00:01
Okay, now let's take a look
at the internal structures
of the left side of the heart.
00:07
Having seen the internal
structure of the right heart,
that should be a lot easier,
although it's not exactly the same.
00:13
And there are some key differences
that we'll point out along the way.
00:17
So here again, is our left atrium.
00:20
And if we faded away,
we can see our atrial septum,
This time from the left, and the
left atrium also has an appendage.
00:29
Although,
it looks different from the right.
00:32
It's smaller. If it's more narrow,
and it's longer
than the right appendage, which
tends to be larger and more broad.
00:41
The left atrium is
receiving pulmonary veins.
00:45
And it's going to go through
a valve similar to the tricuspid,
but slightly different.
00:51
And that's going to be
called the mitral valve.
00:55
So if we look at a cross section
along the long axis here,
we can see the free wall
of the left ventricle,
and the ventricular septum.
01:04
And the left ventricle
has trabeculae corneae,
just like the right side did.
01:09
Although they tend
to be less prominent
and not quite as tall
as they are on the right.
01:15
And where our mitral
valve has leaflets
and other structures that look very
similar to the tricuspid valve.
01:22
In the sense that we have
papillary muscles,
and we have chordae tendinae.
01:27
The only difference is
we only have two leaflets and
two capillaries instead of three.
01:34
If we look at the mitral valve
from the atriums point of view,
it looks like it's
very happy to see us.
01:40
It looks like it's smiling there.
01:41
And above that smile
from our point of view,
that's our anterior leaflet.
01:47
And below,
that's our posterior leaflet.
01:50
Again, we only have two.
01:52
In fact, you would think
tricuspid and bicuspid
would be better than
tricuspid and mitral.
01:56
I don't know what to tell you.
We just call it mitral.
01:58
Sorry, it has two cusps though.
02:01
If we look at the mitral
valve from the ventricle side,
we can see the anterior
and posterior leaflets.
02:09
And the two papillary muscles,
again are named for their location,
not really which
leaflet they attach to.
02:17
Both of them have chordae that
attached to both leaflets.
02:20
It's just that one
is more anteriolateral.
02:24
So it's the anterolateral
papillary muscle.
02:26
And the other is more
posterior medial.
02:28
So it's the posterior
medial papillary muscle.
02:34
One thing I mentioned on the right
that we don't have on the left
was that conus arteriosus,
or infundibulum,
between the tricuspid
and pulmonary valves.
02:44
Here, we don't have that gap between
the mitral and aortic valves.
02:48
Here, the mitral
valve and aortic valve
at a certain point are in what
we call fibrous continuity.
02:54
So there is no conus here.
02:56
And embryologically speaking,
it's the presence of
a conus on the right
and absence of the
conus on the left,
that actually makes sure
that the pulmonary lines up
with the right ventricle,
and the aorta lines up
with the left ventricle.
03:13
The aortic valve is
another semilunar valve,
just like the pulmonary valve.
03:19
And when you see them side by side,
they look very
similar to each other.
03:23
And they're also right
next to each other.
03:26
Again, that reflects the embryology
because they began as
one single mega artery
called the truncus arteriosus
that just got divided
right down the middle.
03:35
So it's no surprise that they look
like mirror images of each other.
03:39
That division of a single artery
resulted in anteriorly,
there being a pulmonary artery
and posteriorly,
there being an aortic valve.
03:49
If we look at the leaflets
of the aortic valves,
we see their names
slightly different
because of their orientation.
03:55
We have a left, we have a right,
and we have a posterior
or non-coronary leaflet.
04:02
And that term reflects the fact
that there are coronary arteries
coming off of these other leaflets.
04:09
So there's a hole just
above the aortic valve here
called the left coronary ostium.
04:15
Ostium is just our word for hole.
04:17
And that's going to feed
into some coronary arteries,
just like there's a hole
on the right,
called the right coronary ostium.
04:24
That's going to feed into the
right sided coronary artery system.