heart consist of 3 surfaces: sternocostal, diaphragmatic, base or posterior surface. 3 boarders right,left, inferior. sterno costal suface contains right atrium and right ventricle. and leftauricle and left ventricle partly. right part of a-v groove and interventricular groove present.

1. HEART- EXTERNAL
FEATURES

3. Heart
Cardia ( Greek word )
• Conical , Hollow muscular organ , consisting of
four chambers , covered by Pericardium situated
within the Middle mediastinum
&
acts as Central pumping organ
of
Cardiovascular system

4. • Measurements :
Length : 12cm ( from base to apex )
Transversely : 8cm ( at its broadest part )
Anteroposteriorly : 6 cm.
Weight : 280 to 340gm.

5. • Shape :
Somewhat Conical / Pyramidal.
• Situation :
Heart situated obliquely behind the body
of Sternum & adjoining parts of Costal
cartilages.
⅓rd part lies to right
&
⅔rd to left of median plane.

6. External Features
• Borders of Heart :
Superior border
Inferior border
Right border
Left border
• Surfaces of Heart :
Anterior surface
Inferior surface
Left surface
Right surface

7. Superior border
• Slightly Oblique .
• Formed by two Atria.
• Mainly by Left Atrium.

8. Inferior border
• Sharp nearly horizontal border
extending from opening of Inferior
vena-cava to Apex of heart.
• Mainly formed by Right ventricle
&small part of it near the apex
formed by Left ventricle.
• Close to apex presents notch –
apical notch/ incisura

9. Apical notch - Importance
• Anterior & Posterior Interventricular grooves meet.
• Anastomosis takes place b/w following arteries :
a. Posterior Interventricular branch of- Right Coronary artery.
b. Anterior Interventricular branch of- Left Coronary
artery.
c. Right & Left Marginal arteries.

10. Right border
• Nearly Vertical & formed by Right atrium.

11. Left border
• Oblique &Convex border.
• Separates Sternocostal & Left surfaces.
• Formed mainly by left ventricle
• Partly by left auricle

13. Anterior / Sternocostal surface
Direction :
Surface facing forwards & upwards.
Formation :
i. Anteriorsurface of Right atrium & its auricle.
ii. Small part of Left auricle.
iii. Anterior surface of Right ventricle ( ⅔rds ).
iv. Anterior surface of Left ventricle ( ⅓rd ).

14. Features
• Anterior part of
Atrioventricular groove
a. Passes downwards & to right
b/w Right atrium &Right
ventricle.
b. Lodges trunk of Right
coronary artery & crossed by
Anterior Cardiac vein.

15. • Anterior interventricular groove :
• Groove passes downwards & parallel to left border of Heart.
• Ends at apical notch on Inferior border of Heart.
• Indicates site of anterior attachment of Interventricular septum.
• Lodges Anterior Interventricular branch of Left Coronary
artery & Great Cardiac vein.

16. Relations
• Covered by Pericardium
• Posterior surface of body of Sternum & 3rd to 6th
costal cartilages of both sides.
• Anterior borders of both Lungs & Pleurae except
part lies behind Cardiac notch of Left lung.
• Uncovered area , Pericardium comes in direct contact
with anterior chest wall & dull on percussion ,
clinically area – Area of superficial cardiac dullness.

17. Inferior / Diaphragmatic Surface
Direction :
flat, rests on central tendon & small
part of left muscular part of
Diaphragm, slopes downwards &
forwards little towards apex.
Formation :
i. ⅔rd by Left ventricle.
ii. ⅓rd by Right ventricle.

18. Features
• Posterior Interventricular groove
a. Traversed obliquely & ends at apical notch
b. Indicates Posterior attachment of Interventricular
septum.
c.Lodges Posterior Interventricular branch of Right
Coronary artery, Middle Cardiac vein & anastomosis
b/w Interventricular branches of both Coronary
arteries.

19. Relations
• Pericardium
• Central tendon & small left muscular part of
Diaphragm
• Cardiac impression of Liver & fundus of
Stomach , below Diaphragm.

20. Left Surface
Direction :
facing upwards, backwards & to left.
Formation :
mostly formed by Left ventricle & partly by Left
atrium & its auricle.
Features : Left part of Atrioventricular groove
i. Upper part of this surface crossed
ii. Lodges following structures :
Termination of Great cardiac vein
a. Trunk & Circumflex branch of Left coronary artery.
b.
c. Beginning of Coronary sinus.

22. Relations
• Pericardium
• Left Phrenic nerve
• Left Pericardiophrenic vessels
• Mediastinal Pleura
• Cardiac impression of Left Lung

24. Right Surface
• Rounded surface.
Formation :
By right atrial wall.
Relations :
i. Pericardium
ii. Pleura
iii. Mediastinal surface of Right lung.

25. Grooves / Sulci of Heart
• Atrioventricular groove / Coronary Sulcus
• Interatrial groove
• Anterior Interventricular groove
• Posterior Interventricular groove

26. Atrioventricular groove / Coronary Sulcus
• Circular groove separates Atria from Ventricles.
• Anteriorly overlapped by Ascending aorta &
Pulmonary trunk.
• Point of junction of Atrioventricular , Interatrial &
Posterior Interventricular grooves
- Crux of Heart.

28. Contents
i. Right part of groove :
Trunk of Right coronary artery.
ii. Left part of groove :
a. Trunk & Circumflex branch of Left coronary artery.
b. Termination of Great Cardiac vein & beginning of
Coronary sinus.
iii. Posterior part of Groove :
a. Coronary sinus.
b. Anastomosis b/w Right & Left coronary arteries.

29. Interatrial groove
• Shallow Posteriorly .
• Anteriorly hidden by Ascending aorta &
Pulmonary trunk.

30. Anterior Interventricular groove
• Runs downwards & to left , nearer to left border of
Heart.
• Lower end of this groove meets Inferior border at
Apical notch.

31. Posterior Interventricular groove
• Situated on Inferior surface placed obliquely.
• Nearer to right margin of this surface.
• Meets Inferior border at Apical notch.

32. Base of Heart
• On the Posterior surface of Heart.
• Most fixed part of Heart.
• Shape :
Some what Quadrilateral shape.
Direction :
Faces backwards & to right.
Formation :
- Mainly by Left atrium
- Partly by Right atrium.

33. • Vertebral Level of Base :
In recumbent posture : T5 to T8.
In Erect posture : T6 to T9.
Boundaries :
Superiorly : Bifurcation of Pulmonary trunk
Inferiorly : Posterior part of Atrioventricular groove
containing Coronary sinus & branches of Coronary
arteries.
To the Right : Right border of Right Atrium
To the Left : Left border of Left Arium.

34. Features
• Following veins opens in the base :
On the Right Atrium :
a. Superiorvenacava : Upper & Posterior part
b. Inferiorvenacava : Lower & Posterior part
On the Left Atrium :
Openings of four Pulmonary veins , two on each side in
posterior surface of Left Atrium.
Posterior Interatrial groove :
Shallow vertical groove b/w two Atria & indicates posterior
attachment of Interatrial septum.

35. Relations
• Posteriorly separated from Vertebral column by
following structures :
i. Pericardium
ii. Right pulmonary veins
iii. Oesophagus
iv. Descending thoracic aorta

36. Clinical Base - Heart
• Auscultatory areas for Aortic & Pulmonary sounds
in / near Parasternal areas of 2nd Intercostal spaces.
• Apex :
Conical projected part of Left ventricle
directed downwards, forwards & to left.
• Situation :
Situated on left 5th Intercostal space
9cm lateral to Midsternal line, just medial to
Midclavicular line.

37. • Relations :
Overlapped by Anterior border of Left
lung & Pleura.
• Importance :
Living subject , Apical pulsations may
be seen & felt over this region.

38. Chambers
of
Heart