心臟解剖PPT演示課件

心臟解剖&心臟傳導系統(tǒng)位置位于縱隔腔內(nèi)左右肺之間2/3在中線左側(cè)方向：右后上－左前下MidLine概述：心房為薄壁，低壓心腔左右心房以房間隔分隔導管從右心房到左心房，需行房間隔穿刺術(shù)，經(jīng)卵圓窩通路進入左心房右心房：在右心室收縮期充盈接受來自于SVC，IVC，CS的血液靜脈血右心房IVC右心房IVC右心房IVCTricuspidValveAnnulus(TVA)IVCRightAuricle(or)RightAtrialAppendageIVC柯氏三角點CS竇口His束邊緣Todaro氏腱三尖瓣環(huán)IVC左心房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肺靜脈心室概述左右心室間以室間隔相隔分流入道和流出道左心室

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接受來自右心房的血液將血液泵入肺動脈Viewedfromabove左右心室橫截面右心室心壁結(jié)構(gòu)心外膜最外層Outermostlayer薄層，漿膜Thin,serousmembrane心肌層Myocardium中層Middlelayer工作心肌Workingmuscleofheart心內(nèi)膜Endocardium最內(nèi)層InnermostlayerLinesmyocardium心包Pericardium心包腔PericardialSac內(nèi)含少量漿膜液Smallamountofliquid纖維骨架纖維骨架分離心房和心室為心臟瓣膜提供框架心臟瓣膜(房室瓣)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心室壓力低于心房壓力時，房室瓣開放心臟收縮期

心臟瓣膜心臟瓣膜心臟舒張期心臟瓣膜（半月瓣）肺動脈瓣：連接RV與PA主動脈瓣：連接LV與AoPulmonicValveAorticValve心臟瓣膜在心動周期中的作用腱索與乳頭肌腱索腱索連接房室瓣和乳頭肌乳頭肌發(fā)自心內(nèi)膜,連接于腱索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系統(tǒng)

ConductionSystem心臟傳導系統(tǒng)組成竇房結(jié)（SANode）Theheart’smainPacemakerLocatednearjunctionofRAandSVCBachman’sBundleconductsactivationfromSAnodetoLA結(jié)間束（InternodalTracts）ConductsactivationfromSAnodeacrossatria纖維骨架（FibrousSkeleton）

barriertoconductionfromatriatoventricles房室結(jié)房室結(jié)(AVnode)位于三尖瓣上方，CS開口前方激動從心房經(jīng)AV傳導到His束(bundleofHis)TrafficCopSecondarypacemakeroftheheartAVDelay的作用Iftheventriclescontractwhenthemitralandtricuspidvalvesareopen,bloodtendstogobackwardsinsteadofforwardsBydelayingit120to150milliseconds,thatallowstheatriatoemptyandthentheventriclestocontractagainstclosedvalves.希氏束希氏束（BundleHis）StartofVentricularConductionSystemConductsimpulsesthroughseptumtobundlebranchesNormallythesoleelectricalconnectionbetweenatriaandventricles束支（BundleBranches）DownSeptumWallTransmitsimpulsesfromthebundleofHistobothventricles浦氏纖維網(wǎng)（PurkinjeFibers）

SpecialcellsofconductionthroughouttheventriclesTertiarypacemakeroftheheart20-40bpmHis-PurkinjeSystemTheseareliketheAutobahn.SinusnodeandAVnodehavespeedlimitsofaboutabout25mphAtriumandventricularmuscleis70or75mphHis-PurkinjesystemisliketheAutobahnat150mph.ItallowsveryrapidconductiondowntotheapexoftheheartLargecellsandallowcontractiondowntotheapexsotheheartsqueezesapexbacktobase.心臟電傳導的組成SANodeInternodalTractsandBachman’sBundleAVNodeBundleofHisBundleBranchesPurkinjeFibersCardiacAnatomyQuizPleaseidentifythefollowinganatomicpoints.SANodeBachman’sBundleInternodalTractsAVNodeBundleofHisBundleBranchesPurkinjeFibers1.2.3.4.5.6.7.8.9.10.11.12.13.SuperiorVenaCavaOSofSuperiorVenaCavaRightAtriumOSofInferiorVenaCavaCoro