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HUMAN
HEART
DR. NWOSU C.I.A.,
MSc,MBBS,MD.
LEARNING OBJECTIVES
The heart is a 3-layered, 4-chambered double pump that,
in the embryo invaginated into a preexisting sac,
The surfaces and borders in the surface anatomy of the
heart enables accurate diagnosis in trauma and diseases,
The knowledge of the heart layers is helpful in the
appreciation of such diseases as rheumatic carditis,
The fibrous skeleton is dense connective tissue to which
structures of the heart are attached,
There are 4 heart valves, 2 A-V valves & 2 semilunar
valves: PAMT,
All 4 heart valves are located directly behind the sternum,
but the sound of their closure is heard in areas different
from their anatomical location,
The closure of the A-V valves is responsible for the first
heart sound, whereas the closure of the semilunar valves
is responsible for the second heart sound,
Venous return, stroke volume & cardiac output,
The cardiac cycle describes events from the beginning of
one beat to the beginning of the next,
Posterior
surface or
base
Diaphragmatic
surface
HEART CHAMBERS
RIGHT ATRIUM
TENDON OF TODARO
Tendon of Todaro
Valve of IVC (Eustace)
Valve of coronary sinus
(Thebesius)
Crista terminalis
RIGHT VENTRICLE
Inlet & outlet valves,
Inlet part is roughened by trabeculae carnae, ridges, 3
papillary muscles attached to tendinous cords,
Outlet part is the smooth, arterial infundibulum = conus
arteriosus
Supraventricular crest supports the following structures
- anterosuperior leaflet of tricuspid valve,
- septomarginal band (septomarginal trabecula = moderator band)
- separating the attachments of tricuspid & pulmonary
valves,
INTERVENTRICULAR
SEPTUM
Indicated externally by AIVG and PIVG,
In cross section, the interventricular septum bulges into the RT ventricle
Right ventricle
Left
ventricle
Interventricular
septum
atrium
LEFT VENTRICLE
Rough inlet and smooth outlet (aortic
vestibule)
Like the Rt ventricle, the inlet is roughened
by trabeculae carnae, ridges,and 2 papillary
muscles attached to their tendinous cords,
No Moderator band,
Wall 3 X as thick as the wall of the Rt
ventricle
During systole, the papillary muscle begins
to contract before the general myocardium:
a mechanism to tighten the cords & pull
together the valve cusps to avoid prolapse
Trabeculae carnae
HEART VALVES
The cardiac valves are 2 ATRIOVENTRICULAR & 2 SEMILUNAR,
Each heart valve consists of a core of connective tissues covered by endocardium ;
thus whatever affects the endocardium affects the heart valves e.g bacterial
endocarditis
VALVE
P
A
M
MCL)
T
ICS)
ANAT. LOCATION
3rd CC
3rd ICS
4th CC
4th ICS
(3344)
AUSCULTATION SITE
2 nd LT ICS
2 nd RT ICS
cardiac apex (5th Lt ICS
Rt inferiormost ST (? 5th RT
(2255)
Ascending
aorta
RT coronary
ostium
Coronary
sinuses
LT coronary
ostium
HEART VALVES
HEART VALVES
& HEART
SOUNDS
Normal heart
valves produce
sounds only when
they close
Where might specific
valves be best
heard?
remember that
the sounds are
produced by
BLOOD FLOW
hitting/moving
each structure
project the most
likely passage of
soundwaves ie. the
direction of blood flow
through each gate
CARDIAC
CYCLE
THANK YOU
PRACTICE QUESTIONS
EMBRYOLOGIC SUMMARY
EKG BASICS
When one part of cardiac muscle depolarizes and becomes
electronegative relative to other parts,electrical current also
spreads from the electronegative part into adjacent tissues
(electropositive) all the way to the surface ; recordable on
electrocardiograph,
Electrocardiographic leads are bipolar limb leads, precordial
(chest) leads & augmented unipolar limb leads,
The basic electrocardiographic waves are :
P due to atrial depolarization,
QRS complex due to ventricular depolarization, contraction,
and atrial repolarization (atrial T wave obscured by QRS
complex) ,
T wave due to ventricular repolarization,
P-R interval is about 0.16 second.
VALVULAR INSUFFICIENCY