心脏的解剖和生理心内介入中心观察点位置心脏壁和遮盖物心腔瓣膜内部观前面观后面观上面观透视影像前后位(AP)
—AP(有时也称作PA)是心脏的正面观，X线球管和影像增强仪与脊柱和胸骨在一条直线上影像上脊柱在心脏的稍左侧
胸骨在脊柱的正上方肋骨的角度向下心脏的轮廓在影像中心偏右侧右前斜位右前斜位(RAO):观察心脏“长轴
”脊柱在左侧胸骨在右侧垂直于室间隔左前斜位(LAO)在LAO位,可见到:脊柱在心脏的右侧胸骨在左侧肋骨角度
向左向下心脏的短轴轮廓在LAO位,左心室:间隔壁在影像的左侧侧壁在影像的右侧左前斜位静脉和动脉毛细血管有节奏的
周期右心右心接受乏氧的血液低压系统容量泵心室壁薄呈新月型收缩舒张两期都有冠脉的灌注左心左心接受含氧的血液
高压系统压力泵心室壁厚呈圆锥型仅舒张期有冠脉的灌注体循环和肺循环心肌梗死心肌梗塞相对应部位右冠脉供应区：窦房结
55%，房室结的90%，希氏束90%，右房右室游离壁、部分室间隔前降支：左前壁、室间隔前部、部分右心室回旋支：窦房结45%，左
房左室侧壁评估指标心脏功能右心接受乏氧的血液低压系统容量泵心室壁薄呈新月型收缩舒张两期都有冠脉的灌注射血分数
心输出量每搏输出量心率HREF4个主要评估指标(CO,SV,HR,EF)心脏每分钟泵出的血液量一次心脏收缩
期间，心脏泵出的血液量每分钟心跳数心脏每搏泵出的血液百分比CO=HRxSV正常值=4-8L/mEF= 射
出的血液量 总血液量正常值=50-60%收缩性心力衰竭=EF<40%COSV收缩期:心腔的收缩舒张期:心腔
的舒张心输出量:在一特定的时间内，心脏射出的血液量－在静息状态下，正常值为4-7升/分射血分数:每次心跳中，心室泵出的血
液量与收缩前心室的血液量之比(用%测量)－正常的EF值为50-70%机械运动Discusstheseterms:si
tuatedtowardthemidlineofthebodyorastructureMedialdenot
ingapositionfartherfromthemidlineofthebody;pertainingt
oasideLateralsituatedatordirectedtowardthefrontAnterio
rsituatedatordirectedtowardthebackPosteriornearesttoa
pointofreference,astoacenterortothepointoforiginora
ttachmentProximalremote;fartherfromanypointofreferenceDi
stalsituatedbelowInferiorsituatedaboveSuperiorDefinitionT
ermSlidecontainsautomatic(bodyplanes)andclick-throughanim
ationIntroducethetopicswithintheFieldI/FundamentalsCour
se.Slidehasautomatically-timedanimation(titleslideemphasiz
escurrenttopic)Slidecontainsautomatic/looping(heartbeat)an
dclick-throughanimationTheheartdoesnotsimplyhangfreelyi
nthechestcavity.arounditisalooseprotectivesackoftissu
ecalledthepericardiumTheheartliesinsidethissack,whichi
slooseenoughtopermitthehearttobeateasily.Theoutermem
braneoftheheartiscalledtheepicardiumUndertheepicardium
isathicklayerofmusclecalledthemyocardium,whichformsthe
actualworkingpartoftheheartThemyocardiumisthickestint
heleftventricleandthinnestintheatriaTheinsideofthehea
rtislinedwithasmooth,shinymembranecalledtheendocardium.
Slidecontainsclick-throughanimationSlidecontainsclick-t
hroughanimationLikeanypump,thehearthasvalvestokeepthe
bloodflowingintherightdirection.Properfunctionoftheses
mallflapsoftissuespellsthedifferencebetweenhealthandsic
kness,andoftenbetweenlifeanddeath.Theheartisequippedw
ith4setsofvalves.Thevalvesbetweentheatriaandventricles
arecalledtheatrioventricularvalves.Thevalveleadingintot
herightventriclehas3flaps;itiscalledthetricuspidvalve
(acuspisavalveflaporleaflet).Thevalvebetweenthelefta
triumandventriclehastwocuspsandiscalledthemitralvalve.
Thesevalvesswingdownwardintotheventricles.Duringdiastol
e,orrelaxation,thevalvesswingopen,allowingthebloodtofl
owdownintotheventricles.Whentheventriclescontract,these
valvessnapshut,preventinganybloodfromflowingbackupinto
theatria.Eachoftheoutletvalvesfromtheventricleshast
hreecusps.Thevalveattheentrytothepulmonaryarteryisca
lledthepulmonicvalve.Thevalveattheentrytotheaortaisc
alledtheaorticvalve.Whentheventriclescontract,theseoutle
tvalvesareforcedopen.Thebloodrushesintothepulmonaryar
teryandtheaorta.Whentheventriclesrelax,thevalvesclose,
shuttingoffanybackwardflowintotheventricles.Ifthehear
tistofunctionefficiently,thesevalvesmustbeabsolutelywat
ertight.Theymustopenfreelyandwidelytoletthebloodflow
forwardwiththepumpingactionoftheheart.Stenosisofavalve
meansthevalvecan’tswingopenaswidelyasitshould.Regurg
itationreferstoleakingofthevalve.Slidecontainsclick-t
hroughanimationSlidecontainsclick-throughanimationSlidecon
tainsclick-throughanimationSlidecontainsclick-throughanimat
ionSlidecontainsclick-throughanimationSlidecontainsclick-t
hroughanimationSystole:Theventriclescontract.Thepressure
insidetheventriclesrises.Whenthepressureinsidetheventr
iclesishigherthanthepressureinsidetheatria,theatriovent
ricularvalvesareslammedshut.Themitralandtricuspidvalve
sareforcedshutearlyinventricularsystole.Theinrushofbl
oodfromtheveinsfillstheatriaagainsttheseclosedvalves.
Thesameriseinpressureforcestheoutletvalvesopen,sothat
bloodcanflowoutoftheventriclesintothepulmonaryarteryan
dtheaorta.Theaorticandpulmonicvalvesareforcedopenearl
yinventriclularsystole.Diastole:Theventriclesrelax.The
pressureintheventriclesfall.Whenitfallsbelowthepressur
eintheatria,theAVvalvesswingopenandbloodrushesintoth
eventricles.Themitralandtricuspidvalvesareforcedopenea
rlyindiastole.Thesamefallinpressuredropsthepressurein
theventriclesbelowthepressureintheaortaandpulmonaryart
ery.Thehigherpressureinthegreatvesselsforcestheoutlet
valvesshut,holdingthebloodinthelungsandinthewholebody
.Theaorticandpulmonicvalvesareforcedshutearlyindiasto
le.SlidecontainsautomaticanimationThebloodthathascompl
eteditscoursethroughthetissuesofthebodyflowsbacktothe
heartthroughtheveins.Theveinscometogether,growinglarger
,untiltheyendintwogreatveins(superiorandinferiorvenac
ava)thatemptyintothetopandbottomoftherightatrium.Bloo
dflowsfromtherightatriumintotherightventricleandoutto
thelungsthroughthepulmonaryvalveandpulmonaryarteryFrom
theleftatrium,bloodflowsdownintheleftventricle,through
theaorticvalve,andthenouttheaortatothebody.解剖
位置侧面Side侧面Side后面BackMidline中间下面Botto
m上面Top远端Farthest前面Front近端Nearest中线心尖部心脏在两肺之间，胸骨的后面
心内膜心肌心包心外膜冠状动脉围绕着心脏的组织4个心腔右心房右心室左
心房左心室右心房右心室左心房左心室4个瓣膜肺动脉瓣二尖瓣主动脉瓣三尖瓣
至头和手臂的动脉上腔静脉肺动脉瓣左冠状动脉主动脉瓣二尖瓣主动脉弓三尖瓣右冠状
动脉从内部看右冠状动脉右心室左心室左冠状动脉左心房心大静脉右心房从前面看左冠状动脉回旋支冠状静脉窦下腔静脉
左心室右心室右冠状动脉肺静脉主动脉弓上腔静脉从后面看三尖瓣肺静脉右心
房主动脉瓣肺动脉瓣左心房二尖瓣从上往下看瓣膜右心室左心室右心房左心耳二尖瓣环三尖瓣环主动脉瓣环肺动脉瓣环
右肺静脉右肺动脉上腔静脉左肺静脉肺动脉干下腔静脉膈肌主动脉二尖瓣环三尖瓣环左心室右心室主动脉瓣环主动脉
右心房肺动脉瓣环肺动脉干动脉高压系统，将心脏的血液运送至全身血管壁上的平滑肌有利于灌注小动脉与毛细血管连接静脉低
压系统，回收血液至心脏血管内的瓣膜有利于血液回收小静脉与毛细血管连接起始到结束的距离约5000英里毛细血管组织细胞小静脉小动脉动脉从心脏静脉至心脏动脉和静脉之间的连接收缩/舒张在心脏单向血流中，瓣膜起到了关键作用心腔和血管内压力的变化有利于瓣膜打开和紧密关闭，阻止血液倒流收缩期发生收缩舒张期收缩之间的休息右心房右肺动脉分支右心室左心室左心房肺静脉三尖瓣左肺动脉肺静脉主动脉弓肺泵上腔静脉下腔静脉右肺动脉左肺动脉分支右肺动脉上腔静脉下腔静脉右心房右肺动脉分支右心室肺静脉左肺动脉分支三尖瓣左肺动脉肺静脉Aorta主动脉弓体泵左心房左心室主动脉头和上肢手臂心脏消化道肾脏肺躯干和上肢体循环体循环肺循环血液是如何流向身体的心肌梗死时发生了什么坏死的心肌阻塞的冠状动脉缺血–血液供应减少，导致组织缺氧坏死–由于缺氧导致组织死亡心律失常使节律不规则当冠状动脉被阻塞时，含氧的血液不能到达下游细胞 |
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