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Heart anatomy

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RobbinsHobbin

The document discusses the anatomy and structure of the heart valves, conducting system, blood supply, innervation, and applied anatomy. It notes that the heart contains two pairs of valves - atrioventricular and semilunar - which ensure one-way blood flow. The right and left atrioventricular valves have different numbers of cusps. The aortic and pulmonary valves are semilunar in shape. The conducting system initiates and spreads cardiac impulses, while the coronary arteries supply blood to the heart muscle. Applied anatomy discusses common causes of ischemic heart disease.

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Valves of the heart • Provides unidirectional flow of blood. • 2 pairs: atrioventricular valve & semilunar valve • A.V. valve: • Right a.v. valve is known as tricuspid valve because of 3 cusps(anterior, posterior & septal) • Left a.v. valve(mitral) is known as bicuspid valve due to 2 cusps.(anterior/aortic &posterior) • Both valves have following components: 1.Fibrous ringor annulus to which cusp attach 2.Leaflet or cusp 3.Chorda tendinae-connects upper free margin of the cusp to papillry muscle 4.Papillary muscle-whose contraction makes the valve competant.
Semilunar valve • Aortic & pulmonary valve are semilunar valves-cusps are semilunar in shape. • Each valve has 3 cusps which are attached to the fibrous scallop of the orifice by convex margin. • Free margin shows fibrous nodule (nodule of Arantius ) at the centre with 2 thin lunule at the side. • Opposite the cusp, vessel walls are dilated to form aortic & pulmonary sinuses. • Applied anatomy: stenosis, valvar incompetence leading to regurgitation (murmur)
Skeleton of the heart • It consists of 4 fibrous rings around A.v. orifice, pulmonary & aortic orifices • Pulmonary & aortic rings are • connected by fibrous septum called tendon of infundibulum. • Right & left A.V. rings are united by trigonum fibrosum dextrum. • Aortic & left A.V. rings are connected by trigonum fibrosum sinistrum. • These interconnected fibrous rings provide attachment to cardiac muscle & supports the valve • It disturbs the continuity between atrial & ventricular muscle. So impulses are propagated through conductng system of the heart
Conducting system of the Heart • They are the specialized myocytes for initiation & conduction of cardiac impulses. It includes: • Sinuatrial node(S.A node) • Atrioventricular Bundle & its 2 limbs • Subendocardial plexus of purkinje fibers. • Heart beat is myogenic.
Conducting system of the Heart
Blood supply of the heart • Heart is supplied by 2 coronary arteries- rt.&lt. arising from ascending aorta. • coronary is derived from the word `crown’which encircles the base of ventricle as a crown • Each coronary artery is vasvasorum • Right coronary artery: • Arises from ant. Aortic sinus & passes forward to the right betn pulmonary trunk & rt auricle. • Then runs in the rt. Coronary sulcus to the junction of rt. & inferior border of the heart. • It winds around the inferior border to reach diaphragmatic surface of the heart. Here it runs backward & to the left to reach posterior iv groove & terminates anastomosing with left coronary artery.
Blood supply of the heart
Contd.. • Left coronary artery: Larger than right coronary artery. • Arises from left posterior aortic sinus . • Pecularities: • Sometimes left coronary artery may arise from pulmonary trunk. • Sympathetic stimulation constricts the epicardial artery & dilate intramuscular arteries. • It is the only vessel where blood flows in diastole. • Cardiac & extracardiac anastomosis • 85% of Inter- atrial anastomosis takes place in precapillary level &15% in capillary level. So they are not typical end arteries but functionally behave like end arteries.
Inter-atrial anastomosis • Sites of anastomosis are: • Kugel’s artery: artterial branch of both coronary arteries communicates at ant. atrial wall. • Anastomosis between anterior & posterior interventricular artery near to the apex. • Annulus of Vieussens- anastomosis betn rt. & left conal artery around the infundibulum. • In the intervenricular septum • Near the crux of the heart • Coronary perdominance: • Most case right coronary predominance where posterior interventricular artery is derived from right coronary artery(70%). • Minority of population has left coronary predominance-from left coronary artery. • In balanced pattern branches of both run in or near the sulcus.
Venous drainage of the heart • Great cardiac vein • Middle cardiac vein • Small cardiac vein • Oblique vein of left atrium(of Marshal) • Left marginal vein • Anterior cardiac vein • Venae cordis minimae(Thebesian vein) • All veins excep last two drain into coronary sinus which open into rt. Atrium.
Contd..
Nerve supply of the heart • Derived from cardiac plexus formed by sympathetic (T1-T4/T5) & parasympathetic(vagus) nerves. • Cardiac plexus suprficial-below the arch of aorta deep-infront of bifurcation of trachea
Applied anatomy • Common cause of death in developed countries-ischaemic heart disease • Sudden obstruction of major branch of coronary vessels lesd to myocrdial infarction. • Common branches for occlusion are: • Anterior interventricular artery • Rt. coronary artery • Circuflex branch of left coronary artery

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Heart anatomy

  • 1. Valves of the heart • Provides unidirectional flow of blood. • 2 pairs: atrioventricular valve & semilunar valve • A.V. valve: • Right a.v. valve is known as tricuspid valve because of 3 cusps(anterior, posterior & septal) • Left a.v. valve(mitral) is known as bicuspid valve due to 2 cusps.(anterior/aortic &posterior) • Both valves have following components: 1.Fibrous ringor annulus to which cusp attach 2.Leaflet or cusp 3.Chorda tendinae-connects upper free margin of the cusp to papillry muscle 4.Papillary muscle-whose contraction makes the valve competant.
  • 2. Semilunar valve • Aortic & pulmonary valve are semilunar valves-cusps are semilunar in shape. • Each valve has 3 cusps which are attached to the fibrous scallop of the orifice by convex margin. • Free margin shows fibrous nodule (nodule of Arantius ) at the centre with 2 thin lunule at the side. • Opposite the cusp, vessel walls are dilated to form aortic & pulmonary sinuses. • Applied anatomy: stenosis, valvar incompetence leading to regurgitation (murmur)
  • 3. Skeleton of the heart • It consists of 4 fibrous rings around A.v. orifice, pulmonary & aortic orifices • Pulmonary & aortic rings are • connected by fibrous septum called tendon of infundibulum. • Right & left A.V. rings are united by trigonum fibrosum dextrum. • Aortic & left A.V. rings are connected by trigonum fibrosum sinistrum. • These interconnected fibrous rings provide attachment to cardiac muscle & supports the valve • It disturbs the continuity between atrial & ventricular muscle. So impulses are propagated through conductng system of the heart
  • 4. Conducting system of the Heart • They are the specialized myocytes for initiation & conduction of cardiac impulses. It includes: • Sinuatrial node(S.A node) • Atrioventricular Bundle & its 2 limbs • Subendocardial plexus of purkinje fibers. • Heart beat is myogenic.
  • 6. Blood supply of the heart • Heart is supplied by 2 coronary arteries- rt.&lt. arising from ascending aorta. • coronary is derived from the word `crown’which encircles the base of ventricle as a crown • Each coronary artery is vasvasorum • Right coronary artery: • Arises from ant. Aortic sinus & passes forward to the right betn pulmonary trunk & rt auricle. • Then runs in the rt. Coronary sulcus to the junction of rt. & inferior border of the heart. • It winds around the inferior border to reach diaphragmatic surface of the heart. Here it runs backward & to the left to reach posterior iv groove & terminates anastomosing with left coronary artery.
  • 7. Blood supply of the heart
  • 8. Contd.. • Left coronary artery: Larger than right coronary artery. • Arises from left posterior aortic sinus . • Pecularities: • Sometimes left coronary artery may arise from pulmonary trunk. • Sympathetic stimulation constricts the epicardial artery & dilate intramuscular arteries. • It is the only vessel where blood flows in diastole. • Cardiac & extracardiac anastomosis • 85% of Inter- atrial anastomosis takes place in precapillary level &15% in capillary level. So they are not typical end arteries but functionally behave like end arteries.
  • 9. Inter-atrial anastomosis • Sites of anastomosis are: • Kugel’s artery: artterial branch of both coronary arteries communicates at ant. atrial wall. • Anastomosis between anterior & posterior interventricular artery near to the apex. • Annulus of Vieussens- anastomosis betn rt. & left conal artery around the infundibulum. • In the intervenricular septum • Near the crux of the heart • Coronary perdominance: • Most case right coronary predominance where posterior interventricular artery is derived from right coronary artery(70%). • Minority of population has left coronary predominance-from left coronary artery. • In balanced pattern branches of both run in or near the sulcus.
  • 10. Venous drainage of the heart • Great cardiac vein • Middle cardiac vein • Small cardiac vein • Oblique vein of left atrium(of Marshal) • Left marginal vein • Anterior cardiac vein • Venae cordis minimae(Thebesian vein) • All veins excep last two drain into coronary sinus which open into rt. Atrium.
  • 12. Nerve supply of the heart • Derived from cardiac plexus formed by sympathetic (T1-T4/T5) & parasympathetic(vagus) nerves. • Cardiac plexus suprficial-below the arch of aorta deep-infront of bifurcation of trachea
  • 13. Applied anatomy • Common cause of death in developed countries-ischaemic heart disease • Sudden obstruction of major branch of coronary vessels lesd to myocrdial infarction. • Common branches for occlusion are: • Anterior interventricular artery • Rt. coronary artery • Circuflex branch of left coronary artery