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By the end of this section, you will be able to:
  • Describe the location and position of the heart within the body cavity
  • Describe the internal and external anatomy of the heart
  • Identify the tissue layers of the heart
  • Relate the structure of the heart to its function as a pump
  • Compare systemic circulation to pulmonary circulation
  • Identify the veins and arteries of the coronary circulation system
  • Trace the pathway of oxygenated and deoxygenated blood thorough the chambers of the heart

The vital importance of the heart is obvious. If one assumes an average rate of contraction of 75 contractions per minute, a human heart would contract approximately 108,000 times in one day, more than 39 million times in one year, and nearly 3 billion times during a 75-year lifespan. Each of the major pumping chambers of the heart ejects approximately 70 mL blood per contraction in a resting adult. This would be equal to 5.25 liters of fluid per minute and approximately 14,000 liters per day. Over one year, that would equal 10,000,000 liters or 2.6 million gallons of blood sent through roughly 60,000 miles of vessels. In order to understand how that happens, it is necessary to understand the anatomy and physiology of the heart.

Location of the heart

The human heart is located within the thoracic cavity, medially between the lungs in the space known as the mediastinum. [link] shows the position of the heart within the thoracic cavity. Within the mediastinum, the heart is separated from the other mediastinal structures by a tough membrane known as the pericardium, or pericardial sac, and sits in its own space called the pericardial cavity    . The dorsal surface of the heart lies near the bodies of the vertebrae, and its anterior surface sits deep to the sternum and costal cartilages. The great veins, the superior and inferior venae cavae, and the great arteries, the aorta and pulmonary trunk, are attached to the superior surface of the heart, called the base. The base of the heart is located at the level of the third costal cartilage, as seen in [link] . The inferior tip of the heart, the apex, lies just to the left of the sternum between the junction of the fourth and fifth ribs near their articulation with the costal cartilages. The right side of the heart is deflected anteriorly, and the left side is deflected posteriorly. It is important to remember the position and orientation of the heart when placing a stethoscope on the chest of a patient and listening for heart sounds, and also when looking at images taken from a midsagittal perspective. The slight deviation of the apex to the left is reflected in a depression in the medial surface of the inferior lobe of the left lung, called the cardiac notch    .

Position of the heart in the thorax

This diagram shows the location of the heart in the thorax.
The heart is located within the thoracic cavity, medially between the lungs in the mediastinum. It is about the size of a fist, is broad at the top, and tapers toward the base.

Everyday connection

Cpr

The position of the heart in the torso between the vertebrae and sternum (see [link] for the position of the heart within the thorax) allows for individuals to apply an emergency technique known as cardiopulmonary resuscitation (CPR) if the heart of a patient should stop. By applying pressure with the flat portion of one hand on the sternum in the area between the line at T4 and T9 ( [link] ), it is possible to manually compress the blood within the heart enough to push some of the blood within it into the pulmonary and systemic circuits. This is particularly critical for the brain, as irreversible damage and death of neurons occur within minutes of loss of blood flow. Current standards call for compression of the chest at least 5 cm deep and at a rate of 100 compressions per minute, a rate equal to the beat in “Staying Alive,” recorded in 1977 by the Bee Gees. If you are unfamiliar with this song, a version is available on www.youtube.com. At this stage, the emphasis is on performing high-quality chest compressions, rather than providing artificial respiration. CPR is generally performed until the patient regains spontaneous contraction or is declared dead by an experienced healthcare professional.

When performed by untrained or overzealous individuals, CPR can result in broken ribs or a broken sternum, and can inflict additional severe damage on the patient. It is also possible, if the hands are placed too low on the sternum, to manually drive the xiphoid process into the liver, a consequence that may prove fatal for the patient. Proper training is essential. This proven life-sustaining technique is so valuable that virtually all medical personnel as well as concerned members of the public should be certified and routinely recertified in its application. CPR courses are offered at a variety of locations, including colleges, hospitals, the American Red Cross, and some commercial companies. They normally include practice of the compression technique on a mannequin.

Cpr technique

The top panel shows a schematic of a person performing CPR and demarcates the region in the chest where the compression must be performed. The bottom panel shows a photo of a person performing CPR on a dummy.
If the heart should stop, CPR can maintain the flow of blood until the heart resumes beating. By applying pressure to the sternum, the blood within the heart will be squeezed out of the heart and into the circulation. Proper positioning of the hands on the sternum to perform CPR would be between the lines at T4 and T9.

Questions & Answers

explain respiratory centers
Tharshana Reply
which enzyme help in excretion of bile
Sakshi Reply
how conversion of Beta-carotiene into vitamin-A takes place
Sakshi
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Sakshi
what is gross anatomy
Saroj Reply
The study of large structure of the body
Mablean
what is scrotum
Dakshit Reply
a bag of skin near the penis which contains the testicles
Mablean
hi
Sardar
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Sardar
Why are you on my digits
Mablean
hi
Kryme
how does it work?
Uriah Reply
I want to know the fertilization process in human
Nana Reply
Which plane divides the body into right and left parts
Kaeze
sagittal plane
Irvin
Thank you
Kaeze
Homestatic regulations usually involves a (n) _ that detects a particular stimulus, and a(n) _that respond to the stimulus by communicating with a (n) _whose activity has an effect on the same stimulus.
Kaeze
A cell is producing proteins to be transported out of that cell. They will be processed on ribosomes that are
Kaeze
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Azoyenime Reply
Haemophilia
Aliyu
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Ganesh Reply
Diabetes insipidus or diabetes mellitus would most likely be indicated by ________.
Ganesh
oral cavity how miean
Ganesh Reply
oral cavity how mean what
Suresh
seems to me every one is here a doctor and worse part is that even they donot know what to ask.
Muhammad
they know what to ask the problem is how to ask it.too much broken english.
George
dear George ongeche I think if they ask these kind questions and telling themselves as HCPs or medical student's .these are the basic ones go ask something more interesting .
Muhammad
what is blood red
Ahmad Reply
what is human anatomy?
Arpita Reply
tell me what is human anatomy?
Arpita
what is Openstax?
Arpita
arpita jana I think it's not the forum to ask such basic question...
Muhammad
study of structure of an object in this case human body.
Suresh
what are deferent between trasemicacid and vitamin k
Ubah Reply
This medication is used to treat heavy bleeding during your menstrual period. Tranexamic acid works by slowing the breakdown of blood clots, which helps to prevent prolonged bleeding. It belongs to a class of drugs known as antifibrinolytics
Muhammad
jj
John
In the body, vitamin K plays a major role in blood clotting. So it is used to reverse the effects of “blood thinning” medications when too much is given; to prevent clotting problems in newborns who don’t have enough vitamin K; and to treat bleeding caused by medications including salicylates, sulfo
Muhammad
Vitamin K plays a key role in helping the blood clot, preventing excessive bleeding. Unlike many other vitamins, vitamin K is not typically used as a dietary supplement. Vitamin K is actually a group of compounds. The most important of these compounds appears to be vitamin K1 and vitamin K2. Vitami
Muhammad
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Muhammad
26 vertebrea bone
Bhumi
wathe is blood function
dhena Reply
Blood, fluid that transports oxygen and nutrients to the cells and carries away carbon dioxide and other waste products. ... It is a tissue because it is a collection of similar specialized cells that serve particular functions. These cells are suspended in a liquid matrix (plasma), which makes the 
Ashiish
how tissue carries waste matrial
Nadeem
how many bone in human body?
Islam Reply
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Islam
206
Nadeem
heart layers
Suresh
endoceime is the inner layer of heart
pandit
What is buffer?
Peer Reply
a buffer is a solution that resists a chemical change.
George
Yup it also balances the solutions
Peer

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Source:  OpenStax, Anatomy & Physiology. OpenStax CNX. Feb 04, 2016 Download for free at http://legacy.cnx.org/content/col11496/1.8
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