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ANATOMY OF HEART &
BLOOD VESSELS
by
dr. Rahmadini Djalal M.Biomed
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HEART (Cor, Cardia)
• The heart is a hollow, fibromuscular organ of a
conical/pyramidal form, with a base, apex and
a series of surfaces and ‘borders’
• It occupies the middle mediastinum between
the lungs and the pleurae, enclosed in the
pericardium
• It is placed obliquely behind the corpus sterni
and adjoining left costal cartilages and ribs;
approximately 1/3 lies right of the midline
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Location of the heart in the thorax
Mediastinum
Pericardium
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Pericardium
Middle mediastinum
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•
The middle mediastinum is
centrally located in the thoracic
cavity.
It contains the pericardium, heart,
origins of the great vessels,
various nerves & smaller vessels
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The pericardium is a fibroserous sac
surrounding the heart and the roots of
the great vessels.
The fibrous pericardium is a tough
connective tissue outer layer that
defines the boundaries of the middle
mediastinum
The serous pericardium is thin and
consist of 2 parts :
 The parietal layer lines the inner surface of
the fibrous
 The visceral layer (epicardium) of serous
pericardium adheres to the heart and forms
its outer covering
The pericardial cavity : is a narrow space
created between the two layers of serous
pericardium containing a small amount of
fluid
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Subdivisions of the mediastinum
Sagittal section of the pericardium
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Fibrous pericardium
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is a cone-shaped bag with its
base on the diaphragm and its
apex continuous with adventitia of
the great vessels
The base is attached to the central
tendon of the diaphragm and to a
small muscular area of the
diaphragm on the left side
Anteriorly, it is attached to the
posterior surface of
the sternum by
sternopericardial
ligaments
Serous pericardium
•
The parietal & visceral layers of
serous pericardium are continuous
at the roots of great vessels.
These reflections of serous
pericardium occur in 2 locations :
 The first superiorly, surrounding
the arteries, the aorta and
pulmonary trunk
 The second more posteriorly,
surrounding the veins, the
superior and inferior vena cava
and the pulmonary veins
The oblique pericardial sinus : the
zone of reflection surrounding the
veins is “J-shaped” & cul-de-sac
formed within the “J”, posterior to
the left atrium
The transverse pericardial sinus : a
passage between the two sites of
reflected serous pericardium
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Posterior portion of pericardial sac showing reflections of serous
pericardium
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Surfaces of the heart
•
Anterior surface : consists mostly of the right ventricle with some of the right
atrium on the right and some of the left ventricle on the left
•
Diaphragmatic surface : consists of the left ventricle and small portion of the
right ventricle separated by the posterior interventricular groove. This surface
faces inferiorly, rests on the diaphragm, is separated from the base of the
heart by the coronary sinus & extends from the base to the apex of the heart
•
Posterior surface (base) : the base of the heart is quadrilateral & directed
posteriorly. It consists of : the left atrium, a small portion of the right atrium, the
proximal parts of the great veins (superior & inferior vena cavae and the
pulmonary veins)
From the base of the heart projects forward, downward, and to
the left , ending in the apex. The apex of the heart is formed by
the inferolateral part of the left ventricle ( is positioned deep to
the left 5th intercostal space
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Anterior surface of the heart
Right atrium
Right ventricle
Left ventricle
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Base of the heart
Superior vena
cava
Left atrium
Right atrium
Inferior vena
cava
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Diaphragmatic surface of the heart
Left ventricle
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Margins of the heart
External sulci
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Inferior margin (acute) is defined
as the sharp edge between the
anterior & diaphragmatic surfaces
of the heart. It is formed mostly by
right ventricle and a small portion
of the left ventricle near the apex
The obtuse margin separates the
anterior & left pulmonary surfaces.
It is round and extends from left
auricle to the cardiac apex. It is
formed mostly by the
left ventricle and
superiorly by a small
portion of the left
auricle
•
The coronary sulcus circles the
heart, separating the atria from the
ventricles. It contains the right
coronary artery, the small cardiac
vein, the coronary sinus & the
circumflex branch of the left
coronary artery
The anterior & posterior
interventricular sulci separate
the two ventricles. The anterior
interventricular sulcus contains the
anterior interventricular artery &
the great cardiac vein. The
posterior interventricular sulcus
contains the posterior
interventricular artery & the
middle cardiac vein
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HEART CHAMBERS
Right Atrium
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Externally, there is no outstanding feature except : the right auricle, a small flap
shaped like a dog’s ear (auricle = little ear) that projects from the superior corner of
the atrium
Internally, it has two parts : a smooth-walled posterior part & an anterior part lined
by horizontal ridges called : the pectinate muscles
A large C-shaped ridge called : the crista terminalis separates the two parts of the
atrium
Posterior to the end of this crista is the : fossa ovalis, a depression in the
interatrial septum that mark the spot where an opening existed
in the fetal heart (foramen ovale)
Inferiorly & anteriorly, the right atrium opens into the right ventricle through the
tricuspid valve (right atrioventricular valve)
13
e
Crista terminalis
Pectinate
muscles
Fossa ovalis
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Right Ventricle
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Receives blood from the right atrium and pumps it into the pulmonary circuit
via an artery called the pulmonary trunk
Externally, the right ventricle forms most of the anterior surface of the heart
Internally, its walls are marked by irregular ridges of muscle, called trabeculae
carnae. Additionally, cone-shaped papillary muscles (anterior, posterior &
septal) project from the walls into the ventricular cavity.
Thin, strong bands called chordae tendineae project superiorly from the
papillary muscles to the flaps (cusps) of the tricuspid valve
A single specialized trabeculum: the septomarginal trabecula (moderator
band) forms a bridge between the lower portion of the interventricular septum
and the base of the anterior papillary muscle → carries a portion of the cardiac
conduction system, right bundle of the atrioventricular bundle to the anterior
wall of the right ventricle
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Left Atrium
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It forms most of the heart’s posterior
surface, receives oxygen-rich blood
from the lungs through two right &
two left pulmonary veins
The only part of the left atrium visible
anteriorly is its left auricle.
Internally, most of the the atrial wall
is smooth, with pectinate musle lining
the auricle only
The left atrium opens into the left
ventricle through the
mitral valve
Left Ventricle
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It forms the apex of the heart,
pumps blood into the systemic
circuit.
Like the right ventricle, it contains
trabecula carneae, papillary
muscles, chordae tendineae & the
cusps of mitral valve.
Superiorly, the left ventricle opens
into the aorta through the aortic
semilunar valve
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HEART VALVES
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HEART VALVES
Aortic valve
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It consists of three semilunar cusps
with the free edge of each projecting
upward into the lumen of the
ascending aorta
Between the semilunar cusps and
the wall of the asc.aorta are pocket
like sinuses – the right, left and
posterior aortic sinuses
The right and left coronary artery
originate from the right
and left aortic sinuses
Pulmonary Valve
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It consists of three semilunar cusps
with free edge projecting upward
into the lumen of pulmonary trunk
The free superior edge of each cusp
has a middle, thickened portion : the
nodule of the semilunar cusp, and a
thin lateral portion : the lunule of
semilunar cusp
Relative to their fetal position before
rotation of the outflow tracks, the
cusps are named the left, right and
anterior semilunar cusps
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HEART VALVES
Aortic Valve
Pulmonary Valve
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Points on the anterior thoracic surface where sounds of the
heart valves are heard most clearly
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CARDIAC SKELETON
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The cardiac skeleton is a collection of dense, fibrous connective tissue in the form
or four rings with interconnecting areas in a plane between the atria & the ventricles
The four rings of the cardiac skeleton surround the two atrioventricular orifices, the
aortic orifice and opening of the pulmonary trunks
They are the annulus fibrosus
The interconnecting areas include :
The right fibrous trigone, which is a thickened area of connective tissue between the
aortic ring and right atrioventricular ring
The left fibrous trigone, which is a thickened area of connective tissue between the
aortic ring and left atrioventricular ring
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Cardiac skeleton
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Coronary arteries
Right coronary artery
Left coronary artery
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Originates from the right aortic
sinus of the ascending aorta.
It passes anteriorly and to the right
between right auricle & pulmonary
trunk, then descends vertically in
the coronary sulcus, between right
atrium & right ventricle
It branches : atrial branch, right
marginal branch and posterior
interventricular
branch
•
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Originates from the left aortic
sinus of the ascending aorta.
It passes between the pulmonary
trunk and the left auricle before
entering the coronary sulcus
While still posterior to the
pulmonary trunk, it divides into its
two terminal branches : the
anterior interventricular branch
and the circumflex branch
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Cardiac Veins
Great cardiac vein
Middle cardiac vein
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It begins at the apex of the heart,
it ascends in the anterior
interventricular sulcus, reaching
the coronary sulcus then it turns to
the left and continues onto the
base of the heart. At this point, it is
associated by circumflex artery
Continuing along its path in the
coronary sulcus, it gradually
enlarges to form the
coronary sinus , which
enters the right atrium
It begins near the apex of the
heart and ascends in the posterior
interventricular sulcus toward the
coronary sinus. It is associated
with the posterior interventricular
branch of the right coronary artery
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Cardiac veins
Small cardiac vein
Posterior cardiac vein
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It begins in the lower anterior
section of the coronary sulcus
between the right atrium and right
ventricle
It continues in this groove onto the
base of the heart where it enters
the coronary sinus at its atrial end.
It is accompanied by the right
coronary artery throughout its
course and may receive
the right marginal vein
•
It lies on the posterior surface
of the left ventricle just to the
left of the middle cardiac vein
It enters the coronary sinus
directly or joins the great
cardiac veins
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Other cardiac veins
The anterior veins of right
ventricle (anterior cardiac vein)
•
Are small veins that arise on the
anterior surface of the right
ventricle. They cross the coronary
sulcus and enter the anterior wall
of the right atrium. They drain the
anterior portion of the right
ventricle
Venae cordis minimae / Veins
of Thebesius
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A group of smallest cardiac veins
Draining directly into the cardiac
chambers, they are numerous in
the right atrium and right ventricle,
are occasionally associated with
the left atrium, and are rarely
associated with the left ventricle
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Coronary blood vessels
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THE BLOOD VESSELS
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The complex system of blood vessels in the body called the vascular system
has two basic circuit : the pulmonary circuit & the systemic circuit
The pulmonary circuit carries blood to and from the lungs for the uptake of
oxygen and the removal carbon dioxide from body tissues
The systemic circuit carries oxygenated blood throughout the body and picks up
carbon dioxide from body tissues
THE SYSTEMIC CIRCULATION :
The systemic arteries
The systemic veins
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The systemic arteries
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Aorta
Arteries of the head and neck
Arteries of the upper limb
Arteries of the thorax
Arteries of the abdomen
Arteries of the pelvis and lower limbs
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Major arteries of the systemic circulation
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Arteries of the head and neck
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Arteries of the right upper limb and thorax
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Arteries of the lower limb
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Major veins of the systemic circulation
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Veins of the head and neck
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Veins of the right upper limb and thorax wall
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