Right Ventricle
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A ventricle is one of two large chambers toward the bottom of the
heart The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide t ...
that collect and expel
blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the c ...
towards the peripheral beds within the body and lungs. The blood
pump A pump is a device that moves fluids (liquids or gases), or sometimes slurries, by mechanical action, typically converted from electrical energy into hydraulic energy. Pumps can be classified into three major groups according to the method they u ...
ed by a ventricle is supplied by an
atrium Atrium may refer to: Anatomy * Atrium (heart), an anatomical structure of the heart * Atrium, the genital structure next to the genital aperture in the reproductive system of gastropods * Atrium of the ventricular system of the brain * Pulmona ...
, an adjacent chamber in the upper heart that is smaller than a ventricle. Interventricular means between the ventricles (for example the
interventricular septum The interventricular septum (IVS, or ventricular septum, or during development septum inferius) is the stout wall separating the ventricles, the lower chambers of the heart, from one another. The ventricular septum is directed obliquely backwar ...
), while intraventricular means within one ventricle (for example an
intraventricular block An intraventricular block is a heart conduction disorder — heart block of the ventricles of the heart. An example is a right bundle branch block, right fascicular block, bifascicular block, trifascicular block. Types Types of intraventricul ...
). In a four-chambered heart, such as that in
human Humans (''Homo sapiens'') are the most abundant and widespread species of primate, characterized by bipedalism and exceptional cognitive skills due to a large and complex brain. This has enabled the development of advanced tools, culture, ...
s, there are two ventricles that operate in a double circulatory system: the right ventricle pumps blood into the
pulmonary circulation The pulmonary circulation is a division of the circulatory system in all vertebrates. The circuit begins with deoxygenated blood returned from the body to the right atrium of the heart where it is pumped out from the right ventricle to the lungs. ...
to the
lung The lungs are the primary organs of the respiratory system in humans and most other animals, including some snails and a small number of fish. In mammals and most other vertebrates, two lungs are located near the backbone on either side of t ...
s, and the left ventricle pumps blood into the
systemic circulation The blood circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the entire body of a human or other vertebrate. It includes the cardiovascular system, or vascular system, tha ...
through the
aorta The aorta ( ) is the main and largest artery in the human body, originating from the left ventricle of the heart and extending down to the abdomen, where it splits into two smaller arteries (the common iliac arteries). The aorta distributes ...
.


Structure

Ventricles have thicker walls than atria and generate higher
blood pressure Blood pressure (BP) is the pressure of circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term "blood pressure" r ...
s. The physiological load on the ventricles requiring pumping of blood throughout the body and lungs is much greater than the pressure generated by the atria to fill the ventricles. Further, the left ventricle has thicker walls than the right because it needs to pump blood to most of the body while the right ventricle fills only the lungs. On the inner walls of the ventricles are irregular muscular columns called
trabeculae carneae The trabeculae carneae (columnae carneae, or meaty ridges) are rounded or irregular muscular columns which project from the inner surface of the right and left ventricle of the heart.Moore, K.L., & Agur, A.M. (2007). ''Essential Clinical Anatomy: ...
which cover all of the inner ventricular surfaces except that of the
conus arteriosus The infundibulum (also known as ''conus arteriosus'') is a conical pouch formed from the upper and left angle of the right ventricle in the chordate heart, from which the pulmonary trunk arises. It develops from the bulbus cordis. Typically, the i ...
, in the right ventricle. There are three types of these muscles. The third type, the
papillary muscle The papillary muscles are muscles located in the ventricles of the heart. They attach to the cusps of the atrioventricular valves (also known as the mitral and tricuspid valves) via the chordae tendineae and contract to prevent inversion or prol ...
s, give origin at their apices to the
chordae tendinae The chordae tendineae (tendinous cords), colloquially known as the heart strings, are inelastic cords of fibrous connective tissue that connect the papillary muscles to the tricuspid valve and the mitral valve in the heart. Structure The chordae ...
which attach to the cusps of the
tricuspid valve The tricuspid valve, or right atrioventricular valve, is on the right dorsal side of the mammalian heart, at the superior portion of the right ventricle. The function of the valve is to allow blood to flow from the right atrium to the right vent ...
and to the
mitral valve The mitral valve (), also known as the bicuspid valve or left atrioventricular valve, is one of the four heart valves. It has two cusps or flaps and lies between the left atrium and the left ventricle of the heart. The heart valves are all one-w ...
. The mass of the left ventricle, as estimated by
magnetic resonance imaging Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio wave ...
, averages 143 g ± 38.4 g, with a range of 87––224 g. The right ventricle is equal in size to the left ventricle and contains roughly 85 millilitres (3 imp fl oz; 3 US fl oz) in the adult. Its upper front surface is circled and convex, and forms much of the
sternocostal The sternocostal joints, also known as sternochondral joints or costosternal articulations, are synovial plane joints of the costal cartilages of the true ribs with the sternum. The only exception is the first rib, which has a synchondrosis jo ...
surface of the heart. Its under surface is flattened, forming part of the diaphragmatic surface of the heart that rests upon the diaphragm. Its posterior wall is formed by the
ventricular septum The interventricular septum (IVS, or ventricular septum, or during development septum inferius) is the stout wall separating the ventricles, the lower chambers of the heart, from one another. The ventricular septum is directed obliquely backwar ...
, which bulges into the right ventricle, so that a transverse section of the cavity presents a semilunar outline. Its upper and left angle forms a conical pouch, the
conus arteriosus The infundibulum (also known as ''conus arteriosus'') is a conical pouch formed from the upper and left angle of the right ventricle in the chordate heart, from which the pulmonary trunk arises. It develops from the bulbus cordis. Typically, the i ...
, from which the pulmonary artery arises. A tendinous band, called the tendon of the conus arteriosus, extends upward from the right atrioventricular fibrous ring and connects the posterior surface of the conus arteriosus to the aorta.


Shape

The left ventricle is longer and more conical in shape than the right, and on transverse section its concavity presents an oval or nearly circular outline. It forms a small part of the sternocostal surface and a considerable part of the diaphragmatic surface of the heart; it also forms the apex of the heart. The left ventricle is thicker and more muscular than the right ventricle because it pumps blood at a higher pressure. The right ventricle is triangular in shape and extends from the tricuspid valve in the right atrium to near the
apex of the heart The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide to t ...
. Its wall is thickest at the apex and thins towards its base at the atrium. When viewed via cross section however, the right ventricle seems to be crescent shaped.Haddad F, Couture P, Tousignant C, Denault AY. The right ventricle in cardiac surgery, a perioperative perspective: I. Anatomy, physiology, and assessment. Anesth Analg. 2009;108(2):407-21. doi:10.1213/ane.0b013e31818f8623. The right ventricle is made of two components: the sinus and the conus. The Sinus is the inflow which flows away from the tricuspid valve. Haddad F, Couture P, Tousignant C, Denault AY. The right ventricle in cardiac surgery, a perioperative perspective: I. Anatomy, physiology, and assessment. ''Anesth Analg''. 2009;108(2):407-21. doi:10.1213/ane.0b013e31818f8623. Three bands made from muscle, separate the right ventricle: the parietal, the septal, and the moderator band. The moderator band connects from the base of the anterior papillary muscle to the ventricular septum.


Development

By early maturity, the walls of the left ventricle have thickened from three to six times greater than that of the right ventricle. This reflects the typical five times greater pressure workload this chamber performs while accepting blood returning from the pulmonary veins at ~80mmHg pressure (equivalent to around 11 kPa) and pushing it forward to the typical ~120mmHg pressure (around 16.3 kPa) in the aorta during each heartbeat. (The pressures stated are resting values and stated as relative to surrounding atmospheric which is the typical "0" reference pressure used in medicine.)


Function

During
systole Systole ( ) is the part of the cardiac cycle during which some chambers of the heart contract after refilling with blood. The term originates, via New Latin, from Ancient Greek (''sustolē''), from (''sustéllein'' 'to contract'; from ''sun ...
, the ventricles contract, pumping blood through the body. During
diastole Diastole ( ) is the relaxed phase of the cardiac cycle when the chambers of the heart are re-filling with blood. The contrasting phase is systole when the heart chambers are contracting. Atrial diastole is the relaxing of the atria, and ventric ...
, the ventricles relax and fill with blood again. The left ventricle receives oxygenated blood from the
left atrium The atrium ( la, ātrium, , entry hall) is one of two upper chambers in the heart that receives blood from the circulatory system. The blood in the atria is pumped into the heart ventricles through the atrioventricular valves. There are two atr ...
via the
mitral valve The mitral valve (), also known as the bicuspid valve or left atrioventricular valve, is one of the four heart valves. It has two cusps or flaps and lies between the left atrium and the left ventricle of the heart. The heart valves are all one-w ...
and pumps it through the
aorta The aorta ( ) is the main and largest artery in the human body, originating from the left ventricle of the heart and extending down to the abdomen, where it splits into two smaller arteries (the common iliac arteries). The aorta distributes ...
via the
aortic valve The aortic valve is a valve in the heart of humans and most other animals, located between the left ventricle and the aorta. It is one of the four valves of the heart and one of the two semilunar valves, the other being the pulmonary valve. The ...
, into the systemic circulation. The left ventricular muscle must relax and contract quickly and be able to increase or lower its pumping capacity under the control of the nervous system. In the diastolic phase, it has to relax very quickly after each contraction so as to quickly fill with the oxygenated blood flowing from the
pulmonary vein The pulmonary veins are the veins that transfer oxygenated blood from the lungs to the heart. The largest pulmonary veins are the four ''main pulmonary veins'', two from each lung that drain into the left atrium of the heart. The pulmonary vei ...
s. Likewise in the systolic phase, the left ventricle must contract rapidly and forcibly to pump this blood into the aorta, overcoming the much higher aortic pressure. The extra pressure exerted is also needed to stretch the aorta and other arteries to accommodate the increase in blood volume. The right ventricle receives deoxygenated blood from the right atrium via the
tricuspid valve The tricuspid valve, or right atrioventricular valve, is on the right dorsal side of the mammalian heart, at the superior portion of the right ventricle. The function of the valve is to allow blood to flow from the right atrium to the right vent ...
and pumps it into the pulmonary artery via the
pulmonary valve The pulmonary valve (sometimes referred to as the pulmonic valve) is a valve of the heart that lies between the right ventricle and the pulmonary artery and has three cusps. It is one of the four valves of the heart and one of the two semilunar va ...
, into the pulmonary circulation.


Pumping volume

The typical healthy adult heart pumping volume is ~5 liters/min, resting. Maximum capacity pumping volume extends from ~25 liters/min for non-athletes to as high as ~45 liters/min for Olympic level athletes.


Volumes

In
cardiology Cardiology () is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart d ...
, the performance of the ventricles are measured with several volumetric parameters, including
end-diastolic volume In cardiovascular physiology, end-diastolic volume (EDV) is the volume of blood in the right or left ventricle at end of filling in diastole which is ammount of blood present in ventricle at the end of diastole systole. Because greater EDVs cause ...
(EDV),
end-systolic volume End-systolic volume (ESV) is the volume of blood in a ventricle at the end of contraction, or systole, and the beginning of filling, or diastole Diastole ( ) is the relaxed phase of the cardiac cycle when the chambers of the heart are re-fil ...
(ESV),
stroke volume In cardiovascular physiology, stroke volume (SV) is the volume of blood pumped from the left ventricle per beat. Stroke volume is calculated using measurements of ventricle volumes from an echocardiogram and subtracting the volume of the blood i ...
(SV) and
ejection fraction An ejection fraction (EF) is the volumetric fraction (or portion of the total) of fluid (usually blood) ejected from a chamber (usually the heart) with each contraction (or heartbeat). It can refer to the cardiac atrium, ventricle, gall bladder, ...
(Ef).


Pressures

Ventricular pressure is a measure of
blood pressure Blood pressure (BP) is the pressure of circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term "blood pressure" r ...
within the ventricles of the
heart The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide t ...
.


Left

During most of the
cardiac cycle The cardiac cycle is the performance of the human heart from the beginning of one heartbeat to the beginning of the next. It consists of two periods: one during which the heart muscle relaxes and refills with blood, called diastole, following ...
, ventricular pressure is less than the pressure in the
aorta The aorta ( ) is the main and largest artery in the human body, originating from the left ventricle of the heart and extending down to the abdomen, where it splits into two smaller arteries (the common iliac arteries). The aorta distributes ...
, but during
systole Systole ( ) is the part of the cardiac cycle during which some chambers of the heart contract after refilling with blood. The term originates, via New Latin, from Ancient Greek (''sustolē''), from (''sustéllein'' 'to contract'; from ''sun ...
, the ventricular pressure rapidly increases, and the two pressures become equal to each other (represented by the junction of the blue and red lines on the diagram on this page), the
aortic valve The aortic valve is a valve in the heart of humans and most other animals, located between the left ventricle and the aorta. It is one of the four valves of the heart and one of the two semilunar valves, the other being the pulmonary valve. The ...
opens, and blood is pumped to the body. Elevated left ventricular end-diastolic pressure has been described as a risk factor in cardiac surgery. Noninvasive approximations have been described. An elevated pressure difference between the
aortic pressure Central aortic blood pressure (CAP or CASP) is the blood pressure at the root of aorta. Studies have shown the importance of central aortic pressure and its implications in assessing the efficacy of antihypertensive treatment with respect to cardi ...
and the left ventricular pressure may be indicative of
aortic stenosis Aortic stenosis (AS or AoS) is the narrowing of the exit of the left ventricle of the heart (where the aorta begins), such that problems result. It may occur at the aortic valve as well as above and below this level. It typically gets worse ov ...
.


Right

Right ventricular pressure demonstrates a different pressure-volume loop than left ventricular pressure.


Dimensions

The heart and its performance are also commonly measured in terms of ''dimensions'', which in this case means
one-dimensional In physics and mathematics, a sequence of ''n'' numbers can specify a location in ''n''-dimensional space. When , the set of all such locations is called a one-dimensional space. An example of a one-dimensional space is the number line, where the ...
distances, usually measured in millimeters. This is not as informative as volumes but may be much easier to estimate with (e.g.,
M-Mode echocardiography Medical ultrasound includes diagnostic techniques (mainly imaging techniques) using ultrasound, as well as therapeutic applications of ultrasound. In diagnosis, it is used to create an image of internal body structures such as tendons, muscl ...
or with
sonomicrometry Sonomicrometry is a technique of measuring the distance between piezoelectric crystals based on the speed of acoustic signals through the medium they are embedded in. Typically, the crystals will be coated with an epoxy 'lens' and placed into the ...
, which is mostly used for animal model research). Optimally, it is specified with which plane the distance is measured in, e.g. the dimension of the longitudinal plane. Fractional shortening (FS) is the
fraction A fraction (from la, fractus, "broken") represents a part of a whole or, more generally, any number of equal parts. When spoken in everyday English, a fraction describes how many parts of a certain size there are, for example, one-half, eight ...
of any diastolic dimension that is lost in systole. When referring to endocardial luminal distances, it is EDD minus ESD divided by EDD (times 100 when measured in percentage). Normal values may differ somewhat dependent on which
anatomical plane An anatomical plane is a hypothetical plane used to transect the body, in order to describe the location of structures or the direction of movements. In human and animal anatomy, three principal planes are used: * The sagittal plane or lateral ...
is used to measure the distances. Normal range is 25–45%, Mild is 20–25%, Moderate is 15–20%, and Severe is <15%. Cardiology Diagnostic Tests Midwall fractional shortening may also be used to measure diastolic/systolic changes for inter-ventricular septal dimensions and posterior wall dimensions. However, both endocardial and midwall fractional shortening are dependent on myocardial wall thickness, and thereby dependent on long-axis function. By comparison, a measure of short-axis function termed epicardial volume change (EVC) is independent of myocardial wall thickness and represents isolated short-axis function.


Clinical significance

An
arrhythmia Arrhythmias, also known as cardiac arrhythmias, heart arrhythmias, or dysrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow. A resting heart rate that is too fast – above 100 beats per minute in adults ...
is an
irregular heartbeat Arrhythmias, also known as cardiac arrhythmias, heart arrhythmias, or dysrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow. A resting heart rate that is too fast – above 100 beats per minute in adults ...
that can occur in the ventricles or atria. Normally the heartbeat is initiated in the
SA node The sinoatrial node (also known as the sinuatrial node, SA node or sinus node) is an oval shaped region of special cardiac muscle in the upper back wall of the right atrium made up of cells known as pacemaker cells. The sinus node is approximat ...
of the atrium but initiation can also occur in the
Purkinje fibres The Purkinje fibers (; often incorrectly ; Purkinje tissue or subendocardial branches) are located in the inner ventricular walls of the heart, just beneath the endocardium in a space called the subendocardium. The Purkinje fibers are specia ...
of the ventricles, giving rise to premature ventricular contractions, also called ventricular extra beats. When these beats become grouped the condition is known as
ventricular tachycardia Ventricular tachycardia (V-tach or VT) is a fast heart rate arising from the lower chambers of the heart. Although a few seconds of VT may not result in permanent problems, longer periods are dangerous; and multiple episodes over a short period ...
. Another form of arrhythmia is that of the
ventricular escape beat In cardiology, a ventricular escape beat is a self-generated electrical discharge initiated by, and causing contraction of the ventricles of the heart; normally the heart rhythm is begun in the atria of the heart and is subsequently transmitted ...
. This can happen as a compensatory mechanism when there is a problem in the conduction system from the SA node. The most severe form of arrhythmia is
ventricular fibrillation Ventricular fibrillation (V-fib or VF) is an abnormal heart rhythm in which the ventricles of the heart quiver. It is due to disorganized electrical activity. Ventricular fibrillation results in cardiac arrest with loss of consciousness and no p ...
which is the most common cause of
cardiac arrest Cardiac arrest is when the heart suddenly and unexpectedly stops beating. It is a medical emergency that, without immediate medical intervention, will result in sudden cardiac death within minutes. Cardiopulmonary resuscitation (CPR) and possib ...
and subsequent sudden death. *
Ventricular septal defect A ventricular septal defect (VSD) is a defect in the ventricular septum, the wall dividing the left and right ventricles of the heart. The extent of the opening may vary from pin size to complete absence of the ventricular septum, creating one ...
*
Atrioventricular septal defect Atrioventricular septal defect (AVSD) or atrioventricular canal defect (AVCD), also known as "common atrioventricular canal" (CAVC) or "endocardial cushion defect" (ECD), is characterized by a deficiency of the atrioventricular septum of the heart ...


See also

*
Wiggers diagram A Wiggers diagram, named after its developer, Carl Wiggers, is a unique diagram that has been used in teaching cardiac physiology for more than a century. In the Wiggers diagram, the X-axis is used to plot time subdivided into the cardiac phases ...


References


External links


Photo of dissection at uc.edu

Left Ventricle – Cell Centered Database
* {{DEFAULTSORT:Ventricle (Heart) Cardiac anatomy Cardiovascular physiology