1 Cardiac Anatomy Flashcards

1
Q

What is a normal heart rate?

A

60-100 bpm

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2
Q

What is a normal ABP?

A

Arterial blood pressure; 120/80

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3
Q

What is a normal CVP? What does it estimate?

A

Central venous pressure; 2-6 (mean= 5)

**estimates right atrial pressure

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4
Q

What physical observation can be made in a patient with elevated CVP?

A

Jugular vein distension

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5
Q

What is a normal PAP? How is it measured?

A

Pulmonary arterial pressure; 25/10

**Measured via central line in internal jugular vein -> superior vena cava -> right atrium -> R ventricle -> pulmonary artery

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6
Q

What is a normal pulmonary wedge pressure? How is it measured?

A

Usually ~15

**Balloon inflated in pulmonary artery and “regurgitation pressure” measured (flow back from lungs)

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7
Q

What pressure is estimated by the pulmonary wedge? What could cause this to be elevated?

A

Left atrial pressure

**elevated in cardiac tamponade as blood fills the pericardium and allows less filling of the heart

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8
Q

On radiograph, how big should a patient’s heart be?

A

Less than half the greatest thoracic diameter (measured from inside the rib cage at its widest point near the diaphragm)

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9
Q

What is the most common part of the heart injured in a puncture wound to the right of the sternum? To the left?

A

To the right= right atrium

To the left= right ventricle

**the L ventricle has a small portion at the “front” of the heart but mostly wraps backward, the L atrium is completely posterior

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10
Q

What are the layers of the pericardium from superficial to deep?

A
  • fibrous pericardium **non-distendable
  • parietal layer of the serous pericardium
  • visceral layer of the serous pericardium (outer layer of epicardium)

**Note; pericardial “cavity” is capillary thin (potential space)

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11
Q

Describe the areas where you would hear sounds from all 4 heart valves

A
  • Aortic= intercostal space 2, right of sternum
  • Pulmonary= intercostal space 2, left of sternum
  • Tricuspid= just lateral to body of the sternum below rib 5
  • Mitral= apex of heart at intercostal space 5
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12
Q

How can breathing affect cardiac output?

A

Deep breathing can increase cardiac output as the diaphragm pulls down and relieves some pressure on the heart

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13
Q

Name these numbered vessels

**What is the long vessel coming down off of “1”?

A
  1. R brachiocephalic (internal thoracic/mammary coming off inferiorly)
  2. R subclavian
  3. R common carotid
  4. L common carotid
  5. L subclavian
  6. R coronary (note SA nodal branch coming off superiorly)
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14
Q

When do the coronary arteries perfuse the heart?

A

When the aortic valve is closed in diastole

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15
Q

Where is the anterior ventricular artery?

A

Also called the LAD; branches off the left coronary artery and passes inferiorly to perfuse the left ventricle

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16
Q

What are the branches of the left coronary artery?

A

The anterior interventricular branch (LAD) and circumflex artery

17
Q

What are the three most important vessel pairs perfusing the heart?

A
  1. Anterior interventricular artery (LAD) with the great cardiac vein
  2. R Marginal branch (off R coronary) with the small cardiac vein
  3. Posterior interventricular artery with the middle cardiac vein
18
Q

What are the 2 semilunar valves?

A

**3 leaflets;

  1. Aortic
  2. Pulmonary
19
Q

Where is the SA node located? AV node?

A

SA= where the superior vena cava and atrium meet (more external)

AV= where all the chambers of the heart meet (more internal; next to the fossa ovalis and opening of the coronary sinus)

20
Q

When do the mitral and tricuspid valves close?

A

Atrioventricular valves close very soon after systole begins during isovolumetric ventricular contraction (LUB)

21
Q

When do the aortic and pulmonary valves close?

A

Beginning of diastole (DUB)

22
Q

Describe the wiggers diagram

A
23
Q

What is the effect of parasympathetic innervation of the heart?

A

Motor control to decrease HR and SV

24
Q

What is the effect of sympathetic innervation of the heart?

A

Postganglionic fibers come from upper chain ganglia to the heart (3 cervical and T1-T5) to increase HR and SV

25
Q

Where do pain afferents coming from the heart enter the spinal cord?

A

T1-T5 (reason for referred pain at those dermatomes)

26
Q

What chamber of the heart has the capability of compressing the esophagus when it hypertrophies?

A

Left atrium (hypertrophies most commonly with mitral valve stenosis/prolapse)

27
Q

Describe the path usually taken to complete a coronary angioplasty/stent

A

femoral artery -> external iliac -> common iliac -> aorta -> R/L coronary artery to occlusion

28
Q

Describe a triple bypass

A

Vein grafts from the legs are taken, flipped (to correct direction of valves) and sewn to the aorta and the…

  1. right coronary artery
  2. LAD
  3. circumflex artery

**Can also take the left internal thoracic/mammary artery branching off the L subclavian artery and reattach it inferior to the clot in the LAD

29
Q

Where are the most common sites of coronary occlusion? (6)

A

1= LAD

30
Q

Describe the cardiac effects/causes of systolic and diastolic dysfunction of the heart

A
  • Systolic dysfunction
    • thinned cardiac muscle
    • usually post-MI or from myocarditis
  • Diastolic dysfunction
    • hypertrophy
    • usually due to hypertension (or can be just from aging; some genetic component)
31
Q

Describe the systemic symptoms of left and right heart failure

A
  • Left
    • dyspnea
    • severe pulmonary congestion
    • NO increase in CVP
  • Right
    • cyanosis, hepatomegaly, ascites
    • edema
    • engorgement of jugular veins
    • INCREASED venous pressure