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SF3 - Test 1 > 1 - Heart > Flashcards

1 - Heart Flashcards

1
Q

What is the rough overview of the structure of the heart?

A

Four Chambers

Atria - Receive Venous Blood

Ventricles - Pump d blood to body/lungs

Right Side A/V = Pulmonary Circuit

Left Side A/V = Systemic Circuit

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2
Q

What is the main objective of the Right and Left sides of the heart?

A

Right: Right Atrium/Right Ventricle

Forms Pulmonary Circuit

R-Atrium: Deoxygenated blood from body from superior vena cava and inferior vena cava

R-Ventricle: Pumps to lungs via pulmonary trunk

Left: Left Atrium/Left Ventricle

Forms Systemic Circuit

L-Atrium: Oxygenated blood from four pulmonary veins.

L-Ventricle: Pumps oxygenated blood to body via ascending aorta

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3
Q

Shape of the heart and divisional landmarks

A

Pyramid

Right Side mostly anterior

Left Side mostly posterior

- - -

Atrioventricular Sulcus - Separates atria from ventricles

Anterior and Posterior interventricular Sulci - Separates Right and Left Ventricles

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4
Q

Surface of the Heart:

Anterior (Sternocostal)

Inferior (Diaphragmatic)

Posterior (Base)

A

Anterior (Sternocostal) - mostly right ventricle

Inferior (Diaphragmatic) - right and left ventricles

Posterior (Base) - left atrium (Base of Pyramid)

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5
Q

Right Atrium: Divisions

A

Can be divided into two division by vertical ridge: Crista Terminalis

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6
Q

Right Atrium: Anterior Part

A

Has pectinate muscles

“pectinate = comb-like”

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7
Q

Right Atrium: Posterior Part

A

Smooth walled, receives superior and inferior vena cava, and the coronary sinus

Posterior Wall:

- forms part of the septum dividing L/R Atria

  • Has fossa ovalis
  • Has Limbus of the Fossa Ovalis (upper margin of fossa)

`

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8
Q

Clinical: Foramen Ovale Fetal Defect

Atrial Septal Defect (ASD)

A

Foramen Ovale allowed blood from right atrium to flow to left atrium (bypassing pulmonary circuit)

At birth, this is closed

- - -

ASD - Congenital malformation; minor, defect called Probe-Patent Forman Ovale

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9
Q

Right Atrium: Right Auricle

A

“ear”

Small blind pouch like appendange of atrium

Lined by Musculi Pectinati

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10
Q

Right Ventricle: Overall Summary

A

Thick-walled, muscular pump

Trabeculae Carneae

Infundibulum (Conus Arteriosis)

Posterior Wall of Right Ventricle

Tricuspid Valve

Pulmonary Valve

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11
Q

Right Ventricle: Trabeculae Carneae

A

“fleshy beams”

Irregular ridges of muscle that line ventricular lumen

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12
Q

Right Ventricle: Infindibulum (Conus Arteriosus)

A

Superior, cone-shaped part of ventricle

Smooth

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13
Q

Right Ventricle: Posterior Wall

A

Forms part of interventricular septum separating ventricles

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14
Q

Right Ventricle: Tricuspid Valve

Cusps

Chordae Tendineae

A

Located at right atrioventricular orifice; prevents blood from flowing back into Right Atrium following ventricular contraction.

Cusps = thick valve coverings preventing backflow; Anterior, Posterior, Septal

Chordae Tendineae:

Small cords which attach free margins and ventricular surface of each cusp to papillary muscle on ventricular walls

Attaches two adjacent cusps

*The Chordae Tendineae connect Papillary Muscles to the Cusps; giving tension to the system. Force of ventricular blood closes the valve*

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15
Q

Right Ventricle: Anulus Fibrosis

A

Ring of fibrous tissue surrounding the orifice that serves as attachmnt site for valve cusps

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16
Q

Right Ventricle: Pulmonary Valve

A

Located at pulmonary orifice at superior end of conus arteriosus; blood takes L-shaped path from right atrioventricular orifice to its outflow through pulmonary orifice

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17
Q

Right Ventricle: Pulmonary Valve - Cusp Type?

A

Three Semilunar cusps

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18
Q

Right Ventricle: Pulmonary Valve

A

Three semilunar cusps; sinus on each cusp

Once contraction is complete (systole), blood flows back into sinuses behind cusps, closing pulmonary orifice

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19
Q

Clinical: Pulmonic Valvular Incompetence

A

Volve does not close properly

Due to thickened and inflexible free margins of cusps

Results in backflow of blood into right ventricle from pulmonary trunk, heart as a heart murmur (turbulent blood flow)

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20
Q

Fibrous Skeleton of the Heart

A

Rings of connective tissues which surround orifice of pulmonary trunk and right atrioventricular orifice on right side and orifice of ascending aorta and left atrioventricular orifice on left side

1. Attachment for Valves

2. Attachment for Cardiac Fibers

3. Separates Atrial/Ventricular Muscles

4. Gives Rigidity to orifices

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21
Q

Left Atrium: Organization

A

Mostly Smooth Walled–lining of left auricle contains pectinate muscles

Receives FOUR pulmonary veins

Forms most of posterior heart

Contains valve for foramen ovale

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22
Q

Left Ventricle: Overview

A

Walls 3x Thicker bc SYSTEMIC CIRCULATION

Biscuspid (Mitral) Valve

Aortic Valve

23
Q

Left Ventricle: Lining of Ventricular Cavity

A

Well developed trabeculae carneae except for smooth-walled aortic vestibule

24
Q

Left Ventricle: Interventricular Septum

A

Two Parts:

1. Muscular Part: Thick, Most of septum

2. Membranous Part: Thin, Site of Ventricular Septal Defects (VSD); upper part of septum and inferior to the right and posterior cusps of aortic valve

25
Q

Left Ventricle: Biscuspid (Mitral) Valve

A

Two cusps

Commonly affected by calcium deposits in Rheumatic Fever, can be “stuck” together which is audible as heart murmur

26
Q

Left Ventricle: Aortic Valve

A
  • Similar to pulmonary valve

- Aortic Sinus (3x) = Right/Left Open to Coronary Arteries

During diastole (relaxation) blood backflows, flipping down valve and flowing out Coronary Arteries

27
Q

Clinical: Stenosis of Aortic Orifice

A

Narrowing of the aortic orifice due to adherence of “free” margins of cusps as a result of disease

28
Q

Valves in Systole and Diastole

A

Diastole:

Atria Contract, Ventricles Relax

Tricuspid / Mitral OPEN

Aortic / Pulmonary CLOSED

Systole:

Atria Relax, Ventricles Contract

Tricuspid / Mitral CLOSED

Aortic / Pulmonary OPEN

29
Q

Coronary Vessels: Overview

A

Blood within chambers does not provide oxygen/nutrients to muscles of hear; Coronary Vessels on exterior of hear provide this.

30
Q

Coronary Vessels: Right Coronary Artery

A

Arises from Right Aortic Sinus

Descends Atrioventricular Sulcus (b/t R Atrium & R Ventricle) on anterior surface of the heart, continuing to posterior surface

Supplies:

R Atrium
R Ventricle

Sinoatrial Node

Atrioventricular Node

Posterior 1/3 of Interventricular Septum

Small portions of left Atrium and Ventricle

31
Q

Coronary Vessels: Right Coronary - Sinu-Atrial Nodal Brance

A

Supplies Sinu-atrial Node

Always ends up in Right Atrium

32
Q

Coronary Vessels: Right Coronary - AV (atrio-ventricular) Nodal Artery

A

Supplies AV Node

33
Q

Coronary Vessels: Right Coronary - Posterior Interventricular Branch (Posterior Descending Artery)

A

Located on Sulcus of same name, suplied right and left ventricles and posterior 1/3 of interventricular septum

Can anastoose with Anterior Interventricular Branch of Left Coronary

34
Q

Coronary Vessels: Left Coronary Artery

A

Originates from Aortic Sinus of Left Cusp of Aortic Valve

Supplies:

Mostly Left Side of Heart

Left Atrium

Left Ventricle

Anterior 2/3 of Interventricular Septum

Atrioventricular Bundles

35
Q

Left Anterior Descending (LAD) [Anterior Interventricular Branch]

A

Branch of Left Coronary Artery

Runs inferior in Anterior Interventricular Sulcus towards apex

Can anastomose with the Posterior Interventricular Branch of the Right Coronry Artery

  • Supplies both ventricles and anterior 2/3 of Interventricular Septum
36
Q

Coronary Branching Variation

Right vs Left Dominance

A

Right: Posterior Interventricular Artery is branch of Right Coronary Artery

Left: Posterior Interventricular Artery is branch of the circumflex branch of the left coronary artery

37
Q

Clinical: Coronary Arterial Dominance

A

Left Dominant: Blockage of left coronary will result in ischemia of interventricular septum = less chance of survival from blockage in Left Dominant Heart

Right Dominant: Blockage of left coronary will result in decreased blood flow, but collateral circulation can develop via Posterior Interventricular Artery of Right Coronary = better chance of survival

38
Q

Clinical: Atherosclerotic Plaque in Coronary Arteries

A

Vessel lumens narrowed, risk b/c branches are functionally end arteries.

Anastomoses often small, insufficient to supply enough blood if suddenly stopped.

Results in Myocardial Infarction (heart attack)

39
Q

Clinical: Coronary Artery By-Pass Graft

  1. Vein
  2. Arterial Source
A
  1. Occuluded Artery can be replaced by vein (usually Great Saphenous from leg)

Graft from aorta to end beneath occlusion

  1. Internal Thoracic (branch of Subclavian) attached directly beneath occlusion
40
Q

Clinical: Angioplasty

A

Balloon catheter inserted into ascending aorta, and into occluded artery.

Balloon expanted to clear blockage.

41
Q

Coronary Veins: Coronary Sinus

A

Large vein in posterior part of atrioventricular sulcus

Receives most of blood of the heart via its tributaries

Opens into the right atrium (superior to opening of the inf. vena cava)

42
Q

Coronary Veins: Coronary Sinus Tributaries

(For locations, prepare via practical)

A

Great Cardiac Vein:

Drains area supplied by left coronary artery

Middle Cardiac Vein:

Drains area supplied by Posterior Interventricular Artery

Small Cardiac Vein:

Drains area suuplied by Marginal Artery

43
Q

Coronary Veins: Anterior Cardiac Veins

A

Drain directly into the right atrium

44
Q

Coronary Veins: Smallest Cardiac Veins

A

Tiny vessels within heart wall that open directly into chambers of heart

45
Q

Electrical Conduction System of Heart: Sinuatrial (SA) Node

A

Pacemaker of the Heart

Right Atrium, Superior Crista Terminalis (base of Superior Vena Cava)

Generates electrical impulses, spread throughout the atrial muscles of both right and left sides.

Causes Atrial CONTRACTION

Waves does NOT reach ventricles directly due to Fibrous Skeleton (rings) of heart

46
Q

Electrical Conduction System of Heart: Atrioventricular (AV) Node

A

Located Inferior Part of the Interatrial Septum

Receives impulse from Atrial Muscles

Relays via AV Bundles (ONLY electrical connection between atria/ventricles)

DELAY BUILT IN TO ALLOW ATRIA TO CONTRACT FULLY BEFORE VENTRICLES CONTRACT

47
Q

What is the only electrical connection between the Atria and the Ventricles?

A

AV Node

Delay intented to allow atria to fully empty before ventricle contraction

48
Q

Electrical Conduction System of Heart: Atrioventricular (AV) Bundles

A

Pierces fibrous rings separating atria from ventricles and passes through membranous part of interventricular septum

Divides into:

1. Right - Courses via Moderator Band; bridges lower portion of septum and anterior wall at Base of the Anterior Papillary Muscle

2. Left - Runs down left side of septum to supply ventricle and papillary muscles

49
Q

Clinical: Artificial Pacemaker

A

Damage to conduction system can cause abnormal ventricular contraction

Pacemaker attached to chest wall, electrical field fed through Cephalic or Subclavian Vein

Implanted in right ventricle

50
Q

Innervation of Heart: Autonomic Nervous System

Vagus Nerve

Sympathetics

Sensory

A

Vagus - Parasympathetic nerve, decreases heart rate and force; constricts coronary arteries

Sympathetics - Incrase heart rate and force of the beat; dilates coronary arteries

Sensory - Heart insensitive to touch, temperature; Pain sensitive to ischemia; course in cardiac branches and mid/inf br. of sympathetic trunk

Enter at T1-T4 on Left Side

51
Q

Clinical: Referred Pain in Heart

A

Sensory enter Spinal T1-T4 on Left Side

Intercostobrachial Nerve - T2

Chest/Arm Pain, T1 - T4 dermatomes

52
Q

Surface Markings of Heart (Borders)

Right

Inferior

Left

Superior

A

Right - 3rd - 6th R Costal Cart

Inferior - L 5th Intercostal Space

Left - L 2nd Intercostal Space

Superior - 2nd L - 3rd R Costal Cart

53
Q

Clinical: Heart Sound Locations

A

Tricuspid - Left Lower Sternum near 5th intercostal space

Mitral - Left 5th intercostal, mid clavicular

Pulmonary - Medial Left 2nd Intercostal Space

Aortic - Medial Right 2nd Intercostal Space

54
Q
A

SF3 - Test 1 (28 decks)

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