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HEART DESCRIPTION, PRENATAL & POSTNATAL CIRCULATION

HEART DESCRIPTION:

The heart is a double self adjusting muscular pump in unison/simultaneously to propel blood
to the body. The RIGHT side of the heart receives poorly-oxygenated blood from the body
through the superior and inferior vena cava, and pumps it through the pulmonary trunk to the
lungs for oxygenation. The LEFT side of the heart receives well-oxygenated blood coming
from the lungs through pulmonary veins and pumps it into the aorta for distribution to the
body.
The heart has 4 chambers: right and left atria and right and left ventricles. The atria are
the receiving chambers that pump blood to the ventricles, which are the discharging
chambers. The SYNCHRONOUS pumping actions of the hearts 2 atrioventricular pumps make
up the CARDIAC CYCLE. The cycle begins with a ventricular relaxation (DIASTOLE) and ends
with a ventricular contraction (SYSTOLE).
The wall of each chamber of the heart consists of 3 layers:
1. EPICARDIUM: a thin external layer (mesothelium) formed by the visceral layer of
serous pericardium.
2. MYOCARDIUM: a thick middle layer composed of cardiac muscle
3. ENDOCARDIUM: a thin internal layer (endothelium) lining membrane of the heart
that also covers its valves.
The heart has an APEX, BASE, 4 SURFACES and 4 BORDERS.
APEX:
- Formed by the inferolateral part of left ventricle
- Located posterior to left 5th intercostals space usually 9cm from the median plane
- Where the sound of mitral valve closing is mostly heard (apex beat)
- Underlies the spot where the heart beat may be auscultated on the thoracic wall.
BASE:
- The hearts posterior aspect formed mainly by left atrium with a lesser contribution by
right atrium
- Faces posteriorly toward the bodies of vertebra T6-T9 and it is separated from them by
pericardium, oblique pericardial sinus, esophagus and aorta
4 SURFACES:
- Anterior/sternocostal surface RV
- Inferior/diaphragmatic surface LV (and RV)
- Left/pulmonary surface LV
- Right/pulmonary surface RA
4 BORDERS:
- Right border RA and extends between SVC & IVC
- Left border LV (and left auricle)
- Inferior border RV (and LV)
- Superior border RA, LA and auricles, the pulmonary trunk and ascending aorta
emerge from this border and SVC enters its right site. It forms the floor of the
transverse pericardial sinus.

PRENATAL CIRCULATION:

O2 blood from placenta in

UMBILICAL VEIN

DUCTUS VENOSUS
LIVER

HEPATIC VEIN
JOINS WITH
IVC
O2 BLOOD FROM IVC REMAINS &
MIXES WITH BLOOD FROM SVC &
CORONARY SINUS

R. ATRIUM

O2 BLOOD FROM
SVC AND
CORONARY SINUS

OVAL FORAMEN

RIGHT VENTRICLE
LEFT ATRIUM
PULMONARY TRUNK
LEFT VENTRICLE
LUNGS
ASCENDING AORTA

PULMONARY
VEINS

DUCTUS ARTERIOSUS

BLOOD RETURNS TO PLACENTA VIA

UMBILICAL ARTERIES

NOTE:
Ductus arteriosus protects lungs from overloading and allow R ventricle to strengthen
and function at full capacity
Circulatory adjustments occur after birth (ductus arteriosus becomes ligamentum
arteriosum) when lungs expand & circulation of fetal blood through placenta stops.
Decrease in pulmonary vascular resistance, increase in pulmonary blood flow (as lungs
expand with first breath), pressure in right heart (atrium) falls in comparison with
pressure in left heart (atrium) and oval foramen closes.
Ductus venosus constricts = ligamentum venosum, ductus arteriosus = ligamentum
arteriosum, umbilical vein and arteries constrict = ligamentum teres and medial

umbilical ligaments. Therefore all blood entering liver enters through proper hepatic
artery.

POSTNATAL CIRCULATION:

DEOXYGENATED BLOOD
ENTERS R ATRIUM VIA
CORONARY SINUS, IVC & SVC

VIA TRICUSPID VALVE

R VENTRICLE

PULMONARY TRUNK
DISTRIBUTION
AROUND THE
BODY

LUNGS

PULMONARY VEINS

L ATRIUM

VIA MITRAL VALVE

L VENTRICLE

AORTA