Surface anatomy of the heart

Question 1

Mediastinum

Answer 1

Central part of the thoracic cavity and contains the heart

Question 2

Thoracic wall superior aperture

Answer 2

The thoracic entrance: In root of the neck
(borders)
• Anterior: Superior border of manubrium + Sternal notch
• Lateral: First ribs with rib cartilages
• Posterior: T1 - body protrudes anteriorly to the opening
• Suprapleural membrane
(Sibson’s fascia)

Question 3

Question 4

Thoracic wall inferior aperture

Answer 4

Thoracic exit
• Anterior: Xiphisternal joint
• Lateral: Fused costal cartilages of ribs 7-10 + Ribs 11-12
• Posterior: T12 - body protrudes ant. into opening
• Diaphragm

Question 5

Heart and the great vessels are approx. in _______ and are surrounded _________ by the lungs and ant. by _____________

Answer 5

the middle of the thorax
laterally and post.
the sternum and central part of the thoracic cage

Question 6

Borders of the heart are variable and depend on

Answer 6

the position of the diaphragm and the build and physical condition of the person

Question 7

The outline of the heart can be traced on the ant. surface of the thorax

Question 8

Borders of heart

Answer 8

The superior border:
inf. border of the second left costal cartilage to the sup border of the
right 3rd costal cartilage.

Right:
Right 3rd rib cartilage – Right 6th rib cartilage

Inferior:
Right 6th rib cartilage - Left 5th intercostal space, close to left
midclavicular line

Left:
Left 5th intercostal space midclavicular line - Left 2nd rib
cartilage

Question 9

Sup border contains

Answer 9

auricles,largevessels:SVC,ascendingaorta,pulmonaryarteries

Question 10

Right border contains

Answer 10

• Right atrium

Question 11

inf. border contains

Answer 11

• Right ventricle, apex

Question 12

left border contains

Answer 12

Left ventricle

Question 13

Valves are located

Answer 13

posterior to the body of sternum:

Question 14

Valves of the heart

Answer 14

PAMT
• Pulmonary valve
• Aortic valve
• Mitral valve
• Tricuspid valve

Question 15

Pulmonary valve:

Answer 15

• at the junction of the sup and middle 1/3rd of the body of the
  sternum
• near left 3rd costal cartilages

Question 16

Aortic valve:

Answer 16

• Just below and to the right of the pulmonary valve on the left side
  of the middle 3rd of the sternum
• level with the left 3rd intercostal space

Question 17

Mitral valve:

Answer 17

• Overlaps the tricuspid area
• More sup. and to the left of the sternal body
• at the left 4th costal cartilage

Question 18

• Tricuspid valve:

Answer 18

• in the median plane of the inferior 3rd of the sternal body, opposite
  the 4th and 5th intercostal spaces

Question 19

Osculation sites of the heart valves are different to their surface markings.
Why?

Answer 19

The transmission of heart sound is dependent on factors such as:
- The proximity of the respected chambers to the thoracic cage
- and the direction of the blood flow

Question 20

Where do you listen for the valves?

Answer 20

Aortic valve:
At the right, second intercostal space - close to the sternum

Pulmonary valve:
At the left, second intercostal space - close to the sternum

Mitral valve:
At the apex of the heart
- At the left, 5th intercostal space - in the midclavicular line

Tricuspid valve:
- inf. to left sternal margin
- in the left, 4th intercostal space

Question 21