Oleh

Dr Regina M Hutasoit M Kes

Departemen anatomi
Fakultas Kedokteran
Universitas Nusa Cendana
2019

ANATOMI CARDIOVASKULER
(BLOK CARDIO)
SURFACE ANATOMY
 INCISURA JUGULARIS
STERNI
 ANGULUS STERNI
LOUISI/ludovici
 PROCESSUS
XIPHOIDEUS
 Patokan Angulus
Sterni (Costa II)

2
PROYEKSI LETAK JANTUNG

 Tepi kiri-cranial berada

pd tepi caudal pars
cartilaginis costa II sin,
di lateral tepi sternum
 Tepi kiri-caudal berada
pd ruang intercostalis 5,
kira-kira 9 cm di kiri
linea mediana atau 2
cm di medial linea
medioclavicularis
 Tepi kanan-cranial
berada pd tepi cranialis
pars cartilaginis costa III,
1 cm dari tepi lateral
sternum
 Tepi kanan-caudal
berada pd tepi cranial
pars cartilaginis costa VI,
1 cm di lateral tepi
sternum
PERKUSI JANTUNG

 Percussion is performed at the 3rd, 4th, and

5th intercostal spaces from the left anterior
axillary line to the right anterior axillary line (Fig.
B1.17)
Auskultasi area
MEDIASTINUM: CENTRAL COMPARTEMENT OF THE
THORACIC CAVITY
 berisi jantung, aorta, dan
arteri besar, pembuluh
darah vena besar, trakea,
kelenjar timus, saraf,
jaringan ikat, kelenjar getah
bening dan salurannya

Terdiri dari
1.Mediastinum Superior
2.Mediastinum Inferior :
 MEDIASTINUM ANTERIUS
 MEDIASTINUM MEDIUM
 MEDIASTINUM POSTERIUS
This vertical movement of mediastinal structures must be
considered during physical and radiological examinations in
the erect and supine positions..
LAPISAN STRUKTUR JANTUNG
1.PERICARDIUM, tdd:
-lapisan Fibrosa
-lapisan Serosa ; parietal dan
viseral
---pericardial cavity
2.MYOCARDIUM
3.ENDOCARDIUM
MORFOLOGI JANTUNG

UKURAN :
P = 12 cm ,
L = 8 – 9 cm,
Tebal = 6 cm
BASIS CORDIS
 Dibentuk oleh : ATRIUM
SINISTRUM + ATRIUM DEXTRUM
+ bag.prox.PEMBULUH DRH
BESAR

 Setinggi vertebrae T6-T9

dipisahkan olehpericardium,
oblique pericardial sinus,
esophagus, and aorta.

 BATAS :
 Superior = bifurcatio
a.pulmonalis
 Inferior = sulcus coronarius
 Dexter = sulcus terminalis
 Sinister = v.obliqua atrii sinistri
APEX CORDIS
 Dibentuk oleh inferolateral
VENTRICULUS SINISTER (L)
 Letak caudo-ventral sinister
 Ruang intercostal 5 sinister
 Kira-kira 9 cm dari Linea
mediana atau 2 jari di medial
linea medioclavicularis sinister

 Remains motionless
throughout the cardiac
cycle.
 Is where the sounds of
mitral valve closure are
maximal (apex beat
COR IN SITU
The four surfaces of the heart :
1.Anterior (sternocostal) surface,
formed mainly by the right
ventricle.
2.Diaphragmatic( inferior) surface,
formed mainly by the left
ventricle and partly by the right
ventricle; it is related mainly to
the central tendon of the
diaphragm.
3.Right pulmonary surface, formed
mainly by the right atrium.
4.Left pulmonary surface, formed
mainly by the left ventricle; it
forms the cardiac impression of
the left lung
ATRIUM KANAN (ATRIA DEXTRA)

-Dinding anterior kasar---

MM.PECTINATI
-Dinding posterior lebih
halus---tdpt fosa ovale
mrpkan intraatrial
septum, asal dari sinus
venosus
Dipisahkan oleh sulcus
terminalis dan crista
terminalis
 MUARA dari :
1.VENA CAVA SUPERIOR
(tdk berkatup)---at the right 3rd costal
2.VENA CAVA INFERIOR–
the 5th costal cartilage ( has a rudimenter valve)
3. SINUS CORONARIUS : dari vena vena cordis- is
between the right AV orifice and the IVC orifice.
Foramen Ovale :
has a flap-like valve that permits a right to left shunt of
blood but prevents a left to right shunt. closed oval
foramen is represented in the postnatal interatrial
septum by the depressed oval fossa.
----ASD (atrial septal defect)
VENTRIKEL KANAN

 the largest part of the

anterior surface of the
heart
 almost the entire inferior
border of the heart
 The interior of the right
ventricle has irregular
muscular elevations
(trabeculae carnae).
 Thick interior wall
Orificium AV(tricuspid
valve)
located :
-inferior dan posterior
-post manubrium sterni
-the level of the 4th and
5th intercostal spaces.

Katup tricuspid: The pulmonary valve at the apex of

the conus arteriosus is at the level of
Chordae tendinae the left 3rd costal cartilage. The
(mm.Papilaris) attach to semilunar valves.
free edge and ventrikel
surface anterior
posterior and septal.
ATRIUM KIRI (L)
4.An interatrial septum that
Karakteristik
slopes posteriorly and to
1.A larger smooth-walled the right.
part and a smaller
5.A left AV orifice (mitral
muscular auricle
valve)
containing pectinate
muscles.
2.Four pulmonary veins (two
superior and two inferior)
entering its smooth
posterior wall
3.A slightly thicker wall than
that of the right atrium.
-Pembentuk basis cordis
-Muara V.PULMONALIS
DEXT et SIN yang tidak
berkatup
VENTRIKEL KIRI (L)
Karakteristik :
 Tebal 2-3x Ventrikel kanan
 Dindingnya dipenuhi oleh
trabecula carneae lebih
banyak dibanding ventrikel
kanan.
 Bentuknya lebih seperti
conus dibanding ventrikel
kanan.
 Katup mitral
 An aortic orifice that lies in
its right posterosuperior
 the ascending aorta begins
at the aortic orifice.
Mitral valve is located posterior
to the sternum at the level
of the 4th costal cartilage.

 Each of its cusps receives

tendinous cords from more
than one papillary muscle.
The semilunar aortic valve,
 MEMBENTUK APEX CORDIS between the left
DAN FACIES DIAFRAGMA ventricle and the
ascending aorta, is
obliquely placed
At the level of the 3rd
intercostal space.
KATUP KATUP JANTUNG
 “Tricuspid” valve
 RA to RV
 Pulmonary or pulmonic
valve
 RV to pulmonary trunk
(branches R and L)
 Mitral valve (the
bicuspid one)
 LA to LV
 Aortic valve
 LV to aorta
 NODUS SINUATRIALIS SA NODE
 PACE MAKER
 Berada pada ujung cranial sulcus terminalis, di antero-
lateral muara vena cava superior pd atrium dextrum
 Suplai darah dari a.coronaria dextra
 Diinnervasi oleh N.vagus dexter

27
 NODUS ATRIOVENTRICULARIS
AV NODE
 Berada pada septum atriorum, di cranialis muara
sinus coronarius
 Suplai darah dari a.coronaria dextra
 Innervasi oleh N.vagus sinister

28
FASCICULUS ATRIOVENTRICULARIS
 CRUS DEXTER (RAMUS DEXTER) :
 Berada di kanan Septum ventriculorum,
menuju ke apex cordis, masuk ke moderator
band; mencapai dinding ventriculus dan
m.papillaris anterior
 Membentuk anyaman serabut Purkinje, di
dalam m.papillaris dan dinding ventriculus
dexter

29
 CRUS SINISTER (Ramus sinister) :
 1 – 3 berkas, berbentuk bulat atau datar
 Ke ventral menuju ke apex cordis

 M.papillaris

 Anyaman Purkinje pd lapisan

subendocardial

30
 INNERVASI C O R

SYMPATHIS :
 Ggl.paravertebrale Th.1 – 5

 Ggl.cervicale

PARASYMPATHIS : N.VAGUS
 R.cardiacus superius

 R.cardiacus inferius

 R.cardiothoracis

31
REFERRED PAIN
 Tidak sensitive touch, cutting,
cold, and heat;
 sensitif :ischemia dan sisa
metabolit ---nyeri pada miokard.

 afferent pain fibers run centrally

in the middle and inferior cervical
branches and especially in the
thoracic cardiac branches of the
sympathetic trunk.
 The axons of these primary
sensory neurons enter spinal cord
segments T1 through T4 or T5,
especially on the left side.
VASCULARISASI
Arteri coronaria cab ke 1 aorta
> A.CORONARIA DEXTRA
> A.CORONARIA SINISTRA

A.CORONARIA DEXTRA memperdarahi

 Sulcus atrioventricularis
 Sulcus coronarius, menuju ke Crux cordis
 R.marginalis, r.transversus,r.descendens posterior
 The right atrium.
 Most of right ventricle.
 Part of the left ventricle (the diaphragmatic surface).
 Part (usually the posterior third) of the IV septum.
 The SA node (in approximately 60% of people).
 The AV node (in approximately 80% of people).

33
A.CORONARIA SINISTRA
 Pendek
 Membentuk ramus descendens
anterior dan ramus circumflexus
 Kadang-kadang ada ramus medianus
 Sulcus longitudinalis anterior

 Memperdarahi:
-left atrium.
-Most of the left ventricle
-Part of the right ventricle.
-Most of the IVS (usually its anterior two thirds), including the AV
bundle of the conducting system of the heart, through its
perforating IV septal branches.
-The SA node (in approximately 40% of people).

34
CORONARY ARTERY
<1> Tipe Kanan, paling
banyak, dominan
a.coronaria dextra,
vascularisasi facies
posterior ventriculus dext
et sinister
<2> Tipe Simetris,
percabangan
r.descendens post tidak
melewati sulc.long.post
<3> Tipe Kiri, paling sedikit,
a.cor.dext hanya sampai
margo acutus
Lokasi infark
ALIRAN DARAH VENA

 SINUS CORONARIUS menerima darah dari:

 V.CARDIACA MAGNA>>

 V.CARDIACA MEDIA—frm RCA

 V.POSTERIOR VENTRICULI SINISTRI

 V.CARDIACA PARVA—frm RCA

 V.OBLIQUE ATRII SINISTRI (Marshalli)—sisa fetal

36
AORTA
 Ventriculus sinister
 Diameter 3 cm
 Ascendens, lalu kedorsal kiri
 Hiatus aorticus diaphragmatis

 AORTA ASCENDENS
 ARCUS AORTAE
 AORTA DESCENDENS (aorta thoracalis – aorta
abdominalis )

37
 a.Carotis communis sinistra

Arteri Anonyma
a.Subclavia sinistra
Arcus aorta
Aorta descendens
Aorta ascendens

a.Coronaria sinistra
a.Coronaria dextra
 AORTA ASCENDENS
 Panjang 5 cm
 Ditutupi oleh pericardium viscerale

 Berjalan oblique ke cranial, anterior, kanan

 Pangkal : sinus aorticus anterior, sinus aorticus

sinister dan sinus aorticus dexer

39
 ARCUS AORTA
 Tepi cranial artic.sternoclavucularis
1.Ascendens, dorsal
 Ventral trachea,
lalu ke kiri trachea
 Descendens di kiri
corpus vert.thor.
2.AORTA DESCENDENS
 Lig.arteriosum Botalli
 A.ANONYMA,
 A.CAROTIS COMMUNIS,
 A.SUBCLAVIA

40
 A.PULMONALIS
 Kelanjutan dari Conus arteriosus ventriculus
dexter
 Panjang 5 cm

 Ramus sinister dan Ramus dexter a.pulmonalis

 Ramus dexter, lebih besar dan lebih panjang

 Ramus sinister, pendek, kecil

41
 VENAE PULMONALIS
 4 buah
 Bermuara kedalam Atrium sinistrum

 V.pulmonalis dextra berada didorsal Atrium

dextrum, diantara v.cava superior dan vena
cava inferior
 V.pulmonalis sinistra berada dicaudal
a.pulmoalis

42
43
 CIRCULASI SISTEMIK
 ALIRAN DARAH
 ARTERI : dinding otot polos, berdenyut
 VENA : dinding tipis, valvula
 COR(ventricle sin.) – AORTA –
ARTERI – ARTERIOLE
– CAPILER – JARINGAN
 capiler – venule – vena – vena cava
superior et inferior-cor (Atrium dextra)
 VENTRICULUS SINISTER
Aorta ascendens – arcus aortae – aorta
descendens (= aorta thoracalis ) – aorta
abdominalis – arteria iliaca communis –
a.iliaca interna-a.ilica externa – a.femoralis –
a.poplitea – a.tibialis anterior – a.tibialis
posterior – a.dorsalis pedis
ALIRAN DARAH VENA :

 EXTREMITAS INFERIOR : vena saphena magna-

v.saphena parva – v.femoralis – v.iliaca – vena
cava inferior

 EXTREMITAS SUPERIOR : v.cephalica, v.ulnaris-

v.radialis – v.brachialis – v.axillaris-v.subclavia –
vena cava superior
 CIRCULASI PULMONAL
 ventriculus dexter
 arteria pulmonalis

 pulmo

 vena pulmonalis

 atrium sinistrum

 Pergantian Karbon dioksida dengan Oksigen (

darah – eritrosit )
 BASIC PATHWAY OF BLOOD
FLOW
SVC
Pulmonary
Right Tricuspid Right
Semilunar
Atrium Valve Ventricle
IVC Valve

Systemic Pulmonary
Capillaries Trunk

Aorta Pulmonary
Arteries

Aortic Semilunar Valve

Pulmonary
Left Capillaries
Bicuspid
Ventricle Left Atrium Pulmonary
Valve
Veins
TERIMAKASIH