THE HEART

 POSITION-

Inferior surface – central portion of the diaphragm

Inferior border- level of xiphisternal synchondrosis

Pericardial sac- visceral pericardium

Lies 1/3rd – rt.,

2/3rd lt. of midline
 Surface projections of the heart-

Outline- 4 points
1)lt. superior pt. – lower border of 2nd lt. rib & 1.2
cm to lt. border of the sternum
2)Rt. Superior pt.- upper border of rt.3rd cartilage
& 1cm to the rt. Border of the sternum
3)Rt. Inferior pt.- 5th rt. Sternocostal jt.
4)Lt. inferior pt.- 5th lt. IC space, 7-9cm to midline
 Surface projections of the valves
2 pairs of valves-a pair of atrioventricular valves
and a pair of semilunar valves (Lunule)
Cusps are folds of endocardium, strengthened by
fibrous layer
Lt. AV – 4th sternocostal jt. On lt.
Rt. AV – cross pt. of 4th IC space & ant. Midline
Aortic valve – 3rd IC space of lt. border of sternum
Pulmonary valve – 3rd sternocostal Jt. On left
 Heart
 Conical, hollow muscular organ
 Oblique placement 1/3 Rt, 2/3rd Left.
 12x9cm , 300 g in males and 250 g in females
 4 chambered
 Grooves/ sulcus
 Apex-Lt ventricle, base-Posterior surfsce
 Valves
Atrioventricular:
 Fibrous ring, 2surfaces (Atrial, ventricular )
and free margin. Ventricular and free are
rough.
 Tied up by Chorda tendinae to papillary
muscles. Blood vessels-to basal1/3 &fib.ring
 Valves are closed during ventricular systole
Applied anatomy
 1st & 2nd heart sounds, stenosis, regurgitation
Semilunar valves- smooth margin-Lunule
 Arteries:
Coronary arteries-2 (Rt & Lt)-Coronary sulcus
Rt CA- branches-
Large- Marginal, posterior interventricular
Small- Nodal, Rt atrial, infundibular, and terminal
Rt atrium, Rt ventricle, Lt ventricle (part), conducting
system and post part of IV septm
Lt CA- Branches-
Large- anterior intraventricular, diaphragmatic surface
of Lt. ventricle
Small- Lt. atrial, pulmonary- terminal
Lt. atrium, ventricles, anterior part of interventricular
septum
Part of Lt. branch of AV bundle
 Cardiac anastomoses
 Extra cardiac anastomoses- vasavasora of
aorta& pulmonary arteries, internal thoracic
arteries, bronchial arteries & phrenic arteries
 Retrograde flow of blood in veins

APPLIED ANATOMY
coronary thrombosis- MI, ventricular fibrillation
Incomplete obstruction – angina pectoris
 Veins of the heart
 Coronary sinus- largest vein of the heart-
posterior coronary sulcus – rt. Atrium.
 Tributaries- the great cardiac vein,
The middle cardiac vein,
The small cardiac vein,
Posterior vein of Lt. ventricle,
Oblique vein of lt. atrium (of marshall)
Rt. Marginal vein
Anterior cardiac veins- 3-4 small veins- rt. ventricle
Venae cordis minimi (Thebesian veins)- smallest
cardiac veins
 Lymph nodes
 2 trunks- Rt.  brachiocephalic nodes
Lt.  tracheobronchial nodes
 Nerves supply
Parasympathetic- vagus- inhibitory – heart rate
decreases
Sympathetic N.- 3-5 spinal Nerves- cardio
acceleratory & dilate coronory arteries
The sympathetic & parasympathetic form
superficial & deep cardiac plexus, follow
coronory arteries to reach myocardium
 Applied anatomy
 Precordium- chest wall overlying the heart
 Bradycardia, Tachycardia, arrhythmia,
palpitations,
 Pericarditis, myocarditis, endocarditis
 Dextrocardia
 Angina, MI, CCF, cor pulmonale,