Lecture notes
Cardiology anatomy
- Module
- Cardiology anatomy
- Institution
- Newcastle University (NCL)
This gives a detailed description of cardiology anatomy
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Cardiac anatomyMediastinum is the central compartment of the thoracic cavity. It is covered on each side by
mediastinal pleura. It is a highly mobile region.
The superior mediastinum extends from rib 1 to the sternal angle (T4-T5). It contains:
Superior vena cava
Brachiocephalic veins
Aortic arch
Thoracic duct
Trachea
Oesophagus
Thymus
Vagus nerves
Left recurrent laryngeal nerve
Phrenic nerves
The inferior mediastinum extends from the sternal angle to the diaphragm. It is divided into the
anterior, middle and posterior mediastinum. The inferior mediastinum altogether contains:
Anterior
o Thymus
o Lymph nodes
o Fat and connective tissue
Middle
o Pericardial sac
o Heart
o Roots of great vessels
o Ascending aorta
o Arch of azygous vein
o Main bronchi
Posterior
o Oesophagus
o Thoracic duct
o Azygous and hemi-azygous veins
o Thoracic duct
o Vagus nerves
o Sympathetic trunks
o Splanchnic nerves
The inferior vena cava enters at T8 along with the phrenic nerve. The oesophagus enters at T10 with
the vagus nerve. The aorta enters at T12 along with the thoracic duct and the azygous vein.
Pericardium
This is a double walled fibrous membrane that encloses the heart and the great vessels. The
pericardial sac lies posterior to the body of the sternum, from the 2 nd to the 6th costal cartilages and
the level of T5-T8 vertebrae. The tough external fibrous layer is continuous with the central tendon
of the diaphragm.
, Running outside of the heart is the fibrous pericardium. It is attached to the great vessels, the central
tendon of the diaphragm and the sternum. The internal pericardium is made up of the parietal layer
and the visceral layer – this is the serous pericardium. In between these layers, there is a potential
for cardiac tamponade. The visceral layer runs along the heart while the parietal layer is along the
outside. The fibrous pericardium protects the heart against sudden overfilling. The pericardial cavity
contains serous fluid which enables the heart to move and beat in a frictionless environment.
Layers of heart
The heart is made up of the epicardium, the myocardium and the endocardium. The visceral layer of
the serous pericardium comprises the epicardium.
Order of layers from inside to outside:
Endocardium
Myocardium
Epicardium (serous pericardium - visceral layer)
Pericardial cavity
Serous pericardium (parietal layer)
Fibrous pericardium
The myocardium contains intercalated discs and cardiac muscle fibres to allow the muscle to
contract.
The endocardium lines the inside of the heart and the valves.
Supply to the pericardium
Arterial supply to epicardium (visceral layer):
Pericardiacophrenic artery
Coronary artery
Venous drainage:
Pericardiacophrenic veins
Internal thoracic veins
Nerve supply:
Phrenic nerves (C3-C5) primarily. The pain sensations we feel are produced by the phrenic
nerves and commonly referred to the skin (C3-C5 dermatomes) particularly the ipsilateral
shoulder region.
Vagus nerves
Sympathetic trunks
Direction of blood
The valves attach to the walls of the heart muscle by chordae tendineae.
Atrioventricular valves:
Mitral (bicuspid)
Tricuspid
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