092414 cardiac anatomy Flashcards
central venous pressure
pressure in right atrium, or pressure of blood going into right atrium from the rest of the body
when you look at the heart on radiography, what should you look for?
heart-cardiac size, pulmonary vessels
mediastinum-hilar structures, position of trachea, aortic arch
heart should not be more than 1/2 diameter of thorax
heart and aortic arch are where respective to the midline
left of midline
aortic semilunar valve–heart valve sound is where?
intercostal space 2, to right of sternum
pulmonary semilunar valve sound is where?
intercostal space 2, to left of sternum
tricuspid valve sound is where?
lateral left to body of sternum below rib 5
mitral valve sound is where?
apex of heart at intercostal space 5
pneumonic for heart sounds
all patients take meds
the pericardial sac is attached to what below?
diaphragm
where do you have the brachiocephalic artery-on the right or left?
right
pericardium’s 3 layers
visceral layer of serous pericardium
parietal layer of serous pericardium
fibrous pericardium-thick connective tissue layer
visceral layer of serous pericardium is equivalent to
outer layer of epicardium
left coronary artery branches into
left circumflex artery and anterior interventricular artery (left anterior descending artery/LAD)
anterior interventricular artery travels with what vein
great cardiac vein
right marginal branch of right coronary artery travels with
small cardiac vein
posterior interventricular artery travels with
middle cardiac vein (posterior interventricular vein)
paradoxical emboli
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)
blood can have stasis where in the heart?
right auricle, creating clots
moderator band
muscle that transmits conduction from some of the right bundle to the anterior papillary muscle
where does the longest delay in the conduction of the heart
at the Av node
does the pulmonary artery or the aortic artery have the anterior cusp?
pulmonary
how to orient yourself with looking at the heart
look for coronary arteries-the aorta
how do the coronary arteries get blood?
when diastole occurs-blood flows back into the coronary arteries
Wigger diagram
study
parasympathetic innerv to the heart has what kind of control
motor control over HR and SV
sympathetic postganglion fibers to the heart come from what ganglia?
upper chain ganglia-3 cervical and T1-T5
afferents from the heart enter the spinal cord where?
T1-T5
cardiac plexus is located where and contains what
near tracheal bifurcation and ligamentum arteriosum
contains vagus nerve branches and sympathetic nerves to the heart
what portion of the heart can press against the esophagus?
left atrium
sites of coronary artery occlusion in order of frequency
LAD-most frequent then right coronary artery circumflex branch of left coronary artery left coronary artery posterior interventricular branch marginal artery
common causes of heart failure
myocardial infarction toxins (alcohol) HTN myocarditis idiopathic/genetic
systolic dysfunction examples
post-MI
primary dilated cardiomyopathy
myocarditis
thin heart muscle-not generating enough force
diastolic dysfunction examples
hypertension
hypertrophic cardiomyopathy
restrictive cardiomyopathy
aging
significant ventricle hypertrophy–stroke volume is compromised b/c the space for filling is narrowed
signs and symptoms of heart failure in the case of inadequate cardiac output
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)
if you have left sided heart congestion, what would you see?
lot of interstitial fluid in lungs; difficulty breathing
orthopnea (difficulty breathing when lying flat)
if you have right sided congestion in heart, what would you see
edema cyanosis enlarged jugular veins enlargement of liver, ascites elevated venous pressures
