Heart. Heart valves

Anatomy of the heart. Heart valvesA detailed overview of the anatomy of the heart. Atria and ventricles. The right and left atrioventricular valve. Valves of the pulmonary trunk and aorta
~ 7 min

The cardiovascular system is a system of organs that ensures the delivery of substances necessary for vital activity to all cells and tissues of the human body.

It consists of three components:

  • Heart (cor in Latin), which acts as a kind of pump for blood
  • Heart (cor)
    Heart (cor)
  • Vessels (vasa), which perform a transport function by distributing blood throughout the body
  • Vessels (vasa)
    Vessels (vasa)
  • And blood itself, which contains oxygen, as well as nutrients.

In this video, we will focus in detail on the structure of the heart.

The heart is a large cone-shaped muscular organ, which lies in the thoracic cavity in the mediastinum, mainly on the left.

Heart (cor)
Heart (cor)

The work of the heart continuously provides the entire body with nutrients and oxygen. This is due to the constant contraction of the cells that make up the walls of the heart called cardiomyocytes. It should be noted that there are two types of cardiomyocytes:

1. Typical, working cardiomyocytes that contract mechanically under the influence of electrical impulses

and

2. Atypical cardiomyocytes. They generate and conduct nerve impulses. Such cardiomyocytes form the so-called conducting system of the heart.

The sequential contraction of the myocardium forms the cardiac cycle. Proper operation of the phases of this cycle is necessary for the nutrition of every cell of our body.

The human heart has four cavities, which are called chambers.

These are the left atrium (atrium sinistrum)

Left atrium (atrium sinistrum)
Left atrium (atrium sinistrum)
Left atrium (atrium sinistrum)
Left atrium (atrium sinistrum)
Left atrium (atrium sinistrum)
Left atrium (atrium sinistrum)

The left ventricle (ventriculus sinister)

Left ventricle (ventriculus sinister)
Left ventricle (ventriculus sinister)
Left ventricle (ventriculus sinister)
Left ventricle (ventriculus sinister)
Left ventricle (ventriculus sinister)
Left ventricle (ventriculus sinister)

Right atrium (atrium dextrum)

Right atrium (atrium dextrum)
Right atrium (atrium dextrum)
Right atrium (atrium dextrum)
Right atrium (atrium dextrum)
Right atrium (atrium dextrum)
Right atrium (atrium dextrum)

Right ventricle (ventriculus dexter)

Right ventricle (ventriculus dexter)
Right ventricle (ventriculus dexter)
Right ventricle (ventriculus dexter)
Right ventricle (ventriculus dexter)
Right ventricle (ventriculus dexter)
Right ventricle (ventriculus dexter)

The right ventricle and left atrium are components of the pulmonary circulation, and the left ventricle and right atrium are components of the systemic circulation.

Systemic circulation
Systemic circulation
Pulmonary circulation
circulation

Let’s consider the external structure of the heart

It has the following surfaces:

1) Anterior one is the sternocostal surface (facies sternocostalis)

Sternocostal surface (facies sternocostalis)
Sternocostal surface (facies sternocostalis)

2) The inferior one is the diaphragmatic surface (facies diaphragmatica)

Diaphragmatic surface (facies diaphragmatica)
Diaphragmatic surface (facies diaphragmatica)

3) The lateral ones are the pulmonary surfaces (facies pulmonalis), right and left

Left pulmonary surfaces (facies pulmonalis)
Left pulmonary surfaces (facies pulmonalis)
Right pulmonary surfaces (facies pulmonalis)
Right pulmonary surfaces (facies pulmonalis)

4) The base of the heart (basis cordis)

Base of the heart (basis cordis)
Base of the heart (basis cordis)

5) The apex of the heart (apex cordis)

Apex of the heart (apex cordis)
Apex of the heart (apex cordis)

There are depressions or sulci on the surfaces of the heart:

1) The coronary sulcus (sulcus coronarius), which is located between the atria and ventricles.

Coronary sulcus (sulcus coronarius)
Coronary sulcus (sulcus coronarius)
Coronary sulcus (sulcus coronarius)
Coronary sulcus (sulcus coronarius)

2) The anterior interventricular sulcus (sulcus intraventricularis anterior)

Anterior interventricular sulcus (sulcus intraventricularis anterior)
Anterior interventricular sulcus (sulcus intraventricularis anterior) (inferior) interventricular sulcus (sulcus interventricularis posterior)

3) The posterior (inferior) interventricular sulcus (sulcus interventricularis posterior)

Posterior (inferior) interventricular sulcus (sulcus interventricularis posterior)
Posterior (inferior) interventricular sulcus (sulcus interventricularis posterior)

4) The notch of the cardiac apex (incisura apicis cordis), which communicate the anterior and posterior interventricular sulci between each other.

On the outside, the heart is covered with the so-called pericardium (pericardium)

Pericardium (pericardium)
Pericardium (pericardium)

The heart wall consists of three layers:

  1. Epicardium (epicardium)

    Epicardium (epicardium)
    Epicardium (epicardium)
  2. Myocardium (myocardium)

    Myocardium (myocardium)
    Myocardium (myocardium)
  3. Endocardium (endocardium)

    Endocardium (endocardium)
    Endocardium (endocardium)

The epicardium is the external fibrous capsule of the heart, the initial parts of the pulmonary trunk and aorta, and the final parts of the pulmonary veins and venae cavae. It passes into the serous pericardium.

Epicardium (epicardium)
Epicardium (epicardium)

The myocardium is the middle muscle layer. The atrial myocardium is separated from the ventricular myocardium.

The atrial myocardium consists of two layers:

The superficial layer consists of circularly arranged fibers

Left atrium (atrium sinistrum)
Left atrium (atrium sinistrum)

The deep layer consists of longitudinally arranged fibers

Right atrium (atrium dextrum)
Right atrium (atrium dextrum)

The ventricular myocardium consists of three layers:

The superficial layer consists of longitudinally arranged fibers, and forms a helix (vortex cordis) at the apex of the heart

Helix (vortex cordis)
Helix (vortex cordis)
Helix (vortex cordis)
Helix (vortex cordis)

The middle layer consists of circularly arranged fibers

Middle layer
Middle myocardial bundles

The internal layer consists of longitudinally arranged fibers

Inner layer
Inner layer

The endocardium is the internal layer of the heart, which covers the papillary and pectinate muscles, chords and valves.

Endocardium (Endocardium)
Endocardium (Endocardium)

The heart also has a skeleton of sorts, which is called the fibrous skeleton of the heart and includes the following structures:

  1. Right anulus fibrosus (anulus fibrosus dexter)

    Right anulus fibrosus (anulus fibrosus dexter)
    Right anulus fibrosus (anulus fibrosus dexter)
  2. Left anulus fibrosus (anulus fibrosus sinister)

    Left anulus fibrosus (anulus fibrosus sinister)
    Left anulus fibrosus (anulus fibrosus sinister)

    Located in the projection of the coronary sulcus

  3. The anulus fibrosus of the aorta (anulus fibrosus aortae)

    Anulus fibrosus of the aorta (anulus fibrosus aortae)
    Anulus fibrosus of the aorta (anulus fibrosus aortae)
  4. The anulus fibrosus of the pulmonary trunk (anulus fibrosus trunci pulmonalis)

    Anulus fibrosus of the pulmonary trunk (anulus fibrosus trunci pulmonalis)
    Anulus fibrosus of the pulmonary trunk (anulus fibrosus trunci pulmonalis)
  5. The right fibrous trigone (trigonum fibrosum dexter)

    Right fibrous trigone (trigonum fibrosum dexter)
    Right fibrous trigone (trigonum fibrosum dexter)
  6. The left fibrous trigone (trigonum fibrosum sinister)

    Left fibrous trigone (atrium sinistrum)
    Left fibrous trigone (atrium sinistrum)

In the right fibrous trigone, there is an opening through which the fibers of the conductive system of the heart pass

Let’s consider each of the four chambers of the heart in greater detail.

The right atrium (atrium dextrum) has an additional cavity called the right auricle (auricula dextra).

Right auricle (atrium dextrum)
Right auricle (atrium dextrum)
Right auricle (atrium dextrum)
Right auricle (atrium dextrum)
Right auricle (atrium dextrum)
Right auricle (atrium dextrum)

From the inferior side, it is delimited by the right atrioventricular orifice (ostium atrioventiculare dextrum) and the tricuspid valve (valva tricuspidalis), through which venous blood enters the right ventricle.

Right atrioventricular orifice (ostium atrioventiculare dextrum)
Right atrioventricular orifice (ostium atrioventiculare dextrum)
Right atrioventricular orifice (valva atrioventiculare dextrum)
Right atrioventricular orifice (valva atrioventiculare dextrum)

The interatrial septum (septum interatriale), on the surface of which there is an oval fossa (fossa ovalis), is a border between the right and left atria.

Interatrial septum (septum interatriale)
Interatrial septum (septum interatriale)
Oval fossa (fossa ovalis)
Oval fossa (fossa ovalis)

The superior and inferior vena cava (vena cava inferior et vena cava superior) end by the right atrium in the area of the sinus of venae cavae (sinus venarum cavarum).

Sinus of venae cavae (sinus venarum cavarum)
Superior and inferior vena cava (sinus venarum cavarum)
Superior vena cava (vena cava superior)
Superior vena cava (vena cava superior)
Inferior vena cava (vena cava inferior)
Superior and inferior vena cava (vena cava inferior)

There is a coronary sinus (sinus coronarius) of the heart between them.

Coronary sinus (sinus coronarius)
Coronary sinus (sinus coronarius)

In the area of the confluence of the inferior vena cava there is a valve of the inferior vena cava (valvula venae cavae inferioris), at the same level there is a valve of the coronary sinus (valvula sinus coronarii).

Valve of the coronary sinus (valvula venae cavae inferioris)
Inferior vena cava (valvula venae cavae inferioris)
Valve of the coronary sinus (valvula sinus coronarii)
Valve of the coronary sinus (valvula sinus coronarii)

On the internal surface of the right auricle and partially the anterior wall of the atrium, there are pectinate muscles (mm. pectinati).

Pectinate muscles (mm. pectinati)
Pectinate muscles (mm. pectinati)

The right ventricle (ventriculus dexter) is separated from the left one by the interventricular septum (septum interventriculare).

Right ventricle (ventriculus dexter)
Right ventricle (ventriculus dexter)
Interventricular septum (septum inteventriculare)
Interventricular septum (septum inteventriculare)

In the right ventricle, there is an opening of the pulmonary trunk (ostium trunci pulmonalis). Venous blood enters the lungs through the pulmonary trunk.

Opening of the pulmonary trunk (ostium trunci pulmonalis)
Opening of the pulmonary trunk (ostium trunci pulmonalis)

There is a tricuspid valve (valva tricuspidalis) between the superior and inferior chambers of the right half of the heart. It regulates the flow and release of blood in this part of the heart. Let’s consider it’s structure in greater detail.

The right atrioventricular (tricuspid) valve (valva atrioventricularis dextra / valva tricuspidalis) consists of:

Tricuspid valve (valva tricuspidalis)
Tricuspid valve (valva tricuspidalis)

1. The anulus fibrosus (annulus fibrosus)

Anulus fibrosus (annulus fibrosus)
Anulus fibrosus (annulus fibrosus)

2. Anterior, posterior, and septal cusps (cuspis anterior, cuspis posterior, cuspis septalis),

Anterior cusps (cuspis anterior)
Anterior cusps (cuspis anterior)

which are covered with endocardium

Posterior cusps (cuspis posterior)
Posterior cusps (cuspis posterior)
Septal cusp (cuspis septalis)
Septal cusp (cuspis septalis)

3. Tendinous chords, which are are attached to the three papillary muscles holding the valve cusps.

Tendinous chords (chordae tendineaea)
Tendon chords (chordae tendineaea)

4. Between the papillary muscles, there are trabeculae carneae (trabeculae carneae)

Trabeculae carneae (trabeculae carneae)
Trabeculae carneae (trabeculae carneae)

The pulmonary trunk (truncus pulmonalis) arises from the right ventricle in the area of the conus arteriosus (conus arteriosus). It is also separated from the ventricular cavity by a valve.

Conus arteriosus (conus arteriosus)
Conus arteriosus (conus arteriosus)
Pulmonary trunk (truncus pulmonalis)
Pulmonary trunk (truncus pulmonalis)

The pulmonary valve (valva trunci pulmonalis) consists of:

Pulmonary valve (valva trunci pulmonalis)
Pulmonary valve (valva trunci pulmonalis)

1. The anulus fibrosus (annulus fibrosus)

2. The left semilunar cusp, right semilunar cusp and anterior semilunar cusp (valvae semilunares)

3. Nodules of the semilunar cusps

Left semilunar cusp (valva semilunaris sinistra)
Left semilunar valve (valva semilunaris sinistra)
Right semilunar cusp (valva semilunaris dextra)
Right semilunar valve (valva semilunaris dextra)
Anterior semilunar cusp (valva semilunaris anterior)
Front semilunar valve (valva semilunaris anterior)
Semilunar valve nodules (noduli valvularum semilunarium)
Semilunar valve nodules (noduli valvularum semilunarium)

4. Sinuses of the pulmonary trunk (lunulae valvularum semilunarium)

Sinuses of the pulmonary trunk (lunulae valvularum semilunarium)
Sinuses of the pulmonary trunk (lunulae valvularum semilunarium)

The left half of the heart has similar structural features. Let’s consider it in greater detail.The left atrium (atrium sinistrum), just like the right one, has an additional cavity called the left auricle (auricula sinistra). Pectinate muscles are present on the internal surface of the auricle.

Left atrium (atrium sinistrum)
Left atrium (atrium sinistrum)
Left auricle (auricula sinistra)
Left auricle (auricula sinistra)

From the inferior side, the atrium is delimited by the left atrioventricular orifice (ostium atrioventriculare sinistrum) and the left atrioventricular (bicuspid or mitral) valve (valva atrioventricularis sinistra (mitralis)).

Left atrioventricular orifice (ostium atrioventriculare sinistrum)
Left atrioventricular orifice (ostium atrioventriculare sinistrum)
Left atrioventricular (bicuspid or mitral) valve (valva atrioventricularis sinistra (mitralis))
Left atrioventricular (bicuspid or mitral) valve (valva atrioventricularis sinistra (mitralis))
Left atrioventricular (bicuspid or mitral) valve (valva atrioventricularis sinistra (mitralis))
Left atrioventricular (bicuspid or mitral) valve (valva atrioventricularis sinistra (mitralis))

Four pulmonary veins (venae pulmonalis) end by the cavity of the left atrium.

Left pulmonary veins (venae pulmonalis)
Left pulmonary veins (venae pulmonalis)
Right pulmonary veins (venae pulmonalis)
Pulmonary veins (venae pulmonalis)

The left ventricle (ventriculus sinister) is located below the atrium.

Left ventricle (ventriculus sinister)
Left ventricle (ventriculus sinister)

The left ventricle is the largest chamber of the heart. Its wall is the thickest, and its contraction provides a large volume of blood discharge into the aorta, which is the largest artery of our body.

Aorta (aorta)
Aorta (aorta)

Let’s consider the structure of the left atrioventricular (bicuspid or mitral) valve (valva atrioventricularis sinistra (mitralis)). It consists of:

Left atrioventricular (bicuspid or mitral) valve (valva atrioventricularis sinistra (mitralis)).
Left atrioventricular (bicuspid or mitral) valve (valva atrioventricularis sinistra (mitralis)).

1. The anulus fibrosus (annulus fibrosus)

Anulus fibrosus (annulus fibrosus)
Anulus fibrosus (annulus fibrosus)

2. The anterior and posterior cusps (cuspis anterior et posterior), which are covered with the endocardium

Anterior cusps (cuspis anterior)
Anterior cusps (cuspis anterior)
Posterior cusps (cuspis posterior)
Posterior cusps (cuspis posterior)

3. The tendinous chords (chordae tendineae), which are attached to two papillary muscles (mm. papillares) holding the valve cusps.

Tendinous chords (chordae tendineae)
Tendinous chords (chordae tendineae)
Papillary muscles (mm. papillares)
Papillary muscles (mm. papillares)

4. The trabeculae carneae (trabeculae carneae), which are located between the papillary muscles.

Trabeculae carneae (trabeculae carneae)
Trabeculae carneae (trabeculae carneae)

The aorta (aorta), which also has its own valve (valva aortae), arises from the left ventricle in the area of the aortic orifice (ostium aortae).

Aortic orifice (ostium aortae)
Aortic orifice (ostium aortae)
Aorta (aorta)
Aorta (aorta)
Aortic valve (valva aortae)
Aortic valve (valva aortae)

It consists of the following structures:

1. The anulus fibrosus (annulus fibrosus)

2. The right semilunar cusp, posterior semilunar cusp, and left semilunar cusp (valvulae semilunares dextra, posterior et sinistra)

Right semilunar cusp (valvulae semilunares dextra)
Right semilunar cusp (valvulae semilunares dextra)
Posterior semilunar cusp (valvulae semilunares posterior)
Posterior semilunar cusp (valvulae semilunares posterior)

3. Nodules of the semilunar cusps

Left semilunar cusp (valvulae semilunares sinistra)
Left semilunar cusp (valvulae semilunares sinistra)
Semilunar valve nodules (noduli valvularum semilunarium)
Semilunar valve nodules (noduli valvularum semilunarium)

4. Sinuses of Valsalva or aortic sinuses (sinus aortae in Latin)

Aortic sinuses (sinus aortae)
Aortic sinuses (sinus aortae)

The right and left halves of the heart are separated from each other and normally do not communicate in any way. There is an interventricular septum between the ventricles, which has two parts:

The muscular part (pars muscularis)

The membranous part (pars membranacea)

Membranous part (pars membranacea)
Membranous part (pars membranacea)
Dictionary

Anatomy of the heart. Heart valves

Heart
cor
Sternocostal surface
facies sternocostalis
Diaphragmatic surface
facies diaphragmatica
Pulmonary surface
facies pulmonalis
Base of the heart
basis cordis
Apex of the heart
apex cordis
Coronary sulcus
sulcus coronarius
Anterior interventricular sulcus
sulcus intraventricularis anterior
Posterior interventricular sulcus
sulcus interventricularis posterior
Notch of the cardiac apex
incisura apicis cordis
Epicardium
epicardium
Myocardium
myocardium
Vortex of the heart
vortex cordis
Endocardium
endocardium
Right and left anulusfibrosus
anuli fibrosi dexter et sinister
Connective tissue rings of the aorta and pulmonary trunk
anuli fibrosi aortae et truncipulmonalis
Right fibrous trigone
trigonum fibrosum dexter
Left fibrous trigone
trigonum fibrosum sinister
Right atrium
atrium dextrum
Right auricle
auricula dextra
Right atrioventricularorifice
ostium atrioventiculare dextrum
Tricuspid valve
valva tricuspidalis
Interatrial septum
septum interatriale
Fossa ovalis
fossa ovalis
Sinus of venae cavae
sinus venarum cavarum
Superior vena cava
vena cava superior
Inferior vena cava
vena cava inferior
Intervenous tubercle
tubrerculum intervenrosum
Coronary sinus of the heart
sinus coronarius
Valve of the inferior vena cava
valvula venae cavae inferioris
Valve of the coronary sinus
valvula sinus coronarii
Musculi pectinati
mm. pectinati
Right ventricle
ventriculus dexter
Interventricular septum
septum interventriculare
Opening of the pulmonary trunk
ostium truncipulmonalis
Right atrioventricular valve
valva atrioventricularis dextra
Anterior cusp
cuspis anterior
Posterior cusp
cuspis posterior
Septal cusp
cuspis septalis
Trabeculae carneae
trabeculae carneae
Conus arteriosus
conus arteriosus
Pulmonary trunk
truncus pulmonalis
Pulmonary valve
valva trunci pulmonalis
Left semilunar cusp
valvula semilunaris sinistra
Right semilunar cusp
valvula semilunaris dextra
Anterior semilunar cusp
valvula semilunaris anterior
Sinuses of the pulmonary trunk
lunulae valvularumsemilunarium
Left atrium
atrium sinistrum
Left auricle
auricula sinistra
Left atrioventricularorifice
ostium atrioventriculare sinistrum
Left atrioventricularvalve
valva atrioventricularis sinistra
Anterior cusp
cuspis anterior
Posterior cusp
cuspis posterior
Pulmonary veins
venae pulmonales
Left ventricle
ventriculus sinister
Aortic orifice
ostium aortae
Aorta
aorta
Aortic valve
valva aortae
Right semilunar cusp
valvula semilunaris dextra
Posterior semilunarcusp
valvula semilunaris posterior
Left semilunar cusp
valvula semilunaris sinistra
Aortic sinus
sinus aortae
Muscular part
pars muscularis
Membranous part
pars membranacea
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