092414 cardiac anatomy

Question 1

central venous pressure

Answer 1

pressure in right atrium, or pressure of blood going into right atrium from the rest of the body

Question 2

when you look at the heart on radiography, what should you look for?

Answer 2

heart-cardiac size, pulmonary vessels

mediastinum-hilar structures, position of trachea, aortic arch

heart should not be more than 1/2 diameter of thorax

Question 3

heart and aortic arch are where respective to the midline

Answer 3

left of midline

Question 4

aortic semilunar valve–heart valve sound is where?

Answer 4

intercostal space 2, to right of sternum

Question 5

pulmonary semilunar valve sound is where?

Answer 5

intercostal space 2, to left of sternum

Question 6

tricuspid valve sound is where?

Answer 6

lateral left to body of sternum below rib 5

Question 7

mitral valve sound is where?

Answer 7

apex of heart at intercostal space 5

Question 8

pneumonic for heart sounds

Answer 8

all patients take meds

Question 9

the pericardial sac is attached to what below?

Answer 9

diaphragm

Question 10

where do you have the brachiocephalic artery-on the right or left?

Answer 10

right

Question 11

pericardium’s 3 layers

Answer 11

visceral layer of serous pericardium
parietal layer of serous pericardium
fibrous pericardium-thick connective tissue layer

Question 12

visceral layer of serous pericardium is equivalent to

Answer 12

outer layer of epicardium

Question 13

left coronary artery branches into

Answer 13

left circumflex artery and anterior interventricular artery (left anterior descending artery/LAD)

Question 14

anterior interventricular artery travels with what vein

Answer 14

great cardiac vein

Question 15

right marginal branch of right coronary artery travels with

Answer 15

small cardiac vein

Question 16

posterior interventricular artery travels with

Answer 16

middle cardiac vein (posterior interventricular vein)

Question 17

paradoxical emboli

Answer 17

usually, you expect an embolus from the leg to be lodged in the lungs. however, paradoxical emboli occur if there’a shunt in the system that allows venous blood to go to the arterial side w/o passing lungs (ex is a patent foramen ovale)

Question 18

blood can have stasis where in the heart?

Answer 18

right auricle, creating clots

Question 19

moderator band

Answer 19

muscle that transmits conduction from some of the right bundle to the anterior papillary muscle

Question 20

where does the longest delay in the conduction of the heart

Answer 20

at the Av node

Question 21

does the pulmonary artery or the aortic artery have the anterior cusp?

Answer 21

pulmonary

Question 22

how to orient yourself with looking at the heart

Answer 22

look for coronary arteries-the aorta

Question 23

how do the coronary arteries get blood?

Answer 23

when diastole occurs-blood flows back into the coronary arteries

Question 24

Wigger diagram

Answer 24

study

Question 25

parasympathetic innerv to the heart has what kind of control

Answer 25

motor control over HR and SV

Question 26

sympathetic postganglion fibers to the heart come from what ganglia?

Answer 26

upper chain ganglia-3 cervical and T1-T5

Question 27

afferents from the heart enter the spinal cord where?

Answer 27

T1-T5

Question 28

cardiac plexus is located where and contains what

Answer 28

near tracheal bifurcation and ligamentum arteriosum contains vagus nerve branches and sympathetic nerves to the heart

Question 29

what portion of the heart can press against the esophagus?

Answer 29

left atrium

Question 30

sites of coronary artery occlusion in order of frequency

Answer 30

``` LAD-most frequent then right coronary artery circumflex branch of left coronary artery left coronary artery posterior interventricular branch marginal artery ```

Question 31

common causes of heart failure

Answer 31

``` myocardial infarction toxins (alcohol) HTN myocarditis idiopathic/genetic ```

Question 32

systolic dysfunction examples

Answer 32

post-MI primary dilated cardiomyopathy myocarditis thin heart muscle-not generating enough force

Question 33

diastolic dysfunction examples

Answer 33

hypertension hypertrophic cardiomyopathy restrictive cardiomyopathy aging significant ventricle hypertrophy--stroke volume is compromised b/c the space for filling is narrowed

Question 34

signs and symptoms of heart failure in the case of inadequate cardiac output

Answer 34

``` as a result of inadequate cardiac output: fatigue cool extremities mental obtundation organ dysfxn (kidneys, liver) ``` as a result of tissue congestion (due to elevated diastolic pressures): shortness of breath (dyspnea) swelling of legs (pedal edema) swelling of abdomen (ascites)

Question 35

if you have left sided heart congestion, what would you see?

Answer 35

lot of interstitial fluid in lungs; difficulty breathing orthopnea (difficulty breathing when lying flat)

Question 36

if you have right sided congestion in heart, what would you see

Answer 36

``` edema cyanosis enlarged jugular veins enlargement of liver, ascites elevated venous pressures ```