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samenvatting anatomie van hart

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samenvatting van de anatomie van het hart

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  • May 7, 2024
  • 5
  • 2022/2023
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ANATOMIE HART




STERNUM

 3 delen : manubrium, corpus & xyphoid
 Insnoeringen voor ribben
 Sternotomie: Pijn borst maar ook rug -> ribben worden gespreid
 Na operatie vastmaken met ijzerdraad



ARTERIA MAMMARIA

 Meest gebruikte greffe
 afkomstig van subclavia -> sternumrand -> a. epigastrica & musculphrenicus takken


BLOEDFLOW

1) veneus bloed lichaam naar vena cava superior & inferior
2) rechter atrium
3) tricuspidalis klep
4) rechter ventrikel
5) pulmonalis klep
6) arteria pulmonalis -> longen
7) vena pulmonalis
8) linker atrium
9) mitralisklep
10) linker ventrikel
11) aortaklep
12) aorta

! linker atria is zeer moeilijk toegankelijk

 langs rechterkamer -> door sternum -> linker atria
 langs aorta -> aortaklep & mitralisklep (veel tegenstroming)

druk meten in verschillende kamers

 via vena jugularis -> vena cava superior -> rechter atrium -> opblazen katheder -> volgen
flow



RECHTERATRIUM

Klep van eustachius aan vena cava inferior

Klep van thebesius aan sinus coronarius

, KLINISCH BELANG RECHTER ATRIUM

 meting CVD (centraal veneuze druk)
 plaatsing atriale pacemaker lead
 sinusknoop -> geeft ritme aan
 atrium septum defect (ASD) -> congentiaal (links-rechts shunt)
 thrombus, longembolen door diep veneuze thrombose (DVT)

ASD

- secundum ASD midden in atrium septum
- primum ASD zijkant septum
- SVC sinus venosus ASD gelegen bij superior vena cava
- IVC sinus venosus ASD gelegen bij inferior vena cava



! steekwonden in borst -> vaak in rechterventrikel !



Ventrikel septum defect (VSD) is congenitaal & ventrikel septum defect ruptuur (VRS) is postinfarct



KLINISCH BELANG LINKER ATRIUM

 Thrombusvorming in linker hartoor
 Oorsprongen voor VKF (voorkamerfibrilatie)
 Dilatatie bij mitralisklepinsufficiëntie
 Chirurgische toegang tot mitralisklep -> hechtingen in linkeratrium zijn instabiel


KLINISCH BELANG LINKERVENTRIKEL

 3 x gespierder dan RV
 Meer conische vorm
 Pomt tegen hoge weerstand
 Ischemie
 Infarct, aneurysma
 Hartfalen
 Klepafwijkingen


TRICUSPIDALISKLEP

- 3 driehoekige klepblaadjes (anterior (infundibulair), posterior (marginaal), mediaal (septaal))
- Verbonden met anulus
- Verbonden aan papilairspieren met chordae tendineae
- Gelegen naar bundel van His met AV noduw
- Veel voorkomend is tricuspidalisklep insufficinetie door dilatatie anulus & RV
- Congenitale afwijking: ebstein anomalie (grootte atrium > ventrikel) & AV kanaal

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