ANATOMI

SISTEM CARDIOVASCULAR

Chelvi Wijaya
 SYSTEMA
CARDIOVASCULAR
CAVITAS THORACIS
C0R
PEMBULUH DARAH BESAR
 DINDING THORAX
 SKELETON

 ARTICULUS

 MUSCULUS

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 SKELETON
 VERTEBRA THORACALIS I – XII
 STERNUM
 COSTAE :
 COSTA VERA < 1 – 7 >
 COSTA SPURIA < 8-10 >
 COSTA FLUCTUANTES <11-12>

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Location in Thorax

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 APERTURA THORACIS
SUPERIOR :
 CORPUS V.THORACALIS I
 COSTA I

 MANUBRIUM STERNI

 BIDANG DATAR MIRING CRANIO-

DORSAL ke CAUDOVENTRAL

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 APERTURA THORACIS
INFERIOR
 CORPUS VERT.THOR.XII
 CARTILAGINIS COSTA X – XII
 PROCESSUS XIPHOIDEUS
 DIAPHRAGMA THORACIS
 BIDANG DATAR, OBLIQUE, VENTRO-
CRANIAL ke CAUDO-DORSAL

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 ARTICULUS
 <1> JUNCTURA COSTOVERTEBRALIS :
 ARTICULUS CAPITULI

 ARTICULUS COSTOTRANSVERSALIS

<2> JUNCTURA COSTOSTERNALIS

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 Cardiovacular System
Anatomy/HD/UNHAS/2007 9
 MUSCULUS
1) Lapisan Superficial : berperan pd
Extremitas superior, bag.dinding abdomen,
seperti m.pect.major, m.rectus abd,
m.obl.abd.ext, m.lat.dorsi,
mm.rhomboidei,m.serratus anterior, dsb

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 2) Lapisan Intermedia :
 M.intercostalis externus

 M.intercost.internus

3) Lapisan Profundus :
 M.subcostalis

 M.transversus thoracis

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 M.INTERCOSTALIS EXTERNUS :
o 11 psg

o Membrana intercostalis anterior

M.INTERCOSTALIS INTERNUS
 11 psg

 Membrana intercostalis posterior

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 Cardiovacular System
Anatomy/HD/UNHAS/2007 13
 VASCULARISASI
1) A.MAMMARIA INTERNA

A.EPIGASTRICA A.MUSCULOPHRENICA
SUPERIOR

Cabang lain : rr.perforantes, a.intercost.ant,

a.pericardiacophrenica,rr.mediast,
rr.sternalis

Cardiovacular System
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 Cardiovacular System
Anatomy/HD/UNHAS/2007 15
2) A.INTERCOSTALIS POSTERIOR
<ruang intercostalis I dan II >

VENA INTERCOSTALIS bermuara ke

dalam V.AZYGOS dan V.HEMIAZYGOS

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 INNERVASI
N.INTERCOSTALIS :
 r.anterior n.spin.Th.I – XII

 n.subcostalis

 mempersarafi dinding thorax dan

dinding ventral abdomen

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 Cardiovacular System
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 Cardiovacular System
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 SURFACE ANATOMY
 Dapat dipalpasi :
INCISURA JUGULARIS STERNI
ANGULUS STERNI LOUISI
PROCESSUS XIPHOIDEUS
 Patokan Angulus Sterni (Costa II)

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 Linea sternalis lateralis
 Linea medioclavicularis

 Linea axillaris anterior – media

– posterior
 Linea scapularis

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 MAMMA
 KULIT
 SISTEM REPRODUKSI ( ASI )
 LOKALISASI : antara Costa II – Costa VI,
di medial tepi sternum, dilateral mencapai
Linea axillaris
 STRUKTUR : KELENJAR, FAT dan
JARINGAN IKAT

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 Cardiovacular System
Anatomy/HD/UNHAS/2007 23
 MEDIASTINUM

MEDIASTINUM SUPERIUS
MEDIASTINUM INFERIUS
MEDIASTINUM SUPERIUS

• Batas ventral : Manubrium sterni +

m.sternohyoideus + m.sternothyroideus
• Batas dorsal : Corpus v.Th.I-IV
• Batas lateral : Pleura mediastinalis
• Batas caudal : bidang datar melalui
Angulus sternalis Louisi

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• ISI :
a> retrosternal: kelenjar Thymus
b> prevertebralis: trachea,
oesophagus, n.recurrens sinister,
duct.thoracicus
c> intermedia: arcus aortae,
N.vagus, n.phrenicus

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 Cardiovacular System
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 Cardiovacular System
Anatomy/HD/UNHAS/2007 29
• MEDIASTINUM ANTERIUS
• MEDIASTINUM MEDIUM
• MEDIASTINUM POSTERIUS

Berisi : ll.nn., jaringan ikat, fat

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MEDIASTINUM MEDIUM

• Berisi : pericardium + cor, aorta

asc,vena cava sup,muara
v.azygos,v.pulmonalis sinistra et
dextra dan n.phrenicus dexter et
sinister

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MEDIASTINUM POSTERIUS

• ISI :
• Aorta thoracalis, v.azygos,
v.hemiazygos, N.vagus, n.phrenicus,
bifurcatio trachea, bronchus,
oesophagus, ductus thoracicus

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 COR
MORFOLOGI
LOKALISASI
STRUKTUR
MORFOLOGI

• ORGAN MUSCULAR, bentuk CONUS

• APEX – BASIS CORDIS
• UKURAN P = 12 cm , L = 8 – 9 cm,
Tebal = 6 cm
• ATRIUM DEXTRUM et SINISTRUM
• VENTRICULUS DEXTER et SINISTER

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APEX CORDIS :

 Dibentuk oleh UJUNG VENTRICULUS

SINISTER
 Letak caudo-ventral sinister
 Ruang intercostal 5 sinister
 Kira-kira 9 cm dari Linea mediana
atau 2 jari di medial linea
medioclavicularis sinister

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STRUKTUR COR

• ENDOCARDIUM
• MYOCARDIUM
• PERICARDIUM, terdiri dari lapisan
Fibrosa dan lapisan Serosa
• Lapisan SEROSA = EPICARDIUM
• CAVITAS PERICARDIALIS
• REFLEXI PERICARDII
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LOKALISASI

• Bertumpu pd Diaphragma thoracis

• Di antara kedua pulmo
• Retrosternal
• Kira-kira 5 cm di caudalis proc.xiphoideus

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PROYEKSI COR

• 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

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• 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

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STRUKTUR ATRIUM DEXTRUM

• <1> SINUS VENARUM = SINUS

VENARUM CAVARUM
• Letak di antara muara vena cava superior
dan ostium atrioventriculare dextrum
• Permukaan licin

• <2> AURICULA DEXTRA

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AURICULA DEXTRA

• KANTONG
• MM.PECTINATI
• MUARA dari :
 VENA CAVA SUPERIOR
 VENA CAVA INFERIOR
 SINUS CORONARIUS
SEPTUM ATRIORUM + FOSSA OVALIS
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VENTRICULUS DEXTER
• DINDING TEBAL
• OSTIUM ATRIOVENTRICULARE DEXTRUM
• VALVULA TRICUSPIDALIS
• CHORDAE TENDINAE
• TRABECULAE CARNEAE
• M.PAPILLARIS
• OSTIUM TRUNCI PULMONALIS =
ORIFICIUM A.PULMONALIS
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ATRIUM SINISTRUM

• AURICULA SINISTRA
• OSTIUM ATRIOVENTRICULARE
SINISTRUM
• VALVULA MITRALIS
• MUARA V.PULMONALIS DEXT et SIN

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VENTRICULUS SINISTER
• APEX CORDIS
• DINDING SANGAT TEBAL
• VALVULA BICUSPIDALIS
• CHORDAE TENDINAE
• TRABECULAE CARNEAE
• M.PAPILARIS
• PANGKAL AORTA + VALVULA
SEMILUNARIS
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 SEPTUM VENTRICULORUM :
PARS MEMBRANACEA
PARS MUSCULARIS

SKELETON CORDIS :
ANULUS FIBROSUS DEXTER et SINISTER
TRIGONUM FIBROSUM DEXTRUN et SINISTRUM

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 THE CONDUCTING SYSTEM
• NODUS
SINUATRIALIS =
KEITH-FLACK
• NODUS
ATRIOVENTRICULA
RIS = ASCHOFF-
TAWARA
• FASCICULUS
ATRIOVENTRICULA
RIS

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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

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INNERVASI C O R

• <1> INTRINSIC
• <2> EXTRINSIC : Sympathis dan
Parasympathis

• SYMPATHIS :
Ggl.paravertebrale Th.1 – 5
Ggl.cervicale
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• PARASYMPATHIS : N.VAGUS
R.cardiacus superius
R.cardiacus inferius
R.cardiothoracis

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 VASCULARISASI
• A.CORONARIA DEXTRA
• A.CORONARIA SINISTRA

A.CORONARIA DEXTRA :
 Sulcus atrioventricularis
 Sulcus coronarius, menuju ke Crux cordis
 R.marginalis, r.transversus,r.descendens
posterior
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A.CORONARIA SINISTRA

• Pendek
• Membentuk ramus descendens anterior
dan ramus circumflexus
• Kadang-kadang ada ramus medianus
• Sulcus longitudinalis anterior

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 a.Carotis communis sinistra

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

a.Coronaria sinistra
a.Coronaria dextra

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Vena cordis
Sinus coronarius

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TIPE VASCULARISASI COR

<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
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ALIRAN DARAH VENA

• SINUS CORONARIUS :
• V.CARDIACA MAGNA
• V.CARDIACA MEDIA
• V.POSTERIOR VENTRICULI SINISTRI
• V.CARDIACA PARVA
• V.OBLIQUE ATRII SINISTRI (Marshalli)

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

• AORTA ASCENDENS
• ARCUS AORTAE
• AORTA DESCENDENS (aorta thoracalis
– aorta abdominalis ) 58
 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

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 ARCUS AORTA
• Tepi cranial artic.sternoclavicularis
• Ascendens, dorsal
• Ventral trachea, lalu ke kiri trachea
• Descendens di kiri corpus vert.thor.
• AORTA DESCENDENS
• Lig.arteriosum Botalli
• A.ANONYMA, A.CAROTIS COMMUNIS,
A.SUBCLAVIA
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 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
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 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.pulmonalis

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 Basic Pathway of Blood Flow
CS

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 Cardiovacular System
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