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2. Heart

a) Fibrous skeleton


In reality, the right atrium and ventricle are more anterior rather than “right” of the left atrium and ventricle. One can consider these right and left chambers as being functionally separate.

Atria and ventricles are divided by an “8” shaped fibrous skeleton in the sagittal plane.



There is no muscular continuity across the fibrous skeleton.
The only physiological link is the atrioventricular bundle.

b) Major chambers and compartments


Chamber

Right atrium

Right ventricle

Left atrium

Left ventricle

Receives vessels

IVC

SVC


Pulmonary trunk

Pulmonary veins

Aorta

Relation in heart

All of right border

Most of anterior surface of heart

All of posterior surface of heart
Small portion (the left auricle) peeks onto left border

Seen posteriorly, but not of posterior surface
Peeks out on the left anteriorly, forming the left border




Anterior surface


*Note that, as in most anatomical diagrams, the left auricle is drawn exaggerated.

It is nowhere near this big in reality.

But it can be visualized radiologically as a slight concavity in that area.

Posterior surface


Note the oblique and transverse sinuses from the defects between the visceral pericardium and parietal pericardium are shown here.




Diaphragmatic (inferior) surface


This is the clearest representation of how the chambers are divided up.

Important features are:



  • Arterioventricular groove (red)

    • Coronary sinus

    • Right coronary artery

  • Interventricular groove (blue)

Note that the coronary sinus is venous, and the right coronary artery is arterial.

Hence:



3. Surface markings of the heart


  • Right border (red)

  • Inferior border (blue)

  • Left border (yellow)

  • Intersection at the right and inferior borders (purple)

  • Intersection of the left and inferior borders (green)


Diagram of surface markings of heart


Lower border of right 2nd costal cartilage




Lower border of left 2nd costal cartilage

2cm from sternal margin












Lower border of right 6th costal cartilage




Left 5th intercostal space

9cm from midline



APEX
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