ANATOMY OF THE HEART
By:Dr Mohammed Faez
The Heart
The heart is a chambered muscular organ that pumps blood received from the veins into the arteries, thereby maintaining the flow of blood through the entire circulatory system.
The Heart
• The heart is surrounded by membrane called Pericardium.
The Pericardium
• The pericardium is a fibroserous sac that encloses the heart and the roots of the great vessels.
• The pericardium lies within the middle mediastinum.
The Pericardium
The Pericardium
• Its function is to restrict excessive movements of the heart as a whole and to serve as a lubricated container in which the different parts of the heart can contract.
The Pericardium• Pericardium – a double-
walled sac around the heart composed of:
1. A superficial fibrous pericardium
2. A deep two-layer serous pericardium
a. The parietal layer lines the internal surface of the fibrous pericardium
b. The visceral layer or epicardium lines the surface of the heart
• They are separated by the fluid-filled pericardial cavity
The Pericardium
The Pericardium
The Pericardium
The Pericardium
Blood Supply• The pericardium blood
supply is from the pericardiacophrenic branches of the internal thoracic arteries.
Nerve Supply• The pericardium nerve
supply the fibrous pericardium and the parietal layer of serous pericardium are supplied by the phrenic nerve.
Heart Wall
• Epicardium – visceral layer of the serous pericardium
• Myocardium – cardiac muscle layer forming the bulk of the heart
• Fibrous skeleton of the heart – crisscrossing, interlacing layer of connective tissue
• Endocardium – endothelial layer of the inner myocardial surface
Heart Wall
• Endocardium– deepest layer of the heart– smooth lining to reduce friction of bloodflow
• Myocardium– middle layer of the heart– location of muscle fibers responsible for pumping
• Pericardium– outer protective layer– composed of :– visceral pericardium– paricardial cavity– parietal pericardium
Heart Wall
Heart Wall
The Heart
• The heart is a hollow muscular organ that is somewhat pyramid shaped and lies within the pericardium in the mediastinum .
• It is connected at its base to the great blood vessels but otherwise lies free within the pericardium.
The Heart
The HeartThe heart surfaces:• The anterior (sternocostal) surface
comprises the: right atrium, atrioventricular groove, right ventricle, a small strip of left ventricle and the auricle of the left atrium.
• The inferior (diaphragmatic) surface comprises the: right atrium, atrioventricular groove and both ventricles separated by the interventricular groove.
• The posterior surface (base) comprises the left atrium receiving the four pulmonary veins.
The Heart
The Heart Chambers
• Four chambers– Two atria (Right and Left)– Two ventricles (Right and
Left)
The Heart Chambers• Atria – Features
small, thin-walled chambers
– Functions receiving chambers for
blood returning to the heart from the circulation
push the blood into the adjacent ventricles.
The Heart Chambers
• Atria – Receive blood
from Right side Superior and
Inferior Vena Cava Coronary Sinus
(draining the myocardium)
Left side Pulmonary Veins
The Heart Chambers
• Ventricles – Features
make up most of the mass of the heart
the walls of the left ventricle are 3X thicker than those of the right
The Heart Chambers
• Ventricles – Functions
discharging chambers of the heart
propel blood to Pulmonary Trunk (right ventricle), Aorta (left ventricle)
The Right Atrium
• Receives deoxygenated blood from the inferior vena cava below and from the superior vena cava above.
• Receives the coronary sinus in its lower part.
• The upper end of the atrium projects to the left of the superior vena cava as the right auricle.
The Right Atrium
• The sulcus terminalis is a vertical groove on the outer surface of the atrium. This groove corresponds internally to the crista terminalis .
• Above the coronary sinus the interatrial septum forms the posterior wall. The depression in the septum the fossa ovalis are presents the site of the foramen ovale.
RA
The Right Ventricle
• Receives blood from the right atrium through the tricuspid valve .
• The edges of the valve cusps are attached to chordae tendineae which are, in turn, attached below to papillary muscles.
The Right Ventricle
• The wall of the right ventricle is thicker than that of the atria but not as thick as that of the left ventricle.
• The wall contains a mass of muscular bundles known as trabeculae carneae.
• The infundibulum is the smooth walled outflow tract of the right ventricle.
The Right Ventricle
• The pulmonary valve is situated at the top of the infundibulum.
• It is composed of three semilunar cusps.
• Blood flows through the valve and into the pulmonary arteries via the pulmonary trunk to be oxygenated in the lungs.
RV
The Left Atrium
• Receives oxygenated blood from four pulmonary veins which drain posteriorly.
• The cavity is smooth walled except for the atrial appendage.
• On the septal surface a depression marks the fossa ovalis.
The Left Atrium
• The mitral (bicuspid) valve guards the passage of blood from the left atrium to the left ventricle.
LA
The Left Ventricle• The wall of the left ventricle is
thicker than the right ventricle but the structure is similar.
• The thick wall is necessary to pump oxygenated blood at high pressure through the systemic circulation.
• Trabeculae carneae project from the wall with papillary muscles attached to the mitral valve cusp edges by way of chordae tendineae.
The Left Ventricle
• The vestibule is a smooth walled part of the left ventricle which is located below the aortic valve .
LV
The 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• 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
Atrioventricular Valve
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
• Heart sounds (“lub-dup”) due to valves closing– “Lub” - closing of atrioventricular
valves– “Dub”- closing of semilunar valves
Semilunar Valve
The Heart Valves
• Right AV (Tricuspid)– separates the right
atrium from the right ventricle. Prevents backflow into atrium.
• Left AV (Bicuspid)– separates the left
atrium from the left ventricle. Prevents backflow into atrium.
• Pulmonary valve– separates the right
ventricle from the pulmonary arteries. Prevents backflow after ventricular contraction.
• Aortic valve– separates the left
ventricle from the aorta. Prevents backflow after ventricular contraction .
Atrioventricular valves Semilunar valves
The Heart Valves
Pulmonarysemilunar valve
Aorticsemilunar valve
Left AV(bicuspid)valve
Right AV(tricuspid)valve
Chordaitendineae
Papillarymuscle
The Heart Valves
Arterial Supply of the Heart
• The arterial supply of the heart is provided by the right and left coronary arteries, which arise from the ascending aorta immediately above the aortic valve.
Coronary Arteries
The origins of the coronary arteries are as follows:
• The left coronary artery arises from the aortic sinus immediately above the left posterior cusp of the aortic valve .
• The right coronary artery arises from the aortic sinus immediately above the anterior cusp of the aortic valve.
Right coronary artery
Branches– Right marginal arteries
(acute marginal artery)– Posterior
interventricular artery. (in post. IV sulcus)
– Sinoatrial nodal artery.– Atrioventricular nodal
artery.
Left coronary artery
Branches– Left anterior descending
(LAD) or anterior interventricular artery. (lies in anterior IV sulcus)• Septal branches.• Diagonal branches
– Left marginal artery. (Obtuse marginal artery)
– Left circumflex artery.
Coronary Arteries
Venous Drainage of the Heart
• Most blood from the heart wall drains into the right atrium through the coronary sinus ,which lies in the posterior part of the atrioventricular groove .
• It is a continuation of the great cardiac vein.
• It opens into the right atrium to the left of the inferior vena cava
Venous Drainage of the Heart
Nerve Supply of the Heart
• The heart is innervated by sympathetic and parasympathetic fibers of the autonomic nervous system via the cardiac plexuses situated below the arch of the aorta.
• The sympathetic supply arises from the cervical and upper thoracic portions of the sympathetic trunks, and the parasympathetic supply comes from the vagus nerves.
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External Heart: Anterior View
External Heart: Posterior View
Gross Anatomy of Heart: Frontal Section
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