 Cardiovascular system consist of The apex, located approximately

heart and great vessels at the 5th intercostal space, left to

 Vessels make 2 types of circulations
and heart pumps blood to both;
1. Systematic circulation ;
carries oxygenated blood
(from heart to organs)
2. Pulmonary circulation ;
Carries deoxygenated blood
(from heart to lungs)
Arteries here contains
The surfaces of the heart ;
deoxygenated blood
Veins contain oxygenated
blood
 Blood vessels that carry blood from
heart are arteries
 Blood vessels that carry towards
heart are veins
midclavicular line, projects
anteriorly, inferiorly, and to the
left and moves freely within the
pericardial sac.
 The heart is covered by the
pericardial membrane.
 the sternocostal surface/anterior
surface;
on the anterior side of the heart,
formed mostly by the right
ventricle with portions of the right
atrium and left ventricle;

HEART
 hollow muscular organ
 in the anterior (middle)
mediastinum

 within the pericardial sac.

 Covered by pericardium
(outermost layer)  the base/posterior surface ;
on the posterior and superior sides
 In thoracic cavity of the heart,
 Rests on the central tendon of the formed by the left atrium and a
diaphragm portion of the right atrium

 Is flanked on either side by the

right and left pulmonary cavities.
 Conical shape.
 Parts;

The base; anchored by the great

vessels, is on its superior and
posterior surfaces.

 the diaphragmatic
surface/inferior surface ;
on the inferior side of the heart,
formed by the left and right
ventricles.
 Three grooves on the external
surface of the heart determine the
position of the chambers:
 The coronary sulcus ;
encircles the heart between the
atria and ventricles.
Separates atrium and ventricles
Because the heart has an oblique
orientation, the sulcus is nearly
vertical.
 The anterior interventricular
sulcus
a longitudinal groove
marks the position of the
interventricular septum on the
anterior surface.
 The posterior interventricular
sulcus
a longitudinal groove
marks the position of the
interventricular septum on the
diaphragmatic surface
these separates ventricles
 The crux of the heart is a point on
the posterior surface of the heart
where the coronary
(atrioventricular) and
interventricular sulci meet. It
marks the junction of the four
chambers of the heart.
 The wall of the heart consists of
three layers:
◦ 1. The epicardium
the thin outermost layer,
formed by the visceral layer
of the serous pericardium
◦ 2. The myocardium
the thick layer of cardiac
muscle, thickest in the
walls of the ventricles
outer and inner
longitudinal and middle
circular
myocardium of atria are outer
longitudinal and inner circular
myocardium of left ventricle is thicker
than right because it pumps blood to the
systemic circulation
 ◦ 3. The endocardium
the thin internal layer,
which lines the chambers
and valves of the heart
 A cardiac skeleton of dense
fibrous connective tissue forms
four fibrous anuli (rings) and
intervening trigones that separate
the chambers of the heart, provide
anchoring points for cardiac
muscle fibers and cardiac valves,
and insulate electrical impulses of
the heart’s conduction system
 Chambers of the heart are 4;
1. Right atrium
2. Right ventricle
3. Left atrium
4. Left ventricle
 Divides the heart into 2 by cardiac
septum
The atria
 The atria are the thin-walled inflow
chambers of the heart.
RIGHT ATRIUM
 The right atrium receives the
superior and inferior vena cava
from the systemic circulation and
the cardiac veins from the heart.
 Has 3 openings for;
1. Superior vena cava
2. Inferior vena cava
3. Coronary sinus
Carries deoxygenated
blood frm wall of heart
to heart
 Medial wall is made by interatrial
septum
 The oval fossa (fossa ovalis), is a
remnant of the oval foramen
(foramen ovale) is an opening
through which blood was shunted
from the right to left atria in the
prenatal circulation.
 Between right atrium and right
ventricle is the right
atrioventricular orifice
 Tricuspid valve containing;
1. Anterior cusp
2. Posterior cusp
3. Medial / Septal cusp
 All these cusps are made by
endocardium
 Each cusp is connected to chordae
tendineae / tendinous cords
 Tendinous cords connect to
papillary muscles
 On the surface is a projection
called auricle (also present is left)
 Right ventricle pumps blood to
pulmonary circulation

 The right atrium is divided into two
parts by a muscular ridge, the
terminal crest (crista terminalis).
 The two parts of the right atrium
are
1. the venous sinus (sinus
venarum), a smooth-walled
region on the posterior wall that
contains the openings of the;
superior vena cava
inferior vena cava
coronary sinus
anterior cardiac veins
 2. the atrium proper, the anterior right branch of the atrioventricular
muscular portion that, like the bundle) that facilitates the
right auricle, contains pectinate coordinated contraction of the
muscles. papillary muscle.

2. The conus arteriosus

RIGHT VENTRICLE (infundibulum),
Pulmonary trunk arises from here
 The ventricles are thick-walled
and blood flows from right
chambers that connect to the out-
ventricle to pulmonary trunk
flow channels of the heart: the
 Between right ventricle and
right ventricle to the pulmonary
pulmonary trunk is the pulmonary
artery and the left ventricle to the
valve (semilunar valve)
aorta.
 pulmonary trunk is divided into
 The walls of the ventricles are
right and left pulmonary arteries
marked with a meshwork of thick
 The left ventricle, which includes
muscular ridges known as
the apex of the heart, is the
trabeculae carneae.
thickest-walled chamber of the
 Most of the interventricular
heart.
septum is muscular, but there is a
 Similar to the right ventricle, the
small membranous part at the
left is divided into inflow and
superior end that is a common site
outflow portions
of septal defects.
1. The left ventricle proper,
 The right ventricle is the smaller
which receives blood from the left
and thinner walled of the two
atrium. A large anterior and small
ventricles.
posterior papillary muscle arise
 A muscular ridge, the
from its floor
supraventricular crest, separates it
2. The aortic vestibule
into two parts:
Aorta arises from here
1. The right ventricle proper
the smooth-walled outflow
the inflow portion of the ventricle
channel through which blood flows
that receives blood from the right
into the aorta.
atrium
An anterior and a posterior
papillary muscle arise from its
 Between aorta and left ventricle is
floor, and a septal papillary
the aortic valve (semilunar valves)
muscle arises from the
interventricular septum.
A muscular septomarginal
 The left atrium is smaller but
trabecula (moderator band)
thicker walled than the right atrium
extends from the septum to the
and receives the four to five
base of the anterior papillary
pulmonary veins from the lungs.
muscle and carries a part of the
The atrial walls are smooth, with
electrical conduction system (the
 the pectinate muscles confined to
the left auricle.
 The left atrium receives the
pulmonary veins from the lungs.
 Each atrium is associated with an
auricle, a small pouch that expands
the capacity of the atrium and
whose roughened walls contain
pectinate muscles.
 Between left atrium and left
ventricle is the left atrioventricular
valve
 It is the bicuspid valve having;
1. Anterior cusp
2. Posterior cusp
 Between right and left atria are
foramen caecum which later
becomes oval fossa
 Endocardium makes the valves
PERICARDIUM
 2 types of pericardium;
1. Fibrous pericardium
composed of tough in-
elastic connective tissue
attached inferiorly to the
diaphragm
is continuous superiorly
with the tunica adventitia
(outer layer) of the great
vessels.
2. Serous pericardium;
I. Parietal layer
II. Visceral layer
firmly adheres to the
outer surface of the
heart as the
epicardium.
continuous with the
parietal layer of the
serous pericardium at
the root of the great
vessels.
 Between parietal and visceral
layers is pericardial cavity
containing serous fluid
 Pericardiacophrenic arteries,
branches of the internal thoracic
arteries, provide the main blood
supply to the pericardium.
 Veins that accompany the arteries
drain into the superior vena cava.
 The vagus (CN X) and phrenic
nerves (C3–C5) and branches from
the sympathetic trunks innervate
the pericardium.
 Pericardial pain is often referred
via the phrenic nerve to the skin of
the ipsilateral supraclavicular
region (dermatomes C3–C5).
 Pericardium innervated by phrenic
nerve.
 Pericarditis can cause referred pain
to the shoulder.
Coronary Veins - LOW-YIELD
 The coronary sinus
receives most of the venous
return from the heart
runs in the posterior coronary
sulcus between the left atrium and
ventricle.
The thebesian valve guards the
orifice of the coronary sinus where
it drains into the right atrium near
the opening of the inferior vena
cava.
 The large veins of the heart are
tributaries of the coronary sinus.
◦ The great cardiac vein
travels with the anterior
interventricular artery and
drains the left atrium and
both ventricles.
◦ The posterior left
ventricular vein drains the
diaphragmatic surface of
the left ventricle.
◦ The posterior
interventricular (middle
cardiac) vein runs in the
posterior interventricular
groove with the posterior
interventricular artery and
drains the posterior part of
the interventricular
septum.
◦ The small cardiac vein,
which drains the posterior
right atrium and the right
ventricle, accompanies the
right coronary artery in the
atrioventricular groove.
◦ The oblique vein of the left
atrium drains left atrium.
◦ Anterior cardiac veins
drain the anterior surface
of the right ventricle and
open directly into the right
atrium.
THE INNERVATION OF
HEART
 The autonomic nerves of the
cardiac plexus innervate the
conduction system of the heart;
they therefore regulate the heart
rate but do not initiate the
heartbeat.
◦ Sympathetic innervation
increases the rate and
force of contractions by
increasing the response of
the SA and AV nodes. It
also allows dilation of the
coronary arteries.
◦ Parasympathetic
innervation decreases the
rate of contractions and
causes vasoconstriction of
the coronary arteries.
◦ Visceral sensory fibers
innervating the
 baroreceptors (receptors
that measure blood
pressure) and
chemoreceptors (receptors
that measure blood CO2) in
the heart and aortic arch
travel with the
parasympathetic fibers of
the vagus nerve.

◦ Visceral sensory fibers

carrying pain sensation
travel with sympathetic
fibers to the T1–T5 spinal
cord.