00:01
Finally, the literal heart of
the course, the heart itself.
00:06
We're going to start with
a nice anterior view,
with the pericardium removed,
we're always going to keep in mind
that the heart doesn't
just look like this
when it's sitting in the chest,
it's covered by that pericardium.
00:18
So we can actually see,
the pericardium has been cut here,
as a reminder that it
doesn't look like this.
00:25
We see the superior vena cava,
the inferior vena cava,
and what they're attaching to
is the first part of the heart,
the right atrium.
00:35
The right atrium is going to
lead into the right ventricle,
and eventually pump out the
pulmonary artery out to the lungs.
00:43
You'll notice from an anterior
point of view, though,
we don't see as
much left ventricle.
00:48
That's because the heart is not
only a little bit off to the left,
but it's also rotated a little
bit so that it points to the left,
so that from an
anterior point of view,
you see a lot more of the
right heart than you do the left.
01:01
Regardless, we can make out there's
a little bit of a line here,
there's a little bit of fat,
and that's actually
our external marker for
something called the
interventricular septum,
or the border between
the two ventricles.
01:15
This point at the inferior portion
of these ventricles
is called the cardiac apex.
01:21
And the cardiac apex, again,
doesn't just point straight down,
it's sort of points down
or inferior into to the left.
01:29
And the left ventricle is going
to pump out the ascending aorta,
which is going to arch and
eventually become a descending aorta
as it heads down
towards the abdomen.
01:41
And before it does that,
it's going to give those branches
we just mentioned.
01:44
The brachiocephalic trunk,
and then directly off
of the aortic arch
is the left common carotid
and the left subclavian arteries.
01:54
If we swing around to not exactly
posterior, not exactly inferior,
sort of posterior inferior view,
we're going to see
some of the stuff
we really couldn't see from
the anterior view.
02:06
We again can still see
the superior vena cava
and the inferior vena cava
and the right atrium for reference.
02:13
But now we can actually see
a little bit of those branches
of the pulmonary.
02:17
We see the left pulmonary artery
and the right pulmonary artery.
02:21
We also can now see
the pulmonary veins,
these are very
posterior structures.
02:26
You see them
on the left and the right.
02:28
They're both feeding
into the left atrium,
which is really the most posterior
of all of these structures.
02:35
And we can see a lot more
of our left ventricle finally.
02:39
Again, the cardiac apex is
pointing down into the left.
02:43
And here we can see the aortic arch
as it was disappearing out
of our anterior view
as it's coming posteriorly
and starting to turn downward
as a descending aorta.
02:57
Now let's take a look at the
internal structure of the heart.
03:01
Starting with the right atrium.
03:04
So what we've done here
is cut a little flap
so we can see the inner workings.
03:09
We have the superior vena cava,
and the inferior vena cava
draining into this right atrium
with their deoxygenated blood.
03:17
But there's a third source
of deoxygenated blood
entering the right atrium,
something called
the coronary sinus.
03:24
And the coronary sinus is
essentially where
the venous drainage
of the hearts own veins
enter the heart.
03:32
Here there's a little bit
of the tricuspid valve
that's going to separate our right
atrium from our right ventricle.
03:39
And our right ventricle
we can't quite see yet
but we know it's going
to be a little bit more
anterior and inferior
than our atrium.
03:47
And it's going to pump out
the pulmonary artery.
03:51
So let's take a look inside
that right ventricle.
03:55
We have the blood coming
in from the right atrium
through the tricuspid valve.
04:01
And these cusps, there's three
of them, as the name implies,
are attached to the heart
via these tenderness cords
appropriately called
chordae tendineae
any that attached to
finger like muscles
on the right ventricle wall
called papillary muscles.
04:17
And just like there's
a tricuspid valve
we have three papillary muscles.
04:22
One anteriorly, posteriorly,
and one septal
are located along the septum
between the two ventricles.
04:30
And this is the
interventricular septum here
and if we were to poke
our finger through
or in congenital heart disease turn
how the ventricular septal defect,
we would end up directly into
the left ventricle chamber.
04:43
The outflow of the right ventricle
is through the pulmonic valve
into the pulmonary artery
and out into the lungs.
04:52
And here we see the
aortic arch branching over
that right branch of the pulmonary
artery that we just can't see.
05:01
Now, let's switch around
to the left side,
and look at the left
atrium and ventricles.
05:07
So here we see the pulmonary veins
entering into the left atrium
after having just got
oxygenated blood from the lungs.
05:14
And here we have a mitral valve,
it looks similar
to the tricuspid valve,
except instead of three cups,
we have two.
05:22
We still have chordae tendineae,
and we still have
papillary muscles,
but we only have two -
the anterior and posterior sides.