Anatomy of heart

2. POSITION OF
HEART
• It is placed obliquely behind
the body of sternum.
• Heart is conical hollow
muscular organ situated in the
middle of mediastinum

3. STRUCTURE
OF HEART
• It is enclosed in a
fibrous sac called
pericardium. Which
consists of fibrous
pericardium and
serous pericardium.

4. EXTERNAL FEATURES OF
HEART
• Apex: formed entirely by left
ventricle.
• Directed
downwards,forwards,and to the
left.
• It is situated in the left
fifth intercostal space 9 cm
lateral to the midsternal
line.

5. BASE OF THE
HEART
• Also called posterior
surface of the heart.
• Formed mainly by the
left atrium and small
part of right atrium.
• In relation to the
base we can see the
opening of 4 pulmonary
veins which opens into
left atrium and
superior and inferior
vena cava which opens
into right atrium.

6. BORDERS OF HEART
• Upper border is slightly
oblique and is formed by 2
atria mainly by the left
atrium.
• Right border is more or
less verticle and is
formed by the right
atrium.
• It extends from SVC to
IVC.
• Inferior border is nearly
horizontal and formed
mainly by the right
ventricle.
• A small part of it is
formed by apex.
• Left border is oblique and

7. Cardiac
shadow
in chest
X-Ray

8. Surfaces of
heart
• Anterior or sternocostal surface is formed mainly by the
right atrium and right ventricle.
• Inferior or diaphragmatic surface rests on the central
tendon of diaphragm. And is formed left two third by left
ventricle and right one third by right ventricle.
• The left surface is formed mainly by the left ventricle
and partly by the left auricle.

9. TYPES OF CIRCULATIONS
Systemic and Pulmonary

10. Right
Atrium
• Right upper chamber of the
heart.
• Receives venous blood from
the whole body and pumps to
the right ventricle.
• It is elongated vertically
receiving SVC from the upper
end and IVC from the lower
end.
• Along the right border there
is a shallow vertical groove
which passes from SVC to IVC
and this groove is called
Sulcus Terminalis and produced

11. INTERNAL FEATURES OF RIGHT
ATRIUM
• Smooth or posterior
part: most tributaries
like SVC and IVC opens
into it.
• Rough or anterior
part: presents series
of transverse muscular
ridges called musculi
pectinati
• It receives coronary
sinus at the smooth
end.

12. Right Ventricle
• Triangular chamber which
receives blood from right
atrium and pumps it into the
lungs via pulmonary veins.
• It has two surfaces anterior
or sternocostal and inferior
or diaphragmatic.
• Internally it has two orifices
: tricuspid orifice guarded by
tricuspid valve and pulmonary
orifice guarded by pulmonary
valve.
• The wall of right ventricle is
thinner than that of left
ventricle.

13. Tricuspid
valve
• Controls the flow from
right atrium to right
ventricle.
• These are muscular ridges
which extends from
ventricular septum to the
base of the anterior
papillary muscle.

14. Left atrium
• Quadrangular chamber
situated posteriorly.
• It forms the left two
third of the base of the
heart, greater part of the
upper border and parts of
sternocostal border.
• It receives oxygenated
blood from lungs via
pulmonary veins

15. Left
ventricle
• Receives oxygenated blood from left
atrium and pumps to the whole body via
Aorta.
• Externally it is divided into three
surfaces anterior or sternocostal,
inferior or diaphragmatic and left
surface.
• Internally it has two parts
• Lower rough part with trabeculae
carnae.
• Upper smooth part or aortic vestibule
which gives origin to ascending aorta.
• It has two orifices bicuspid or mitral
orifice guarded by mitral valve and
aortic orifice guarded by aortic
valve.

16. AORTA

17. Mitral/bicuspid valve
• It has 2 cusps
• A large anterior and aortic
cusp which lies between
mitral and aortic orifices
• A small posterior or mitral
cusp.
• It is smaller and thicker
than tricuspid valve.

18. SEMILUNAR
VALVES
• AORTIC VALVE
• It is located in left ventricle
of the heart.
• It has three cusps which when
closed they contain a sinus
called aortic sinus or sinus of
Valsalva.
• Aortic valves is open
ventricular systole.
• Pulmonary valve
• This valve is located between
right ventricle.
• Also has three cusps.
• Similar to aortic valve this
valve opens in ventricular
systole.

19. ARTERIAL
SUPPLY
OF HEART

21. Branches
of right
coronary
artery
• Atrial branches are anterior posterior
and lateral.
• One of the posterior branches is called
SA nodal artery.
• Right conus forms an arterial circle
around pulmonary trunk with a similar
branch from the left coronary artery.
• Ventricular branches are as anterior and
posterior group.
• Anterior group lies on the sternocostal
surface while posterior group transverse
the diaphragmatic surface of heart.
• Right marginal artery arises as right
coronary artery crosses the right border
of heart.

23. LEFT CORNARY
ARTERY
• Left coronary artery is larger than
right coronary artery and arises from
left posterior aortic sinus of
ascending aorta.
• Course:
• It first runs forwards and to the left
and emerges between the pulmonary
trunk and the left auricle. Here it
gives anterior interventricular branch
which runs downward into the groove.
• After giving off the anterior
interventricular branch it runs to the
left in the left anterior coronary
sulcus.
• It winds around the left border of the
heart and continues in the posterior
coronary sulcus and terminates with

24. Branches
of left
coronary
artery
• Anterior interventricular branch is the
largest branch, it descends in the
interventricular groove and gives
following branches:
• 1. Anterior ventricular branches for the
ventricles. The large branch is called
left diagonal artery.
• 2. Septal branch supply anterior two third
of the interventricular septum,
• 3. Left conus artery forms an arterial
ring around the pulmonary trunk with
similar branch from right coronary artery.
• Circumflex branch is the terminal branch
of left coronary artery and gives
following branches:
• 1. Left marginal artery which lies along
the left border of the heart till the
apex.
• Anterior and posterior ventricular
branches.
• Arterial branches which are in anterior
posterior and lateral groups.

26. Veins of
the heart
• Great cardiac vein
• Middle cardiac vein
• Right marginal vein
• Posterior vein of
the left ventricle
• Oblique vein of the
left atrium
• Anterior cardiac
veins
• Venae cordis
minimae

27. NERVE SUPPLY
OF HEART
• Heart is supplied by both
sympathetic and parasympathetic
fibres.
• Parasympathetic nerve reach the
heart via vagus nerve.
• Sympathetic nerves are derived
from upper four to five thoracic
segments of the spinal cord.
• Both parasympathetic and
sympathetic nerves form the
superficial and deep cardiac
plexus, the branches of which run
along the coronary arteries to
reach the myocardium.

28. Apical
view of
heart in
ECHO.

29. Parasternal
view of
heart in
Echocardiog
ram

30. How
heart
look
in
ECHO?