Anatomy of the heart right atrium
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor(s)-in-Chief: Rim Halaby, Yazan Daaboul
Right Atrium
- The right atrium forms the right border of the heart.
- The superior vena cava and the inferior vena cava drain systemic venous blood into the smooth posterior wall of the right atrium.
- In contrast, the right atrium’s anterior wall is ridge-like; it is composed internally of pectinate muscles, a rough muscular wall.
Right auricle:
- The right atrium contains a right auricle, an ear-like conical muscular pouch that overlaps the ascending aorta.
- The right auricle is an embryonic structural remnant that allows the right atrium to increase its capacity.
Opening of the superior and inferior vena cava:
- The superior vena cava opens in the interior right atrium at its superior part, at the level of the right third costal cartilage.
- The inferior vena cava opens in the interior right atrium at its inferior part, almost in line with the superior vena cava at approximately the level of the fifth costal cartilage.
Coronary Sinus:
- It is a venous collection, whereby systemic blood is received at the posterior part of the coronary groove from the cardiac veins into the coronary sinus. The latter is a derivative of an embryonic structure called the venous sinus.
- The opening or orifice of the coronary sinus is located between the right atrioventricular orifice and the inferior vena cava orifice.
Sinus Venarum:
- The adult right atrium also contains posteriorly a smooth-walled pouch called sinus venarum, on which the coronary sinus, and superior and inferior vena cava bring poorly oxygenated blood to the heart.
- Sinus venarum is formed by the incorporation of the venous sinus (L. sinus venosum), an embryonic structure, into the primordial atrium. As a result, sinus venarum provides further capacity for the right atrium.
- The sinus venorum is separated from the primordial atrium by means of 2 structures: the sulcus terminalis (terminal groove) externally which extends from the front of the superior vena cava to the front of the inferior vena cava, and represents the line of union of the sinus venosus of the embryo with the primitive atrium. Internally, the separation is indicated by the crista terminalis (terminal crest).
Fossa Ovalis:
- Fossa ovalis is a depression in the inter-atrial septum.
- It is a remnant of the foramen ovale, an embryonic physiological shunt, significant for fetal oxygenation and nutrition from the mother’s placenta to fetus’s left atrium without passing through the lungs.
- The limbus of the fossa ovalis (annulus ovalis) is the prominent oval margin of the fossa ovalis.
- It is located on the medial wall of the right atrium and circumscribes the septum primum the fossa ovalis anteriorly, posteriorly, and superiorly.