sheet no.29

*Blood from right atrium pass through tricuspid valve to the right ventricle .

Right ventricle:
-form:
1- ant. Surface of the heart.
2- inf. Surface of the heart.
3- inf. Border of the heart.

-it receives blood through tricuspid valve then it pumps it to the lungs through pulmonary valve via pulmonary trunk.

-it divides into rough & smooth parts.

Rough part (ant.):

-consists of :

1- trabeculae carnea:

- it means network of trabeculae like carination arbitrarily
(i.e. they aren’t parallel to each other nor vertical to each other).
-they are a network of trabeculae of myocardium bulging into the cavity of the right ventricle, so as the heart should work as one
unit ( we call this syncytium = unisome = 1 unit).
-when the heart receives the impulse (or the pulse) from S.A.
nodes it should work as one unit .
-All of heart chambers are working at the same time (synchronously) , i.e., if one is working the other should work too,
if one is relaxing the other is contracting & if one is pumping the other is receiving. So heart won't stop working unless a person
dies.

2- papillary muscles:

-papilla like = nipple .
-their bases are projecting from the wall.
-their apexes are in the cavity.
*in other words papillary muscles are attached by their bases to
the wall & their apexes are swimming in the cavity.
-extending from papillary muscles cord like tendons called corda tendinea
.
3-corda tendinea:

Which attached to the free margin of the cusps of the valves.
*papillary muscles receive the impulse before the wall of the ventricle to contract before the contraction of the ventricle's
wall, so by the time the wall of the ventricle contracts, cusps should be approximated tightly to each other to prevent regurgitation (return back) of blood from ventricle to atrium, otherwise the valve or the papillary muscles or the corda tendinea or the wall are syndromes (defected).
-sometimes we hear that there’s a problem in the muscles of the heart which we call myopathy.

-it’s like a parachute man:

1-the man is the papillary muscle.
2-the parachute is cusps.
3-the ropes of parachute are the corda tendinea.
-if the cusps are defected(perforated), blood will return back and we will have valve stenosis or incompetent valve.

Smooth part(post.):

-called infundibulum or (conus arteriosus) .
-at the right side the smooth part is post. & the rough is ant.
-the only smooth part in the right ventricle is infundibulum.
-the coming blood is called inflow.
-the out coming blood is called outflow.
-the inflow should reach the rough part which is rocks like, so as the wall of the heart won’t bulge from that stream
-the splashes of blood which is coming should be spread (so rough part).
-but we need the outflow to be directed toward a tube that is why it’s directed that way (so smooth part).
-e.g: the body of the dam facing water always made of rocks
(rough part), not sands (smooth part) to work as shock absorber
& distributing the strength & power.

[THE INFLOW IS ROUGH, THE OUTFLOW IS SMOOTH]

LEFT ATRIUM:

-forming the base of the heart.
-receives oxygenated blood from both lungs via 4 pulmonary veins, then send it to the left ventricle via bicuspid valve (mitral valve).
-left & right auricles (auricle = dog ear) are the reserve part of the atrium & it is rough, it’s like the attic of the room, so if the blood flow increased in the room it will go to the attic.

Atrium ----> is the main chamber.

Auricle ----> is the attic.



LEFT VENTRICLE:

-main chamber of the heart.
-forming: apex, left border & share in the inf. Surface.
-the thickness of the wall is ~ 3x than right ventricle, so the blood pressure in the left is 6x than the right ventricle.
- the cavity(lumen) is circular, pushing the interventricular septum (IVS) towards the right.
*we can diagnose the right & left ventricles when we look to the computerized tomography (C.T) from the difference of their walls & cavities.
-right ventricle is 1/3 thickness, 1/6 blood pressure (B.P) & the lumen is crescent in shape.
-the inflow part of the right ventricle is rough containing same as right, but they are more powerful, larger (mega size) than the
right, because it is the main chamber so the left ventricle has :

1-trabecula carneae.
2-papillary muscle.
3-corda tendinae.
-the smooth part is called (aortic vestibule) which represents the outflow part.
-blood’s flow:



Left atrium ---->bicuspid valve
left ventricle (return back to) aortic vestibule ----> aorta.

-The current which enters the left ventricle comes towards the apex, so it has the max. heart beat.

-atrial side (the 2 atrii) separated from ventricle side by the atrioventricular septum (A.V.S) from inside, where, valves of the heart are built.(and this is the place where we put the artificial valves on the septum)

-from outside atria are separated from ventricles by coronary sulcus containing (transversing/transmitting) coronary arteries right & left.


I WANT TO DIDICATE THIS SHEET TO ALL MY FRIENDS SPICIALLY:
NAJD, RASHA, LARA , RUBA ,LAMA, SAWSAN, SONDOS, RAWAN, DO3A2, AYA, ALA2 7JAZEE, 2S7AR, DEENA, ALA2 7LAISEE, BAYAN, DO3A2 ALJARRA7, AMAL, MAJD, RUBA HALASE.
قل للطبيب تخطفه يد الردى ياشافي الأسقام من أرداك
قل للمريض نجا
Little addition to sheet 28: apex is located in the left 5th intercostal space>> ♦