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Cardiac Anatomy
The detailed anatomy of the heart can be found in anatomy textbooks. The
following presents only a brief description of cardiac anatomy so that the physiology of
the cardiac cycle can be understood.
Venous
blood enters the right atrium (RA) of the heart through the superior
vena cava (SVC) and inferior vena cava (IVC). The right atrium has a
relatively thin muscular wall and easily expands with blood as it fills (i.e.,
it is highly
compliant).
Because of its high compliance, the RA pressure is normally very low (0-3 mmHg).
It also undergoes spontaneous contractions (see cardiac
cycle) to aid in the filling of the right ventricle (RV). Blood
passes from the RA to the RV through the tricuspid valve. The free wall
of the right
ventricle is not as thick as the left ventricle, and anatomically it
wraps itself around part of the larger, and thicker, left ventricle. The
RV wall, however, is thicker and more muscular than the RA, so that when it
contracts, it can develop considerably more pressure (~25 mmHg) than the RA. As
the RV contracts and generates pressure, blood leaves the RV, flows across an
open semilunar pulmonic valve, and enters the pulmonary artery that
distributes the output of the right ventricle to the lungs where exchange of
oxygen and carbon dioxide occur. The pulmonic valve, like all healthy heart
valves, permits blood to flow in only one direction. Blood returns to the heart
from the lungs through four pulmonary veins that enter the left atrium
(LA). This chamber is similar to the RA in that it is very distensible,
although the blood pressure within the LA is several mmHg higher than the RA
(6-10 mmHg in the LA compared to 0-3 mmHg in the RA). Blood flows from the LA,
across the mitral valve, and into the left ventricle (LV). The LV
wall is very thick so that it can generate high pressures when it contracts
(normally ~120 mmHg at rest ). When the LV contracts, blood is expelled through
the semilunar aortic valve and into the aorta, which then
distributes blood to the arterial system.
The tricuspid and mitral valves (also called atrioventricular, or AV valves) have
fibrous strands (chordae tendineae) on their leaflets that attach to papillary
muscles located on the respective ventricular walls. The papillary muscles
contract during ventricular contraction and generate tension on the valve leaflets via the
chordae tendineae to prevent the AV valves from bulging back into the atria and becoming
incompetent. The semilunar valves (pulmonic and aortic) do not have analogous
attachments.
Continue to Cardiac Cycle
RK Revised
08/03/07
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