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General Surgery
Pericardium, Heart, and Great Vessels
Built from Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
What’s inside
16 sections · 198 slides
Overview
- Scope of this topic
Historical landmarks
- How cardiac anatomy and surgery advanced
- Anatomic and Surgical History of the Pericardium, Heart, and Great Vessels in the Thorax
- Anatomic and Surgical History of the Pericardium, Heart, and Great Vessels in the Thorax (continued)
- Anatomic and Surgical History of the Pericardium, Heart, and Great Vessels in the Thorax (continued)
- Anatomic and Surgical History of the Pericardium, Heart, and Great Vessels in the Thorax (continued)
- Anatomic and Surgical History of the Pericardium, Heart, and Great Vessels in the Thorax (continued)
- Anatomic and Surgical History of the Pericardium, Heart, and Great Vessels in the Thorax (continued)
Embryogenesis
- Origin of the cardiogenic area
- Formation of the heart tube
- Sequence of cardiac morphogenesis
- Dextral looping and the S-shaped heart
- Septation of the primitive heart
- Formation of the definitive atria
- Formation of the ventricles
- Double inlet and double outlet malformations
- Closure of the interventricular foramen
- Partitioning of the outflow tract
- Development of the venae cavae
- Persistence of the left supracardinal vein
- Development of the conduction system
Congenital anomalies
- Limits of classifying congenital heart disease
- Pathogenetic Classification of Congenital Cardiovascular Malformations
- Pathogenetic Classification of Congenital Cardiovascular Malformations (continued)
- Pathogenetic Classification of Congenital Cardiovascular Malformations (continued)
- Pathogenetic Classification of Congenital Cardiovascular Malformations (continued)
- Syndromic congenital heart disease
- Syndromes Featuring Congenital Heart Disease
- Syndromes Featuring Congenital Heart Disease (continued)
- Syndromes Featuring Congenital Heart Disease (continued)
- Syndromes Featuring Congenital Heart Disease (continued)
- Syndromes Featuring Congenital Heart Disease (continued)
- Syndromes Featuring Congenital Heart Disease (continued)
- Syndromes Featuring Congenital Heart Disease (continued)
- Syndromes Featuring Congenital Heart Disease (continued)
- Pericardial anomalies
- Anomalies of the Pericardium
- Congenital pericardial defects
- Congenital foramen of the left parietal pericardium
- Pericardial cysts and diverticula
- Groups of cardiac and great vessel anomalies
- Anomalies of the Aorta
- Anomalies of the Aorta (continued)
- Anomalies of the superior vena cava
- Left retro-aortic brachiocephalic vein
Pericardium
- Divisions of the mediastinum
- Divisions and contents of the mediastinum
- Pericardium and its relation to the heart
- Structure of the pericardial sac
- Layers of the pericardium
- Wall of the pericardium from outside in
- Oblique sinus of the pericardium
- Transverse sinus and its surgical use
- Pericardial sinuses with probes in place
- Pericardial fluid volume and compliance
- Superior and posterior relationships of the pericardium
- Shape, fixation and relations of the pericardial sac
- Blood supply of the pericardium
- Arteries, veins and lymphatics of the pericardium
- Pericardial malignancy
- Innervation of the parietal pericardium
Pericardial operations
- Indications for pericardiocentesis
- Malignant pericardial effusion
- Approaches for pericardiocentesis
- Pericardiotomy and pericardiectomy
- Postpericardiotomy syndrome
External topography of the heart
- Projection of the heart on the chest wall
- Valve projection and auscultation sites
- Weight of the adult heart
- Sternocostal surface and the great veins
- Anterior or sternocostal surface
- Anterior view of the intact heart
- Median sternotomy exposure
- Posterior aspect of the heart
- Posterior and diaphragmatic surfaces
- Posterior view of the intact heart
- Sulci of the heart
- Contents of the atrioventricular sulcus
- Interventricular sulcus and the crux
- Contents of the interventricular sulcus
Fibrous cardiac skeleton
- Primitive muscular spongework of the ventricles
- Skeleton of the heart
- Trigones and the conus tendon
- Valves, skeleton and the origins of the coronary arteries
- Electrical insulation of atria from ventricles
- The disputed tendon of the infundibulum
- Accessory bundles and pre-excitation
Chambers of the heart
- Right atrium: relations and function
- Crista terminalis and the two halves of the atrium
- Interior of the right atrium
- Fossa ovalis and probe patency
- Openings of the right atrium
- Coronary sinus and its tributaries
- Small venous openings of the right atrium
- Tendon of Todaro
- Right ventricle: relations and external features
- Interior of the right ventricle
- Moderator band and pseudotendons
- Papillary muscles of the right ventricle
- Tricuspid valve spread out
- The four valve orifices
- Pulmonary orifice
- Left atrium: relations and external features
- Interior of the left atrium
- Left ventricle: general features
- Surface separation of the ventricles
- Interior of the left ventricle
- Septal surface and pseudotendons of the left ventricle
- Mitral valve
- Aortic valve opened out
- Cusps, lunules and nodules
- Atrioventricular junction from the atrial aspect
Coronary circulation
- Origin of the coronary arteries from the aortic sinuses
- Coronary orifices and the sinutubular junction
- Right and left coronary orifices in the aortic sinuses
- Left coronary artery and its main branches
- Coronary branches within the myocardium
- Left circumflex artery
- Coronary dominance
- Two patterns of coronary dominance
- Right coronary artery
- Conus artery and the arterial circle of Vieussens
- Anomalies and variants of the coronary arteries
- Sinoatrial nodal artery
- Course, branches and anastomoses of the right coronary artery
Cardiac veins and lymphatics
- Cardiac veins
- Tributaries of the coronary sinus
- Anterior cardiac veins and cardiac lymphatics
Innervation of the heart
- Components of the cardiac conduction system
- Pathway of the cardiac impulse
- Internodal conduction: the debate
- The three internodal tracts
- Conduction system, tricuspid valve and the membranous septum
- Extrinsic innervation of the heart
- Cardiac nerves and plexuses
- Sympathetic and sensory fibres to the heart
- Functional components of the vagus nerve
- Autonomic nervous system and the cardiac plexus
- Cardiac plexuses
- Intrinsic cardiac neuronal network
Nodes, the crux and accessory pathways
- Sinoatrial node and its surroundings
- Blood supply and outflow of the sinoatrial node
- Atrioventricular node
- Arterial supply of the atrioventricular node
- U-turn of the right coronary artery at the crux
- The U-turn of James
- Dissected heart showing the U-turn and the posterior wall
- Knuckle of the artery in the fat of the crux
- Actual appearance of the arteries at the crux
- True origins of the arteries and the U-turn
- Triangle of Koch
- Atrioventricular bundle and its branches
- Left bundle branch and Purkinje fibres
- Sites of accessory conduction pathways
Great vessels in the thorax
- Pulmonary trunk
- Bifurcation of the pulmonary trunk and the ductus
- Pulmonary embolectomy
- Thoracic aorta and the plane of the sternal angle
- Familial thoracic aortic aneurysm
- Superior vena cava
- Superior vena cava syndrome
- Inferior vena cava and the pulmonary veins in the thorax
- Histology of the heart wall
- The cardiac myocyte at work
Surgical approaches
- Approaches to the right side of the heart
- Approaches to the left side of the heart
- Surgical applications of the coronary circulation
- Angioplasty, minimally invasive bypass and transplantation
Anatomic complications
- Blunt cardiac trauma
- Planning cardiac surgery from diagnostic studies
- Complications of pericardial procedures
- Exposure of the subclavian and axillary vessels
- Subclavian artery exposure through a clavicular incision
- Exposure of the aortic arch and proximal left subclavian artery
- Complications of median sternotomy
- Thoracotomy, cardiac and great vessel complications
- Points to carry away
- References
- References (continued)
- References (continued)
- References (continued)
- Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
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