this slide is about the anatomy, surface markings and clinical anatomy of the heart and the thorax with references.

1. Submitted by : Dr. ADITI(PT)
MPT-Cardiothoracic Pulmonary
FINAL YEAR
Cardiothoracic anatomy

2. Mediastinum
 Mediastinum (Latin intermediate) is the middle space
left in the thoracic cavity inbetween the lungs.
 IT is divided into 3 subdivisions :
 Superior mediastinum
 Middle mediastinum
 Inferior mediastinum
 Boundaries
 Anteriorly: Sternum, Posteriorly : Vertebral column
,Super iorly : Thoracic inlet lnferiorly: Diaphragm On
each side: Mediastinal pleura.

3. INTRODUCTION
 The heart is a muscular organ situated in the center
of the chest behind the sternum. It consists of four
chambers: the two upper chambers are called the
right and left atria, and the two lower chambers are
called the right and left ventricles.
 The right atrium and ventricle together are often
called the right heart, and the left atrium and left
ventricle together functionally form the left heart
 The heart has:
An apex directed downwards, forwards and to the
left, . A base (posterior surface) directed
backwards; and . Anterior/sternocostal . Inferior and .
Left lateral surfaces.

4. EMBRYOLOGY
 The heart develops from two endocardial tubes that
merge, loop, and septate to form the heart.
 During the intrauterine stage, the septum between
the two atrial is open, and a ductus (ductus
arteriosus) connects the pulmonary artery to the
aorta effectively bypassing the pulmonary
circulation because the lungs are not functional.
 Rapidly after birth, these two connections close,
establishing separate pulmonary and system
circulations.

5. Surface marking

6. SULCI OF HEART
 It is a groove on the outer surface of the heart marking
the division between the atria and the ventricles :-
 Atrioventricular sulcus
 Anterior interventricular sulcus
 Posterior interventricular sulcus

7. Pericardial layers and layers of
heart

8. LOCATION OF HEART WITHIN
THORAX
 the heart is usually positioned within the mediastinum
with one-third of its mass to the right of the midline,
and with its own long axis directed from the right
shoulder towards the left hypochondrium.
 In very rare circumstances, the entire bodily structure
can be mirror-imaged in the setting of normality, or
when there is an associated congenital cardiac
malformation.
 In other circumstances, more common than the
mirror-imaged situation, but still relatively rare, the
structures of the body that usually demonstrate
lateralization are arranged in isomeric fashion

9. LOCATION OF HEART WITHIN
THORAX

10. CLINICAL ANATOMY OF
HEART
 Normally the cardiac apex or apex beat is on the
left side. In the condition called dextrocardia, the
apex is on the right side (Fig. 18.9). Dextrocardia
may be part of a condition called situs inaersus in
which all thoracic and abdominal viscera are a
mirror image of normal.

11. Blood supply of the heart

12. CLINICAL SIGNIFICANCE
 The heart is a vital organ. If the heart stops,
cessation of blood flow and oxygen supply will
occur, leading to irreversible brain damage within
4 to 5 minutes. Cessation or impairment of
cardiac function may occur due to lack to the
blood supply to cardiac muscle (coronary artery
disease), stenosis or regurgitation in cardiac
valves (valvular heart disease), intrinsic
weakness of heart muscle (cardiomyopathy), or
ineffective cardiac rhythms.

13. PHYSIOLOGIC VARIANTS
 The general structure of the heart is quite uniform
in healthy individuals.
 However, some variations do occur. The heart is
arranged more horizontally in the chest in short
and obese individuals, while it is more vertical in
tall and thin people.
 An athlete’s heart may be physically larger.
 Coronary arteries show variations in branching
patterns and relative sizes.

14. THORAX
 Thorax (Latin chest) forms the upper part of the trunk
of the body. It not only permits boarding and lodging
of the thoracic viscera, but also provides necessary
shelter to some of the abdominal viscera,
 The thoracic cavity contains the principal organs of
respiration-the lungs and of circulation-the heart both
of which are vital for life.
 The skeleton of thorax is also known as the thoracic
cage. It is an osseocartilaginous, elastic cage which is
primarily designed for increasing and decreasing the
intrathoracic pressure, so that air is sucked into the
lungs during inspiration and expelled during
expiration.

15. CLINICAL ANATOMY OF
THORAX
 The skeleton of thorax is also known as the
thoracic cage. It is an osseocartilaginous, elastic
cage which is primarily designed for increasing
and decreasing the intrathoracic pressure, so that
air is sucked into the lungs during inspiration and
expelled during expiration.

16. REFERENCE
 https://www.ncbi.nlm.nih.gov/books/NBK470256/#
_article-22652_s9_
 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC15
71338/
 BDChaurasiasHumanAnatomyVolume1/BD_Chau
rasia/6thEdition.