Done by :

Osama Jahmani
Instructor–Faculty of Medicine
 Heart - Introduction

 The Cardiovascular System consists of three interrelated components :

1. Blood
 is a liquid connective tissue that consists of two portions:
A. Blood plasma : (55% of blood volume)
B. Formed elements : (45% of blood volume)
• Red blood cells, white blood cells, Platelets.

2. Heart : muscular pump.

3. Blood vessels
 Heart - Introduction

 The heart : is a hollow muscular organ that pumps blood to all parts of the body.

 Location :
 The heart rests on the diaphragm and is situated in the middle mediastinum of the thoracic cavity between the
lungs and deep to the sternum and costal cartilages.

 Mediastinum : is an anatomical region that extends from the sternum to the vertebral column, the first rib to
the diaphragm, and between the coverings (pleurae) of the lungs.

 Shape : Pyramidal or conical .

 Measurements :
 Length : 12 cm
 Width : 9 cm
 Weight : 300 g in males; 250 g in females
 Size : slightly larger than one’s own clenched fist

 Position : The heart assumes an oblique position in the thorax.

 one-third of it lies to the right and two-thirds to the left of the body’s midline.
 Heart - Introduction

 Coverings of the heart :

 The heart is surrounded and protected by a triple-layered sac called the pericardium.

 The functions of the pericardium are:

A. holds the heart in place and keeps it from overfilling with blood.
B. restricts excessive movements of the heart.
C. limits the cardiac distension.
D. serves as a lubricated container in which heart can contract and relax smoothly.

 Layers of the Heart Wall : The heart wall consists of three layers.

1. Epicardium (external layer) : thin , transparent membrane covering its external surface.it contains :
 thick layer of adipose tissue in some areas .
 blood vessels, lymphatics, and nerves that supply the myocardium.

2. Myocardium (middle layer) : is composed of cardiac muscle tissue. It makes up approximately 95 % of the
heart wall. (responsible for the pumping action of the heart)

3. Endocardium (inner layer) : is a thin layer of endothelium overlying a thin layer of connective tissue that lines
the interior of the heart chambers.
 Middle
mediastinum

Pericardium
 Heart - External Features

 The heart presents the following external features:

 Apex : is the pointed end of the heart.

• is formed by the tip of the left ventricle.
• It is directed anteriorly, inferiorly, and to the left.
• It lies at the level of the 5th left intercostal space, 9 cm from the midline and just medial to the
midclavicular line.

 Base : is opposite the apex.

 is formed mainly by the posterior surface of the left atrium.

 Four surfaces: sternocostal, diaphragmatic, left pulmonary and right pulmonary.

 Four borders: right, left, superior, and inferior.

 Four chambers : right atrium , left atrium , right ventricle , left ventricle.

 Demarcation of chambers of the heart on the surface :

1. Coronary sulcus (atrioventricular groove) : encircles the heart and separates the atria from the ventricles.

2. Anterior interventricular sulcus: separates the right and left ventricles on the sternocostal surface.
3. Posterior interventricular sulcus: separates the right and left ventricles on the diaphragmatic surface .
 The heart acts as a double pump.

1. The right pump : is the pump for pulmonary circulation.

It receives deoxygenated blood from the body and sends it to
the lungs .
2. The left pump : is the pump for systemic circulation.
It receives oxygenated blood from the lungs and sends it to all
the body tissues .
 Pulmonary circuit : The blood vessels that carry blood to and
from the lungs.
 Systemic circuit : the blood vessels that transport blood to
and from all body tissues. except the air sacs (alveoli) of the
lungs
 Heart Chambers : Right Atrium , Left Atrium

 The atria : are the two upper thin-walled receiving chambers for blood returning to the heart by way of the great
veins.

A. Right atrium :
 Shape: thin-walled quadrilateral chamber.
 Communication : It receives deoxygenated blood from three veins:
1. Superior vena cava: returns the blood to the heart from the upper half of the body.
2. Inferior vena cava: returns the blood to the heart from the lower half of the body.
3. Coronary sinus : drains most of the blood from the heart.

B. Left atrium :
 Shape : thin-walled quadrangular chamber. It makes up most of the heart’s base.
 Communication : It receives oxygen-rich blood returning from the lungs through two right and two left
pulmonary veins.

 External features o the atria :

 each atrium has a small earlike extension called an auricle that slightly increases its volume.

 Internal features of the atria :

 Interatrial septum : is a vertical septum between the atria that separates them internally.
 Fossa ovalis: a shallow oval depression in the interatrial septum that marks the spot where an opening existed
in the fetal heart.
 It represents the site of foramen ovale in the fetus where most of the blood that enters the right atrium
passes through the foramen ovale into the left atrium and joins the systemic circulation.
 Heart Chambers : Right Ventricle , Left Ventricle

 The ventricles : are the two lower or pumping chambers.

A. Right ventricle :
 Shape : thick-walled triangular chamber.
 Communication : It receives deoxygenated blood from right atrium and pumps it to the lungs through
pulmonary trunk.

B. Left ventricle :
 Shape : thick-walled triangular chamber that forms the apex of the heart and most of diaphragmatic surface of
the heart.
 Communication : It receives oxygenated blood from left atrium and pumps it to the whole body through aorta.

 Internal features of the ventricles :

 Interventricular septum : vertical septum (mostly muscular wall) between the ventricles that separates them
internally.

 Inflowing lower part : It is rough due to presence of the muscular ridges called the trabeculae carneae.
• Trabeculae Carneae : irregular muscular ridges . (give the walls a sponge like appearance)
• Papillary muscles : are nipple shaped muscular projections from the walls into the ventricular cavity.
• Chordae tendineae (heart strings) : are thin, strong bands (tendonlike cords) that connect the valve cusps
to conical papillary muscles on the floor of the ventricle.

 Outflowing upper part : It is smooth.

Differences between the right and left ventricles

Inferior view of transverse section showing

differences in thickness of ventricular walls
 Heart Valves

 There are two pairs of valves in the heart :

1. Atrioventricular valves : regulate the openings between the atria and ventricles.
A. Right atrioventricular valve is called : tricuspid valve.
B. Left atrioventricular valve is called : bicuspid (mitral) valve.

2. Semilunar Valves : regulate the flow of blood from the ventricles into the great arteries.
A. Pulmonary valve .
B. Aortic valve .

 Valve Function : Heart valves open (to allow blood flow) and close (to prevent the backflow of blood) in response to
differences in blood pressure on each side of the valves.

 The two atrioventricular valves : prevent the backflow of blood into the atria during contraction of the
ventricles.
 The two semilunar valves : prevent backflow from the great arteries into the ventricles.

 Notes :
 There are no valves where the great veins empty into the atria.
 Chordae tendinae and papillary muscles are associated with Atrioventricular valves.
 No chordae tendinae or papillary muscles are associated with semilunar valves.
 Tricuspid valve Bicuspid (Mitral) valve

• located between the right atrium • located between the left atrium and
and right ventricle left ventricle
• guards the right atrioventricular • guards the left atrioventricular
orifice orifice
• consists of three cusps. • consists of two cusps.

Left
atrium
Pulmonary valve
Right
Mitral valve
atrium Aortic valve
Left
Tricuspid valve ventricle

Right
ventricle

Pulmonary valve Aortic valve

• located between the right ventricle • located between the left ventricle
and pulmonary trunk. and aorta.
• guards pulmonary orifice • guards aortic orifice

• consists of three semilunar cusps. • consists of three semilunar cusps.

The Pathway of Blood Flow Through the Heart
 Midterm Exam
Date : 6/12/2023

Lectures : 1-10

Labs : 1-4

Questions : MCQ’s (multiple choice questions )

Number of questions: 50

Distribution of marks : 50
About 30 (lectures)
About 20 (labs)

Sample of the Exam

Theory ( lectures ) Practical ( labs )
Q: The longest muscle in the body is ? Q: The black arrow refers to ?
A. Biceps brachii A. Frontal bone
B. Vastus lateralis B. Sphenoid bone
C. Sartorius C. Ethmoid bone
D. Trapezius D. Zygomatic bone
E. Deltoid E. Vomer