HEART-I

ASRA KHAN
Table of contents
◦ Introduction
◦ Structure of heart
◦ Relation of heart
◦ Borders and surfaces
◦ Sulci
◦ Auricle
◦ Pericardium
◦ Layers of heart
◦ Chambers of heart
Cardiovascular system
◦ It consist of:
1. Heart.
2. Blood vessels.
◦ Forms a tubular system, which is particularly a closed system.
◦ Lined throughout by a single layer of flat cells called “endothelium” and
filled with blood.
Heart:
◦The heart is hollow, conical muscular organ.
◦Acts as a pump, beats approximately 2.5 billion times in a
lifetime.
◦It is about 12cm long, 9cm wide and 6cm thick with an average
mass of 250g in adult females and 300g in males.
◦It rests on diaphragm, near the midline of the thoracic cavity.
◦It lies in “mediastinum” an anatomical region that extends from
sternum to vertebral column, from 1 st rib to diaphragm and
between the lungs.
Relations of the heart:
◦ Superiorly: Aorta, SVC, pulmonary artery and pulmonary vein.
◦ Inferiorly: Diaphragm.
◦ Posteriorly: Esophagus, trachea, left and right bronchus, descending
aorta, IVC, thoracic vertebrae.
◦ Anteriorly: Ribs and intercostal muscles.
◦ Laterally: Lungs.
◦ Apex is formed by the tip of left ventricle and rests on diaphragm.
◦ Base of the heart is its posterior surface, and formed by atria of the
heart.
Surfaces and borders:
◦ 3 surfaces and 4 borders:
◦ Sternocostal or anterior surface is deep to sternum and ribs.
◦ Diaphragmatic or inferior surface is part of heart between apex and right border.
◦ The pulmonary or left surface occupies the cardiac notch of left lung.
◦ Right border is formed by right atrium and it faces right lung, extends from
inferior surface to the base.
◦ Inferior border formed by right ventricle and partly left ventricle.
◦ Left border formed by left auricle and left ventricle, faces the left lung and
extends from base to apex.
◦ Superior border formed by both atria.
Sulci:
◦ Grooves on the outer surface of heart marking the division between atria
and ventricles:
1. Atrioventricular sulcus: separates atria from ventricles, right coronary, left
coronary artery, coronary sinus and circumflex artery.
2. Anterior interventricular sulcus: between left and right ventricle on
anterior surface, marks the location of interventricular septum, contains
left anterior descending artery and great cardiac vein.
3. Posterior interventricular sulcus: between left and right ventricle on
posterior surface, contains posterior interventricular artery and middle
cardiac vein.
Auricle:
◦Anterior surface of each atrium is a wrinkled pouch like
structure known as auricle.
◦Each auricle slightly increases the capacity of an atrium so
that it can hold a greater volume of blood.
Pericardium:
◦ Heart is enclosed in double walled sac called the pericardium.
◦ It consist of:
1. Fibrous pericardium.
2. Serous pericardium.
◦ Fibrous pericardium composed of tough, inelastic, dense and irregular
connective tissue.
◦ Functions of fibrous pericardium are:
1. Prevents overstretching of heart.
2. Protection of heart.
3. Anchors the heart in mediastinum.
Cont.
◦ The serous pericardium is thinner membrane that forms double layer
around heart.
◦ Outer parietal layer: It is fused to fibrous pericardium.
◦ Inner visceral layer: Also called Epicardium helps the layer of the heart wall
to adhere tightly to the surface of heart.
◦ Space between these parietal and visceral layers is called pericardial
space.
◦ A fluid is present between parietal and visceral layer for lubrication and
prevention of friction called pericardial fluid.
Layers of heart:
1. Epicardium: Thin, transparent outer
layer of heart wall, contains blood
vessels and lymphatics.
2. Myocardium: It is responsible for
pumping action of heart, composed
cardiac muscle fibers.
3. Endocardium: Glistening white sheet
of endothelium, it lines the heart
chambers and covers the fibrous
skeleton of heart valves.
Chambers and valves of heart:
◦ 4 chambers.
1. Right atrium.
2. Left atrium.
3. Right ventricle.
4. Left ventricle.
◦ Right atrium receives deoxygenated blood from SVC and IVC and pumps it
to right ventricle through tricuspid valve which further pumps the blood to
pulmonary circulation for oxygenation through pulmonary trunk and
pulmonary valve.
◦ After oxygenation from lungs the oxygenated blood enters left atrium
through 2 pairs of pulmonary veins, from here blood enters left ventricle
through bicuspid/mitral valve, and from LV blood enters aorta through
aortic valve to be pumped in systemic circulation.
Right atrium (RA):
◦ RA forms right border of heart receives blood from SVC,IVC and
coronary sinus.
◦ It is about 2-3 mm in diameter.
◦ Posterior wall is smooth but anterior wall is rough due to presence of
muscular ridges called pectinate muscles.
◦ RA and LA separated by inter-atrial septum, prominent feature of
which is an oval depression called Fossa Ovalis.
◦ Between RA and RV there is tricuspid valve having three leaflets
anterior, septal and inferior. The cusps are attached tendon like cords
called “chordae tendineae”, which in turn are connected to cone
shaped “papillary muscles”.
Right ventricle (RV):
◦It is about 4-5mm in thickness and forms most of the anterior
surface of heart.
◦It contains a series of ridges formed by bundles of cardiac muscle
fibers called “trabeculae carneae” which helps in conduction.
◦RV separated from LV by interventricular septum.
◦Blood from RV enters pulmonary trunk through pulmonary valve
having three cusps anterior, left and right cusp.
◦No chordae tendinea and papillary muscles attached to pulmonary
valve.
Left atrium:

◦It is about same thickness as about right atrium and

form most of the base of heart.
◦It has smooth anterior and posterior walls, because
pectinate muscles are confined to the auricle of left
atrium.
◦From LA blood enters LV through bicuspid valve
having 2 cusps anterior and posterior.
Left Ventricle:
◦ Thickest chamber of heart about 10-15mm and forms the apex of heart.
◦ Like RV, the LV also have trabeculae carnaea and has chordae tendineae
that anchors the cusps of bicuspid valves to papillary muscles.
◦ Blood passes from LV through aortic valve having 3 cusps left and right
coronary cusp and non coronary cusp, into ascending aorta from here
blood enters into coronary arteries, branching from ascending aorta and
carry blood to heart wall.
◦ Reminder of blood passes into arch of aorta and descending aorta, which
further passes blood throughout the body.
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