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Surface projections of the heart - want to learn more about it?

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Surface projections of the heart

The surface projections of the heart are the anatomical points that medical professionals use to orientate themselves on the human thorax when noninvasive clinical examinations are being performed on the heart, such as observation, palpation, percussion and auscultation.

This article will highlight the main points which are essential for locating the borders of the heart when it is covered by bones, muscles, vessels and skin. Two parts of the heart are projected onto the chest, the borders of the heart and the anulus fibrosus or fibrous skeleton of the heart.

Recommended video: Anterior view of the Heart
Structures seen on the anterior view of the heart.

Borders of the Heart

Anatomical

The superior border of the heart is a convex line that runs from the inferior border of the second left costal cartilage to the superior border of the third right costal cartilage.

The right border of the heart is a convex line that runs from the third right costal cartilage to the sixth right costal cartilage.

Costal cartilages 1-6 - ventral view

The inferior border of the heart is a convex line that runs from the sixth right costal cartilage to the fifth intercostal space close to the left midclavicular line.

The left border of the heart is a convex line that runs from the fifth intercostal space close to the left midclavicular line to the inferior border of the second left costal cartilage.

Imaging

On an X-ray, the heart can be seen as an outline with several convexities on each side. On the right side, there are three convexities running in the craniocaudal direction. These include:

Heart X-Ray and Border of Superior Vena Cava (green) - coronal view

On the left side of the heart there are four convexities. In a craniocaudal order they appear as:

At the point where the left side of the heart touches the diaphragm, the apex can be located.

Heart - lateral-left view

The Anulus Fibrosus

Upon the diagram that is constructed by using an x-ray to outline the borders of the heart, when two convex lines are drawn connecting the lower right corner of the heart to the upper left corner, the right and left limit of the coronary groove is pinpointed. These two lines embody the surface projections of the anulus fibrosus which contains the heart valves.

The Heart Valves

Using the markings that locate the area of the anulus fibrosus and moving in the same direction from lower right to upper left, the four heart valves can also be located:

Heart valves - cranial view

  • In third place is the aortic valve, which superiorly borders the right ventricle and is more superficial than the right atrioventricular valve
  • Lastly, the pulmonary valve due to the fact that the pulmonary trunk is situated on the left side of the ascending aorta and is slightly posterior to it.

Summary

The surface projections of the heart are the anatomical points that medical professionals use to orientate themselves on the human thorax when noninvasive clinical examinations are being performed on the heart. They are as follows:

  • Superior border - a convex line that runs from the inferior border of the second left costal cartilage to the superior border of the third right costal cartilage.
  • Right border - a convex line that runs from the third right costal cartilage to the sixth right costal cartilage.

  • Inferior border - a convex line that runs from the sixth right costal cartilage to the fifth intercostal space close to the left midclavicular line.

  • Left border - a convex line that runs from the fifth intercostal space close to the left midclavicular line to the inferior border of the second left costal cartilage.

On an X-ray, the heart can be seen as an outline with three convexities on the right side (superior vena cava, right atrium, and inferior vena cava) and four convexities on the left (aortic arch, pulmonary trunk, left atrium/auricle, left ventricle).

Surface projections of the heart - want to learn more about it?

Our engaging videos, interactive quizzes, in-depth articles and HD atlas are here to get you top results faster.

Sign up for your free Kenhub account today and join over 852,397 successful anatomy students.

“I would honestly say that Kenhub cut my study time in half.” – Read more. Kim Bengochea Kim Bengochea, Regis University, Denver

Show references

References:

  • Thorax: Heart. Netter's AnatomyLab (netteranatomy.com)
  • John A. McNulty, Ph. D. Projections and auscultations of heart valves. Loyola University Medical Education Network.

Author:

  • Dr. Alexandra Sieroslawska

Illustrators:

  • Costal cartilages 1-6 - ventral view - Yousun Koh
  • Heart valves - cranial view - Yousun Koh
© Unless stated otherwise, all content, including illustrations are exclusive property of Kenhub GmbH, and are protected by German and international copyright laws. All rights reserved.

Related Atlas Images

Anterior view of the heart

Posteroinferior view of the heart

Right atrium and ventricle

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