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1. ANATOMY OF HEART
PRESENTER : DR RAJESH MUNIGIAL
SENIOR RESIDENT
DEPT. OF CARDIAC ANAESTHESIA
JNMC, BELGAUM

2. TOPICS OF DISCUSSION
• Introduction
• Embryology
• Heart
• Great vessels
• Fetomaternal circulation
• Coronary anatomy
• Venous drainage of heart
• Histology

3. EMBRYOLOGY OF HEART
• The cardiovascular system is one of the first body systems to
appear within the embryo. It is active by the beginning of the
fourth week – when the placenta is unable to meet the
requirements of the growing embryo.
• The development of the heart begins with the formation of
the primitive heart tube following the folding of the embryo
during the end of the third week.

7. The HEART :

8. The Heart :
The heart measures about 12 x 9 cm and weighs about
300 g in males and 250 g in females.

9. Contents of the Pericardium
• Heart with cardiac vessels and nerves.
• Ascending aorta.
• Pulmonary trunk.
• Lower half of the superior vena cava.
• Terminal part of the inferior vena cava.
• The terminal parts of the pulmonary veins.
Nerve Supply :
The fibrous and parietal pericardia are supplied by the phrenic nerves. They are
sensitive to pain.
The epicardium is supplied by autonomic nerves of the heart, and is not sensitive to
pain.
Pain of pericarditis originates in the parietal pericardium alone. On the other hand,
cardiac pain or angina originates in the cardiac muscle or in the vessels of the heart.

10. APEX OF THE HEART

11. ANTERIOR SURFACE

12. INFERIOR SURFACE

13. Base of the heart ( posterior surface)

14. CHAMBERS OF THE HEART
• The heart is divided by vertical septa into four chambers:
● Left and right atria .
● Left and right ventricles.
The right atrium lies anterior to the left atrium, and the right ventricle
lies anterior to the left ventricle

15. RIGHT ATRIUM

16. CAVITY OF RIGHT ATRIUM

17. RIGHT VENTRICLE
The interior has two parts :
a. The inflowing part is rough due to the
presence of muscular ridges called
trabeculae carneae.
b. The outflowing part or infundibulum
is smooth and forms the upper conical
part of the right ventricle which gives
rise to the pulmonary trunk
c. The two parts are separated by a
muscular ridge called the
supraventricular crest or infundibulo-
ventriculat crest situated between the
tricuspid and pulmonary orifices.

18. LEFT ATRIUM AND LEFT VENTRICLE
1.The posterior surface of the atrium forms the anterior wall of
the oblique sinus of pericardium .
2 The anterior wall of the atrium is formed by the interatrial
septum.
3 Two pulmonary veins open into the atrium on each side of
the posterior wall.
4 The greater part oI the interior of the atium is smooth walled
Externally, the left ventricle has three surfaces :
Anterior or sternocostal, inferior or diaphragmatic, and left.
The interior is divisible into two parts.
a. The lower rough part
b. The upper smooth part
There are two well-developed papillary muscles, anterior
and posterior. Chordae tendinae from both muscles are
attached to both the cusps of the mitral valve.
The walls of the left ventricle are three times thicker than
those of the right ventricle.

19. Valves of the heart

20. ATRIOVENTRICULAR VALVES
Both valves are made up of the following components.
a. A fibrous ring to which the cusps are attached .
b. The cusps are flat and project into the ventricular cavity. Each cusp has an attached
and a free margin, and an atrial and a ventricular surface.
The atrial surface is smooth . The free margins and ventricular surfaces are rough and
irregular due to the attachment of chordae tendinae.
c.The chordae t€ndinae connect the free margins and ventricular surfaces of the
cusps to the apices of the papillary muscles. They prevent eversion of the free margins
and limit the amount of ballooning of the cusps towards the cavity of the atrium.

21. d. The atrioventricular valves are kept competent by active contraction of
the papillary muscles, which pull on the chordae tendinae during
ventricular systole
• Blood vessels are present only in the fibrous ring and in the basal one-
third of the cusps.
• Nutrition to the central two-thirds of the cusps is derived directly from
the blood in the cavity of the heart

22. TRICUSPID VALVE
The tricuspid valve has three cusps and can
admit the tips of three fingers.
The three cusps, the anterior, posterior or
inferior, and septal lie against the three walls
of the ventricle.
Of the three papillary muscles, the anterior is
the largest, the inferior is smaller and
irregular, and the septal is represented by a
number of small muscular elevations

23. MITRAL VALVE
The mitral or bicuspid valve has two cusps, a large anterior or
aortic cusp, and a small posterior cusp. It admits the tips of two
fingers. The anterior cusp lies between the mitral and aortic
orifices. The mitral cusps are smaller and thicker than those of the
tricuspid valve

24. SEMILUNAR VALVES
1)The aortic and pulmonary valves are called semilunar valves because their cusps are
semilunar in shape.
2 Each valve has three cusps which are attached directly to the vessel wall, there being
no fibrous ring. The cusps form small pockets with their mouths directed away from the
ventricular cavity.
3 Opposite the cusps the vessel walls are slightly dilated to form the aortic and
pulmonary sinuses. The coronary arteries arise from the anterior and the left posterior
aortic sinuses

26. GREAT VESSELS

27. Superior vena cava
Superior vena cava is a large venous channel
which collects blood from the upper half of
the body and drains it into the right atrium.
It is formed by the union of the right and left
brachiocephalic or innominate veins behind
the lower border of the first right costal
cartilage close to the sternum.

28. Aorta

29. PULMONARY TRUNK
The wide pulmonary trunk starts from the
summit of infundibulum of right ventricle.
Both the ascending aorta and pulmonary trunk
are enclosed in a common sleeve of serous
pericardium, in front of transverse sinus of
pericardium.
Pulmonary trunk carrying deoxygenated blood,
overlies the beginning of ascending aorta.
It courses to the left and divides into right and
left pulmonary arteries under the concavity of
aortic arch at the level of sternal angle

31. FETOMATERNAL CIRCULATION
The foetus (Greek offspring) is dependent for its entire
nutrition on the mother, and this is achieved through the
placenta attached to the uterus.
As the lungs are not functioning, the blood needs to bypass
the pulmonary circuit

35. CORONARY ANATOMY :The heart is supplied by two coronary arteries, arising
from the ascending aorta. Both arteries run in the coronary sulcus.

37. Right coronary artery:
Areas of distribution
• 1 Right atrium
• 2 Ventricles
a. Greater part of the right ventricle, except the
area adjoining the anterior interventricular
groove.
b. A small part of the left ventricle adjoining the
posterior interventricular groove.
• 3 Posterior part of the interventricular
septum.
• 4 Whole of the conducting system of the heart
except a part of the left branch of the AV
bundle. The SA node is supplied by the left
coronary artery in about 40% of cases.
It arises from the anterior aortic sinus of
ascending aorta.
Branches
1.Large
a. Marginal.
b. Posterior interventricular.
2 Small branches
• Nodal.60% cases.
• Right atrial.
• Infundibular.
• Terminal.
• Right ventricular
• Conus

38. Left coronary artery:Left coronary artery is larger than the right coronary artery. It arises
from the left posterior aortic sinus of ascending aortic.
Branches :
Large branches
a. Anterior interventricular.
b: Branches to the diaphragmatic
surface of the left ventricle,
including a large diagonal branch.
Small branches :
a. Left atrial
b. Pulmonary
c. Terminal
Areas of distribution :
1 Left atrium
2 Ventricles
a. Greater part of the left ventricle, except the area adj
oining the posterior interventricular groove.
b. A small part of the right ventricle adjoining the anterior
interventricular groove.
3.Anterior part of the interventricular septum
4 A part of the left branch of the AV bundle.

40. VENOUS DRAINAGE OF THE HEART

41. CONDUCTION SYSTEM OF HEART

44. NERVE SUPPLY OF THE HEART
By sympathetic & parasympathetic fibers via the cardiac plexus situated
below arch of aorta.
● The sympathetic fibres arise from the cervical & upper thoracic
ganglia of sympathetic trunks.
● The parasympathetic fibres arise from the vagus nerves.
● Postganglionic fibres reach heart along – SAN, AVN & nerve plexus
around coronary arteries
● Symp. Fibers--- accelerate heart rate but Parasymp. Fibers --- slow
heart rate (constriction of coronary arteries

46. HISTOLOGY :

49. REFERENCES
1. B D Chaurasia’s HUMAN ANATOMY VOLUME 1 , 6th Edition
2. Inderbir singh textbook of histology, 6th edition
3. Grey’s anatomy , 42nd edition
4. Hill, M.A. (2024, January 26) Embryology Cardiovascular
System - Heart Histology

50. THANK YOU