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1、心脏解剖及心脏传导系统医学课件,位置,位于纵隔腔内左右肺之间2/3 在中线左侧方向：右后上左前下,Mid Line,概述：心房为薄壁，低压心腔左右心房以房间隔分隔导管从右心房到左心房，需行房间隔穿刺术，经卵圆窝通路进入左心房右心房：在右心室收缩期充盈接受来自于SVC，IVC，CS的血液 静脉血,右心房,IVC,右心房,IVC,Superior Vena Cava,Inferior Vena Cava,Coronary Sinus,右心房,IVC,IVC,IVC,Crista Terminalis,Tendon of Todaro,Eustachian Ridge,柯氏三角,点CS窦口His 束
2、边缘Todaro氏腱三尖瓣环,IVC,Fossa Ovalis,左心房,左心房在左心室收缩期充盈接受来自肺静脉的血液动脉血,肺静脉,Right Superior,Right Inferior,Left Superior,Left Inferior,Left Atrial Appendage,Great Cardiac Vein Coronary Sinus,心室,概述左右心室间以室间隔相隔分流入道和流出道左心室 接受来自左心房的血液将血液泵入主动脉(Ao)，至全身组织左心室室壁厚于右心室右心室接受来自右心房的血液将血液泵入肺动脉,Viewed from above,左右心室横截面,右心室,Tr
3、icuspid Valve,Right Ventricular Outflow Tract(RVOT),Pulmonic Valve,Moderator Band,Bicuspid/Mitral Valve,Aortic Valve,心壁结构,心外膜最外层Outermost layer薄层，浆膜Thin,serous membrane心肌层Myocardium中层Middle layer工作心肌Working muscle of heart心内膜Endocardium最内层Innermost layerLines myocardium心包Pericardium心包腔Pericardial Sa
4、c内含少量浆膜液Small amount of liquid,纤维骨架,纤维骨架分离心房和心室为心脏瓣膜提供框架,心脏瓣膜(房室瓣),只允许血液从心房单向流向心室三尖瓣连接 RA 和 RV二尖瓣连接 LA和 LV心室压力低于心房压力时，房室瓣开放,心脏收缩期,心脏瓣膜,心脏瓣膜,心脏舒张期,心脏瓣膜（半月瓣）,肺动脉瓣：连接RV与PA主动脉瓣：连接LV 与 Ao,Pulmonic Valve,Aortic Valve,心脏瓣膜在心动周期中的作用,腱索与乳头肌,腱索腱索连接房室瓣和乳头肌乳头肌发自心内膜,连接于腱索作用心室收缩迫使房室瓣关闭乳头肌收缩引起腱索紧张预防血液从动脉逆向回流至心室,心脏
5、传导系统 Conduction System,心脏传导系统组成,窦房结（SA Node）The hearts main PacemakerLocated near junction of RA and SVCBachmans Bundle conducts activation from SA node to LA结间束（Internodal Tracts）Conducts activation from SA node across atria 纤维骨架（Fibrous Skeleton）barrier to conduction from atria to ventricles,房室结,房
6、室结(AV node)位于三尖瓣上方，CS开口前方激动从心房经AV 传导到His 束(bundle of His)Traffic CopSecondary pacemaker of the heart,AV Delay 的作用,If the ventricles contract when the mitral and tricuspid valves are open,blood tends to go backwards instead of forwardsBy delaying it 120 to 150 milliseconds,that allows the atria to em
7、pty and then the ventricles to contract against closed valves.,希氏束,希氏束（Bundle His）Start of Ventricular Conduction SystemConducts impulses through septum to bundle branchesNormally the sole electrical connection between atria and ventricles,束支（Bundle Branches）Down Septum WallTransmits impulses from t
8、he bundle of His to both ventricles浦氏纤维网（Purkinje Fibers）Special cells of conduction throughout the ventriclesTertiary pacemaker of the heart20-40 bpm,His-Purkinje System,These are like the Autobahn.Sinus node and AV node have speed limits of about about 25 mphAtrium and ventricular muscle is 70 or
9、75 mphHis-Purkinje system is like the Autobahn at 150 mph.It allows very rapid conduction down to the apex of the heartLarge cells and allow contraction down to the apex so the heart squeezes apex back to base.,心脏电传导的组成,SA NodeInternodal Tracts and Bachmans BundleAV NodeBundle of HisBundle BranchesP
10、urkinje Fibers,Cardiac Anatomy QuizPlease identify the following anatomic points.,SA Node,Bachmans Bundle,Internodal Tracts,AV Node,Bundle of His,Bundle Branches,Purkinje Fibers,1.2.3.4.5.6.7.8.9.10.11.12.13.,Superior Vena Cava,OS of Superior Vena Cava,Right Atrium,OS of Inferior Vena Cava,Coronary Sinus,Inferior Vena Cava,Tricuspid Valve,Right Ventricle,Intraatrial Septum,Intraventricular Septum,Left Atrium,Mitral Valve,Left Ventricle,Review,
