2. The chordae tendineae are fine fibrous cords which fasten the cusps to the musculi papillares and ventricular wall, and prevent the valve being turned inside out when the ventricle contracts.
3. The columnae carneae are fleshy columns, and are of three kinds. The first are attached to the wall of the ventricle in their whole length and are merely sculptured in relief, as it were; the second are attached by both ends and are free in the middle; while the third are known as the musculi papillares and are attached by one end to the ventricular wall, the other end giving attachment to the chordae tendineae. These musculi papillares are grouped into three bundles (fig. 2, o).
4. The moderator band is really one of the second kind of columnae carneae which stretches from the septal to the anterior wall of the ventricle.
5. The pulmonary valve (fig. 2, p) at the opening of the pulmonary artery has three crescentic, pocket-like cusps, which, when the ventricle is filling, completely close the aperture, but during the contraction of the ventricle fit into three small niches known as the sinuses of Valsalva, and so are quite out of the way of the escaping blood. In the middle of the free margin of each is a small knob called the corpus Arantii (fig. 2, q), and on each side of this a thin crescent-shaped flap, the lunula (fig. 2, r), which is only made of two layers of endocardium, whereas in the rest of the cusp there is a fibrous backing between these two layers.
The left auricle is situated at the back of the base of the heart, behind and to the left of the right auricle. Running down behind it are the oesophagus and the thoracic aorta. When it is opened it is seen to have a much lighter colour than the other cavities, owing to the greater thickness of its endocardium obscuring the red muscle beneath. There are no musculi pectinati except in the auricular appendage. The openings of the four pulmonary veins are placed two on each side of the posterior wall, but sometimes there may be three on the right side, and only one on the left. On the septal wall is a small depression like the mark of a finger-nail, which corresponds to the anterior part of the fossa ovalis and often forms a valvular communication with the right auricle. The auriculo-ventricular orifice is large and oval, and is directed downward and to the left. Foramina Thebesii and venae minimae cordis are found in this auricle, as in the right, although the chamber is one for arterial or oxidized blood.
At the lower part of the posterior surface of the unopened auricle, lying in the left auriculo-ventricular furrow, is the coronary sinus, which receives most of the veins returning the blood from the heart substance; these are the right and left coronary veins at each extremity and the posterior and left cardiac veins from below. One small vein, called the oblique vein of Marshall, runs down into it across the posterior surface of the auricle, from below the left lower pulmonary vein, and is of morphological interest.
The left ventricle is conical, the base being above, behind and to the right, while the apex corresponds to the apex of the heart and lies opposite the fifth intercostal space, 3½ in. from the mid line. The following structures are seen inside it:—
1. The mitral valve guarding the auriculo-ventricular opening has the same arrangement as the tricuspid, already described, save that there are only two cusps, named marginal and aortic, the latter of which is the larger.
2. The chordae tendineae and columnae carneae resemble those of the right ventricle, though there are only two bundles of musculi papillares instead of three. These are very large. A moderator band has been found as an abnormality (see J. Anat. and Phys. vol. xxx. p. 568).
3. The aortic valve has the same structure as the pulmonary, though the cusps are more massive. From the anterior and left posterior sinuses of Valsalva the coronary arteries arise. That part of the ventricle just below the aortic valve, corresponding to the infundibulum on the right, is known as the aortic vestibule.