Podcast
Questions and Answers
Which of the following is the most anterior chamber of the heart?
Which of the following is the most anterior chamber of the heart?
What is the location of the fossa ovalis?
What is the location of the fossa ovalis?
Interatrial Septum
What is the name of the structure that divides the smooth surface of the right atrium from the muscular surface of the right atrium and right atrial appendage?
What is the name of the structure that divides the smooth surface of the right atrium from the muscular surface of the right atrium and right atrial appendage?
Crista Terminalis
What is the normal oxygen saturation level in the right atrium?
What is the normal oxygen saturation level in the right atrium?
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What is the normal area range for the tricuspid valve?
What is the normal area range for the tricuspid valve?
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The pulmonary valve has thinner cusps than the aortic valve.
The pulmonary valve has thinner cusps than the aortic valve.
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Which artery is associated with the right coronary cusp of the aortic valve?
Which artery is associated with the right coronary cusp of the aortic valve?
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What is the name of the small "nugget" located on the edge of each aortic valve cusp?
What is the name of the small "nugget" located on the edge of each aortic valve cusp?
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If the nodule of Arantius is too thick, it can prevent the valve from closing properly and cause blood to leak backwards.
If the nodule of Arantius is too thick, it can prevent the valve from closing properly and cause blood to leak backwards.
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What is the name of the very fine, hair-like projections that are often seen on the aortic valve cusps?
What is the name of the very fine, hair-like projections that are often seen on the aortic valve cusps?
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In relation to the left ventricle, what is the normal oxygen saturation level?
In relation to the left ventricle, what is the normal oxygen saturation level?
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Which of the following is NOT a component of the left ventricle?
Which of the following is NOT a component of the left ventricle?
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The left ventricle's inflow tract is also known as the mitral valve inflow.
The left ventricle's inflow tract is also known as the mitral valve inflow.
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What is the name of the anatomical dilation between the aortic valve and ascending aorta?
What is the name of the anatomical dilation between the aortic valve and ascending aorta?
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Match the following terms with their descriptions:
Match the following terms with their descriptions:
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Study Notes
Order of Flow & Details
- Pages 9-14 cover the order of blood flow through the heart, excluding cardiac veins.
Flow through the Heart
- Blood flows towards the heart through veins.
Order of Flow
- Superior Vena Cava
- Inferior Vena Cava
- Right Atrium
- Tricuspid Valve
- Right Ventricle
- Pulmonic Valve
- Main Pulmonary Artery
- Right Pulmonary Artery
- Left Pulmonary Artery
- Pulmonary Veins (4)
- Left Atrium
- Mitral Valve
- Left Ventricle
- Aortic Valve
- Ascending Aorta
- Aortic Arch / Transverse Aorta
- Brachiocephalic / Innominate Artery
- Left Common Carotid Artery
- Left Subclavian Artery
- Descending Aorta
Venous Return
- Three vessels return deoxygenated blood to the right atrium (RA): Superior Vena Cava (SVC), Inferior Vena Cava (IVC), and Coronary Sinus (CS).
Superior Vena Cava (SVC)
- Receives deoxygenated blood from the upper body (head, neck, upper chest, arms).
- Drains into the superior portion of the right atrium.
- Considered a large vein (~2 cm wide and ~7 cm long).
Inferior Vena Cava (IVC)
- Receives deoxygenated blood from the lower body (abdominal organs, pelvis, legs, feet).
- Drains into the lower, posterior portion of the right atrium.
- Passes along the right side of the aorta, in front of the spine.
- Diameter: 1.2–2.1 cm.
Coronary Sinus (CS)
- Cardiac veins return blood to the RA from the coronary artery system.
- The Coronary Sinus is part of the cardiac venous system.
- Positioned behind the LA, along the posterior atrioventricular groove.
- Cardiac veins empty into the CS (like a "coronary gutter").
- CS is the third vein emptying into the RA, separated by the Thebesian valve.
- Approximately 2.5 cm (1 inch) in length.
- Lowest O2 saturation of the body (60%).
Right Side
- Relevant information on the right side of the heart.
Right Atrium (RA)
- Receiving chamber for systemic and coronary venous return.
- Receives deoxygenated blood from the SVC, IVC, and Coronary Sinus.
- Normal RA O2 saturation: 75%.
- Fills more during inspiration.
- Pressure in the RA is less than pressure in the veins.
Normal Embryonic Remnants
- Fossa Ovalis
- Eustachian Valve
- Chiari Network
- RA Appendage (RAA)
- Crista Terminalis
Fossa Ovalis
- Remnant of the Foramen Ovale (FO).
- In utero, the FO is a normal, necessary shunt that should close at birth.
- Location: Interatrial Septum
Eustachian Valve
- Normal embryonic remnant.
- Directed flow from IVC across the RA, through the foramen ovale, to the LA.
- Helped direct blood through the fetal shunt to bypass lungs.
- Location: Junction of IVC & RA.
Chiari Network
- Another embryonic remnant.
- Web-like structure that may appear on echo as a mobile, thin membrane with a whip-like motion.
- Location: RA near entrance of IVC.
Right Atrial Appendage (RAA)
- Another name for appendage = auricle.
- Pouch-like extension off of the RA.
- Broad & triangular.
Crista Terminalis (aka Terminal Crest)
- Smooth, muscular ridge that divides the smooth surface of the RA from the muscular & rigid surface of the RA & RAA.
Tricuspid Valve
- Located between RA & RV.
- Largest of the valves.
- Most inferior valve.
- Same attachment anatomy as MV, just in the right ventricle (chordae tendinae, papillary muscles, annulus fibrosus).
- 3 leaflets (Medial/Septal, Anterior, Posterior).
- Normal TV valve area: 7–9 cm2.
Right Ventricle
- Most anterior chamber of the heart.
- Lies beneath the sternum.
- Receives deoxygenated blood from the RA.
- Normal RV O2 saturation: 75%.
- Compared to LV: thinner walls, smaller, triangular/ crescent shaped, contains moderator band, more coarse trabeculations.
Right Ventricular Components
- Right Ventricular Inflow Tract (RVIT)
- Trabeculations
- Moderator Band
- Right Ventricular Outflow Tract (RVOT)
- Antero-superior RV Wall
- RV Muscular Fold
Right Ventricular Inflow Tract (RVIT)
- Path into the RV.
- Area between TV apparatus & papillary muscles of RV.
Trabeculations
- Make up the inner surface of RV.
- Distinctive criss-cross muscular bands.
- Coarser than trabeculations of LV.
Moderator Band
- Aka septomarginal trabeculation.
- Fibrous band crossing RV apex.
- Spans across RV from septum to RV papillary muscle.
- Unique to RV; landmark.
Right Ventricular Outflow Tract (RVOT)
- Aka INFUNDIBULUM
- Aka Conus Arteriosus
- Pathway out of the RV.
- Smooth-walled, funnel shaped at the entrance of the pulmonary trunk.
Pulmonic Valve
- Most superior of all valves.
- Located between RV & MPA.
- Thinner cusps than AoV.
- Normal Pulmonic Valve Area (PVA): >2 cm2.
- Comparable to AoV.
- 3 cusps (Anterior, Right Posterior, Left Posterior).
Main Pulmonary Artery (MPA)
- Aka Pulmonary Trunk.
- Normal MPA dimensions: 3 cm wide x 5 cm long.
- Typically smaller than the Aorta; otherwise, dilated.
- RV pumps deoxygenated blood through the PV & into the MPA; it bifurcates into the Right & Left Pulmonary Arteries.
Pulmonary Arteries & Pulmonary Veins
- Pulmonary Arteries are the only arteries that carry deoxygenated blood to the lungs and divide into smaller arteries, arterioles, and capillaries to exchange carbon dioxide for oxygen in the lung alveoli.
- Pulmonary Veins (4) carry oxygenated blood from the lungs to the left atrium. They are the only veins to carry oxygenated blood
Left Side
- Relevant information on the left side of the heart.
Left Atrium (LA)
- Most posterior chamber.
- Receiving chamber for pulmonary venous return.
- Receives oxygenated blood from PV4 & lungs.
- Normal LA O2 saturation: 98%.
- Respirations affect venous return & chamber filling.
- LA filling decreases with inspiration.
- LA filling increases with expiration.
- Blood flows to the LV through MV(mitral valve).
- Compared to RA: thicker walls, higher pressure.
Normal Embryonic Remnants of LA
- LA Appendage (LAA)
- Coumadin Ridge
Left Atrial Appendage (LAA)
- Normal remnant of embryonic LA.
- Long, tubular, hooked structure.
- Attached to the LA.
- Lies within the pericardium, alongside LV
- Filling & emptying are directly derived from LV function.
- Better LV contractions/relaxations, better emptying/filling of LAA.
- Acts as a decompression chamber.
- Increases LA surface area and aids in contraction.
- Prone to thrombus. Important note: irregularities( Afib )and MV and MV diseases, potentially dangerous thrombus can move to the brain and cause a stroke.
Coumadin Ridge
- Another name for Left Lateral Ridge
- Aka Warfarin Ridge
- Not associated with Coumadin or Warfarin administration
- Lies between the LAA and LUPV, easily mistaken for a tumor.
- "Q-Tip Sign" due to appearance and is non-pathological.
Mitral Valve
- Resembles a smiley face in SAX between LA & LV.
- Anchored via chordae tendinae & papillary muscles(Postero-Medial & Antero-Lateral).
- Normal MV Area (MVA): 4–6 cm².
Mitral Valve Anatomy
- Only valve with 2 leaflets: Anterior Mitral Valve Leaflet (AMVL), and Posterior Mitral Valve Leaflet (PMVL); they meet at the commissures.
- Names of the commissures are the same as the papillary muscles, Postero-Medial and Antero-Lateral.
- Anterior mitral valve (divided in A1,A2,A3).
- Posterior mitral valve (divided in P1, P2, P3).
Left Ventricle (LV)
- Most essential chamber; receives oxygenated blood from LA.
- Must pump to the entire body.
- Largest/Strongest of 4 chambers with the thickest walls.
- Shape: Conical...forms the apex.
- Compared to RV: thicker walls, larger chamber, more conical, less trabeculated, higher pressure.
- Normal LV O2 saturation: 98%.
Left Ventricle Components
- LV Inflow Tract (MV Inflow)
- LV Outflow Tract (LVOT)
- LV Free Wall
LV Inflow (MV Inflow)
- Road into the LV.
- Includes MV annulus, leaflets, and chordae tendineae.
- Entire LV from base to apex.
Left Ventricular Outflow Tract (LVOT)
- Consists of AMVL and IVS.
- Pathway out of the LV.
Aortic Valve
- Located between the LV and Aorta.
- Housed by the Aortic Root.
- Same area as the Sinus of Valsalva.
- Anatomic dilation between AoV & A Ao.
- Normal AoV Area: >2 cm².
- 3 pocket-like AoV Cusps: Right Coronary Cusp (RCC), Left Coronary Cusp (LCC), and Non-Coronary Cusp (NCC).
Aortic Valve Cusps
- Each cusp is associated with a Sinus of Valsalva, a pocket-like structure in the area of the AORTA.
- Right Coronary Cusp (RCC) gives rise to the Right Coronary Artery.
- Left Coronary Cusp (LCC) gives rise to the Left Coronary Artery.
- Non-Coronary Cusp (NCC) gives rise to nothing.
Nodule of Arantius
- On the edge of each cusp, in the center is a small "nugget".
- Ensures complete closure of the valve.
- If too thick, it can prevent the valve from closing all the way, allowing blood to leak backward, known as regurgitation.
Lambl's Excrescences
- Very fine, hair-like projections visualized on Aortic Valve Cusps, often on the edge of closure sites.
- Surgical removal may be suggested.
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Description
Test your knowledge on the anatomy of the heart with this quiz. Explore questions about the chambers, valves, and structures of the heart, including oxygen saturation levels and specific features like the fossa ovalis and Arantius nodules. Perfect for students in medical or biological sciences.
