Surface anatomy of heart, valves and great
vessels
Important landmarks for surface
anatomy
Arbitary lines
• Thorax is mapped out by arbitary
lines which are as follows:
•
Midsternal,
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
axillary lines
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
• 2nd left rib
• 3rd right rib
• 6th right rib
• 5th intercostal space (midclavicular
line)
Join these points together to get the
boundary of heart
Coronary sulcus
• 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.
Cardiac valves
• Pulmonary valve
Upper level of 3rd left costal cartilage
• Aortic valve
At the level of 3rd costal cartilage,
medial and below the pulmonary
valve
Mitral valve (left AV valve)
4th costal cartilage
• Tricuspid valve (right AV valve)
4th costal cartilage on the right side
Great vessels of the body
Ascending Aorta
1) Beginning at the level of the lower
border of the left 3rd costal cartilage.
2) Upto the right 2nd costal cartilage. At
the sternal angle
Arch of the Aorta
• Behind the lower half of the
manubrium sterni.
• 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
Ends at the sternal end of the left 2nd costal cartilage.
Descending Thoracic Aorta
• Descending thoracic aorta is marked by two parallel lines 2.5 cm
apart
Begins at the sternal end of the left 2nd costal cartilage
Pass downwards and medially
Ends in the median plane 2.5 cm above the transpyloric plane.
Pulmonary trunk


First mark the pulmonary valve by a horizontal line 2.5 cm long, mainly along
the upper border of the left 3rd costal cartilage and adjoining part of the
sternum.
Then mark the pulmonary trunk by two parallel lines 2.5 cm apart from the
pulmonary orifice upwards to the left 2nd costal cartilage.
1. Superior vena cava
2. Inferior vena cava
3. Right atrium (blue)
4. Right ventricle
5. Left ventricle (red)
6. Aorta
7. Pulmonary trunk
Superior vena cava
• Lower border of the right 1st costal cartilage to the upper border of
the 3rd 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
line