1. Right atrium
1.1. Posterior wall
1.1.1. Smooth
1.1.2. It is the inter atrial septum
1.1.2.1. Fossa ovalis
1.1.2.2. Anulus ovalis
1.1.2.3. Atrioventricular (AV) node
1.1.2.3.1. most anterior inferior
1.1.2.3.2. septal cusp of tricuspid
1.1.3. 3 openings
1.1.3.1. Superior vena cava
1.1.3.1.1. NO valve
1.1.3.2. Inferior vena cava
1.1.3.2.1. Rudimentary valve
1.1.3.3. coronary sinus orifice
1.1.3.3.1. between the inferior vena cava and the right AV orifice
1.1.3.3.2. Rudimentary valve
1.2. Anterior wall
1.2.1. Rough -> musculi pectinati
1.2.2. Right auricle
1.2.2.1. what separates if from the posterior wall
1.2.2.1.1. Sulcus terminalis (external)
1.2.2.1.2. Crista terminalis (internal)
1.3. Right AV valve (tricuspid)
2. Right ventricle
2.1. Openings
2.1.1. Tricuspid valve
2.1.1.1. anterior cusp
2.1.1.2. septal cusp
2.1.1.3. posterior (inferior) cusp
2.1.2. Pulmonary valve
2.1.2.1. A funnel shaped structure leads to it (the infundibulum)
2.1.2.2. right cusp
2.1.2.3. left cusp
2.1.2.4. anterior cusp
2.2. Internal structures
2.2.1. Trabeculae carneae
2.2.1.1. ridges of cardiac muscles
2.2.1.2. 3 papillary muscles, each gives chordae tendineae to 2 cusps
2.2.1.3. moderator band
2.2.1.3.1. Shortcut to convoy the right branch of the AV bundle
2.2.2. Inter ventricular wall
2.2.2.1. Membranous wall
2.2.2.1.1. very thin, superior
2.2.2.2. Muscular part
2.2.3. Lumen is crescent shape
3. Orientation
3.1. Apex
3.1.1. left ventricle
3.2. Base
3.2.1. Mainly left atrium
3.2.2. right atrium
3.3. Anterior surface
3.3.1. Mainly right ventricle
3.3.2. right atrium
3.3.3. left ventricle
3.4. Inferior surface
3.4.1. Mainly left ventricle
3.4.2. Right ventricle
3.5. Right border
3.5.1. Right atrium
3.6. Left border
3.6.1. Left ventricle
3.6.2. Left auricle
3.7. Inferior border
3.7.1. Right ventricle
3.8. Superior border
3.8.1. Vessels
4. Skeleton of the heart
4.1. Fibrous rings surrounding the heart, made of collagen
4.2. Fibrous trigons connect the rings
4.3. Make up the membranous inter ventricular septum
4.4. Function
4.4.1. electrical insulation
4.4.2. support and muscle attachment
5. Left atrium
5.1. similar structure to the right atirum
5.2. Openings
5.2.1. 4 pulmonary viens
5.2.1.1. Left superior pulmonary vien
5.2.1.2. Left inferior pulmonary vien
5.2.1.3. 2 right pulmonary viens
5.2.1.4. NO valves
5.2.2. Mitral valve (left AV)
6. Left ventricle
6.1. Openings
6.1.1. Mitral valve
6.1.1.1. Anterior cusp
6.1.1.2. Posterior cusp
6.1.2. Aortic valve
6.1.2.1. Vestibule leads to it (like the infundibulum)
6.1.2.2. right cusp
6.1.2.3. left cusp
6.1.2.4. posterior cusp
6.2. Internal structures
6.2.1. No moderator bands
6.2.2. Two papillary muscles
6.2.3. Thick walls
6.2.4. The lumen is circular in shape
7. Coronary circulation
7.1. Artries
7.1.1. Right coronary artery
7.1.1.1. Sinuatrial nodal branch (60%)
7.1.1.2. Right conus artery
7.1.1.2.1. feeds infundibulum
7.1.1.3. Right marginal branch
7.1.1.3.1. supplies right ventricle
7.1.1.4. Atrioventricular nodal branch (posterior, 65%)
7.1.1.5. Posterior inter ventricular artery (90%, right dominance)
7.1.1.5.1. supplies both ventricles posteriorly
7.1.2. Left coronary artery
7.1.2.1. Anterior inter ventricular artery
7.1.2.1.1. diagonal branch
7.1.2.1.2. left conus artery
7.1.2.1.3. supplies the bundle of HIS
7.1.2.2. Circumflex branch
7.1.2.2.1. Left marginal artery
7.2. Veins
7.2.1. Coronary sinus
7.2.1.1. Small cardiac vein
7.2.1.1.1. with right marginal
7.2.1.2. Middle cardiac vein
7.2.1.2.1. with posterior inter ventricular
7.2.1.3. Great cardiac vein
7.2.1.3.1. with anterior inter ventricular
7.2.2. Right atrium
7.2.2.1. Anterior cardiacl vein
8. Neve supply
8.1. Cardiac plexus
8.1.1. sympathetic
8.1.1.1. preganglionic fibers
8.1.1.1.1. T1-T6
8.1.1.2. Postganglionic fibers
8.1.1.2.1. cervical trunk
8.1.1.2.2. upper thoracic trunk
8.1.1.3. efferent
8.1.1.3.1. increasing rate & contraction force
8.1.1.3.2. vasoconstriction
8.1.1.4. afferent
8.1.1.4.1. referred pain
8.1.2. parasympathetic
8.1.2.1. vagus nerve
8.1.2.2. efferent
8.1.2.2.1. lowering rate & contraction force
8.1.2.2.2. vasoconstriction
8.1.2.3. afferent
8.1.2.3.1. reflexes
9. Pericardium
9.1. surface anatomy
9.1.1. posterior to the sternum, 2-6 costal cartilages
9.1.2. anterior to 5-8 thoracic vertebrae
9.2. Fibrous pericardium
9.2.1. anchors the heart and prevents over stretching
9.2.2. attached to diaphragm, sternum, and major blood vessels
9.2.3. Innervated by the phrenic nerve
9.3. Serous pericardium
9.3.1. parietal layer -> fused to the fibrous pericardium
9.3.1.1. innervated by phrenic nerve
9.3.2. visceral layer (epicardium)
9.3.2.1. innervated by sympathetic trunk & vagus (it's part of the heart)
9.3.3. both are continues around major blood vessles
9.3.4. 50 ml of pericardial fluid in the cavity between them
9.4. Pericardial sinuses
9.4.1. result during development and has NO clinical significance
9.4.2. Transverse sinus
9.4.2.1. between arteries and veins
9.4.3. Oblique sinus
9.4.3.1. within the veins
10. Large vessels of thorax
10.1. Artries
10.1.1. Ascending aorta
10.1.1.1. it's inside the pericardium
10.1.1.2. right and left coronary arteries
10.1.2. Arch of aorta
10.1.2.1. Brachiocephalic trunk
10.1.2.1.1. Right subclavian
10.1.2.1.2. Right common carotid
10.1.2.1.3. behind the right sternoclavicular joint
10.1.2.1.4. right recurrent laryngeal nerve
10.1.2.2. left common carotid
10.1.2.3. left subclavian
10.1.2.4. ligamentum arteriosum binds it with pulmonary trunk biforcation
10.1.2.5. left recurrent laryngeal nerve encircles it
10.1.3. Descending thoracic aorta
10.1.3.1. Posterior intercostals
10.1.3.2. subcostals
10.1.3.3. pericardial
10.1.3.4. oesophageal
10.1.3.5. bronchial
10.1.4. Pulmonary trunk
10.1.4.1. Right pulmonary artery
10.1.4.1.1. goes behind ascending aorta
10.1.4.2. Left pulmonary artery
10.1.4.2.1. goes in front of descending aorta
10.1.4.3. also inside the pericardium with the ascending aorta
10.2. Veins
10.2.1. Superior Vena Cava
10.2.1.1. left brachiocephalic
10.2.1.2. right brachiocephalic
10.2.1.2.1. right subclavian
10.2.1.2.2. internal jaguar
10.2.1.2.3. forms at the root of the neck
10.2.2. Azygus veins
10.2.2.1. Main Azygus vein
10.2.2.1.1. most anterior
10.2.2.1.2. on the right side
10.2.2.1.3. ascends though aortic opening of diaphragm at 5th thoracic vertebra
10.2.2.1.4. superior hemiazygos
10.2.2.1.5. Inferior hemiazygos (Accessory)
10.2.2.1.6. right subcostal
10.2.2.1.7. right ascending lumber
10.2.3. Inferior Vena Cava
10.2.4. Pulmonary veins