HEART

Heart
 Hollow muscular organ
 Pyramidal in shape
 Lies within the pericardium in the
mediastinum
 Surface Markings of the
Heart
 Apex: left ventricle
 5th (L) ICS 3 ½ “ from the midline
 Superior border: roots of the great
vessels
 2nd (L) CC ½” from edge of sternum to
3rd ® CC ½” from edge of sternum
 Surface Markings of the
Heart
 Right border: right atrium
 3rd ® CC ½” from the edge of sternum
downward to 6th ® CC ½” from the edge
of sternum
 Left border: left ventricle
 2nd (L) CC to the apex
 Inferior border: right ventricle and
apical part of (L) ventricle
 6th ® CC to apex
 Cardiac Borders of the
Heart
 Right: right atrium
 Left: Left auricle and left ventricle
 Lower: Right ventricle
 Apex: Left ventricle
 Walls of the heart
 Epicardium
 Outer visceral layer of serous
pericardium
 Myocardium
 Middle, thick layer of cardiac muscle
 Endocardium
 Inner, thin layer of endothelial layer
 Structure of the Heart
 Atrial part: atrial septum
 Runs from anterior wall backward and to
the right
 Ventricular part: ventricular septum
 Runs obliquely
 Upper part: thin membranous

 Lower part: thick muscular

 Skeleton of the Heart
 Fibrous rings that surrounds the AV,
aortic and pulmonary orifices
 Continous with the membranous part
of the ventricular septum
 Supports the bases of the valve
cusps
 Prevent the valve from stretching
and becoming incompetent
 Chambers of the Heart
 Right atrium
 Right ventricle
 Left atrium
 Left ventricle
 Right Atrium
 Anterior to the left atrium
 Consists of a main cavity and an
auricle
 External vertical groove: sulcus
terminalis
 Internal ridge: crista terminalis
 Posterior to the ridge: smooth sinus
venosus
 Anterior to the ridge: trabeculated
 Right Atrium
 Superior vena cava: no valve
 Larger inferior vena cava:
rudimentary non-functional valve
 Coronary sinus: between the IVC and
AV orifice
 With rudimentary non-functional valve
 Right AV orifice: anterior to the IVC
 With tricuspid valve
 Right Atrium
 Fetal remnants
 Fossa ovalis
 Foramen ovale
 Anulus ovalis
 Upper margin
 Right Ventricle
 Forms the greater part of the
anterior surface
 Anterior to the left ventricle
 Has thicker wall than right atrium
 Right Ventricle
 Internal surface: trabeculae carnae
 Papillary muscle
 Attached to the ventricular wall
 Connected to the cusps of tricuspid valve
(chordae tendinae)
 Moderate band
 Part of the conducting system (AV bundle)
 Simple prominent projections
 Right Ventricle
 Tricuspid Valve
 Guards the AV orifice
 3 cusps (anterior, septal, inferior)
 Right Ventricle
 Pulmonary valve
 Guards the pulmonary orifice
 Infundibulum: funnel shaped
 3 semilunar cusps (2 anterior, 1
posterior)
 Open: upward into the pulmonary trunk
 Left Atrium
 Posterior to the right atrium
 Consists of a main cavity and an
auricle
 Has also rigdes on its interior
 Left Atrium
 Four pulmonary vein
 Through the posterior wall
 No valve
 Left Ventricle
 Situated largely behind the right
ventricle
 Small portion forms the left margin of
the heart and the apex
 Walls are 3x larger than the right
ventricle
 Trabeculae carnae
 2 papillary muscles
 Left Ventricle
 Mitral Valve
 Guards the AV orifice
 2 cusps (anterior, posterior)
 Has chordae tendinae and papillary muscle
 Left Ventricle
 Aortic Valve
 Guards the aortic orifice
 Has 3 cusps (1 anterior, 2 posterior)

 Has aortic sinus

 Anterior: right coronary artery
 Left Posterior: left coronary artery
 Heart Sounds
 1st heart sound
 Closure of AV valves
 2nd heart sound
 Closure aortic and pulmonary valve
 Surface Anatomy Of
Heart Valves
 Tricuspid valve: ® half of the
sternum at the level of 4th ICS
 Mitral valve: left of the sternum at
the level of 4th CC
 Pulmonary valve: medial end of the
3rd (L) CC
 Aortic valve: left half of the sternum
at the level of 3rd ICS
 Heart Sounds
 Tricuspid valve
 Right half of the lower end of the sternal
body
 Mitral valve
 5th ICS MCL
 Pulmonary valve
 Medial end of (L) 2nd ICS
 Aortic valve
 Medial end of ® 2nd ICS
 3 Surfaces of the Heart
 Sternocostal surface (anterior)
 right atrium and ventricle
 Diaphragmatic surface (inferior)
 Right and left ventricles
 Right atrium

 Base (posterior)
 left atrium
 Apex of the Heart
 Left ventricle
 Downward, forward and to the left
 5th (L) ICS, 3 ½” from midline
 Conducting System of
the Heart
 (N): 70-90 bpm
 Atria first then the ventricles
 System
 SA node
 AV node

 AV bundle

 Purkinje fibers
 Sinoatrial Node
 Wall of right atrium in the upper part
of the sulcus terminalis just to the
right of the opening of the SVC
 Atrioventricular Node
 Lower part of the atrial septum just
above the attachment of the septal
cusp of tricuspid valve
 Only route into which impulse travels
from the atria to the ventricle
 Right and Left Bundle Branch
Purkinje fibers
 Arterial Supply of the
Heart
 Ascending Aorta  Aortic valve 
Coronary arteries
 Within the subepicardial connective
tissue
 Right Coronary Artery
 Runs between the pulmonary trunk
and right auricle
 Descends almost vertically in the ®
AV groove, and at the inferior border
of the heart continues posteriorly
along the AV groove to anastomose
with the (L) coronary artery
 Right Coronary Artery
 Right conus artery: infundibulum of ®
ventricle and upper part of the
anterior wall of ® ventricle
 Anterior ventricular branches:
anterior surface of the ® ventricle
 Marginal branch: largest branch. Runs
along the lower margin of the costal
surface to reach the apex
 Right Coronary Artery
 Posterior ventricular branches:
supply the diaphragmatic surface of
the ® ventricle
 Posterior descending artery:
posterior part of the ventricular
septum. AV node
 Atrial branches: anterior and lateral
surfaces of the ® atrium. SA node
 Left Coronary Artery
 Larger than the ®
 Supplies the major part of the heart
 Passes between pulmonary trunk and
(L) auricle, enters the AV groove and
divides into an anterior
interventricular branch and a
circumflex branch
 Left Coronary Artery
 Anterior descending branch:
anastomose with (L) coronary artery
at the posterior interventricular
groove. ® and (L) ventricle, anterior
part of the ventricular septum
 Circumflex artery: left atrium and
ventricle
 Action of the Heart
 Systole
 Diastole