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HEART Nainika Menon Pericardium OBJECTIVES Anatomy of heart Auscultation Pericardium • Pericardial sac Outer: Fibrous pericardium Inner: Parietal layer • Visceral layer = Epicardium (note: myocardium and endocardium) • Pericardial cavity: serous fluid (eliminates friction) Surfaces • Anterior (sternocostal) = R ventricle + part of R atrium + part of L ventricle • Right pulmonary = R atrium • Left pulmonary = L ventricle + part of L atrium • Diaphragmatic = L ventricle + part of R ventricle Base = L atrium + part of R atrium Apex = tip of L ventricle Flow of Blood SVC/IVC Right Atrium Triscuspid valve Right Ventricle Pulmonary (semilunar) valve Pulmonary trunk Lungs Flow of Blood Lungs Pulmonary veins Left atrium Bicuspid/Mitral valve Left ventricle Aortic (semilunar) valve Aorta Special Features ATRIA • Auricles • Right atrium – receives IVC, SVC and coronary sinus • Interatrial septum – fossa ovalis VENTRICLES • Trabeculae carneae • Left ventricle – thicker muscular wall Special features of Valves • TRICUSPID VALVE – Three cusps Ventricular wall Papillary muscles • BICUSPID/MITRAL VALVE – Two cusps • AORTIC/PULMONARY VALVES – Sinuses Chordae tendineae Auscultation (OSCEs) • • • • Tricuspid valve: 5/6th ICS; L sternal edge Pulmonary valve: 2nd ICS; L sternal edge Mitral valve: 5th ICS; midclavicular line (APEX) Aortic valve: 2nd ICS; R sternal edge • Note: sternal angle – 2nd cc ? ? QUIZ! Thank You! [email protected] References • Information from: MOORE, Keith L., Anne AGUR, Arthur DALLEY. Essential Clinical Anatomy. 4th ed. Baltimore: Lippincott Williams & Wilkins, 2011 DRAKE, Richard L., A. Wayne VOGL, Adam W. M. MITCHELL. Gray’s Anatomy for Students. 2nd ed. Philadelphia: Churchill Livingstone, 2010 • Images from: DRAKE, Richard L., A. Wayne VOGL, Adam W. M. MITCHELL. Gray’s Anatomy for Students. 2nd ed. Philadelphia: Churchill Livingstone, 2010