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The chordae tendineae are collagen-rich tensile cords connecting valve leaflets of the mitral valve and tricuspid valve to papillary muscles. Their tension helps restrain the leaflets against displacement toward an atrium during ventricular systole. They are supports for pressure-loaded leaflets, rather than muscles that pull the valves open. The aortic valve and pulmonary valve do not have this chordal apparatus.^[ref]

An original static model shows why the arrangement matters. Suppose a leaflet attachment experiences a resultant force $F=\Delta pA$ from a pressure difference $\Delta p$ acting over effective area $A$. Two equal tethers each carry tension $T$ at angle $\theta$ to the load axis. Their transverse components cancel and their axial components balance the load:A stipulated $\Delta p=10$ kPa over $A=1$ cm${}^2$ gives $F=1$ N. Changing $\theta$ from $30^{\circ }$ to $60^{\circ }$ raises each tether's tension from about $0.577$ to $1$ N without changing the pressure load.

A primary experiment tested the related geometrical question in a left-heart simulator. Force transducers measured selected chordae tendineae while the positions of papillary muscles were changed. Different chordal types responded differently.^[ref] Real leaflets distribute loading among many attachments, so the two-tether model explains a mechanism without supplying a universal chordal force. Material behavior, geometry and the timing of ventricular contraction remain separate inputs.

The pulmonary trunk is the common artery leaving the right ventricle through the pulmonary valve before dividing into the vessels supplying the two lungs. It is the initial shared segment of the pulmonary artery route in the pulmonary circulation. The name artery describes flow away from the heart; the blood in the pulmonary trunk has not yet acquired oxygen in the lungs.^[ref]

At a junction with negligible storage, conservation of mass givesA constructed total blood flow of $5$ L/min could therefore divide into $3$ and $2$ L/min. Measuring the total does not establish equal flow to the two lungs. In a simple steady model with a common upstream and downstream pressure, branch blood flow rates depend on their respective vascular resistance values; the shared inlet does not force the resistances to be equal.

The pulmonary trunk also supplies an important distinction between two measurements. Right ventricular ejection fraction describes change in a chamber volume, whereas forward blood flow in the pulmonary trunk describes transport through a vessel. They agree through stroke volume and heart rate only under the relevant balance assumptions, including negligible backward flow. An anatomical connection is therefore the starting point for a flow model, rather than a substitute for its assumptions.

The pulmonary valve is the heart valve between the right ventricle and pulmonary trunk. During forward ventricular ejection it allows blood to enter the pulmonary circulation; closure limits return from the pulmonary trunk into the relaxing right ventricle.^[ref]

Its pocket-like cusps respond to the changing pressure difference. Unlike the tricuspid valve, the pulmonary valve has no attached chordae tendineae or papillary muscles.^[ref] Thus the same direction-control task is achieved by different supporting structures at the chamber inlet and outlet.

A deliberately idealized valve model sets forward blood flow to zero when the downstream pressure exceeds the upstream pressure, and permits positive flow when ventricular pressure exceeds trunk pressure. This model captures direction but omits the inertia and deformation of real cusps. It is useful for checking the sign of a flow term, not for predicting an exact opening time.

For example, if a constructed cycle sends 80 mL forward and 10 mL backward across the pulmonary valve, net transport is 70 mL. Counting only the positive part of blood flow overestimates net delivery. This is why stroke volume inferred from changing chamber volume and net forward flow in the pulmonary trunk require compatible assumptions about valve function.

The right ventricle is the heart chamber receiving blood from the right atrium through the tricuspid valve and ejecting it through the pulmonary valve into the pulmonary trunk.^[ref] Its output enters the pulmonary circulation rather than passing directly into the aorta.

The chamber's volume changes through the cardiac cycle. Define stroke volume as end-diastolic minus end-systolic volume:The second ratio is the right ventricular ejection fraction. In an original example with $V_{\mathrm{ED}}=100\mathrm{mL}$ and $V_{\mathrm{ES}}=40\mathrm{mL}$, stroke volume is $60\mathrm{mL}$ and ejection fraction $0.60$. At $70$ beats per minute, multiplying stroke volume by rate gives $4.2\mathrm{L}\mathrm{mi}{\mathrm{n}}^{-1}$.

That last conversion represents net forward output only under its stated assumptions. Significant backward or alternate flow can separate chamber-volume displacement from the amount delivered onward. Nor does an ejection fraction alone provide the chamber's absolute output: chambers with different initial volumes can share the same fraction.

In a steady serial-circulation model without shunts or sustained storage, right- and left-sided net outputs must balance. A persistent difference would accumulate blood somewhere in the system. This conservation statement does not require the two ventricles to generate equal pressure or perform identical mechanical work. Anatomy, volume displacement, forward flow and pressure are distinct but connected observations.

Right ventricular ejection fraction is the fraction of the right ventricle's end-diastolic volume that leaves its cavity during systole. If $V_{\mathrm{ED}}$ is the filled volume and $V_{\mathrm{ES}}$ the residual end-systolic volume,where $\mathrm{SV}$ is stroke volume. It is a dimensionless ratio, usually reported as a percentage. The filling and ejection phases must refer to the same cardiac cycle; the tricuspid valve and pulmonary valve determine the normal direction of blood flow.^[ref]

For example, $V_{\mathrm{ED}}=120$ mL and $V_{\mathrm{ES}}=60$ mL give $\mathrm{SV}=60$ mL and $\mathrm{RVEF}=50\%$. A second right ventricle with volumes 200 and 100 mL also has $50\%$ right ventricular ejection fraction, but its stroke volume is 100 mL. A fraction describes emptying relative to the initial volume; it does not specify an absolute cardiac output.

A practical volumetric approach uses magnetic resonance imaging at multiple phases and image segmentation to estimate the two cavity volumes.^[ref] Consistent boundary choices matter because two measurements enter one ratio. For small volume errors, direct differentiation givesShared boundary errors need not act like independent errors. Moreover, cavity volume loss includes any backward flow through an incompetent tricuspid valve; the formula alone does not prove that all of the calculated stroke volume reached the pulmonary trunk.

The tricuspid valve is the right atrioventricular heart valve, between the right atrium and right ventricle. It permits filling from the right atrium and limits backward blood flow during ventricular contraction.^[ref]

The leaflets are supported by chordae tendineae attached to papillary muscles. Rising ventricular pressure brings the leaflets together; tension in the supporting apparatus helps prevent their displacement into the right atrium. The papillary muscles do not need to pull the leaflets open to initiate filling.^[ref]

A useful mechanical analogy is a pressure-loaded flap restrained by tethers. The pressure difference supplies a load, while the tethers limit how far the flap can move. The analogy distinguishes the role of the chordae tendineae from the action of a motorized door.

The valve also determines how to interpret right ventricular ejection fraction. Suppose a constructed ventricular contraction reduces cavity volume by 80 mL, but 20 mL of that loss returns through the tricuspid valve into the right atrium. Only 60 mL remains for forward transport through the pulmonary valve, if other transfers are negligible. The measured cavity-volume change is still 80 mL. An ejection fraction calculated from chamber volumes therefore does not by itself measure the useful forward stroke volume of the pulmonary circulation.

A valve leaflet is a mobile tissue flap forming part of a heart valve. Its movement and contact with neighboring leaflets help permit forward blood flow while limiting backward flow. The supporting cardiac valve annulus, the pressure difference and the leaflet's geometry all contribute to its behavior. The meeting of leaflet surfaces that closes a valve is called coaptation.^[ref]

The mitral valve and tricuspid valve have leaflets supported by chordae tendineae and papillary muscles. The aortic valve and pulmonary valve instead have pocket-like cusps without that chordal apparatus. A leaflet is therefore a functional part of a particular valve structure, not an isolated rigid door.

An original force estimate illustrates the loading scale. A uniform pressure difference $\Delta p$ over an effective area $A$ gives a resultant $F=\Delta pA$. For stipulated $\Delta p=12$ kPa and $A=2$ cm${}^2$, $F=2.4$ N. Doubling the area at the same pressure doubles this resultant, but it does not specify how the load is divided among attachments or distributed as tissue stress.

A primary left-heart simulator experiment measured chordae tendineae forces while moving papillary muscles and found responses that depended on the chordal type.^[ref] This gives a concrete reason to examine leaflet geometry and supporting connections together. Complete coaptation is a contact-and-motion condition; an accurate measurement of one chordal force does not by itself show that the entire valve seals.