𝟑. 𝐏𝐞𝐫𝐢𝐜𝐚𝐫𝐝𝐢𝐮𝐦, 𝐛𝐥𝐨𝐨𝐝 𝐬𝐮𝐩𝐩𝐥𝐲, 𝐚𝐧𝐝 𝐜𝐨𝐧𝐝𝐮𝐜𝐭𝐢𝐧𝐠 𝐬𝐲𝐬𝐭𝐞𝐦 

This video covers the pericardium's anatomy, blood supply, conducting system, and applied anatomy of the heart.
* 𝐂𝐡𝐚𝐩𝐭𝐞𝐫𝐬 (𝐭𝐢𝐦𝐞𝐬𝐭𝐚𝐦𝐩𝐬)💡الفصول (الطوابع الزمنية)
00:00 - Intro (مقدمة)
00:21 - Content (Pericardium) (المحتوى)
‏‪0:50‬‏ - Definition and Types
‏‪ 2:05‬‏ - Fibrous Pericardium
‏‪ 5:21‬‏ - Serious Pericardium
‏‪ 6:36‬‏ - Pericardial Sinuses
‏‪ 8:08‬‏ - Transverse Sinus
‏‪ 9:21‬‏ - Oblique Sinus
12:38 - MCQ
‏13:33 - Arterial supply list
23:48 - Applied anatomy (Angina pectoris)
27:34 - Venous drainage
27:34 - Conducting system
* 𝐈𝐦𝐩𝐨𝐫𝐭𝐚𝐧𝐭 𝐧𝐨𝐭𝐞𝐬 1️⃣:
- The fibrous pericardium is formed of one layer while the serous pericardium is formed of two layers (parietal and visceral).
- The fibrous pericardium is not attached to the heart itself.
- The transverse pericardial sinus separates the arterial side from the venous side of the heart.
* 𝐈𝐦𝐩𝐨𝐫𝐭𝐚𝐧𝐭 𝐧𝐨𝐭𝐞𝐬 2️⃣:
𝟭. 𝗛𝗼𝘄 𝗰𝗮𝗻 𝘄𝗲 𝗶𝗱𝗲𝗻𝘁𝗶𝗳𝘆 𝗽𝗲𝗿𝗶𝗰𝗮𝗿𝗱𝗶𝗮𝗹 𝘀𝗶𝗻𝘂𝘀𝗲𝘀 𝗽𝗿𝗮𝗰𝘁𝗶𝗰𝗮𝗹𝗹𝘆?
a. Transverse pericardial sinus
- It could be identified by passing our finger from the right side between the superior vena cava (behind) and the ascending aorta (in front) and pushing it to the left.
b. Oblique pericardial sinus
- It could be identified by passing two fingers behind the base of the heart (through the pericardial cavity).
- Both pericardial sinuses are continuous with the pericardial cavity.
𝟮. 𝗪𝗵𝗮𝘁 𝗶𝘀 𝘁𝗵𝗲 𝗱𝗼𝗺𝗶𝗻𝗮𝗻𝘁 𝗮𝗻𝗱 𝗻𝗼𝗻-𝗱𝗼𝗺𝗶𝗻𝗮𝗻𝘁 𝗰𝗼𝗿𝗼𝗻𝗮𝗿𝘆 𝗮𝗿𝘁𝗲𝗿𝘆?
a. Heart “dominance” is determined by which of the initial coronary arteries supplies the posterior descending artery (PDA) (posterior interventricular artery) which, in turn, supplies the AV node.
b. The right coronary artery is dominant in approximately 80% of the population.
In 10% of the population, the posterior descending artery (posterior interventricular artery) arises from the left circumflex artery, rendering the right coronary artery (RCA) nondominant, with the remaining 10% of the population being codominant.
* 𝐁𝐚𝐫𝐞 𝐚𝐫𝐞𝐚 𝐨𝐟 𝐭𝐡𝐞 𝐡𝐞𝐚𝐫𝐭: 💉
- It lies at the medial ends of the left 4th and 5th intercostal spaces and is related to the apex of the heart.
- It shows dullness on percussion because lung tissue does not cover it (superficial cardiac dullness).
- This area is used for pericardial puncture (خرم او ثقب) (to aspirate fluid from the pericardium), as the introduced needle will not pass through pleura or lung tissue.
* 𝐖𝐡𝐞𝐫𝐞 𝐢𝐬 𝐭𝐡𝐞 𝐩𝐮𝐧𝐜𝐭𝐮𝐫𝐞 𝐬𝐢𝐭𝐞 𝐟𝐨𝐫 𝐩𝐞𝐫𝐢𝐜𝐚𝐫𝐝𝐢𝐨𝐜𝐞𝐧𝐭𝐞𝐬𝐢𝐬 (𝐏𝐞𝐫𝐢𝐜𝐚𝐫𝐝𝐢𝐚𝐥 𝐭𝐚𝐩𝐩𝐢𝐧𝐠 𝐨𝐫 𝐚𝐬𝐩𝐢𝐫𝐚𝐭𝐢𝐨𝐧)? 💉
1. 𝙁𝙞𝙧𝙨𝙩 𝙨𝙞𝙩𝙚:The needle insertion site is in the fifth left intercostal space close to the sternal margin. Advance the needle perpendicular to the skin (at the level of the cardiac notch of the left lung).
2. 𝙎𝙚𝙘𝙤𝙣𝙙 𝙨𝙞𝙩𝙚: The needle insertion site is in the fifth left intercostal space close to the sternal margin. Advance the needle perpendicular to the skin (at the level of the cardiac notch of the left lung).
* 𝐖𝐡𝐚𝐭 𝐢𝐬 𝐭𝐡𝐞 𝐛𝐞𝐬𝐭 𝐩𝐨𝐬𝐢𝐭𝐢𝐨𝐧 𝐟𝐨𝐫 𝐩𝐞𝐫𝐢𝐜𝐚𝐫𝐝𝐢𝐨𝐜𝐞𝐧𝐭𝐞𝐬𝐢𝐬? 🫀
- Place the patient supine with the head of the bed slightly elevated. The patient should be on continuous electrocardiographic monitoring, have intravenous access, and receive supplemental oxygen.
* 𝐌𝐂𝐐: 💪
1. A 56-year-old patient has a stab wound in his chest. During surgical exploration, there was a penetrating wound in the right ventricle. Which of the following structures could be affected?
A. SA node
B. Right bundle branch
C. AV bundle
D. AV node
2. The bare area of the heart corresponds to which of the following sites close to the sternum?
A. Right atrium
B. Left 1st and 2nd intercostal space
C. Right 2nd and 3rd intercostal space
D. Left 3rd and 4th intercostal space
E. Left 4th and 5th intercostal space
3. Clamping all arterial flow out of the heart is sometimes necessary in cardiac surgery. This could be done within the pericardial sac by inserting the index finger immediately behind the two great arteries and compressing them with the thumb of the same hand. The index finger would have to be inserted into which space?
A. Cardiac notch
B. Coronary sinus
C. Oblique pericardial sinus
D. Coronary sulcus
E. Transverse pericardial sinus
* 𝐅𝐨𝐫 𝐜𝐨𝐧𝐭𝐚𝐜𝐭: 📢
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#pericardium
#heart_blood_supply
#heart_conducting_system
#angina_pectoris