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Gross anatomy of the heart and great vessels

Taken from Wikipedia
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wikipedia
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com, Human Anatomy Flashcards, available at
https://quizlet
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com/12-the-heart-pericardium-and-mediastinum/

Taken from Clinical Gate, Chapter 7 – Imaging Techniques, available at
http://clinicalgate
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com, Anatomy and Physiology, Heart Anatomy, available at
http://philschatz
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html

Taken from BlogSpot, Know Your Heart, Cardiac Cycle, available at http://healthyheartsundar
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co
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html

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Cardiac muscle fibres are attached to the fibrous skeleton of the heart
The fibrous skeleton is a complex framework of dense collagen, forming:
o Four fibrous rings; surround orifices of the valves
o Right and left fibrous trigones; formed by connections between
rings
o Membranous parts; form the interatrial and interventricular septa
Function of the fibrous skeleton
o Keeps shape of AV and semilunar valves, prevents over-distension
o Attachment for leaflets and cusps of valves
o Attachment for myocardium
o Electrical insulator

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Separates myenterically conducted atria and ventricles, so
they contract independently
Surrounds and provides passage for the initial part of the AV
bundle of the conducting system

Taken from Quizlet
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com/6356282/heart-1-flash-cards/

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Coronary sulcus (atrioventricular groove) demarcates the atria from the
ventricles
Anterior and posterior interventricular sulci demarcates the ventricles
Heart appears trapezoidal from anterior or posterior view
o Apex (directed anterior and to the left)
o Base (opposite the apex, facing posteriorly)
o Four sides

Taken from SlideShare
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slideshare
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com, (13) CVS Heart at University of Michigan Ann Arbor, available at
https://www
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com/notes/note/n/-13-cvs-heart/deck/9917613

Right atrium
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Forms right border of the heart
Receives blood from the superior vena cava (SVC) and inferior vena cava
(IVC)and coronary sinus (small opening; medial to IVC)
Right auricle is a conical muscular pouch projecting from the chamber;
increases capacity of the atrium
Two different spaces in right atrium
o Sinus venarum is a smooth posterior section, on which the superior and
inferior vena cavae and coronary sinuses open
o Rough muscular anterior wall composed of pectinate muscle
Smooth and rough parts of the right atrium are separated by
o Sulcus terminalis/terminal groove: vertical groove on external surface
o Crista terminalis/terminal crest: internal surface (smooth muscular
ridge)
Top of sulcus is where SA node is, bottom of sulcus is where AV node is
Right atrioventricular orifice, through which the right atrium discharges blood
to the right ventricle; fibrous ring gives strength
o Contains atrioventricular valve (tricuspid valve)
Opening of coronary sinus (short venous trunk receiving most of the cardiac
veins) is located between the right atrioventricular orifice and the inferior
vena cava orifice
Interatrial septum separating from left ventricle
Oval fossa: small depression in the interatrial septum; remnant of the oval
foramen in the foetus (allows blood to pass from right to left atrium in foetus)

Taken from Drake et al, Gray’s Anatomy for Students, Second Edition

Right ventricle
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Forms largest part of anterior surface, small part of diaphragmatic surface
and entire inferior border
Right atrioventricular orifice (tricuspid): where blood enters from atria
o Surrounded by fibrous rings of the fibrous skeleton
o Fibrous rings keep constant calibre of the orifices, resist dilation
Tricuspid valve guards right atrioventricular orifice,
o Bases of valve cusps are attached to the fibrous ring around the orifice
o 3 cusps – anterior, posterior and septal
Tendinous cords attach to the free edges and ventricular surfaces of the
anterior, posterior and septal cusps; arise from apices of papillary muscles
Papillary muscles: conical muscular projections with bases attached to the
ventricular wall
o Anterior papillary muscle – largest and most prominent, arises from
anterior wall, attach to anterior and posterior cusps of tricuspid valve
o Posterior papillary muscle – can consist of several parts; arises from
inferior wall, tendinous cords attach to posterior and septal cusps of
the tricuspid valve
o Septal papillary muscle – arises from intraventricular septum, tendinous
cords attach to anterior and septal cusps of the tricuspid valve
 Sometimes absent
Cordae tendinae and papillary muscles prevent eversion of tricuspid valves
when ventricle contracts; no backflow of blood
Trabeculae carneae: muscular elevations in interior; can be fixed along
length, or bridge formation; found in inflow tract
Conus arteriosus/infundibulum: tapering of right ventricle into arterial cone;
outflow tract
Supraventricular crest: thick muscular ridge separating the ridged muscular
wall of the inflow part of the chamber from the conus arteriosus
Interventricular septum: strong partition between right and left ventricles,
composed of muscular and membranous parts
o Upper posterior part is thin and fibrous
o Bottom half is thick muscle
Septomarginal trabecula (moderator band): curved muscular bundle that
traverses the right ventricular chamber from the inferior part of the
interventricular septum to the base of the anterior papillary muscle
o Carries the right branch of the AV bundle
Supraventricular crest: deflects incoming blood flow from atria into the
ventricle and outgoing flow into the conus arteriosus toward the pulmonary
orifice
Pulmonary valve: at apex of conus arteriosus; entry to pulmonary trunk
o Edges project into lumen of pulmonary trunk
o Three – left right and anterior; pockets known as pulmonary sinuses
o Lunule: thickened edge of each cusp where they contact each other

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Nodule: apex of the thickened angulated free edge
Blood fills sinuses when ventricle relaxes; closes valves

Taken from Duke Medicine, Anatomy, Lab 4 – Mediastinum and Heart, available at
https://web
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edu/anatomy/lab03/lab3
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com, AN2 03: The Heart at Midwestern University (AZ), available at
https://www
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com/notes/note/n/an2-03-the-heart/deck/10721023

Left atrium
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Forms most of the base of the heart
Left auricle: tubular, muscular structure, trabeculated with pectinate muscles
o Forms superior part of left border of the heart
o Overlaps root of pulmonary trunk
Two divisions
o Posterior smooth wall
o Anterior auricle – rough, pectinate muscle
o No crista terminalis dividing two sections (no nodes)
Semilunar depression in the interatrial septum; floor of oval fossa, with
surrounding ridge (valve of oval fossa)
Four pulmonary veins enter posterior smooth wall
Slightly thicker wall than right atrium
Interatrial septum
Left atrioventricular orifice; blood discharged to left ventricle via the bicuspid
(mitral) valve

Taken from Drake et al, Gray’s Anatomy for Students, Second Edition

Left ventricle
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Forms apex of heart, almost all left (pulmonary) surface and border, and most
of diaphragmatic surface
Arterial pressure much higher than for right ventricle; performs more work
Interior has walls 2-3x as thick as right ventricle; has to pump blood to entire
body and head; much greater pressure required
Walls covered in mesh of trabeculae carnae; finer and more numerous than
those of the right ventricle
Conical cavity (longer than right ventricle)
Anterior and posterior papillary muscles larger than the right ventricle
o Hold mitral valves in place, prevent eversion
Aortic vestibule: smooth-walled, non-muscular supero-anterior outflow
section; leads to aortic orifice and aortic valve
Aortic orifice: lies in right posteriosuperior part, surrounded by fibrous ring to
which the right posterior and left cusps of the aortic valve are attached
 Ascending aorta begins at the aortic orifice
Blood enters via left atrioventricular orifice
Mitral (bicuspid) valve guards left atrioventricular orifice; has two cusps
(anterior [larger] and posterior [smaller])
o Each cusp receives tendinous cords from more than one papillary
muscle
Aortic valve; located between left ventricle and ascending aorta
o Coronary arteries open in right and left sinuses of semilunar cusps
o Cusps fill when left ventricle relaxes; flow to coronary arteries
o No tendinous cords
o Lunule: thickened edge of each cusp where they contact each other
o Nodule: apex of the thickened angulated free edge

Taken from Drake et al, Gray’s Anatomy for Students, Second Edition

Taken from StudyBlue
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studyblue
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doyouknow
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aspx

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Stenosis – valves are creaky, calcified – can’t open
Incompetence – valves are flappy, loose – can’t close

The circulatory system

Taken from Prezi, The Circulatory System, available at https://prezi
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com/heart-anatomy-chambers-vessels-valves/

Taken from Wikipedia
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wikipedia
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org, Artery Walls, available at https://en
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org/wiki/Artery_walls

NOTE: be aware which veins are superficial and which are deep
Deep veins generally run with arteries and have same name; superficial run alone
and have random weird names
Valves only located in veins below the heart – above, gravity can drain, and close to
the heart the pressures pull the blood toward

Taken from emaze, Circulation – Veins Arteries, available at
https://www
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com/@AOLZFRLF/CIRCULATION--VEINS-ARteries
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easynotecards
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santiforestmonastery
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equally in blood supply to the heart
In 15%, LCA is dominant in that the posterior interventricular branch is a
branch of the circumflex artery
In 18%, there is codominance with branches of both the right and left
coronary arteries reaching the crux, giving rise to branches coursing near the
interventricular groove
Some people have only one coronary artery, for others the circumflex branch
arises from right aortic sinus
In 4%, they have an accessory coronary artery

Venous drainage of the heart
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Drained mainly by veins that empty into the coronary sinus and partly by
small veins that empty into right atrium
Coronary sinus: main vein of the heart, runs left to right in posterior part of
coronary sulcus
o Great, middle and small cardiac veins branch off
Great cardiac vein is the main subdivision of the coronary sinus
o First part is the anterior interventricular vein
Middle cardiac vein (posterior interventricular vein) accompanies the
posterior interventricular branch (usually arising from the RCA)
Small cardiac vein accompanies right marginal branch of the RCA
Oblique vein of the left atrium (of Marshall); small vessel
Some cardiac veins dont drain via the coronary sinus
o Anterior cardiac veins
o Smallest cardiac veins

Image taken from RANZCRPart1 Wiki, Thorax: Venous Structure: Coronary Veins, available
at http://ranzcrpart1
...
com/wiki/Thorax:Venous_structure:Coronary_veins

Lymphatic drainage of the heart
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Lymphatic vessels in the myocardium and subendocardial connective tissue
pass to the subepicardial lymphatic plexus
Vessels from the plexus pass to the coronary sulcus and follow the coronary
arteries
A single lymphatic vessel (union of various lymphatic vessels from the heart),
ascends between the pulmonary trunk and left atrium, ending in the inferior
tracheobronchial lymph nodes (usually on right side)

Taken from Loukas et al, A General Outline of the Cardiac Lymphatic System, 2013; Springer
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ac
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nottingham
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uk/nursing/practice/resources/cardiology/function/con
duction
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Embryological development of the heart

Taken from Wikipedia
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wikipedia
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Moore et al
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Seventh Edition

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