心脏解剖实体演示-1|经典教学视频

该视频展示的是香港中文大学心胸外科David Quinn博士和Malcolm Underwood教授以猪心脏为例，进行心脏解剖结构详细讲解（注：猪的心脏稍小，约为人类心脏的2/3，但在解剖学上非常相似）。

这里是全部讲解的Part1

Part2请看这里

下面是结合AI听译的讲解内容，因为是现场讲解，有些口语化或停顿的地方，个别单词听的不清楚，如有错误也请指出然后修改。

Orientation

we've orientated it as you would find it in the operating theater with the surgeon with the blue gloves to the right of the patient as the main operating surgeon and the surgeon with the white gloves to the left of the patient as the assistant with the apex of the heart pointing towards the left of the chest.

Surface anatomy

The features to point out on the surface anatomy are the main course of the left anterior descending artery, which is separating the left and the right ventricles. At the top of the heart you can see the left atrial appendage followed by the pulmonary artery, then the aorta which we'll look at more closely in a minute, and then the right edge will appendage.

Anatomy of the great vessels

We've rotated the heart slightly to see the surface of the aortic root ascending aorta and the arch which is commences at the origin of the common carotid artery. The ascending aorta in cardiac surgery is the preferred point of arterial return cannulation. We can see the structures of aortic route and its relations. The aorta is a thicker wall than the pulmonary artery. The routed here has been exposed to demonstrate the proximity of the left atrium. In particular its roof to the aortic root, an area that may be involved in aortic root abscess formation.

Aortic root 

This is a demonstration of the closed aortic valve with eachly flat identified in a position with its counterpart. The left coronary artery arises from this sinus making this the left coronary cusp (冠状动脉尖). The right coronary artery arises from this sinus making this the right coronary cusp. And no coronary artery arises from this sinus making this the non-coronary cusp. Also demonstrated is the annular attachment of aortic valve which does not occupy the shape of a circle but forms a complex coronet with its attachments between the ventricle and the aortic wall forming semilunar circles that are joined.

 Aorto-mitral (主动脉-二尖瓣) relations

Orientation again is that the left coronary cusp will be here. The right coronary cusp here and this is the non-coronary cusp which we've now divided the aorta towards to demonstrate the attachments of the anterior leaflet the mitral valve. So if I put my thumb down through the left ventricular outflow tract through the aortic valve into the left ventricle. We can see that my thumb here is demonstrating the anterior leaflet of the mitral valve we which we've exposed through the left atrium. I think we can see as well that in some cases may be following mitral valve repair if there was excess tissue in this area of the anterior leaflet of the mitral valve then during systole if I take my finger out of the outflow tract which is here. Then during systole movement of the anterior leaflet across the left ventricular outflow tract could cause an obstruction. I can demonstrate that quite well with my finger which is now defining the anterior leaflet of the mitral valve.

Systemic & pulmonary veins

Next to the aorta is the right atrial appendage which leads to the right atrium. One can see the termination of the superior vena cava (腔静脉) as it enters the right atrium. And at the base the origin of the IVC the inferior vena cava as it enters the right atrium from below. The right atrial appendage is the point of insertion of the venous drainage cannula used during cardiopulmonary bypass. The cannula enters the right atrium but it's tip sits roughly where the tip of the forceps is in the inferior vena cava. Rotating the heart round again brings the left atrium and it's tributaries into view. The left atrium is here, draining into the left atrium are usually for pulmonary veins. Superior pulmonary vein inferior pulmonary vein on the right and in this case a common pulmonary vein but they would usually be - on the left. The right superior pulmonary vein is a site that can be cannulated for drainage of the left ventricle through the superb ammonia vein into the atrium and then into the left ventricle. Cannulation for mitral valve surgery normally involves cannulation separately of the superior vena cava and inferior vena cava.

Mitral valve (二尖瓣) anatomy

Here we can see the mitral valve annulus. The attachments of the leaflets of the mitral valve. If I bring them forward to the atrial wall. The two main leaflets of the mitral valve the anterior leaflet which is usually the larger in its surface area and the posterior leaflet which is usually the smaller. the junction between anterior and posterior leaflets unnamed the commissure's and can be demonstrated at these points of attachment. The posteromedial and the anterolateral commissure. After demonstrating the commissures we can show how the posterior leaflet is divided into segments. P1, P2 and P3 and that the anterior leaflet has corresponding anatomical segments A1, A2 and A3. Through the valve we can catch a glimpse of the sub-valvular apparatus here we can see a primary chord which attaches at its base to the head of in this case the anterolateral papillary muscle will see those in more detail in a minute.

Sub-valvular mitral apparatus

So here's the heart again in its anatomical position and they were now rolling it towards my assessment in order to reveal the mitral valve again through a left atria to me and this is instance we can demonstrate part of the assessment of the mitral valve which is segmental in its design. The main point of reference for the mitral valve assessment is P1 which rarely if ever demonstrates prolapse. In this case we can show intact chords and P1 arising to the level of the annulus but not billowing or prolapsing significantly beyond the level of the mitral annulus. However A1 here can be demonstrated to prolapse be on the level of our reference point the P1 leaflet and we can see that that previously demonstrated cord primary cord which attaches to the edge of the anterior mitral leaflet has been cut allowing the prolapse to occur.