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*Barash > 1 - Cardiac Anatomy > Flashcards

1 - Cardiac Anatomy Flashcards

1
Q

What determines the mechanical capacity of the heart? (5)

A
  1. Cartilaginous skeleton
  2. Fibers
  3. Valves
  4. Coronary blood supply
  5. Conduction system
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2
Q

This provides a useful framework for the analysis of atrial and ventricular systolic and diastolic function.

A

Pressure-volume diagram

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3
Q

Determines the pump performance (4)

A
  1. Heart rate
  2. Preload
  3. Afterload
  4. Myocardial contractility
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4
Q

Is the external resistance to chamber emptying after contraction begins and the aortic valve opens.

A

Afterload

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5
Q

Amount of blood that a chamber contains immediately before contraction.

A

Preload

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6
Q

Is the force of contraction under controlled heart rate and loading conditions

A

Myocardial contractility

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7
Q

Contractility may be quantified using the fall (3)

A
  1. Pressure-volume relation
  2. Isovolumic contraction
  3. Ejection phase analysis
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8
Q

What defines the diastolic function?

A

The ability of a cardiac chamber to effectively collect blood at a normal filling pressure

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9
Q

The atria contains what type of myocardium?

A

Thin orthogonal bands

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10
Q

The LV and RV contain what types of muscle layers (3)

A
  1. Deep sinospiral
  2. Superficial sinospiral
  3. Superficial bulbs spiral
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11
Q

How are the myocardial fibers of the LV are arranged (3)?

A
  1. Perpendicular
  2. Oblique
  3. Helical
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12
Q

How are midmyocardial fibers arranged?

A

Circumferential

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13
Q

These are irregular ridges of the sudendocardium present within the RV chamber and to a lesser extent the LV apex.

A

Trabeculae carnae

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14
Q

True or False

The LV apex and interventricular septum are relatively fixed in space within the mediastinum during contraction and relaxation.

A

True

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15
Q

LV’s lateral and posterior walls shifts movement towards which position during systole?

A

Anterior and to the right

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16
Q

Movement of which side of the heart is responsible for the point of maximal intensity?

A

Lateral and posterior LV walls

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17
Q

The crescent-shaped R is located in reference to the LV?

A

Anterior

Right

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18
Q

Are dilated segments of the aortic root immediately superior to each aortic leaflet.

A

Sinuses of Valsalva

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19
Q

Act as restricting cables to limit the superior motion of the mitral leaflets, facilitating their computation

A

Chordae tendinae

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20
Q

Common cause of mitral regurgitation

A

Chordal rupture

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21
Q

Are composed of subendocardial myocardium that contract with the LV.

A

Papillary muscles

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22
Q

Lateral segment of myocardium stretching between the apical aspects of anterior & septal papillary muscles

A

Moderator band

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23
Q

Which valve does not have a collagenous annulus?

A

Tricuspid valve

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24
Q

This morphology distinguishes the RV from LV.

A

Septal papillary muscle

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25
Q

What is the structure that is found in the mitral valve and which is not found in the tricuspid valve?

A

Collagenous annulus

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26
Q

What is lies in the attioventricular groove that must be carefully avoided during tricuspid valve repair or replacement?

A

Proximal right coronary artery

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27
Q

CORONARY BLOOD SUPPLY

What supplies blood to the LV? (3)

A
  1. LAD
  2. LCCA
  3. RCA
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28
Q

Most coronary blood flow to the “LV” occur during which part of the cardiac cycle?

A

Diastole

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29
Q

LAD supply which part of the myocardium? (3)

A
  1. Medial LV anterior wall
  2. Anterior 2/3rds of the interventricular septum
  3. LV apex
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30
Q

The LCCA and its marginal branches supply which part of the myocardium?

A

Anterior and posterior aspects of the lateral wall

31
Q

RCA provides blood flow to the? (2)

A
  1. Medial posterior wall

2. Posterior 1/3rd of interventricular septum

32
Q

What determines the dominance of the coronary circulation?

A

The major coronary vessel that feeds the posterior descending coronary artery.

33
Q

Coronary blood flow to the RA, RV & LA OCCUR during which part of the cardiac cycle?

A

Systole and diastole

34
Q

The RCA supply blood flow to the?

A

RV

35
Q

What are the major sources of blood supply to the LA?

A

LCCA

36
Q

What supplies the RA?

A

RCA & LCCA

37
Q

3 cardiac veins

A
  1. Great cardiac vein
  2. Anterior cardiac vein
  3. Middle cardiac vein
38
Q

Approximately 85% of total coronary blood flow empty into the into the coronary sinus. Where does the 15% drain?

A

Thebesian veins

39
Q

The capillary to myobril ratio is?

A

1:1

40
Q

A branch of the anterior intermodal pathways rapidly transmits the SA node depolarization to the LA node.

A

Bachman’s bundle

41
Q

This node is responsible for the sequential contraction pattern of the atria and the ventricles.

A

AV node

42
Q

This troponin when combined with tropomyosin becomes the primary inhibitor of actin-myosin binding.

A

Troponin T

43
Q

This troponin binds with other troponins. Is the largest of the troponin proteins.

A

Troponin T

44
Q

Removes most of the Ca ions from the myofilaments and cytosol after membrane depolarization.

A

SERCA (SR Ca ATPase)

45
Q

This partially inhibits the dominant cardiac SERCA

A

Phospholamban

46
Q

What is the rate limiting step of myosin ATPase?

A

Dissociation of ADP and phosphate from myosin.

47
Q

Is an autoregulation method in which myocardial contractility increases with afterload.

A

Anrep effect

48
Q

The effect exhibited by skeletal and heart muscle when subjected to rapidly repeated maximal stimuli following a period of rest. In the resulting series of contractions, each is greater than the preceding one until a state of maximum contraction is reached.

A

Woodworth (staircase) phenomenon

49
Q

Is an autoregulation method by which myocardial tension increases with an increase in heart rate.

A

Treppe or Bowditch effect

50
Q

Three major phases of LV systole (3)

A
  1. Isovolumic contraction
  2. Rapid ejection
  3. Slower ejection phases
51
Q

The S2 is normally split because what valve closes slightly after?

A

Pulmonic valve

52
Q

4 phases of LV diastole

A
  1. Isovolumic relaxation
  2. Early ventricular filling
  3. Diastasis
  4. Atrial systole
53
Q

Which risk factor causes delay in LV relaxation? (2)

A
  1. Age

2. Cardiac disease

54
Q

Atrial systole how much % of stroke volume?

A

15 - 25%

55
Q

LA contraction waves (3)

A

a: LA contraction
c: a second small increase in LA pressure due to the onset of LV contraction due to mitral valve closure
v: LA filling during LV systole, enhanced during mitral regurgitation

56
Q

Stroke volume formula and normal value?

A

EDV - ESV

80 mL

57
Q

Formula for

EF?

A

SV / EDV

67%

58
Q

Normal value of

ESV?
EDV?

A

40 mL

120 mL

59
Q

Four components determine LV afterload?

A
  1. Size and mechanical behavior of arterial blood
  2. Terminal arteriolar vasomotor tone
  3. LV end-systolic wall stress
  4. Physical properties and volume of blood
60
Q

Defined as the ratio of continuous aortic pressure to blood flow.

A

Input impedance

61
Q

This is the most common clinical estimate of LV afterload.

What is its formula?

A

Systemic vascular resistance.

MAP - R arterial pressure

62
Q

What is the most important objective in the clinical management of heart failure?

A

Decreasing LV afterload by reducing the inciting stress.

63
Q

Who are at risk of developing heart failure with normal ejection fraction or diastolic heart failure? (6)

A
  1. Hypertensive
  2. Elderly women
  3. Obese
  4. Renal insufficiency
  5. Anemic
  6. Atrial fibrillation
64
Q

Is the duration of aortic valve closure to mitral valve opening. A commonly used noninvasive index of LV relaxation that is usually measured using M-mode.

A

Isovolumic relaxation time

65
Q

What are the two peaks of transmitral blood flow velocity?

A

E peak: associated with early LV filling

A peak: LA systole

66
Q

The time elapsed as the E wave velocity declines from its value to zero is known as?

A

Deceleration time

67
Q

True or false IVRT, deceleration and A wave increase with age whereas E wave velocity and E/A ratio decrease.

The aging heart becomes less compliant.

A

True

68
Q

Is a pulmonary venous blood velocity wave that occurs while the mitral valve is closed. This wave results from LA relaxation, which stimulates forward movement of blood from the pulmonary veins into the LA.

A

S (systolic) wave

69
Q

Is pulmonary blood flow velocity deflection occurs as the mitral valve opens, blood stored in the LA during LV systole enters the LV, which allows additional blood flow to the LV. This causes the 2nd positive deflection.

A

D (diastolic wave)

70
Q

Pericardium content (4)

A
  1. Heart
  2. Vena cava
  3. Proximal great vessels
  4. Pulmonary veins
71
Q

Pericardial fluid contents (3)

A
  1. Plasma ultrafiltrate
  2. Lymph
  3. Myocardial interstitial fluid
72
Q

Total volume of pericardial interstitial fluid.

A

15 to 35 mL

73
Q

Which structure is being restrained by the pericardium because these structures have low pressures and thinner walls? (2)

A
  1. RA

2. RV

74
Q

Is the influence of the pressure and volume of one ventricle on the function of the other.

A

Ventricular interdependence

*Barash (16 decks)

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