The surfaces and borders of the heart

Orientation and surfaces:

Apex of the heart points in an anteroinferior direction

In the anatomical position, the heart has 5 surfaces formed by different chambers of the heart:

  1. Anterior (sternocostal) - right ventricle

  2. Posterior (base of pyramid) - left atrium

  3. Inferior (diaphragmatic) - left & right ventricles

  4. Right pulmonary - right atrium

  5. Left pulmonary - left ventricle

Borders:

4 main borders separating the surfaces of the heart:

  1. Right border - right atrium

  2. Inferior border - left & right ventricle

  3. Left border - left ventricle (and some of left atrium)

  4. Superior border - right & left atrium and the great vessels

Sulci of the heart:

Heart is divided internally into 4 chambers - these divisions create grooves on the external surface of the heart known as sulci

3 main sulci:

  1. Coronary sulcus (atrioventricular groove) - circles around the heart and represents the separation of the atria from the ventricles

    • Contains the right coronary artery, circumflex branch of the left CA, small cardiac vein & coronary sinus

  2. Anterior interventricular sulcus - located on the anterior surface of the heart and represents the separation of the left and right ventricle

    • Contains the anterior interventricular artery (aka the left anterior descending artery) and great cardiac vein

  3. Posterior interventricular sulcus - located on the posterior surface of the heart and represents the separation of the left and right ventricle

    • Contains the posterior interventricular artery and middle cardiac vein

Pericardial sinuses:

Passageways formed when the pericardium folds around the great vessels

  • oblique pericardial sinus: blind ending passageway located on the posterior surface of the heart

  • Transverse pericardial sinus: found superiorly on the heart, can be used in coronary artery bypass grafting

    • Posterior to the ascending aorta and pulmonary trunk, anterior to superior VC, superior to the LA

    • Separate the arterial and venous vessels of the heart

    • Can be used to identify and subsequently litigate (tie off) the arteries of the heart during coronary artery bypass grafting