FUNCTIONAL ANATOMY

OF
HEART

By
Dr Bini Upendran
 INTRODUCTION
 Heart is the muscular organ
designed to ensure the circulation
of blood through the tissues of the
body.
 The greek name for heart is cardia
from which we have the adjective
“cardiac”.
 The latin name for heart is cor from
which we have the adjective
“coronary”.
SIZE
 The heart is roughly same size of
one’s closed fist.
 It is 12cm long, 9cm wide, 6cm
thick.
 Average mass is 250gm in adult
females and 300gms in adult
males.
 LOCATION

 The heart lies on the

diaphragm, near the midline
of thoracic cavity.

 It lies in mediastinum.

 About 2/3rd of the mass of

heart lies to the left of
body’s midline.
GENERAL FEATURES
 Apex :- It is formed by the left
ventricle near its junction with
interventricular septum.
- It is directed anteriorly ,inferiorly and
to the left.

 Base : It is formed by atria and great

vessels.
- It is directed posteriorly ,superiorly
and to the right.
 General features
continued…..
Surfaces:
 Anterior surface –

formed mainly by right

atrium and right
ventricle.
 Inferior surface – is
formed by the left
ventricle and right
ventricle (2/3rd & 1/3rd)
and rests mainly on the
central tendon of
diaphragm.
 General features continued…
BORDERS:
 Right border - Formed by the

right atrium
 Left border- formed by left
ventricle and partly by left
auricle.
 Upper border- Is slightly

oblique, formed by two atria.

 Inferior border- is nearly

horizontal, formed mainly by

right ventricle.
Continued……..
 Sulci :
 Series of grooves on the surface of
the heart containing coronary
blood vessels and a variable
amount of fat.
 Each sulcus marks the external
boundary between 2 chambers of
the heart. They are –
- Deep coronary
sulcus(atrioventricular sulcus)
- Anterior interventricular sulcus
- Posterior interventricular sulcus
 HEART CHAMBERS
 Heart has four chambers:
 - 2 superior
chambers called atria
- 2 inferior
chambers called
ventricles.
 Atria: They serve a

capacity function as well

as that of contraction.
- Each atrium has a
structure called an
auricle.
Chambers of heart
continued..
 Right atrium : - Has a rough anterior wall and
a smooth posterior wall.
- It is separated from left atrium by interatrial
septum.
- It recieves blood from 3 veins:
- superior vena cava
- inferior vena cava
- coronary sinus
- Received blood from the systemic circulation
passes to right ventricle through a valve
called “tricuspid valve”.
Continued…
 Left atrium :- this chamber lies
posterior to other cardiac
chambers and forms most of the
base of the heart.
-It has a smooth posterior wall and a
smooth anterior wall also.
-It recieves blood through 4
pulmonary veins from lungs and
passes it to left ventricle via “mitral
valve”.
 Continued…..
 Ventricles: They serve as pumps.
 Inside of ventricles contain –
- Trabeculae carneae
- Chordae tendinae
- Papillary muscles

 Significance: “Apex beat” which can be

palpated in left 5th intercostal space in
midclavicular line.
Continued…..
 Right ventricle : - It is separated from left
ventricle by “interventricular septum”.
- It supplies the lung circulation via pulmonary
artery.
 Left ventricle : - Blood from here passes
through aortic valve into ascending aorta.
Some blood from aorta is carried to the
heart wall by coronary arteries. Remainder
of blood passes through aorta throughout
the body.
 Note : “ physiological hypertrophy of left
ventricle”.
 Thickness of right ventrical wall is 0.3-
0.5cm and that of left ventricle is 1.3-
1.5cm.
 HEART VALVES
 2 types of valves in heart –
a) atrioventricular valve:
- tricuspid valve
- mitral valve
b) semilunar valves :
- pulmonary valve
- aortic valve
 The tricuspid valve has 3 cusps
and the mitral valve has 2 cusps.
 The semilunar vlaves have 3
cusps .
Heart valves continued..
 The valves are surrounded by fibrous
tissue rings/annulus.
 Both valves have chordae tendinae,
papillary muscles and valve annulus.
 Papillary muscles play a important role in
preventing the back flow of blood from
ventricles into atria during ventricular
contraction.
 Significance: Papillary muscle
paralysis/rupture of chordae tendinae
causes regurgitation of blood into atria.
 LAYERS OF HEART
WALL
 3 layers of tissues :
- outer pericardium

- middle myocardium

- inner endocardium
Continued…
1) Pericardium :
 The membrane that surrounds and
protects the heart.
 It confines the heart to its position

in mediastinum.
 It has 2 main parts :

- outer fibrous layer

- inner serous layer
Continued ….
 Fibrous pericardium is composed
of tough
inelastic irregular connective tissues
.
 It prevents overstretching of heart .

 Gives protection to heart.

 Anchors the heart in mediastinum.

Continued..
 Serous pericardium : Is deeper
,thinner and delicate membrane that
forms a double layer around the heart
ie – outer parietal layer
- inner visceral layer.
 Between these two layers is a thin
film of fluid called “pericardial fluid”
and the space containing it is called
“pericardial cavity”.
 This fluid reduces the friction b/w two
layers of serous pericardium as heart
moves.
Continued…
2) Myocardium: it is the cardiac muscle
tissue which makes up the bulk of the
heart and is responsible for pumping
action.
 It is involuntary in nature.

 3 types of cardiac muscle fibres are

present :
- muscle fibres which from contractile unit of
heart.
- muscle fibres which forms the pace maker
tissues.
- muscle fibres which from the conductive
system.
Continued..

3) Endocardium: Is the inner most

thin layer of endothelium overlying
a thin layer of connective tissue.
 It provides a smooth lining for the
chambers of heart and covers the
valves of the heart.
 MYOCARDIAL BLOOD SUPPLY:

 3 Major coronary trunk

supply blood to specific
segments of heart.

 Anterior descending branch

of left coronary artery.

 Circumflex branch of left

coronary artery.

 Right coronary artery.

NERVE SUPPLY

 Parasympathetic nerve supply

originates in medulla and passes
through the left and right vagus
nerve.

 Sympathetic nerve supply passes

from spinal cord to the upper four or
five thoracic ganglia.
CONDUCTION SYSTEM OF
HEART
 It is located in myocardium.
 Is responsible for regulating the rate
and rhythm of heart.
 Also called pace maker tissues of
heart.
 They include: - Sinuatrial node
- Atrio ventricular
node
- Bundle of his
- Purkinje fibres.