Heart Anatomy

left pulmonary surface - beneath is left ventricle

Name the surface of the heart and which heart structures are beneath.

right pulmonary surface - beneath is right atrium

Name the surface of the heart and which heart structures are beneath.

sternocostal surface (anterior surface) - beneath is right ventricle

Name the surface of the heart and which heart structures are beneath.

Triangle of Koch - Tendon of Todaro - Coronary Sinus Orifice - Septal Leaflet of Right AV Valve

Name the triangle (8) and its borders

aortic valve

Name the valve

left atrioventricular valve - left AV valve - bicuspid valve - mitral valve

Name the valve

pulmonary valve

Name the valve

right atrioventricular valve - right AV valve - tricuspid valve

Name the valve

small cardiac vein - coronary sinus - right atrium

Name the vein of the heart B and its pathway back to the right atrium

middle cardiac vein - coronary sinus - right atrium

Name the vein of the heart C and its pathway back to the right atrium

coronary sinus - right atrium

Name the vein of the heart D and its pathway back to the right atrium

great cardiac vein - coronary sinus - right atrium

Name the vein of the heart E and its pathway back to the right atrium

left border of the heart

Name the yellow border of the heart.

apex of the heart

Name there feature of the external heart

Take note of the 4 surfaces of the heart in the diagram as well as the heart structures each surface covers.

Take note of the 4 surfaces of the heart in the diagram as well as the heart structures each surface covers.

Commissures

The atrioventricular valves are continuous at the base. What is the name of where they fuse?

The right aortic arch

The brachiocephalic trunk is the remnant of which structure during embryonic development?

The branches of the anterior interventricular (descending) artery are called diagonal branches.

The branches of the anterior interventricular (descending) artery are called __________ branches.

The branches of the circumflex artery and right coronary branches are called marginal branches.

The branches of the circumflex artery and right coronary branches are called __________ branches.

The left aortic sinus

The left coronary artery begins from which sinus?

The left pulmonary artery passes in front of the descending thoracic aorta.

The left pulmonary artery passes in front of the ____________.

The right aortic sinus

The right coronary artery begins from which sinus?

The right pulmonary artery passes in front of the birfurcation of the trachea and the right main bronchus.

The right pulmonary artery passes in front of the ____________.

The parietal serous layer and the visceral serous layer surround the pericardial space.

There are two layers of the serous pericardium. What are their names and what is the name of the space between the two layers called?

- Parietal Serous Layer (more superficial) - Visceral Serous Layer (more deep)

There are two layers of the serous pericardium. What are their names and which one is deeper and which is more superficial?

True

True or False: The parietal serous layer of the pericardium reflects as the visceral pericardium thus it is a continuous structure.

False, the pericardial sac does surround the great vessels.

True or False: The pericardial sac doesn't surround the great vessels.

The right atrium

Veins of the inner third of the myocardium enter the heart directly into all four chambers but the majority enter which chamber of the heart?

Venae Cordis Minimae (AKA Thebesian Veins)

Veins of the inner third of the myocardium enter the heart directly into all four chambers. What name is given to these tiny vessels?

- sternocostal - diaphragmatic - pulmonary (x2) Note the base is not a surface of the heart

What are are the names of the four surfaces of the heart?

The auricle is the muscular pouch that arises from each atrium. The auricle is also called atrial appendage. Their purpose is to increase the capacity of the atrium and also increase the volume of blood that it is able to contain

What are auricles of the heart?

Left and Right Atrioventricular (AV) Bundle Branches

What are the names of the two bundle branches that split from the Bundle of His (AV Bundle)?

- fibrous pericardium - serous pericardium

What are the two layers of the pericardium called?

- The Superficial Spiral Layer (twists the ventricle like a wrung towel) - The Deep Constrictor Group (squeezes the ventricles)

What are the two main layers of the ventricular myocardium?

The heart is obliquely orientated

What direction is the heart orientated?

The septomarginal trabecula attaches to: - the inferior aspect of the interventricular septum - the anterior papillary muscle of the right ventricle

What does the septomarginal trabecula attach to?

The crista terminalis is the ridge that separates the pectinate muscles and the smoothened area of the right atrium.

What is the crista terminalis

The Fibrous Skeleton of the Heart is composed of fibrous or sinoatrial vinous tissue. - They are also essential for normal electrical conduction since the insulate the atrial chambers from the ventricular mass.

What is the fibrous skeleton of the heart composed of?

serous pericardium its layers are called the parietal layer and the visceral layer

What is the inner layer of the pericardium called and what are the names of it's layers?

The left fibrous trigone is the connective tissue bridge between the aortic valve and the left atrioventricular (mitral) valve rings.

What is the left fibrous trigone?

The AV node is located near the interior edge of the interatrial septum, near the opening of the coronary sinus.

What is the location of the atrioventricular (AV) node?

The SA node is located near the junction of the superior vena cava and the right atrium. - its position is often marked by the artery supplying the SA node, which may be the circumflex artery, the right coronary artery, or both

What is the location of the sinoatrial (SA) node?

Regurge

What is the name for back flow of blood (in the wrong direction)?

chordae tendonae

What is the name for the tendinous cords that are attached to the tricuspid and bicuspid valves?

Sinus Septum

What is the name of the fold between the valve of the coronary sinus and the inferior vena cava orifice?

The outermost layer of the pericardium is the fibrous pericardium which has a direct attachment to the the central tendon of the diaphragm and anchors the heart in position.

What is the outermost layer of the pericardium called and what is its function?

Conus arteriosus (infundibulum) - demarcated by a smooth area of the right ventricle

What is the pulmonary artery called before it passes the pulmonary valve?

The right fibrous trigone is the connective tissue bridge between the aortic valve and the right atrioventricular (tricuspid) valve rings.

What is the right fibrous trigone?

the papillary muscles

What muscles do the chordae tendonae attach to?

left and right ventricles

What parts of the heart make up the inferior border of the heart?

left auricle and left ventricle

What parts of the heart make up the left border of the heart?

right atrium

What parts of the heart make up the right border of the heart?

left and right atria

What parts of the heart make up the superior border of the heart?

The left coronary artery supplies: - most of the left atrium - most of the left ventricle - most of the interventricular septum - the AV conduction bundle and its branches

What structures does the left coronary artery supply?

The right coronary artery supplies the: - right atrium - right ventricle - interatrial septum - part of the left atrium - part of the posterior wall of the left ventricle - SA and AV nodes (usually)

What structures does the right coronary artery supply?

The pericardium is a double-layered connective tissue that anchors the hearts position and also prevents friction between the heart and other organs.

What surrounds the heart in the mediastinum and what is its purpose?

The pericardial space helps avoid friction between the heart and the surrounding tissues.

What's the function of the pericardial space?

Obtuse margin of the heart

What's the other name for the left margin of the heart?

The coronary arteries branch from the aortic sinuses of the ascending aorta.

Where do the coronary arteries branch from?

The posterior aortic sinus

Which aortic valve doesn't have an artery leave from it and is therefore called the noncoronary sinus and cusp?

the visceral layer of the serous pericardium

Which layer of the pericardium is also known as the epicardium?

It must pass the mediastinum posterior to the oesophagus and therefore can cause dysphagia lusoria (difficulty swallowing).

A common variation of the aorta is the origin of the right subclavian artery arising distal to the left subclavian artery. What is its significance?

the ventricles

Are chordae tendonae and papillary muscles located in the ventricles or the atria?

Yes, the two surround the heart and hold the pericardial space between them.

Are the parietal and visceral layers of the serous pericardium connected?

The pectinate muscles are smooth muscle, not cardiac muscle.

Are the pectinate muscles smooth muscle, skeletal muscle or cardiac muscle?

The trabeculae carneae muscles are smooth muscle, not cardiac muscle.

Are the trabeculae carneae muscles smooth muscle, skeletal muscle or cardiac muscle?

The height of the Angle of Louis / Sternal Angle, where the transverse thoracic plane passes

At what height does the ascending aorta become the arch of aorta?

1. Blood enters the right atrium from superior and inferior vena cava 2. Blood passes through tricuspid valve (right AV valve) into right ventricle 3. Blood pumped from right ventricle to lungs via pulmonary trunk and arteries (through pulmonary valve) 4. Blood returns to the heart from the lungs via the left and right pulmonary veins (into left atrium) 5. Blood passes through bicuspid valve (left AV valve) into left ventricle 6. Blood pumped from left ventricle to body via ascending aorta (through aortic valve)

Explain Blood Flow through the Heart from the Inferior and Superior Vena Cavas to the Aorta

Eustachian Valve (AKA Valve of the Inferior Vena Cava) - directed incoming oxygenated blood towards foramen ovale; away from the right atrium

Name the ridge and its function during foetal development

aortic sinus

Name the space that is superior to the aortic valve (i.e. in the aorta)

Azygous vein - runs up the right side of the thoracic vertebral column draining itself towards the superior vena cava.

Name the structure

Crista Terminalis

Name the structure

Limbus Fossa Ovalis - border around fossa ovalis

Name the structure

Mediastinum

Name the structure

Ostium of the coronary sinus

Name the structure

Pericardial Sac

Name the structure

Pericardium

Name the structure

Sulcus terminalis of the heart

Name the structure

heart

Name the structure

thoracic cavity

Name the structure

Fossa Ovalis - part of foramen ovale - allowed a right-to-left shunt during foetal development to bypass the pulmonary circuit

Name the structure and its function

The Thebesian Valve guards the coronary sinus

Name the structure and its function

conus arteriosus (infundibulum) - the cone-shaped outflow tract of the right ventricle

Name the structure and its function

The oblique sinus of the pericardium - Located behind the heart at a pericardial reflection between the left and right pulmonary veins as they enter the left atrium

Name the structure and where it is located

Left bundle branch

Name the structure indicated by the purple arrow

right bundle branch

Name the structure indicated by the white arrow

left auricle of the heart

Name the structure of the heart

right auricle of the heart

Name the structure of the heart

Septomarginal Trabecula (AKA moderator band)

Name the structure of the right ventricle

papillary muscles

Name the structure the chordae tendonae attach

diaphragmatic surface (inferior surface) - beneath is left ventricle [and a bit of the right ventricle]

Name the surface of the heart and which heart structures are beneath.

left cusp of pulmonary valve

Name the cusp and the valve. Number 1

anterior cusp of pulmonary valve

Name the cusp and the valve. Number 2

posterior cusp of mitral valve (bicuspid / left AV valve)

Name the cusp and the valve. Number 2

anterior cusp of tricuspid valve (right AV valve)

Name the cusp and the valve. Number 3

right cusp of pulmonary valve

Name the cusp and the valve. Number 3

left cusp of aortic valve

Name the cusp and the valve. Number 4

septal cusp of tricuspid valve (right AV valve)

Name the cusp and the valve. Number 4

posterior cusp of tricuspid valve (right AV valve)

Name the cusp and the valve. Number 5

right cusp of aortic valve

Name the cusp and the valve. Number 5

posterior cusp of aortic valve

Name the cusp and the valve. Number 6

Purkinje fibers

Name the feature of the heart.

atrioventricular (AV) bundle (AKA Bundle of His)

Name the feature of the heart.

atrioventricular node (AV Node)

Name the feature of the heart.

sinoatrial node (SA Node)

Name the feature of the heart.

pericardium

Name the feature of the pericardium A

fibrous pericardium

Name the feature of the pericardium B

serous pericardium

Name the feature of the pericardium C

parietal layer of serous pericardium

Name the feature of the pericardium D

visceral layer of serous pericardium [AKA epicardium]

Name the feature of the pericardium E

pericardial space

Name the feature of the pericardium F

inferior border of the heart

Name the green border of the heart.

Atrioventricular groove [AKA coronary groove]

Name the groove

pectinate muscles (AKA musculi pectanati)

Name the internal muscular feature of the atria

trabeculae carneae

Name the internal muscular feature of the ventricles

Rucurrent laryngeal nerve (right) - wraps the aorta and ascends beside the oesophagus to reach the larynx

Name the nerve

Vagus nerve (right) - descends on the lateral aspect of the aortic arch

Name the nerve

right border of the heart

Name the red border of the heart.

The transverse sinus of the pericardium - Located posterior to the pulmonary trunk and aorta (arteries) but anterior to the superior vena cava (veins)

Name structure A and where it is located

Lunule

Name structure B of the aortic valve

Nodules

Name structure C of the aortic valve

Isthmus of the aorta - a slight constriction of the aorta distal to the left subclavian artery

Name structure D

Left fibrous ring

Name structure G

Right fibrous ring

Name structure M

Anterior Interventricular Groove of the heart

Name structure S2

circumflex artery - branch of left coronary artery

Name the artery of the heart 10 and it's pathway from the aorta

Posterior interventricular groove

Name structure 2

Left fibrous trigone

Name structure 3

Tendon of Todaro - made of subendocardium

Name structure 4

anterior descending artery (AKA anterior interventricular artery) - branch of left coronary artery

Name the artery of the heart 11 and it's pathway from the aorta

posterior descending artery (AKA posterior interventricular artery) - branch of right coronary artery

Name the artery of the heart 12 and it's pathway from the aorta

right coronary artery - branch of ascending aorta

Name the artery of the heart 3 and its pathway from the aorta

right marginal artery - branch of right coronary artery - aorta

Name the artery of the heart 6 and it's pathway from the aorta

left coronary artery - branch of ascending aorta

Name the artery of the heart 8 and its pathway from the aorta

superior border of the heart

Name the blue border of the heart.

anterior cusp of mitral valve (bicuspid / left AV valve)

Name the cusp and the valve. Number 1

There are four (4) borders of the heart: - superior border - inferior border - right border - left border

How many borders of the heart are there and what are their names?

the posterior aspect of the heart

Is the left atrium of the heart located at the posterior or anterior aspect of the heart?

The right pulmonary artery is longer

Is the left or right pulmonary artery longer?

superior vena cava

Name Great Vessel 1

right pulmonary artery

Name Great Vessel 2

right pulmonary veins

Name Great Vessel 22

left pulmonary artery

Name Great Vessel 29

brachiocephalic trunk

Name Great Vessel 3

pulmonary trunk

Name Great Vessel 30

left pulmonary veins

Name Great Vessel 31

left common carotid artery

Name Great Vessel 4

left subclavian artery

Name Great Vessel 5

thoracic aorta

Name Great Vessel 6

inferior vena cava

Name Great Vessel 8

ascending aorta

Name Great Vessel A

arch of aorta

Name Great Vessel B

left recurrent laryngeal nerve

Name nerve 3

Right fibrous trigone

Name structure 1

Ligamentum anteriosum - remnant of ductus arteriosus in the developing foetus

Name structure 14 and what it is the remnant of