Class notes
Gross anatomy of the heart
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Lecture notes of 15 pages for the course Medicine at QUB (Anatomy)
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HEART GROSS ANATOMYThe pericardium 3layered sac surrounding the heart
Fibrous pericardium
Parietal serous pericardium
pericardial sac
Visceral serous layer epicardium
Endocardium myocardium
Fibrous l
serous 2
Penicardi visceral epicardium 3
myocardium4
Endocardium 5
HEART CHAMBER
Fibrous pericardium outermost Tough prevents
over expansion of the heart Attached to the sternum
diaphragm and great vessels
Parietal serous pericardium Lines internal surface
of fibrous pericardium
Visceral serous pericardium Epicardium Lines the
heart contains fat 1 vessels
Parietal and visceral layers are continuous and enclose
a sac Cpericardial with pericardial fluid to
cavity
reduce friction
, In the clinic examples
Pericarditis A inflammatory condition of the
pericardium Common causes are viral and bacterial
infections systemic illness and M l
It must be distinguished from M 1 as treatment and
prognosis are different In both Mls and pericarditis
patients complain of central chest pain which may
radiate to one or both arms However only in pericarditis
pain may be relieved bysitting forward An ECG can
distinguish them both
Pericardial effusion Normally only a tiny amount of
fluid is present between visceral and parietal layers
In certain situations the space can be filled with excess
fluid pericardial effusion
Because the fibrous layer is relatively fixed it
can not expand
easily a rapid accumulation of fluid
within the pericardial sac compresses the heart cardiac
tamponade resulting bi ventricular failure Removing
the fluid with a needle will give relief pericardioscentesis
Constrictive pericarditis Abnormal thickening of the
pericardial sac can compress the heart in
resulting
heart failure The diagnosis is made byinspecting
the JVP Normally it drops an inspiration but in CP
the reverse happens C Kuss ma l s
sign Treatment normally
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