 Good everybody. This is Dr. Sanjay Sanyal, professor of department chair. This is going to be a demonstration of the morphology of the heart, which has been e-viscerated from this canaver. Let's take a look at how the heart is oriented inside the thorax. This is the way we hold the heart. We put the diaphragmatic or the inferior surface of the heart on the little palm of our left hand and then we dorsiflex our left hand radially deviate. So this is the orientation of our heart inside our own chest. So once we do like this, we get four borders and four surfaces and a few salkai and grooves. So let's take them one by one. Now I'm going to turn back the heart. This border that we see here, this is the right border of the heart. The right border of the heart is formed by the right atrium. It extends from opening of the infiravina keva to the opening of the supiravina keva. And we can see there's a shallow sulcus here. This is called the sulcus terminalis. So this is the right border of the heart. The left border of the heart is this one. This is formed mostly by the left ventricle and a little bit by the left atrium. Then we come to the inferior border of the heart. The inferior border of the heart is formed mostly by the right ventricle and very little by the left ventricle. And then we have the supirabord of the heart. The supirabord of the heart is formed mostly by the left atrium and a little bit by the right atrium. That brings me to the next point. This is the apex of the heart. the heart is formed by the inflow lateral surface of the left ventricle and this is the one which is located in relation to the 5th left intercostal space 9cm from the mid-sternal line. This is the plane just x3 to show the right left and infear points of the heart marked abc and the apex with an arrow and diametrically opposite to the apex that means my finger is going like this and for that I will have to turn the heart this is the base of the heart normally the base of the heart is covered and we can see it is covered by the four pulmonary veins so these are the two right pulmonary veins and these are the two left pulmonary veins if we were to remove this then that will be the base of the heart the base of the heart is formed mostly by the left atrium which I mentioned is covered by the opening of the pulmonary veins the base of the heart extends from the bifurcation of the pulmonary trunk which is approximately here to the coronary sulcus which is here so this much is the extent of the base of the heart. The base of the heart is related to the oblique pericardial sinus which is in this place where my finger is located and it is also related to the isophagus and to the t6 to the t9 vertebra so therefore if we want to take a look at the base of the heart we have to do a lateral chest x3 and the portion in front of the corresponding vertebra will be the base of the heart which is the left atrium. This is the barium swallowed to show these are fingers and the lateral chest x3 with the arrow pointing at the base of the heart namely the left atrium if we put any transsexual vigil ECG lead or we want to do a transsexual vigil echocardiography we will see the activity of the left atrium which is formed mostly by the base of the heart now let's take a look at the surfaces remember we have kept the heart like this so therefore the surfaces are also in the same orientation this surface that we see here this is the anterior or the sternocostal surface and I would like you to notice I'm pressing and you can see how the consistency is this was covered the whole heart was covered by thin membrane which is called the epicardium which is the visceral layer of the cirrus pericardium which we have removed and under that there was a thick layer of fat which also we have shaved off and we can see the individual muscle fibers this is the myocardium so this is the sternocostal or the anterior surface of the heart this is formed mostly by the right ventricle then we have the right surface of the heart the right surface of the heart is formed by the right atrium just like the right border was formed by the right atrium so this is the right surface right atrium then we have the left surface of the heart this is the left pulmonary surface this is formed by the left ventricle and finally we have something very important we have the diaphragmatic or the inferior surface of the heart and this was how the heart was resting on my palm and this the way the heart rests on the diaphragm and it is attached to the central tender of the diaphragm by means of the pericardiophrenic ligament. So therefore this is the diaphragmatic or the inferior surface of the heart. This is also formed mostly by the left ventricle and a little bit by the right ventricle and I will turn this to show you something very unique on the diaphragmatic or the inferior surface. If you take a look at these muscle fibers of course I can show you only by pressing here the consistency is considerably different and the appearance is considerably different. This is more firm almost hard inconsistency and it is not yielding to my finger like this area or this area. In all probability this is an area of inferior wall ischemia or infarction and this has become fibrosis. So I would say that this can ever during life had sustained inferior diaphragmatic wall infarction. That's about the surfaces of the heart. Now I shall mention a very important location. I put my finger in one groove here and you can notice that in front of my finger is the pulmonary trunk and the erotic orifice pulmonary trunk erotic orifice and behind my finger is the supere vena keva. So this is the transverse pericardial sinus. Transverse pericardial sinus is the embryonic remnant of the space between the arterial end of the heart and the venous end of the heart. So this is the arterial end this is the venous end when the heart tube folded and the inferior limit of that is formed by the base of the heart which as said is formed by the left atrium. This is a very useful landmark. This is the place where cardiac surgeons put their finger in order to cannulate supere vena keva and the aorta while doing a cardiopulmonary bypass connected to the heart lung machine. This is a diagrammatic representation to show the connections to the heart lung machine from the supere vena keva and the aorta. This is a clinically useful transverse pericardial sinus. Now let's take a look at few other structures. We can see this projection here. It roughly looks like the ear of a person. If you stretch your imagination a little bit this is called the right oracle and this is the left oracle. These are the two respective relatively non-functional appendages of the right atrium and the left atrium. But this can be also a problem because this portion does not contract during contraction of the atrium. It can be stasis of blood here and that can lead to what is known as a ball thrombus and that ball thrombus can throw an embolus and which can lead to cerebral thrombo embolism and cerebral infarction. We can see a groove running here and we can see some blood vessels running in them which we shall describe later. This is atrium intracular groove or the coronary groove. This goes all the way down to the back of the heart. So therefore this whole thing is referred to as the coronary sulcus because it is like a crown. So therefore this is the anterior part of the coronary sulcus and if I turn the heart this is the posterior part of the coronary sulcus and we can see that it is filled with many important blood vessels. Then we can see another groove on the sternocostal surface of the heart. This is the anterior interventricular groove and again we can see some blood vessels here. And if I turn the heart we can see yet another groove here. Don't get misled by this abnormal portion which I had mentioned earlier. This is the posterior interventricular groove and the place where the posterior interventricular groove meets the posterior coronary sulcus. This region is referred to as the crux of the heart and many important events will be taking place at the crux of the heart. So these are the surfaces, borders, grooves and sulcus that we can see. The morphology of the heart.