Anatomy of the heart

Cor(L) Kardia(Gk)
Heart in situ
3 layers of heart
1.Heart
2.Fibrous pericardium
(remember three layers 3.Parietal layer of serous
of arteries)? pericardium
4.Visceral layer of serous
pericardium
5.Pericardial space (cavity)
6.Pleural cavity and lung
 pericardium

• Fibrous pericardium
and serous
pericardium
• Serous part has two
layers;parietal and F
visceral(epicardium)
• Between these two
layers of serous part is
pericardial cavity(***)

hemopericardium(?) cardiac tamponade(?).

To understand ‘potential cavity’

visceral

cavity
cavity
cavity

parietal
 Fibrous pericardium

• Attached superiorly to
the tunics of great
vessels.
• to the central tendon
of diaphragm below.
• and by
• sternopericardial
ligaments to the
sternum.
 Serous pericardium

• Forms two tubes;

• 1. Around the
arteries(aorta and
pulmonary trunk) and
• 2.around the veins
entering the
heart(SVC,IVC, and
• pulmonary veins)
 Pericardial sinuses

• The space between

these tubes forms the
transverse sinus and
• oblique sinus.
 Transverse sinus(***)

• Lies posterior to
ascending aorta and
pulmonary trunk(roots
of great arteries)
• Can be used to ligate
these arteries during
cardiac surgery
 Oblique sinus

• Lies posterior to the

left atrium.
• Provides space for
expansion of left
atrium
• Related intimately to E
esophagus
posteriorly(***)
 Clinical relevance
• Fluid can collect in the pericardial
cavity(“effusion”).
• Removal of this fluid is called
pericadiocentesis.
• Fibrous pericardium is pain sensitive
(supplied by phrenic nerves)(***)
• Pain from here refers to the shoulder(***)
Chambers of the heart

Right atrium,right
ventricle(right heart)
Left atrium and Left
ventricle(left heart)
 Heart(surfaces and borders)

• The heart is shaped

like a pyramid lying
on its side.
• Presents an apex
pointing
downwards,forwards
and to the left.
• Its base lies opposite
the apex on the back
of the heart.
 Apex and base of the heart

• Apex is formed by lower,lateral part of left

ventricle and is
• Situated in the left 5th intercostal space 8-9
cm from midsternal plane.
• Base is the posterior surface,formed by left
atrium(mainly) and partly by right atrium.
 Surfaces of heart

• Sternocostal (anterior) surface mainly by

right ventricle,partly right atrium and left
ventricle.
• Inferior(diaphragmatic) surface mainly by
left ventricle ,partly by right ventricle.
• Right and left surfaces by corresponding
atria and ventricles.
BASE(posterior surface)

Diaphragmatic surface
 borders
• Right border by right
atrium(mainly)
• Inferior margin by right
ventricle(mainly)
• Left(obtuse border)
mostly by left ventricle

•Superior vena cava

•Inferior vena cava
•Right atrium (blue)
•Right ventricle (blue)
•Left ventricle (red)
•Aorta
•Pulmonary trunk
Male or female?
 Sulci(grooves)

• Inter atrial
• Interventricular(anterior and posterior)
• Atrio ventricular (CORONARY sulcus)
• All these sulci meet at the back of the heart.
• This meeting point is called the “crux”of
the heart.
 Coronary sulcus

• the coronary arteries run in this sulcus.

 Right atrium

• Receives
RA
• SVC
• IVC
• Coronary sinus(carrying the
venous blood from the heart
itself) and anterior cardiac veins

Note sulcus terminalis

 Interior of right atrium
All the chambers of the heart have rough and smooth parts!!!
• Rough part(anterior part) has
a vertical ridge “crista
terminalis” and musculi
pectinati(teeth of a comb)
• smooth part (posterior part)
is called sinus venarum
• The inter atrial septum
presents a oval depression-
“fossa ovalis”
Interior of right atrium
 The history of fossa ovalis(***)
• In fetal life, the lungs do not function
• Hence the left heart depends on right heart for blood
supply
• Blood from right atrium is shunted through an opening in
the interatrial septum(foramen ovale)
• This foramen closes after birth to form fossa ovalis and its
prominent edge is called “ limbus fossa ovalis”
 openings in the right atrium

• Openings of
SVC,IVC,Coronary sinus
• Right atrio ventricular
orifice(tricuspid orifice)
which is guarded by the
tricuspid valve

•The SA node is located at the junction of the

superior vena cava with the right atrium.
Other valves in the right atrium

• Valve of IVC and

valve of coronary
sinus(rudimentary)
 Triangle of KOCH

A triangular area close to the

Opening of coronary sinus.
Contains A-V node.

Boundaries
•base of the septal leaflet of the tricuspid valve inferiorly
•anterior margin of the coronary sinus orifice
•tendon of Todaro anterosuperiorly
Interior of right ventricle

• Rough part presents

trabeculae carnae,
papillary muscles and
chordae tendinae
• This part is also called
inflow tract
• 3 papillary muscles
• (anterior,posterior and
• septal)
Note the walls and interior of right ventricle
Interior of right ventricle
• Smooth part is called
“infundibulum”(out flow
tract)
• This leads to pulmonary
trunk.
• a special trabeculum
connects the
interventricular septum
and anterior papillary
muscle(moderator band or
septo marginal band)
 Tricuspid valve
(right A-V valve)
• Cusps are
anterior,posterior and
septal
• Chordae tendinae are
attached to these
 Pulmonary valve
(semi lunar valve)

• The out flow tract is

guarded by pulmonary
valve
• Has three semi lunar
cusps
Semilunar valve

Ascending aorta

(aortic valve)
 Interior of Left ventricle

• Rough part(inflow tract)

• presents trabeculae
carnae,papillary muscles
and chordae
• Two papillary muscles;
anterior and posterior
• Smooth part is called
‘vestibule’ which leads to
the aortic opening
 Mitral valve
(left A-V valve)
• Two cusps; anterior
and posterior
Mitral valve and chordae in action
 Aortic valve
(semi lunar valve)
• The outflow tract is
guarded by aortic
valve
• Has three semi lunar
cusps
Study this slide
 Interventricular septum(***)
parts
• Muscular part and membranous part
• Muscular part is the major part of the septum
• Membranous part is usually deficient in VSD

What is Swiss-cheese septum???

 Fibrous skeleton of the heart

• The valvular openings

are kept in position by
• Fibrous rings around
these places called
“skeleton of the heart”
• The myocardium
originates from this
 Cardiac plexus
(nerve supply of the heart)
 Clinical anatomy
• ASD(atrial septal defect)
• VSD (ventricular septal defect)
• PDA(Patent Ductus Arteriosus)

what is ductus arteriosus?

 P
A
M
T

Position of the valves