অনন্ত জলিল সাহেবের এক cinema তে তিনি যখন তার Heart বের করে ফেলেন , ঠিক তখন থেকে “Sayem ” এর মনে Heart নিয়ে তৈরি হয় বিশাল কৌতুহল। দেখতেই medical college এ ভর্তি হয় এবং কিছুদিন পর চলে আসে তার “The heart ” item.
Mam মুচকি হাসি দিয়ে বললেন, “Sayem” হৃদয়টা এনাটমিকাল পজিশনে ধরে বলা শুরু করো । “
Sayem – This is the viscera of heart with pericardium and roots of great vessels
1) Apex is conical and directed downwards, forwards and to the left and situated in the left 5th intercostal space just medial to the mid-clavicular line.
2) Base is directed upwards, backwards and to the right
3) Sterno-costal surface is directed forwards and upwards
4) Diaphragmatic or inferior surface is directed downwards and backwards
Mam : বাহ! খুব ভালো বলছিসতো। আচ্ছা বলতো Heart er measurement গুলো?
Sayem – Apex to Base 12cm
Antero-Posterior diameter 6 cm
Widest transverse diameter 8-9 cm
Weight – 280 to 320 gm in adult male
It’s size is equivalent to a clenched fist
Mam : Heart কোন Mediastinum এর content? Sayem: Middle Mediastinum
Mam : আচ্ছা তুই Presenting Part গুলা বল?
Sayem: Heart presents –
1)Apex
2) Base
3) 3 borders –
a) Right border
b)Left border
c)Inferior border
4)3 surfaces –
a) Sternocostal surface
b) Diaphragmatic surface
c)Left surface
Mam : আচ্ছা বলতো আমরা Apex beat কোথায় পাই?
Sayem: Apex beat is felt in the left 5th intercostal space just medial to the mid-clavicular line in adult and in the left 4th intercostal space at or just lateral to the mid-clavicular line in the newborn.
Mam : এখন Apex আর Base এর Formation বল?
Sayem : Apex is formed only by left ventricle. Base is formed by, two-third by left atrium and one-third by right atrium.
Base is also the most fixed part of heat.
Mam: Base এর boundary বল
Sayem : Above- Bifurcation of pulmonary trunk
Below- Posterior part of Atrioventricular groove
Right side- Right border of right atrium
Left side- Left border of the left atrium
Mam: Base এর Vertebral level টা বল —
Sayem: In supine position , opposite to T5-T8 and in standing position opposite to T6-T9
Mam: Base এর relation গুলা বল দেখি?
Sayem :1) Oblique sinus
2) Posterior part of fibrous pericardium
3) Right pair of Pulmonary Veins
4) Right and left bronchi
5) Oesophagus with plexus of nerves
6) Descending Thoracic Aorta
7) Thoracic duct
8)Azygos and hemi-azygos vein
9) Greater and lesser splanchnic nerves
10) Posterior mediastinal lymph nodes
Mam: আচ্ছা Right Border formation বল।
Sayem : It is formed only by the right atrium and It extends from the Superior Vena Cava to the Inferior Vena Cava.
Mam: Inferior border নিয়ে বল একটু?
Sayem : It extends from the opening of inferior vena cava to the apex of the heart. This border is accompanied by marginal branch of Right Coronary Artery. Close to apex , it presents a notch called Incisura apicis cordis which gives passage to anterior interventricular branch of left coronary artery.
Mam :আচ্ছা left border টাও বলে ফেল—
Sayem : It extends from left auricle to the apex of the heart and is accompanied by the marginal branch of left coronary artery.
Mam: আচ্ছা Sterno-costal surface এর formation টা বাদ রাখবি কেন?
Sayem : Anterior surface of right atrium and its auricle
A part of anterior surface of left auricle
Anterior surface of right ventricle (two-third)
Anterior surface of left ventricle (one-third)
Mam: Diaphragmatic surface টার formation বল?
Sayem: Two-third by left ventricle
One-third by right ventricle
Sayem : Left surface is formed by left ventricle mainly
And Partly by left atrium and its auricle.
Mam : বলার আগেই বলে ফেললি?
Ok last question?
Tell the clinical base of heart–…..
Sayem: , Clinical base of the heart is represented by a line which extends from the auscultatory area of the aortic sound in the right 2nd intercostal space to that of pulmonary area in the left 2nd intercostal space.
, Mam : তোর জন্য Bonus question —
Tell me about different positions of the heart..
Sayem :
Levocardia – Heart is on left side (normal)
Dextrocardia – Heart is on right side (abnormal)
Mesocardia -Heart lies on midline or mid-saggital plane (abnormal)
Mam : যা ভালো হয়েছে
Sayem: Assalamualaikum mam
উপরে Medical life এর শুরুতে যে item ( exam) face করতে হয় তার একটা নমুনা দেওয়া হয়েছে।
Raiyyan Tahsan. Date:-30-04-2025 Wednesday Time:-03-48-45 Pm
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