In the name of GOD

The heart  Terminology  Definition  Position  Chambers  Layers  External features  Internal features  Coverings  Vessels  Nerves  Imaging  Surface anatomy

The heart : Terminology  Heart  Cor-  Cardiac & Cardio-

The heart : Definition  A hollow muscular cone located in the middle Mediastinum, covered with a fibro-serous covering (pericardium) which acts as a double-pump

The heart : Position  Depends on age, sex, stature, respiration & posture  Over the diaphragm (central t.)  Located in the middle Mediastinum thus:  Behind the meso-sternum  2 nd to 6 th costal cartilage  T4-T8 vertebrae

The heart : Position  1/3 in right, 2/3 in left  Conical shape  lies obliquely in the chest  lies at 45 degree angle  about size of enclosed fist

The heart : Position  Conical shape thus:  An apex &  A base

The heart : External features  4 surface  A base  An apex  4 border  Sulci  AV (coronary)  Inter-ventricular  Inter-atrial  Sub-epicardial Fat  Auricles

The heart : Position  Apex: in left 5 th space medial to mid-clavicular line  Apex beat: PMI=point of maximum impulse  Apex is in ant., inferior & left

Conical shape

Apex & Base Base____________ Apex _________________ Note: A position other than the anatomical position

___Apex Base________

Apex

4 Surfaces  Anterior (Sternocostal)  Left  Inferior (Diaphragmatic)  Right  Base (posterior surface)

Anterior (Sternocostal) surface  RA (& right auricle), RV & LV (a part of )  From LA only its auricle  Sulcus  AV (coronary) : right part  Ant. Interventricular  Pulmonary trunk (emerge from RV )  Aorta (its origin from LV Is phantom)  Outflow tract  SVC & IVC

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AnteriorAnteriorAnteriorAnterior SurSurFFaceaceSurSurFFaceaceF

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Inferior surface  4 chambers  All sulci  Crux of the heart  All veins & arteries

Inferior surface (Crux of the heart)

Right surface  RV  RA (& auricle)  AV sulcus  2 pulmonary veins  Outflow tract  SVC & IVC

Left surface  LV  LA (& auricle)  AV sulcus  2 pulmonary veins  Outflow tract

Left surface

4 Borders of the heart  Right  Left  Inferior  superior

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The heart : Chambers  Two Atrium (Atria)  Two Ventricles  Divided from each other by septa & valves  Septa: between similar chambers  Valves: between different chambers

External features  Four chambers  2 atria  2 ventricles  Auricles  Major veins  Superior & inferior vena cava  Pulmonary veins  Major arteries  Aorta  Pulmonary trunk

External features

Anterior (Sternocostal) surface

Chambers of the Heart – Two Atrium (Atria)  Right and Left (RA & LA)  Divided from each other by interatrial septum (internally) & sulcus (externally)  Divided from ventricles by atrio- ventricular valves (AV valves) (internally) & sulcus (externally)  Receiving chambers  Each has an auricle

interatrial sulcus

AV sulcus

Chambers of the Heart - Ventricles  Right and Left (RV & LV)  Muscular walls  Pumping Chambers  Separated Internally by Interventricular Septum  Externally by Interventricular Sulcus

Inter-ventricular Sulcus

Inter-ventricular septum & Sulcus

Interventricular Septum  Actually belong to LV because:  1- Its thickness  2- Its continuity  LV is circular in section  RV is crescent in section  3- Its function  Contracts toward the lumen of LV

Interventricular Septum

The sulci  Filled with fat  Cardiac vessels lies between these fat  And the pericardium smoothen their surface

Sub-epicardial Fat  Function smooth surface  Its not a energy source unless The end stages of fasting

Fat____________ Sulcus_____

If the fat removed Major Coronary vessels appear Which lies in the sulci

Double-pump

A pump in which the apex move toward the base

The heart : Internal features  Atria  Smooth surface  Rough surface (pectinate muscles)  Ventricles  Smooth surface  Rough surface (trabeculae carnii)

Internal features of RA

 Atria  Smooth surface  Rough surface (pectinate muscles)

Internal features of RA

Internal features of RV Boundary between Smooth & Rough areas

 Ventricles  Smooth surface  Rough surface (trabeculae carnii)

 Rough surface  Ridge  Bridge  Papillary muscle

Papillary muscle

Dirctioon: Why?

Some myocardial bundles end at Papillary muscles

Internal features of LV

Aortic vestibule

Internal features of LA

Interventricular Septum  A thick muscular portion  A membraneous portion: Interventricular part Atrioventricular part

I m p o r t a n c e

Valves

Valves

Valves

Valves

Valves