Heart and Pericardium
Prof. Dr. Selda Önderoğlu
Prof. Dr. H. Selçuk Sürücü
heart
muscular organ
Pumps blood to body.
Shape:conical
Apex is directed downwards
location
location:thoracic cavity
Middle mediastinum
Weight:250-300 gr.
In the adult
• Right and left:mediastinal surfaces of the lungs
• inferior: Diaphragm
• Anterior:: Sternum, costal cartilages,remains of
thymus gland and partially lungs
• Posterior:Oesophagus
relations
General shape
Apex Base
4 surfaces Four borders Apex: directed
anterior,inferior and to the left,
Base:faces posteriorly and to the right
Apex
L ventricle
Forward,
downward&to the left
Prof. Dr. H. Selçuk Sürücü
Base
L & R atria Faces
posteriorly
Prof. Dr. H. Selçuk Sürücü
Diaphragmatic (inf) surface
L ventricle
Prof. Dr. H. Selçuk Sürücü
Sternocostal (ant) surface
R atrium
R ventricle L ventricle
Prof. Dr. H. Selçuk Sürücü
+ v brachiocephalica
Inf border
R ventricle L ventricle
Sup border
L atrium,
roots of great vessels
Right and left borders
Right border,
Right atrium.
Left border,
left ventricle,left auricle.
Surface
projections of borders
Apex:5th
intercostal space 9 cm from midline 2nd left costal cartilage 1 cm from sternum 3rd right costal
cartilage 1cm from sternum
6th right costal
cartilage 1cm from sternum
Prof. Dr. H. Selçuk Sürücü
“ coronary sulcus”, between atria and ventricles.
“anterior interventricular sulcus”,
between ventricules
• “posterior interventricular sulcus”,
between ventricles
External features
R atrium
V cava sup&inf Coronary sinus Pectinate mm Sinus venorum
(sinus of venae cavae) Terminal crest
Interatrial septum Foramen ovale Fossa ovalis Limbus fossa ovalis
Auricle (ant.to crest)
Tricuspid valve
(bw.R atr.&R vent.)
Prof. Dr. H. Selçuk Sürücü
R ventricle
Cusps of tricuspid valve/R
atrioventricular valve (at sup wall)
(ant.+post.+septal)
Interventricular septum (septal wall)
Membranous part muscular part
Atrioventricular part ( bw. R atr&L ventr.) Pro.
R ventricle
Trabeculae carnea Papillary mm
(ant+post+septal) Septomarginal
trabecule
(moderator band) Conus arteriosus (infundibulum) Supraventricular crest
Opening of
pulmonary trunk
(has 3 semilunar cusps- R+L+Ant)
L atrium
Pulmonary vv openings (4 in number)
Valve of foramen ovale During development prevents blood from L atr. to R atr)
Auricle
Mitral valve/
L atrioventricular valve (Ant+post cusps)
Prof. Dr. H. Selçuk Sürücü
L ventricle
Cusps of mitral valve/L atrioventricular valve (Ant+post cusps)
Papillary mm(ant+post) Chordae tendineae
Trabecula carneae
Aortic opening
Aortic valve ( R+L+post semilunar cusps)
(each cusp has lunule,nodule, sinus)
Arteries of heart
Right coronary artery (R
marginal br &Post interventricular br)
Left coronary artery
(Circumflex br+Ant interventricular br)
R&L coronary aa- Both Exit from bulbus aorta
Prof. Dr. H. Selçuk Sürücü
Veins of heart
coronary sinus-receives great,middle,small&post. Cardiac v)
Least cardiac vv (venae cordis minimae-Thebasian vv)- directly into chambers
Anterior right ventricular vv Right marginal v
Great cardiac v
Ant interventricular v
L coronary v
Small cardiac v
R coronary v
Middle cardiac v
Post
interventricular v
Innervation of heart
Symp Psymp
Together They form the cardiac plexus
Sympathetics
Sup cervical
cardiac n (from sup.
Cerv. Gang.)
Middle cervical cardiac n br(from
middle cerv.gang.)
Inf cervical cardiac n (from
cervicothoracic (stellate)gang.
Thoracic cardiac brrs (T 1-4)
Parasympathetics
(vagus nerve (CN X)
Sup cervical cardiac brr
inferior cervical cardiac brr
Thoracic cardiac brr ( of vagus n.)
Lymphatics of heart
R inf
tracheabronchial lymph nodes
Layers of heart
Endocardium:innermost layer
Myocardium: middle layer, muscular
layer,striated,under control of autonomic nervous system
Pericardium: outermost layer, like a sac
Myocardium
Atrial
Ventricular
Conducting system Striated-special type
Under autonomic nervous system control Atrial muscle fibers: 2 layers (inner-each atrium, outer- two atria together)
Ventricular muscle fibers- has complex structure, no distinct layers- vortex
Myocardium
Prof. Dr. H. Selçuk Sürücü
Skeleton of heart
R & L fibrous rings (around
mitral&tricuspid valves
R & L fibrous trigones
Around aortic & pulmonary
valves
Prof. Dr. H. Selçuk Sürücü
Conducting system of heart- specialised myocardial fibers
SA node
at terminal crest AV node,
at interaatrial septum
AV bundle, pars membranacea R & L bundle branches
Purkinje fibers
Pericardium
Fibrous pericardium Serous pericardium
Parietal layer
Visceral layer (epicardium)
“pericardial cavity ”
“liquor pericardii”
Pericardial sinuses-of the
pericardial cavity
Oblique sinus
Bw.Left atrium- Pulmonary vv Like the letter “j”, inverted
Transverse sinus
superior v.c.&leftatrium- pulmonary trunk&ascending aorta
two ends open
nerves of pericardium
Phrenic n –parietal pericardium
(afferent) vagus
Sympathetic trunk
Aorta
ascending aorta Arch of aorta
descending aorta
