PowerPoint® Lecture Slides prepared by Vince Austin, University of Kentucky

Anatomy of Heart
Dr.Vineet Chauhan
M.S.,F.M.A.S.,F.I.A.G.E.S

Human Anatomy & Physiology, Sixth Edition

Elaine N. Marieb
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 Heart Anatomy

 Approximately the size of your fist

 Location
 Superior surface of diaphragm
 Left of the midline
 Anterior to the vertebral column, posterior to the
sternum

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 Heart Anatomy Overview

 4 chambers (RA, RV, LA, LV)

 4 valves
 2 at entry to ventricles (from atria)
 2 at exit from ventricles (to great vessels)
 None at entry to atria

 4 major vessels at the base

 Superior vena cava (entry)
 Inferior vena cava (entry)
 Aorta (exit)
 Pulmonary trunk (exit)
4 Pulmonary veins (entry) = not major vessels

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 Heart dividing lines

Sulci
 Grooves in the heart that divide it
 Contain blood vessels of cardiac muscle
 Coronary sulcus
 Divides atria and ventricles
 Closer to base (top) than apex
 Anterior and posterior interventricular sulci
 Separates left and right ventricles
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 Coverings of the Heart: Anatomy

 Pericardium – a double-walled sac around the heart

composed of:
1. A superficial fibrous pericardium
2. A deep two-layer serous pericardium
 The parietal layer lines the internal surface of the
fibrous pericardium
 The visceral layer or epicardium lines the surface
of the heart
 They are separated by the fluid-filled pericardial
cavity
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 Coverings of the Heart: Physiology

 The pericardium:
 Protects and anchors the heart
 Prevents overfilling of the heart with blood
 Allows for the heart to work in a relatively friction-
free environment

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 Pericardial Layers of the Heart

Figure 18.2
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 Heart Wall

 Epicardium – visceral layer of the serous

pericardium
 Myocardium – cardiac muscle layer forming the
bulk of the heart
 Fibrous skeleton of the heart – crisscrossing,
interlacing layer of connective tissue
 Endocardium – endothelial layer of the inner
myocardial surface

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 External Heart: Major Vessels of the Heart
(Anterior View)

 Vessels returning blood to the heart include:

 Superior and inferior venae cavae
 Right and left pulmonary veins
 Vessels conveying blood away from the heart
include:
 Pulmonary trunk, which splits into right and left
pulmonary arteries
 Ascending aorta (three branches) – brachiocephalic,
left common carotid, and subclavian arteries
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 External Heart: Vessels that Supply/Drain the
Heart (Anterior View)

 Arteries – right and left coronary (in atrioventricular

groove), marginal, circumflex, and anterior
interventricular arteries
 Veins – small cardiac, anterior cardiac, and great
cardiac veins

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 External Heart: Anterior View

Figure 18.4b
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 External Heart: Major Vessels of the Heart
(Posterior View)

 Vessels returning blood to the heart include:

 Right and left pulmonary veins
 Superior and inferior venae cavae
 Vessels conveying blood away from the heart
include:
 Aorta
 Right and left pulmonary arteries

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 External Heart: Vessels that Supply/Drain the
Heart (Posterior View)

 Arteries – right coronary artery (in atrioventricular

groove) and the posterior interventricular artery (in
interventricular groove)
 Veins – great cardiac vein, posterior vein to left
ventricle, coronary sinus, and middle cardiac vein

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 External Heart: Posterior View

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 Gross Anatomy of Heart: Frontal Section

Figure 18.4e
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 Atria of the Heart

 Atria are the receiving chambers of the heart

 Each atrium has a protruding auricle
 Pectinate muscles mark atrial walls
 Blood enters right atria from superior and inferior
venae cavae and coronary sinus
 Blood enters left atria from pulmonary veins

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 Right atrium

 The interior surface of the right atrium can be divided into three
regions:posteriorly- a smooth-walled venous component ,
anteriorly- to the vestibule of the tricuspid valve and the auricle
 The superior vena cava opens into its dome and the inferior vena
cava into its lower posterior part- sinus venosus
 Coronary sinus opens which drains the venous blood of heart
 The auricle is a broad, triangular muscular that projects anteriorly
to overlap right side of ascending aorta
 Anteroinferior in the right atrium is the large, oval vestibule
leading to the orifice of the tricuspid valve

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 Right atrium
 The junction between the venous part (sinus venarum) and the
atrium proper is marked externally by a shallow groove-sulcus
terminalis, The sulcus terminalis corresponds, internally, to the
terminal crest (crista terminalis) which is the site of origin of the
extensive pectinate muscles
 Pectinate muscles - parallel muscular ridges, extend
anterolaterally from the terminal crest and reach into the auricle,
where they form several trabeculations.
 The septal wall presents the fossa ovale, an oval depression
above and to the left of the orifice of the inferior vena cava. Its
floor is the primary atrial septum, - septum primum. The rim of
the fossa is prominent and forms the edge of the so-called
septum secundum, in reality it is merely the infolded walls of the
atrial chambers.
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 Right atrium

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 Pectinate muscle with crista terminalis

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 Left Atrium

 Smaller in volume than the right, the left atrium has thicker walls
(3 mm on average).
 Left atrium is roughly cuboidal and extends behind the right
atrium, separated from it by the obliquely positioned septum.
Thus the right atrium is in front and anterolateral to the right part
of the left atrium.
 The four pulmonary veins open into the upper posterolateral
surfaces of the left atrium, two on each side
 Left atrial auricle is constricted at its atrial junction and all the
pectinate muscles of the left atrium are contained within it. It is
characteristically longer, narrower and more hooked than the
right auricle,
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 Ventricles of the Heart

 Ventricles are the discharging chambers of the heart

 Papillary muscles and trabeculae carneae muscles
mark ventricular walls
 Right ventricle pumps blood into the pulmonary
trunk
 Left ventricle pumps blood into the aorta

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 Ventricles

 Right ventricle wall is

thinner; LV develops 4-6
times more pressure than
right ventricle
 Right ventricle is pouch-
shaped, left ventricle is
round
 Similar internally, but
right ventricle has
moderator band

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Figure 20–7
 Right ventricle

 The inlet and outlet components of the ventricle,

supporting and surrounding the cusps of the
tricuspid and pulmonary valves respectively, are
separated in the roof of the ventricle by the
prominent supraventricular crest (crista
supraventricularis
 The inlet and outlet regions extend apically into and
from the prominent coarsely trabeculated component
of the ventricle. The inlet component is itself also
trabeculated, whereas the outlet component (or
infundibulum) has predominantly smooth walls.
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 Right ventricle
 The trabeculated appearance is caused by a myriad
of irregular muscular ridges and protrusions, which
are known collectively as trabeculae carneae, and
are lined by endocardium.
 The septo marginal trabeculae is prominent -
moderator band (in RV):
 ridge contains part of conducting system
 coordinates contractions of cardiac muscle cells

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 Right ventricle

 Papillary muscles, which are inserted at one end

onto the ventricular wall and are continuous at the
other end with collagenous cords, the chordae
tendineae, inserted on the free edge and elsewhere
on the free aspect of the atrioventricular valves

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 Right ventricle

13- chordae tendinae.

12- papillary muscles
09-trabaculae carneae
10-septomarginal TC
(moderator band)
18- crista
supraventricularis

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 Left ventricle

 The left ventricle is shorter and more conical in

shape than the right, and on transverse section its
concavity presents an oval or nearly circular outline
 It forms a small part of the sternocostal surface and a
considerable part of the diaphragmatic surface of the
heart;
 It also forms the apex of the heart.
 The left ventricle is thicker and more muscular than
the right ventricle because it pumps blood at a
higher pressure.
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 Pathway of Blood Through the Heart and Lungs

Figure 18.5
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 Coronary Circulation

 Coronary circulation is the functional blood supply

to the heart muscle itself
 Collateral routes ensure blood delivery to heart even
if major vessels are occluded

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 Coronary Circulation

 Coronary arteries
 Left and right
 Originate at aortic sinuses
 Elastic rebound forces blood through coronary
arteries only between contractions
 Cardiac veins
 return blood to coronary sinus, opens into right
atrium

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 Coronary Arteries
 Right Coronary Artery. Supplies blood to:
 right atrium, portions of both ventricles, cells of sinoatrial
(SA) and atrioventricular (AV) nodes
 Branches include
 marginal arteries (surface of right ventricle)
 posterior interventricular artery

 Left Coronary Artery. Supplies blood to:

 left ventricle, left atrium, interventricular septum
 Main branches:
 circumflex artery
 anterior interventricular artery
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 Coronary Circulation: Arterial Supply

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 Coronary Circulation: Venous Supply

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 Heart Valves

Four valves, all

at same level in
heart
Fibrous
skeleton:
conective tissue

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Figure 20–8
 Fibrous skeleton

 All four valves are contained within this skeleton

 The fibrous skeleton is strongest at the junction of
the aortic, mitral and tricuspid valves, the so-called
central fibrous body
 Two functions-
 It ensures electrophysiological discontinuity
between the atrial and ventricular myocardial
masses except at the site of penetration of the
conducting tissue
 Stability .
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 Atrioventricular (AV) Valves
 Right AV valve (tricuspid): between RA and RV
 Left AV valve (bicuspid or mitral): between LA and
LV
 Have 3 or 2 fibrous flaps, respectively
 Permit blood flow in 1 direction: atria to ventricles
 Free edges of flaps attach via chordae tendineae to
papillary muscles of ventricle
 Blood pressure closes valve cusps during ventricular
contraction
 muscles tense chordae tendineae, preventing valves from
swinging into atria (opening backward)
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 Tricuspid valve

 Tricuspid valve orifice is best seen from the atrial

aspect and measures 11.4 cm in circumference in
males and 10.8 cm in females.
 Three cusps - located anterosuperiorly, septally and
inferiorly, corresponding to the marginal sectors of
the atrioventricular orifice so named.
 Chordae tendineae are fibrous collagenous structures
supporting the cusps of the atrioventricular valves
which are attached to papillary muscles

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 Mitral valve

 It is smaller than the tricuspid orifice (mean

circumference is 9.0 cm in males, 7.2 cm in
females).
 Mitral valve is typically 4–6 cm² in area.
 It has two cusps, or leaflets, (the anteromedial
leaflet and the posterolateral leaflet) that guard the
opening. The opening is surrounded by a fibrous
ring known as the mitral valve annulus.
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 Mitral valve

 The anterior cusp protects approximately two-thirds

of the valve (imagine a crescent moon within the
circle, where the crescent represents the posterior
cusp)
 The inelastic chordae tendineae are attached at one
end to the papillary muscles and the other to the
valve cusps. Papillary muscles are fingerlike
projections from the wall of the left ventricle.

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 Cardiac valves

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 Heart Valves

Figure 18.8c, d
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 Atrioventricular Valve Function

Figure 18.9
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 Semilunar Valves

 Pulmonary valve
 between RV and pulmonary trunk
 Aortic valve
 between LV and aorta
 Prevent backflow from great vessels (pulmonary
trunk and aorta) into ventricles
 Have no muscular support
 Both have 3 crescent-shaped cusps, support like a
tripod
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 Semilunar Valve Function

Figure 18.10
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 Foramen Ovale

 Before birth, is an opening through interatrial

septum
 Connects the 2 atria
 Seals off at birth, forming fossa ovalis

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 Aortic Sinuses

 Dilations at the base of ascending aorta

 Prevent aortic semilunar valve cusps from sticking
to aorta when open
 Origin points of right and left coronary arteries

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 Internal Heart Dividing Lines

Septa
 Interatrial septum:
 separates atria
 Interventricular septum:
 separates ventricles

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 The Conducting System

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Figure 20–12
 Extrinsic Innervation of the Heart

 Heart is stimulated
by the sympathetic
cardioacceleratory
center
 Heart is inhibited by
the parasympathetic
cardioinhibitory
center

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 Characteristics of
Cardiac Muscle Cells

• Small with one, central nucleus

• Branching interconnections between cells
 Intercalated discs:
 interconnect cardiac muscle cells
 linked by gap junctions to propagate action
potentials

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 2 Types of Cardiac Muscle Cells

 Contractile cells:
 account for 99% of heart tissue
 activated by change in the membrane potential (just
like skeletal muscle cells)
 produce contractions, generate force
 Conducting system:
 initiate and distribute electical activity
 consists of nodes and internodal pathways
 controls and coordinates heartbeat
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 Microscopic Anatomy of Heart Muscle

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 Cardiac Cells vs. Skeletal Fibers

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Table 20-1