ANA 215: INTRODUCTION TO ANATOMY, GROSS

ANATOMY OF THE UPPER, LOWER LIMBS THORAX

AND ABDOMEN

Anatomy of the Heart

Lecturer: Dr. A.E Memudu

Anatomy Department
Edo University Iyamho
 Lecturer: Dr. A.E Memudu Anatomy Department
Edo University Iyamho
Rules in my Class:
1- No Phones: Put your Phones on
Silence. ANY PHONE CEASED WONT
BE RETURNED
2- NO LATENESS
3- ATTENDNACE IS COMPULSORY:
4- NO DISRESPECT IN MY CLASS.
5- GIVE IMPROMPTU TEST AT WILL
 LEARNING OUTCOMES
AT THE END OF THIS LECTURE, YOU SHOULD BE ABLE TO:
 State the anatomical location of the heart
 Describe the structure of the heart
 Describe the chambers of the heart
 Describe the valves of the heart
 Describe the neurovascular supply of the heart
 Clinical correlates

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 LECTURE OUTLINE
Introduction
Anatomy of the heart
Describe the structure of the heart
Describe the chambers of the heart
Describe the valves of the heart
Describe the neurovascular supply of the
heart
Clinical correlates
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 Introduction
 The heart is a fibromuscular organ
 It lies in the middle mediastinium
 Function is to propel blood throughout
the body.
 Weighing roughly 200 – 300
grams (females and males,
respectively)
 Length from base to apex approx. 2 cm
 It lies in an oblique position.

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 Introduction
 The heart, right side of the heart (right heart)
receives poorly oxygenated (venous) blood from the
body through
 the SVC and IVC and pumps it
through the pulmonary trunk and arteries to the
lungs for oxygenation
The left side of the heart (left heart) receives well-
oxygenated (arterial) blood from the lungs through
the pulmonary veins and
pumps it into the aorta for systemic distribution
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Anatomy of the heart

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 Parts of the Heart
 The apex of the heart:
 Is formed by the
inferolateral part of the
left ventricle.
 Lies posterior to the left
5th intercostal space in
adults
 Site for taken reading the
heartbeat
 Area where the sounds
of mitral valve closure
are maximal (apex
beat);

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 Parts of the Heart
 The base of the heart
 Is posterior aspect of the heart
 Formed mainly by the L atrium & part of the R-
atrium.
 Separated from the bodies T6–T9 vertebra by the
pericardium, oblique pericardial sinus, esophagus,
and aorta.
 Extends superiorly to the bifurcation of the
pulmonary trunk&inferiorly to the coronary sulcus.
.

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 Base of the heart
 Receives
 the pulmonary veins
on the right and left
sides of left atrial
part
 the superior and
inferior venae cavae
at the
superioinferior end
of the R- atrial
portion
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 Surfaces of the heart
The four surfaces of the heart are the:
1. Anterior (sternocostal) surface, formed mainly by the
right ventricle.
2. Diaphragmatic (inferior) surface, formed mainly by the
left ventricle and partly by the right ventricle; it is related
mainly to the central tendon of the diaphragm.
3. Right pulmonary surface, formed mainly by the right
atrium.
4. Left pulmonary surface, formed mainly by the left
ventricle; it forms the cardiac impression in the left lung.
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 Heart Borders
The heart appears trapezoidal in both
anterioposterior views hence the four
borders of the heart .They are :
Right border (slightly convex),
formed by the right atrium and
extending between the SVC and the
IVC.
Inferior border (nearly horizontal),
formed mainly by the right ventricle
and slightly by the left ventricle.

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 Heart Borders
Left border (oblique, nearly vertical),
formed mainly by the left ventricle
and slightly by the left auricle.
Superior border, formed by the right
and left atria and auricles in an
anterior view;
 the ascending aorta and
pulmonary trunk emerge from
this border
the SVC enters its right side.
Posterior to the aorta and
pulmonary trunk and anterior to
the SVC,
It forms the inferior boundary of
the transverse pericardial sinus. 13
 Cardiac Grooves
 The interventricular groove
 is the superficial landmark of the interventricular septum.
 It is subdivided into diaphragmatic (inferior) and anterior
components based on its course along the surface of the heart.
 On the sternocostal surface, the anterior groove travels parallel to
the obtuse margin of the ventricle; spanning the distance between
the atrioventricular groove and the acute margin (just right of the
cardiac apex).
 The sulcus continues inferiorly as the diaphragmatic groove near
the midpoint of the ventricle, until it terminates at the
diaphragmatic atrioventricular groove (near the point of entry of
the coronary sinus to the inferior vena cava)
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 Cardiac Grooves
Interatrial groove and sulcus terminalis
Interatrial groove is limited laterally (on either side) by the medial atrial walls.
It corresponds to the interatrial septum
The sulcus terminalis cordis: a groove on the posterior surface of the heart,
known as the
 It indicates the transition point between the true right atrium and the venous
part of the right atrium (where the venae cavae initially drain blood).
Coronary sulcus: represents the septum that separates each atrium from its
ipsilateral ventricle. The coronary sulcus is also known as the atrioventricular
groove (or the coronary groove) where it is the primary pathway along which
the coronary arteries travel as they emerge from the base of the aorta.
Initially, the groove is oblique. It then travels inferolaterally to the right as it
provides a partition between the right atrium and auricle and the right
ventricular margin. 15
 Cardiac Surfaces: Sternocostal (anterior) Surface
 The atrioventricular grooveserves as a
dividing line that separates the anterior
surface of the heart into an atrial and a
ventricular component. The former is
superolateral (i.e. to the right), and the
latter is inferolateral (i.e. to the left), of
the atrioventricular groove

Sternocostal Surface of the Heart

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 Cardiac Cycles and Sounds
Cardiac Cycles
 The synchronous pumping actions of the heart’s two atrioventricular (AV)
pumps constitute the cardiac cycle.
 Begins with a period of ventricular elongation and filling (diastole) and
 Ends with a period of ventricular shortening and emptying (systole)
 Heart Sounds
 Heard using a stethoscope is due to closure of the AV valves :
 a lub (1st) sound as the blood is transferred from the atria into the
ventricles,
 and a dub (2nd) sound as the ventricles expel blood from the heart.
.

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 Right Atrium
Forms the right border of the heart
Receives venous blood from the SVC, IVC, and coronary
sinus
Has ear-like conical muscular pouch - right auricle (increase
capacity of the atrium)
The interior of the right atrium has a:
 Smooth, thin-walled, posterior part (the sinus venarum),
where SVC, IVC) and coronary sinus open into
Rough, muscular anterior wall (Pectinate muscles)
 Has the R-AV orifice through which poorly oxygenated
blood moves into the into the right ventricle 18
 Right Atrium
 The smooth and rough parts of the atrial wall are separated
 externally by a shallow vertical groove, the sulcus terminalis
(terminal groove), and
 internally by a vertical ridge, the crista terminalis or (terminal
crest).
 The SVC opens into its superiorly at 3rd costal cartilage while IVC
opens into it at 5th costal cartilage.
 The opening of the coronary sinus, lies between the R-AV orifice and
the IVC orifice.
 The interatrial septum separates the two atria
 It has an oval fossa (a remnant of the oval foramen valve in the fetus).

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Right Atrium

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 Left Atrium
It forms most of the base of the heart
It has a smooth wall
It receives the right and left pulmonary veins
It has a tubular muscular pouch - left auricle, and trabeculated wall with
pectinate muscles
 A semilunar depression (floor of the Oval Fossa) lies on the
The interior of the left atrium has
a larger smooth-walled part and a smaller muscular auricle containing
pectinate muscles.
It receives four pulmonary veins (two superior and two inferior)
It is thicker than the right atrium.
The left AV orifice empties oxygenated blood received into the Left
VENTRICLE

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Left Atrium

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 Right Ventricle
Largest chamber of the heart and forms the largest
part of the anterior surface of the heart
Superiorly it continues into an arterial cone (conus
arteriosus)- leading to the the pulmonary trunk
The interior has
Irregular muscular elevations (trabeculae
carneae)
A thick muscular ridge:- the supraventricular
crest (separates inflow part of the chamber from
the outflow part)
The AV (tricuspid) orifice is located posterior to
the body of the sternum at the level of the 4th
and 5th intercostal spaces surrounded by one of
the fibrous rings of the fibrous skeleton of the
heart . 23
 Left Ventricle
It forms the apex of the heart and it is thicker than the R-Ventricle ( because
arterial pressure is much higher in the systemic than in the pulmonary
circulation)
The interior of the left ventricle has
Thicker Wall as compared to the R-ventricle.
 Walls are covered with a mesh of trabeculae carneae that are finer and
more numerous than those of the right ventricle.
Its conical cavity is longer than that of the right ventricle.
Anterior and posterior papillary muscles that are larger than those in the
right ventricle.
Its smooth-walled ( aortic vestibule) leads to the aortic orifice and aortic
valve.
A double-leaflet mitral valve guards the left AV orifice
The aortic orifice is surrounded by a fibrous ring to which cusps of the
aortic valve are attached 24
 Heart Valves
 The contents of the left and right side of the heart are isolated from each
other by the respective interatrial and interventricular septa. Similarly, blood
is separated from the atrial and ventricular parts of the heart by the
atrioventricular septa.
 The heart valves allow blood to pass from the atria into the ventricles and
from the ventricles into systemic or pulmonary circulatory systems
 They are
 Atrioventricular valves
 Right atrioventricular valve (Tricuspid)
 Left atrioventricular valve (Bicuspid/mitral)
 Semilunar values
 Right semilunar (Pulmonary Valves)
 Left Semilunar (Aortic Valves)
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 Heart Valves: Atrioventricular Valves
 The valves between each atrium and ventricle are referred to
as atrioventricular valves
 They regulate the flow of blood between the atria and
ventricules).
 The right atrioventricular (tricuspid valve)
 The left atrioventricular valve (mitral valve)
 Each valve complex is made up of
 an orifice that is surrounded by a ring, two or three cusps
that extend centrally to close the orifice, and supporting
structures known as chordae tendineae and papillary
muscles
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 Right Atrioventricular valves (Triscupid )
The tricuspid valve guards the right AV orifice.
 The bases of the valve cusps are attached to the
fibrous ring around the orifice.
Tendinous cords (Chordae tendineae) attach to
the free edges and ventricular surfaces of the
anterior, posterior, and septal cusps (like a
parachute)
The tendinous cords arise from the apices of
papillary muscles (are conical muscular
projections with bases attached to the ventricular
wall.
The papillary muscles begin to contract before
contraction of the right ventricle, tightening the
tendinous cords and drawing the cusps together. 28
 Right Atrioventricular valves (Triscupid )
Three papillary muscles in the right ventricle
correspond to the cusps of the tricuspid valve
 The anterior papillary muscle, the largest and most
prominent of the three, arises from the anterior wall
of the right ventricle; its tendinous cords attach to
the anterior and posterior cusps of the tricuspid
valve.
The posterior papillary muscle, smaller than the
anterior muscle; it arises from the inferior wall of
the right ventricle, and its tendinous cords attach to
the posterior and septal cusps of the tricuspid valve.
The septal papillary muscle arises from the
interventricular septum, and its tendinous cords
attach to the anterior and septal cusps of the
tricuspid valve. 29
 Left Atrioventricular valves (Mitral or Bicuspid )
An aortic orifice that lies in the mitral valve right posterosuperior part
orifice.
The mitral valve is located posterior to the sternum at the level of the 4th
costal cartilage.
The mitral valve has two cusps, anterior and posterior; each receives
tendinous cords from more than one papillary muscle.
 These muscles and their cords support the mitral valve, allowing the cusps
to resist the pressure developed during contractions (pumping) of the left
ventricle
The cords become taut just before and during systole, preventing the cusps
from being forced into the left atrium. The semilunar aortic valve, between
the left ventricle and the ascending aorta, is obliquely placed. It is located
posterior to the left side of the sternum at the level of the 3rd intercostal
space. 30
 Semilunar valves
 The semilunar are vessel valves that controls blood flow from heart chambers to aorta and
pulmonary trunk
 They are the
 Semilunar pulmonary valve and
 Semilunar aortic valve
 The aortic valve
 Lies between the Right ventricle and the ascending aorta,
 It is obliquely placed
 It is located posterior to the left side of the sternum at the level of the 2nd intercostal
space.
 Has 3 cusps (posterior, right, and left),
 The pulmonary valve (anterior, right, and left), like the semilunar cusps of the aortic valve
(posterior, right, and left), is concave
 when viewed superiorly Semilunar cusps do not have tendinous cords to support them. They
are smaller in area than the cusps of the AV valves, and the force exerted on them is less
than half that exerted on the cusps of the tricuspid and mitral valves.
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 Neurovascular supply of the heart
Arterial Supply: The coronary arteries, ( branch of the aorta) , supply
the myocardium and epicardium and it is divided into right and left
coronary arteries arise
Venous Drainage of the Heart. The heart is drained mainly by veins that
empty into the coronary sinus. The coronary sinus receives the great
cardiac vein, the middle cardiac vein and small cardiac veins, left
posterior ventricular vein and left marginal vein.
Lymphatic Drainage of the Heart. Lymphatic vessels in the myocardium
and subendocardial connective tissue pass to the subepicardial
lymphatic plexus and inferior tracheobronchial lymph nodes
Innervation of the Heart. The heart is supplied by autonomic nerve
fibers from the cardiac plexus .
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SUPPLEMENTARY
MATERIALS

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ANATOMY OF THE HEART

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ANATOMY OF THE HEART

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ANATOMY OF THE HEART

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ANATOMY OF THE HEART

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 Heart Sounds Under normal conditions, the apex of the heart is located in
Auscultation is a clinical technique that describes listening to the left, fifth intercostal space, along the midclavicular line, a
sounds generated within certain areas of the body. For vertical, imaginary line extending craniocaudally from the
example, the effect of air passing through the airway during middle of the clavicle. In individuals with non-pendulous
breathing can be appreciated using a stethoscope. The heart breasts, this line usually passes through the nipple. This is the
sounds that are appreciated on auscultation are the audible most ideal point to listen to the mitral valve. The sound
effects of the closure of the heart valves. They are classically generated by the tricuspid valve is best heard at the lower left
described as “lub-dub” sounds that are best heard while sternal edge – this happens to coincide with the most medial
auscultating the precordium (area of the anterior chest wall part of the fifth intercostal space. Both the pulmonary and
around the heart). The “lub” part of the heart sound arises aortic valves are audible in the second intercostal space. The
from the atrioventricular valves, while the “dub” part of the only difference is that the aortic valve is heard in the right
sound is generated by the semilunar valves second intercostal space at the upper right sternal edge, while
the pulmonary valve is auscultated in the left second
intercostal space at the upper left sternal edge.

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