10/2 Thorax II Flashcards

1
Q

which 2 valves come into contact with deoxygenated blood

A

tricuspid (right AV valve) and pulmonary semilunar

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2
Q

which 2 valves come into contact with oxygenated blood

A

mitral and aortic semilunar

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3
Q

describe the flow or blood, from deoxygenated in the peripheral tissue to oxygenated returning to peripheral tissues

A

too long. don’t fuq it up

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4
Q

three layers of the pericardial membrane

A
outer = fibrous pericardium
middle = parietal serous pericardium
inner = visceral serous pericardium
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5
Q

fibrous pericardium

A

outer layer of pericardial membrane
defines the borders of the middle mediastinum

attached to central tendon of diagphram via pericardiophrenic ligaments
blends superiorly with adventitia of great vessels
attached to sternum by sternoperiocardial ligaments

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6
Q

parietal serous pericardium

A

middle layer of pericardial membrane

lines inner surface of fibrous layer

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7
Q

visceral serous pericardium

A

inner layer of pericardial membrane
adheres to the surface of the heart and forms its outer covering
cannot experience pain

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8
Q

where are the parietal and visceral serous pericardia contiguous?

A

roots of the great vessels

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9
Q

pericardial cavity

A

narrow potential space between layers, normally contains serous fluid to reduce friction

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10
Q

innervation of fibrous/parietal serous

A
GSA
phrenic nn (C3-C5)
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11
Q

innervation of visceral serous

A

GVA

fibers in autonomic nn to cardiac plexus

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12
Q

blood supply to pericardium

A

L and R periocardiocophrenic aa that travel along with the phrenic nn.

branches of the internal thoracic aa

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13
Q

pericarditis

A

painful inflammation of the pericardium

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14
Q

pericardial effusion

A

buildup of fluid (blood, pus, etc) in the pericardial cavity. can compress the heart and lead to cardiac tamponade which reduces cardiac output and is an emergency

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15
Q

referred pain of the pericardium

A

innervated by GSA C3-C5 (phrenic nn), so problems here might present as pain in those dermatomes (supraclavicular region of shoulder and lateral neck)

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16
Q

pericardiocentesis

A

removal of fluid from the pericardial cavity with an aspirating needle through the 5th intercostal space, left of the xiphisternal junction w/ help from US

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17
Q

two cardiac sinuses

A

transverse pericardial sinus

oblique pericardial sinus

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18
Q

transverse pericardial sinus

A

seperates arteries from veins, posterior to ascending aorta and pulmonary trunk, anterior to the superior vena cava

can stick finger in here during surgery to seperate aa and vv

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19
Q

oblique pericardial sinus

A

formed by reflections onto the pulmonary vv of the heart, can hold heart here during surgery to stabilize it

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20
Q

weakest heart chamber

A

right atrium

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21
Q

strongest heart chamber

A

left ventricle

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22
Q

what are/function of sulci

A

contain neurovasc supply to the heart within epicardial fat

grooves on the surface that are extensions of internal partitions

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23
Q

name the three sulci

A

coronary sulcus

posterior and anterior sulcus

24
Q

coronary sulcus

A

horizontal band around heart that seperates atria and ventricles

25
anterior and posterior sulci
verticals, mark position of interventricular septa
26
borders of the heart
L: aortic arch, pulmonary trunk, LA, LV R: RA, SVC, IVC Inf: RV, LV, apex
27
name the three surfaces of the heart
sternocostal posterior/base diaphragmatic/inferior
28
sternocostal surface
anterior, just posterior to the sternum and ribs, primarily RV
29
posterior surface
LA and RA posteriorly, the esophagus is immediatley posterior to the LA (images and linked patho), receives all venous inflow, anchored by veins
30
diaphragmatic/inferior surface
sits on diaphragm, mostly LV
31
right border relative to ribs
3rd to 6th ribs
32
left border relative to ribs
2nd to 5th intercostal spaces
33
apex releative to ribs
left 5th intercostal space
34
SVC relative to ribs
right 1st and 2nd intercostal spaces
35
pulmonary trunk relative to ribs
left 2nd intercostal space
36
sinoatrial (SV) node
base of the SVC, cardiac pacemaker | origin of impulse and controler of rate/force of contraction
37
atrioventricular (AV) node location
interatrial septum near the tricuspid valve
38
Atrioventricular bundle
continuous with the AV node, passes through cardiac skeleton, follows interventricular septum, then splits
39
right bundle branch
towards apex of RV, to ant papillary m, then becomes Purkinje fibers which spread throughout the ventricle
40
left bundle branch
towards apex of LV, becomes purkinje fibers which spread throughout ventricle
41
moderator band
causes the electrical impulse to reach the apex of the right ventricle and left ventricle simultaneously, due to the larger lumen of the right ventricle.
42
purkinje fibers
ventricular contraction
43
electrical path
``` SA node Atria AV node AV bundle Bundle branches Purkinje fibers ```
44
sympathetic control of cardiac plexus
Sympathetic Cardiac NN (SCS T1-T5) increase HR increase F of contraction dialate coronary aa
45
parasympathetic control of cardiac plexus
Vagal Cardiac NN (Vagus N, CN X) decrease HR decrease F of contraction constrict coronary aa
46
motor targets of cardiac plexus
SA node AV node coronary aa
47
sensory information of cardiac plexus
(GVA) BP blood chem cardiac pain
48
heart attack referred pain
dermatomes of GVE sympathetic innervation | T1-T4 (chest and UE)
49
aortic semilunar valve
consists of three semilunar cusps (left, right, and posterior) whose free edges project towards the lumen of the ascending aorta (see image, upper right). The cusps form little pocket-like structures called sinuses that fill with blood after ventricular contraction and close the valves passively.
50
myocardial blood supply
R and L coronary aa, first branches of ascending aorta, blood flows in during atrial contraction when semilunar valve is closed
51
heart attack
when the perfusion of the myocardium is insufficient to meet its metabolic needs, resulting in permanent tissue damage. The most common cause is total occlusion of anterior interventricular artery (from left coronary a), aka "widow maker"
52
Coronary dominance
determined by the origin of the posterior interventricular artery. Coronary circulation is considered right dominant if the PDA derives from the right coronary artery (normal pattern, ~85% of the population).
53
coronary sinus
receives all the venous drainage from the heart except the small anterior cardiac veins and the thebesian veins, which drain directly into the heart chambers. drains directly into the right atrium, lies in the coronary suculus on the posterior of the heart between the base and diaphragmatic surfaces
54
three veins of the heart
great cardiac vein middle cardiac vein small cardiac veing
55
great cardiac vein
travels with LAD (anterior interventricular artery) then circumflex artery
56
middle cardiac vein
travels with PDA (posterior interventricular artery)
57
small cardiac vein
travels with marginal a then R coronary a