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  1. 1. ANATOMY OF THE HEART<br />By:<br />Dr Mohammed Faez<br />
  2. 2. The Heart<br />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.<br />
  3. 3. The Heart<br />The heart is surrounded by membrane called Pericardium.<br />
  4. 4. The Pericardium<br />The pericardium is a fibroserous sac that encloses the heart and the roots of the great vessels.<br />The pericardium lies within the middle mediastinum.<br />
  5. 5. The Pericardium<br />
  6. 6. The Pericardium<br />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.<br />
  7. 7. The Pericardium<br />Pericardium – a double-walled sac around the heart composed of:<br />A superficial fibrous pericardium<br />A deep two-layer serous pericardium<br />The parietal layer lines the internal surface of the fibrous pericardium<br />The visceral layer or epicardium lines the surface of the heart<br />They are separated by the fluid-filled pericardial cavity<br />
  8. 8. The Pericardium<br />
  9. 9. The Pericardium<br />
  10. 10. The Pericardium<br />
  11. 11. The Pericardium<br />Blood Supply<br />The pericardium blood supply is from the pericardiacophrenic branches of the internal thoracic arteries.<br />Nerve Supply<br />The pericardium nerve supply the fibrous pericardium and the parietal layer of serous pericardium are supplied by the phrenic nerve.<br />
  12. 12. Heart Wall<br />Epicardium – visceral layer of the serous pericardium<br />Myocardium – cardiac muscle layer forming the bulk of the heart<br />Fibrous skeleton of the heart – crisscrossing, interlacing layer of connective tissue<br />Endocardium – endothelial layer of the inner myocardial surface<br />
  13. 13. Heart Wall<br />Endocardium<br />deepest layer of the heart<br />smooth lining to reduce friction of bloodflow<br />Myocardium<br />middle layer of the heart<br />location of muscle fibers responsible for pumping<br />Pericardium<br />outer protective layer<br />composed of :<br />visceral pericardium<br />paricardial cavity<br />parietal pericardium<br />
  14. 14. Heart Wall<br />
  15. 15. Heart Wall<br />
  16. 16. The Heart<br />The heart is a hollow muscular organ that is somewhat pyramid shaped and lies within the pericardium in the mediastinum .<br />It is connected at its base to the great blood vessels but otherwise lies free within the pericardium.<br />
  17. 17. The Heart<br />
  18. 18. The Heart<br />The heart surfaces:<br />• 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.<br />• The inferior (diaphragmatic) surface comprises the: right atrium, atrioventricular groove and both ventricles separated by the interventricular groove.<br />• The posterior surface (base) comprises the left atrium receiving the four pulmonary veins.<br />
  19. 19. The Heart<br />
  20. 20. The Heart Chambers<br />Four chambers<br />Two atria (Right and Left)<br />Two ventricles (Right and Left)<br />
  21. 21. The Heart Chambers<br />Atria <br />Features <br /><ul><li>small, thin-walled chambers </li></ul>Functions <br /><ul><li>receiving chambers for blood returning to the heart from the circulation
  22. 22. push the blood into the adjacent ventricles.</li></li></ul><li>The Heart Chambers<br />Atria <br />Receive blood from <br /><ul><li>Right side
  23. 23. Superior and Inferior Vena Cava
  24. 24. Coronary Sinus (draining the myocardium)
  25. 25. Left side
  26. 26. Pulmonary Veins</li></li></ul><li>The Heart Chambers<br />Ventricles <br />Features <br /><ul><li>make up most of the mass of the heart
  27. 27. the walls of the left ventricle are 3X thicker than those of the right </li></li></ul><li>The Heart Chambers<br />Ventricles <br />Functions <br /><ul><li>discharging chambers of the heart
  28. 28. propel blood to Pulmonary Trunk (right ventricle), Aorta (left ventricle) </li></li></ul><li>The Right Atrium<br />• Receives deoxygenated blood from the inferior vena cava below and from the superior vena cava above.<br />• Receives the coronary sinusin its lower part.<br />• The upper end of the atrium projects to the left of the superior vena cava as the right auricle.<br />
  29. 29. The Right Atrium<br />The sulcusterminalisis a vertical groove on the outer surface of the atrium. This groove corresponds internally to the cristaterminalis .<br />Above the coronary sinus the interatrial septum forms the posterior wall. The depression in the septum the fossaovalisare presents the site of the foramen ovale.<br />
  30. 30.
  31. 31. RA<br />
  32. 32. The Right Ventricle<br />Receives blood from the right atrium through the tricuspid valve .<br />The edges of the valve cusps are attached to chordaetendineaewhich are, in turn, attached below to papillary muscles.<br />
  33. 33. The Right Ventricle<br />The wall of the right ventricle is thicker than that of the atria but not as thick as that of the left ventricle. <br />The wall contains a mass of muscular bundles known as trabeculaecarneae.<br />The infundibulumis the smooth walled outflow tract of the right ventricle.<br />
  34. 34. The Right Ventricle<br />The pulmonary valve is situated at the top of the infundibulum. <br />It is composed of three semilunar cusps. <br />Blood flows through the valve and into the pulmonary arteries via the pulmonary trunk to be oxygenated in the lungs.<br />
  35. 35.
  36. 36. RV<br />
  37. 37. The Left Atrium<br />Receives oxygenated blood from four pulmonary veins which drain posteriorly.<br />The cavity is smooth walled except for the atrial appendage.<br />On the septal surface a depression marks the fossaovalis.<br />
  38. 38. The Left Atrium<br />The mitral (bicuspid) valve guards the passage of blood from the left atrium to the left ventricle.<br />
  39. 39. LA<br />
  40. 40. The Left Ventricle<br />The wall of the left ventricle is thicker than the right ventricle but the structure is similar. <br />The thick wall is necessary to pump oxygenated blood at high pressure through the systemic circulation. <br />Trabeculaecarneaeproject from the wall with papillary muscles attached to the mitral valve cusp edges by way of chordaetendineae.<br />
  41. 41. The Left Ventricle<br />The vestibuleis a smooth walled part of the left ventricle which is located below the aortic valve .<br />
  42. 42.
  43. 43. LV<br />
  44. 44. The Heart Valves<br />Heart valves ensure unidirectional blood flow through the heart<br />Composed of an endocardium with a connective tissue core.<br />Two major types<br />Atrioventricular valves<br />Semilunar valves<br />
  45. 45.
  46. 46. Atrioventricular (AV) Valves<br />Atrioventricular (AV) valves lie between the atria and the ventricles<br />R-AV valve = tricuspid valve<br />L-AV valve = bicuspid or mitral valve<br />AV valves prevent backflow of blood into the atria when ventricles contract<br />Chordaetendineae anchor AV valves to papillary muscles of ventricle wall<br />Prevent prolapse of valve back into atrium<br />
  47. 47. AtrioventricularValve<br />
  48. 48. Semilunar Heart Valves<br />Semilunar valves prevent backflow of blood into the ventricles<br />Have no chordae tendinae attachments<br />Aortic semilunar valve lies between the left ventricle and the aorta <br />Pulmonary semilunar valve lies between the right ventricle and pulmonary trunk<br />Heart sounds (“lub-dup”) due to valves closing<br />“Lub” - closing of atrioventricular valves<br />“Dub”- closing of semilunar valves<br />
  49. 49. SemilunarValve<br />
  50. 50. The Heart Valves<br />Atrioventricular valves Semilunar valves<br />Right AV (Tricuspid)<br />separates the right atrium from the right ventricle. Prevents backflow into atrium.<br />Left AV (Bicuspid)<br />separates the left atrium from the left ventricle. Prevents backflow into atrium.<br />Pulmonary valve<br />separates the right ventricle from the pulmonary arteries. Prevents backflow after ventricular contraction.<br />Aortic valve<br />separates the left ventricle from the aorta. Prevents backflow after ventricular contraction .<br />
  51. 51. The Heart Valves<br />Pulmonary<br />semilunar valve<br />Right AV<br />(tricuspid)<br />valve<br />Aortic<br />semilunar valve<br />Chordai<br />tendineae<br />Papillary<br />muscle<br />Left AV<br />(bicuspid)<br />valve<br />
  52. 52. The Heart Valves<br />
  53. 53. Arterial Supply of the Heart<br />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.<br />
  54. 54. Coronary Arteries <br />The origins of the coronary arteries are as follows:<br />The left coronary artery arises from the aortic sinus immediately above the left posterior cusp of the aortic valve .<br />The right coronary artery arises from the aortic sinus immediately above the anterior cusp of the aortic valve.<br />
  55. 55. Right coronary artery<br />Branches<br />Right marginal arteries (acute marginal artery)<br />Posterior interventricular artery. (in post. IV sulcus)<br />Sinoatrial nodal artery.<br />Atrioventricular nodal artery.<br />
  56. 56. Left coronary artery<br />Branches<br />Left anterior descending (LAD) or anterior interventricular artery. (lies in anterior IV sulcus)<br />Septal branches.<br />Diagonal branches<br />Left marginal artery. (Obtuse marginal artery)<br />Left circumflex artery.<br />
  57. 57. Coronary Arteries <br />
  58. 58.
  59. 59. Venous Drainage of the Heart<br />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 .<br />It is a continuation of the great cardiac vein.<br /> It opens into the right atrium to the left of the inferior vena cava<br />
  60. 60. Venous Drainage of the Heart<br />
  61. 61. Nerve Supply of the Heart<br />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.<br />The sympathetic supply arises from the cervical and upper thoracic portions of the sympathetic trunks, and the parasympathetic supply comes from the vagus nerves.<br />
  62. 62. THANK YOU<br />
  63. 63.
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  66. 66. External Heart: Anterior View<br />
  67. 67. External Heart: Posterior View<br />
  68. 68. Gross Anatomy of Heart: Frontal Section<br />