: vagal nerve, recurrent laryngeal nerve, sternocleidomastoid muscle and phrenic nerve
MEDIASTINUM all parts.
Draw structures of the heart: atria, ventricles, heart valves, skeleton, conduction system, great
vessels.
PART 2:
Where does the blood come from (and what room) and where does it end?
How does the blood enter the lungs and how does it go back to the lungs?
How does it enter the system and how does it come back?
How does the heart get its own blood supply and where do these vessels arise from?
In a transverse section you can see the descending aorta on the right if you look from above, the
descending aorta is at the side of the left lung.
Pericardial cavity makes sure the heart can move around without any friction. The visceral
pericardium touches the inside of the balloon against the heart, the parietal pericardium is the part
that does not touch the balloon (outside).
Oblique sinus is the sinus where your fingers can touch (explain better)
DRAW: transverse and oblique sinuses. Coronary arteries are in the interventricular sulcus, also
DRAW coronary sulcus (inside = coronary sinus: all venous blood used by the heart muscle is
collected here and comes back into the right atrium).
DRAW: deoxygenated blood comes into the right atrium via the vena cava > coronary sinus collects
all the deoxygenated blood, brings it to the right ventricle > lungs > back into the left atrium through
the pulmonary veins > left ventricle > back into the systemic circuit (kind off a figure 8).
What do both valves do/ prevent?
Diastole is the contraction of the atrium (ventricles filled with blood, ventricles relaxed).
Tricuspid (or right AV valve): if the right ventricle contracts, prevents flow back to the atrium (has to
go to the lungs)
Bicuspid (or left AV valve): same function as tricuspid, on the left side of the heart.
,Semilunar: when the heart relaxes and the blood falls back, it cannot go down. Damage to the
semilunar valve of the right ventricle would affect blood flow to the pulmonary trunk.
- SA node (pacemaker): between crista terminalis and vena cava in right atrium, gives
electrical single to atria and AV node.
- AV node: delays signal from SA a bit to allow for filling of the ventricle than gives it to the
bundle of hiss and the rest of the heart.
- Bundle of His and purkinje fibers: spread the wave impulses along the ventricles, causing
them to contract.
Papillary muscles ensure that the cusps or the tricuspid valve close properly and do not prolapse
into the right atrium.
Where are the points of auscultation of the heart valves?
Bicuspid valve: at the point of the apex (left 5 th intercostal space, midclavicular line).
Tricuspid valve: right 5th intercostal space parasternal.
Pulmonary trunk: right 2th intercostal space parasternal. Splits same as aortic.
Aortic valve: left 2th intercostal space parasternal.
PART 3
The heart starts to develop around 2-3 weeks after fertilisation.
There is no blood flow to the lungs needed yet.
Forming primitive heart
1. Looping: atrium migrates from caudal to cranial
2. Rotation: right atrium and ventricle rotate to ventral (left more posterior)
Dextrocardia: the heart is on the right side (looped to the wrong side).
Septum primum
- foramen primum
- foramen secundum
Septum secundum
- foramen ovale
Tetralogy of Fallot (EXAM QUESTION): pulmonary stenosis – VSD – overriding aorta – enlarged RV.
Stenosis = narrowing.
, Understand the remodelling Sinus venosus: the brachiocephalic veins fuse, umbilical veins
disappear, and the coronary sinus and pulmonary veins develop.
How did the smooth walled atrium develop? EXAM QUESTION
Trabeculated smooth walled part of the atrium (left/right)
Trabeculated part of the right atrium: comes from the primitive atrium
Smooth walled part of the right atrium: incorporation of the sinus venosus in the atrial wall
Trabeculated part of the left atrium: comes from the primitive atrium
Smooth walled part of the left atrium: incorporation of the pulmonary veins in the atrial
wall
Artery away from heart to organs (usually oxygenated), and from vein to heart (usually
deoxygenated). Blood flows from right atrium (RA) to left atrium (LA).
Blood flow before birth: umbilical vein1 > umbilicus > bypasses the liver through the ductus
venosus2 > inferior vena cava (purple) > right atrium > left atrium through the foramen ovale3 (and
right ventricle: pulmonary artery > cross over lungs through ductus arteriosus4 > leaves body
through the umbilical arteries5 > umbilicus > placenta).
After labour (pressure in left atrium suddenly gets really high)
umbilical vein > round ligament of the liver
ductus venosus > ligamentum venosum
- a shunt that allows oxygenated blood in the umbilical vein to bypass the liver.
Connects the umbilical veins with the inferior vena cava.
foramen ovale > oval fossa
- shunts blood from the right atrium to the left atrium.
ductus arteriosus (Botalli) > ligamentum arteriosum
- connects the aorta and the pulmonary artery.
umbilical arteries > medial umbilical ligaments.
Know the process of segmentation of the atria and ventricles and name all components
Understand the origin of the mentioned congenital heart defects and their characteristics
Study questions:
Why are membranous VSDs most common of all heart defects?
PART 1
The heart is located in the anterior part of the mediastinum, immediately posterior to the sternum.
Para(sternal) = next to (sternal).
Posterior and superior mediastinum important to understand (EXAM QUESTION: know which
structure goes through what part of the mediastinum).
Organ systems
Function integumentary system: body temperature regulator, cell fluid maintenance, synthesis of
vitamin D and detection of stimuli.
Function skeletal system: shape, allows movement, makes blood cells, protects the organs and
stores minerals.
Function muscular system: contractibility and movement.
Function nervous system: controlling, regulating and communicating,
Function endocrine system: regulates all biological processes in the body.
Function lymphatic system: protection from illness-causing invaders.
Function digestive system: provides energy.
Explain: vagal nerve, recurrent laryngeal nerve, sternocleidomastoid muscle and phrenic nerve
MEDIASTINUM all parts.
Draw structures of the heart: atria, ventricles, heart valves, skeleton, conduction system, great
vessels.
PART 2:
Where does the blood come from (and what room) and where does it end?
How does the blood enter the lungs and how does it go back to the lungs?
How does it enter the system and how does it come back?
How does the heart get its own blood supply and where do these vessels arise from?
In a transverse section you can see the descending aorta on the right if you look from above, the
descending aorta is at the side of the left lung.
Pericardial cavity makes sure the heart can move around without any friction. The visceral
pericardium touches the inside of the balloon against the heart, the parietal pericardium is the part
that does not touch the balloon (outside).
Oblique sinus is the sinus where your fingers can touch (explain better)
DRAW: transverse and oblique sinuses. Coronary arteries are in the interventricular sulcus, also
DRAW coronary sulcus (inside = coronary sinus: all venous blood used by the heart muscle is
collected here and comes back into the right atrium).
DRAW: deoxygenated blood comes into the right atrium via the vena cava > coronary sinus collects
all the deoxygenated blood, brings it to the right ventricle > lungs > back into the left atrium through
the pulmonary veins > left ventricle > back into the systemic circuit (kind off a figure 8).
What do both valves do/ prevent?
Diastole is the contraction of the atrium (ventricles filled with blood, ventricles relaxed).
Tricuspid (or right AV valve): if the right ventricle contracts, prevents flow back to the atrium (has to
go to the lungs)
Bicuspid (or left AV valve): same function as tricuspid, on the left side of the heart.
,Semilunar: when the heart relaxes and the blood falls back, it cannot go down. Damage to the
semilunar valve of the right ventricle would affect blood flow to the pulmonary trunk.
- SA node (pacemaker): between crista terminalis and vena cava in right atrium, gives
electrical single to atria and AV node.
- AV node: delays signal from SA a bit to allow for filling of the ventricle than gives it to the
bundle of hiss and the rest of the heart.
- Bundle of His and purkinje fibers: spread the wave impulses along the ventricles, causing
them to contract.
Papillary muscles ensure that the cusps or the tricuspid valve close properly and do not prolapse
into the right atrium.
Where are the points of auscultation of the heart valves?
Bicuspid valve: at the point of the apex (left 5 th intercostal space, midclavicular line).
Tricuspid valve: right 5th intercostal space parasternal.
Pulmonary trunk: right 2th intercostal space parasternal. Splits same as aortic.
Aortic valve: left 2th intercostal space parasternal.
PART 3
The heart starts to develop around 2-3 weeks after fertilisation.
There is no blood flow to the lungs needed yet.
Forming primitive heart
1. Looping: atrium migrates from caudal to cranial
2. Rotation: right atrium and ventricle rotate to ventral (left more posterior)
Dextrocardia: the heart is on the right side (looped to the wrong side).
Septum primum
- foramen primum
- foramen secundum
Septum secundum
- foramen ovale
Tetralogy of Fallot (EXAM QUESTION): pulmonary stenosis – VSD – overriding aorta – enlarged RV.
Stenosis = narrowing.
, Understand the remodelling Sinus venosus: the brachiocephalic veins fuse, umbilical veins
disappear, and the coronary sinus and pulmonary veins develop.
How did the smooth walled atrium develop? EXAM QUESTION
Trabeculated smooth walled part of the atrium (left/right)
Trabeculated part of the right atrium: comes from the primitive atrium
Smooth walled part of the right atrium: incorporation of the sinus venosus in the atrial wall
Trabeculated part of the left atrium: comes from the primitive atrium
Smooth walled part of the left atrium: incorporation of the pulmonary veins in the atrial
wall
Artery away from heart to organs (usually oxygenated), and from vein to heart (usually
deoxygenated). Blood flows from right atrium (RA) to left atrium (LA).
Blood flow before birth: umbilical vein1 > umbilicus > bypasses the liver through the ductus
venosus2 > inferior vena cava (purple) > right atrium > left atrium through the foramen ovale3 (and
right ventricle: pulmonary artery > cross over lungs through ductus arteriosus4 > leaves body
through the umbilical arteries5 > umbilicus > placenta).
After labour (pressure in left atrium suddenly gets really high)
umbilical vein > round ligament of the liver
ductus venosus > ligamentum venosum
- a shunt that allows oxygenated blood in the umbilical vein to bypass the liver.
Connects the umbilical veins with the inferior vena cava.
foramen ovale > oval fossa
- shunts blood from the right atrium to the left atrium.
ductus arteriosus (Botalli) > ligamentum arteriosum
- connects the aorta and the pulmonary artery.
umbilical arteries > medial umbilical ligaments.
Know the process of segmentation of the atria and ventricles and name all components
Understand the origin of the mentioned congenital heart defects and their characteristics
Study questions:
Why are membranous VSDs most common of all heart defects?
