Surface anatomy of heart, valves and great
Important landmarks for surface anatomy
• Thorax is mapped out by arbitary lines which are as follows:
The middle line of the sternum • Mammary, or Midclavicular
Runs vertically downward from a point midway between the center of the jugular notch and the tip of the acromion
• Lateral sternal
Along the sternal margin • Parasternal
Midway between the lateral sternal and mammary.
• Anterior and Posterior
Vertically down from the corresponding axillary folds
• Midaxillary line
Runs downward from the apex of the axilla.
• Scapular line
Drawn vertically through the inferior angle of the scapula.
Boundary of the Heart
Parasternally nd• 2 left rib rd• 3 right rib th• 6 right rib th• 5 intercostal space (midclavicular line)
Join these points together to get the boundary of heart
• Line from the 3rd left, to the 6th right, sternocostal joint.
Anterior longitudinal sulcus
Finger’s breadth to the right of the left margin of the heart.
• Pulmonary valve rd Upper level of 3 left costal cartilage
• Aortic valve rd At the level of 3 costal cartilage,
medial and below the pulmonary valve
Mitral valve (left AV valve) th 4 costal cartilage
• Tricuspid valve (right AV valve) th 4 costal cartilage on the right side
Great vessels of the body Ascending Aorta
1) Beginning at the level of the lower rdborder of the left 3 costal cartilage.
nd2) Upto the right 2 costal cartilage. At
the sternal angle
Arch of the Aorta
• Behind the lower half of the
• Its upper convex border is marked by a line
Begins at the right end of the sternal angle
Arches upward and to the left through the centre of the manubrium nd Ends at the sternal end of the left 2 costal cartilage.
Descending Thoracic Aorta
• Descending thoracic aorta is marked by two parallel lines 2.5 cm
apart nd Begins at the sternal end of the left 2 costal cartilage
Pass downwards and medially
Ends in the median plane 2.5 cm above the transpyloric plane.
; First mark the pulmonary valve by a horizontal line 2.5 cm long, mainly along rdthe upper border of the left 3 costal cartilage and adjoining part of the
; Then mark the pulmonary trunk by two parallel lines 2.5 cm apart from the ndpulmonary orifice upwards to the left 2 costal cartilage.
1. Superior vena cava
2. Inferior vena cava
3. Right atrium (blue)
4. Right ventricle
5. Left ventricle (red)
7. Pulmonary trunk Superior vena cava
st• Lower border of the right 1 costal cartilage to the upper border of
rdthe 3 right costal cartilage.
Inferior vena cava
• Inferior vena cava is situated
opposite the upper margin of
the sixth right costal cartilage
about 2 cm. from the midsternal