248 DISEASES OF THE HOESE. 



ture, the aiiriculo-ventricular orifice, which is furnished with a 

 remarkable mechanism of valves, allowing the transmission of blood 

 from the auricles into the ventricles, but preventing a reverse course. 

 The ventricles are thick-walled cavities, forming the more massive 

 portion of the heart toward the apex. They are separated by a par- 

 tition, and are connected with the great arteries — ^the pulmonary 

 artery and the aorta — by which they send blood to all parts of the 

 body. At the mouth of the aorta and at the mouth of the pulmonary 

 artery is an arrangement of valves in each case which prevents the 

 reflux of blood into the ventricles. The anriculo-ventricular valve 

 in the left side is composed of two -flaps, hence it is called the 

 bicuspid valve; in the right side this valve has three flaps and is 

 called the tricuspid valve. The flaps which form these valves are 

 connected with a tendinous ring between the auricles and ventricles ; 

 and each flap of the auriculo-ventricular valves is supplied with 

 tendinous cords, which are attached to the free margin and under- 

 surf ace, so as to keep the valves tense when closed — a condition which 

 is produced by the shortening of muscular pillars with which the 

 cords are connected. The arterial openings, both on the right and 

 on the left side, are provided with three-flapped semilunar-shaped 

 valves, to prevent the regurgitation of blood when the ventricles 

 contract. The veins emptying into the auricles are not capable of 

 closure, but the posterior vena cava has an imperfect valve at its 

 aperture. 



The inner surface of the heart is lined by a serous membrane, the 

 endocardium, which is smooth and firmly adherent to the muscular 

 structure of the heart. This membrane is continuous with the lining 

 membrane of the blood vessels, and it enters into the formation of 

 the valves. 



The circulation through the heart is as follows : The venous blood 

 is carried into the right auricle by the anterior and posterior venaj 

 cavte. It then passes through the right auriculo-ventricular opening 

 into the right ventricle, thence through the pulmonary artery to the 

 lungs. It returns by the pulmonary veins to the left auricle, then is 

 forced through the auriculo-ventricular opening into the left ven- 

 tricle, which propels it through the aorta and its branches into the 

 system, the veins returning it again to the heart. The circulation, 

 therefore, is double, the pulmonary, or lesser, being performed by the 

 right side, and the systemic, or greater, by the left side. 



As the blood is forced through the heart by forcible contractions of 

 its muscular walls, it has the action of a force pump, and gives the 

 impulse at each beat, which we call the pulse— the dilatation of the 

 arteries throughout the system. The contraction of the auricles is 

 quickly followed by that of the ventricles, and then a slight pause 

 occurs ; this takes place in regular rhythmical order during health. 



