ANATOMY OF HEART

LOCATION:

Lies within the pericardium in middle mediastinum

Behind the body of sternum and the 2nd to 6th costal

Cartilages.

In front of the 5th to 8th thoracic vertebrae

A third of it lies to the right of median plane and 2/3 to

the left

Anterior to the vertebral column, posterior to the sternum

EXTERNAL CHARACTERISTICS:

A hollow muscular organ, pyramidal in shape , somewhat

larger than a closed fist; consists of four chambers (right and
left atria, right and left ventricles).

Cardiac Apex is formed by left ventricle and is directed

downwards and forwards to the left. It lies at the level of the
fifth left intercostal space, 1~2cm medial to the left
midclavicular line (9cm from the midline).

The apex beat 【 point of maximum impulse (PMI) 】 ,

is the furthermost point outwards (laterally) and
downwards (inferiorly) from the sternum at which the
cardiac impulse can be felt.
Lateral and/or inferior displacement of the apex beat
usually indicates enlargement of the heart, called
Cardiomegaly

Approximately the size of your fist

Wt. = 250-300 grams

Cardiac base is formed by the left atrium and to a small

extent by the right atrium. It faces backward, upward
and to the right
Two surfaces:
Sternocostal surface is formed mainly by the right atrium
and right ventricle, and a lesser portion of its left is formed by
the left auricle and ventricle. It is directed forwards and
Upwards

Diaphragmatic surface is formed by the ventricles chiefly

the left ventricle, directed backwards and
downwards, and rests upon the central tendon of the
diaphragm
Three borders:

Right border (vertical), is formed entirely by right atrium

Left border (round), is mainly formed by the left ventricle

and partly by the left auricle

Inferior border (horizontal), is formed by the right ventricle

and cardiac apex
Four grooves:

Coronary sulcus (circular sulcus) which marks the division

between atria and ventricles, contains the trunks of the coronary
vessels and completely encircles the heart

Interatrial groove － separates the two atria and is hidden by

pulmonary trunk and aorta in front

Interventricular grooves － anterior and posterior, mark the

division between ventricles (which separates the RV from the LV),
COVERING OF THE HEART:
Pericardium – a double-walled sac around the heart
Composed of:
A superficial fibrous pericardium
A deep two-layer serous pericardium

The parietal layer lines the internal surface of the fibrous

pericardium
The visceral layer or epicardium lines the surface of the heart
They are separated by the fluid-filled pericardial cavity called the
pericardial cavity

Protects and anchors the heart

Prevents overfilling of the heart with blood
Allows for the heart to work in a relatively friction-free environment
LAYERS OF THE HEART WALL:
Epicardium – visceral pericardium

Myocardium – cardiac muscle layer

forming the bulk of the heart

Endocardium – endothelial layer of the

inner myocardial surface
ATRIA OF THE HEART:

Atria - receiving chambers of the heart

Receive venous blood returning to heart

Separated by an interatrial septum (wall)

Foramen ovale - opening in interatrial septum in fetus
Fossa ovalis - remnant of foramen ovale
Pectinate muscles mark atrial walls
Pump blood into ventricles

Blood enters right atria from superior and inferior venae cavae and
coronary sinus
Blood enters left atria from pulmonary veins
VENTRICLE OF THE HEART:

Ventricles are the discharging chambers of the heart

 Papillary muscles and trabeculae carneae muscles mark

ventricular walls

 Separated by an interventricular septum

 Contains components of the conduction system

 Right ventricle pumps blood into the pulmonary trunk

 Left ventricle pumps blood into the aorta

Thicker myocardium due to greater work load

 Pulmonary circulation supplied by right ventricle is a much low

pressure system requiring less energy output by ventricle
 Systemic circulation supplied by left ventricle is a higher pressure
system and thus requires more forceful contractions
Left ventricle

It’s wall is three times thicker

than that of right ventricle
One inlet － left atrioventricular
orifice
One outlet － aortic orifice
Two parts － divided by anterior
cusps of mitral valve
Inflow tract － rough walls
Outflow tract – aortic
vestibule smooth area
leading to aortic orifice
SEPTUMS/FIBROUS SKELETON:

Interatrial septum
Located between right and left atria
Contains fossa ovalis

Interventricular septum
Located between right and left ventricles
upper membranous part
thick lower muscular part

Fibrous skeleton
Fibrous rings that surround the atrioventricular,pulmonary, and aortic orifices
Left and right fibrous trigons
HEART VALVES:
Heart valves ensure unidirectional blood flow through the heart
 Composed of an endocardium with a connective tissue core
 Two major types
 Atrioventricular valves
 Semilunar valves
 Atrioventricular (AV) valves lie between the atria and the
ventricles
 R-AV valve = tricuspid valve
 L-AV valve = bicuspid or mitral valve
 AV valves prevent backflow of blood into the atria when ventricles
contract
 Chordae tendineae anchor AV valves to papillary muscles of
ventricle wall
 Prevent prolapse of valve back into atrium
SEMILUNAR HEART VALVES:

Semilunar valves prevent backflow of blood into the ventricles

Have no chordae tendinae attachments

Aortic semilunar valve lies between the left ventricle and the aorta

Pulmonary semilunar valve lies between the right ventricle and

pulmonary trunk
Tricuspid valve
Guards right atrioventricular orifice
Three triangular cusps: anterior, posterior and septal, the base
of cusps are attached to fibrous ring surrounding the
atrioventricular orifice
Chordae tendineae － fine, white, connective tissue cords,
attach margin of cusps to papillary muscles

Mitral valve
Guards left atrioventricular orifice
Two triangular cusps － anterior and posterior with Similar
structures to those of right
CONDUCTING SYSTEM OF THE HEART:
Cardiac muscle tissue has intrinsic ability to:
Generate and conduct impulses
Signal these cells to contract rhythmically

Conducting system
A series of specialized cardiac muscle cells
Sinoatrial (SA) node sets the inherent rate of
contraction
Sino-atrial node (SA node)
Called the pacemaker cell (P cell)
Located at the junction of right atrium and superior vena cava,
upper part of the sulcus terminalis, under the epicardium

Atrioventricular node (AV node)

Located in the lower part of interatrial septum just above the
orifice of coronary sinus, under the endocardium
Lower part related to membranous part of interventricular septum

Atrioventricular bundle (AV bundle)

Passes forward through right fibrous trigon to reach inferior border
of membranous part
Divides into right and left branches at upper border of muscular
part of interventricular septum
INNERVATION:

Heart rate is altered by external controls

Nerves to the heart include:
Parasympathetic branches of the vagus nerve

Sympathetic fibers – from cervical and

upper thoracic chain ganglia
MAJOR VESSELS OF THE HEART:
Vessels returning blood to the heart include:
Superior and inferior venae cavae
Open into the right atrium
Return deoxygenated blood from body cells
Coronary sinus
Opens into the right atrium
Returns deoxygenated blood from heart muscle (coronary
veins)

Right and left pulmonary veins

Open into the left atrium
Return oxygenated blood from lungs
Vessels conveying blood away from the heart include:

Pulmonary trunk
Carries deoxygenated blood from right ventricle to lungs
Splits into right and left pulmonary arteries

Ascending aorta
Carries oxygenated blood away from left ventricle to body
organs
PATHWAY OF BLOOD THROUGH THE HEART:
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