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Cardioresp > 2 > Flashcards

2 Flashcards

1
Q

what are the main functions of the fibrous pericardium

A

anchor heart in place
attach great vessels, aorta, pulmonary artery and veins
attach pericardiophrenic nerve of diaphragm

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2
Q

parietal layer attaches what structure on the outside

A

fibrous pericardium

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3
Q

What is the pericardium made up of

A

fibrous pericardium and serous membranes (parietal and visceral)

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4
Q

function of pericardium

A

fixes heart in mediastinum
limits heart movements
prevents infection from neighbouring organs
prevents over dilation of heart in cases of acute volume overload
lubrication

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5
Q

what is the cause of cardiac tamponade

A

pleural effusion, abnormal accumulation of fluid in pericardial cavity, increase in intrapericardial cavity, compression of heart chambers, impairment of diastolic filling of both ventricles.

decrease in SV so CO so hypotension and shock and reflex tachycardia

increase of venous pressure so pulmonary congestion (can hear rales) and systemic circulation leads to high IJVP

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6
Q

what pressure of intrapericardial cavity can lead to death

A

10-20mmHg

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7
Q

Treatment of cardiac tamponade, and types

A

pericardiocentesis (catheter and needle to remove excess fluid)
Subxiphoid - most common and safest
parasternal
apical

use ultrasound to tell where accumulation is bc pericardial effusion isn’t always equally distributed

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8
Q

what type of cells make up the epicardium (visceral layer of pericardium)

A

simple squamous epithelia
loose CT
fat

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9
Q

what type of cells make up the myocardium

A

cardiac muscle fibre

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10
Q

what type of cells make up the endocardium

A

continuous w endothelium, lines chambers and valves with projections called trabecular carnae

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11
Q

is the blood propelled by left and right heart the same volume

A

not necessarily on a beat to beat measure but overall yes

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12
Q

What are some external landmarks of the heart

A

coronary groove = atrioventricular sulcus = division entre atria and ventricle on the outside

anterior inter ventricular sulcus

posterior inter ventricular sulcus on the right side

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13
Q

what’s another name for left and right auricles

A

atrial appendage

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14
Q

where are left and right auricles

A

they are attached to atria and overlap root of aorta

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15
Q

how many pulmonary veins are there

A

4

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16
Q

what fraction of right ventricle is anterior

A

2/3

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17
Q

what fraction of left ventricle is posterior

A

2/3

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18
Q

What are some internal landmarks of the heart

A 
papillary muscles
septal papillary muscle 
moderator band
chordae tendinae
trabeculae carne
fossa ovalis
pectinate muscle
cristae terminali
coronary sinus
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19
Q

how many papillary muscles in right side

A

3

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20
Q

how many papillary muscles in right side

A

2

21
Q

what does the moderator band connect

A

anterior papillary muscle to ventricular septum

22
Q

what is the fossa ovalis

A

depression in Right atrium near entry of sup vena cava

23
Q

what are trabeculae carne

A

msucular projections from inner surface of left and right ventricle

24
Q

what is the coronary sinus

A

blood vessel that vascularise myocardium. takes low oxygen blood to right atrium

25
Q

what is the cristae terminali

A

heart muscle at opening of right auricle

26
Q

what is the pectinate muscle?

A

wall of atria

27
Q

Name right atrium and ventricle landmarks

A 
coronary sinus
fossa ovalis
tricuspid valve
     valve cusps
     chordae tendinae
     papillary muscle
trabeculae carnae
pulmonary trunk
     pulmonary semi-lunar valve
moderator band
28
Q

Name left atrium and ventricle landmarks

A 
fossa ovalis
mitral valve
          chordae tendinae
          papillary muscle
trabeculae carnae
ascending aorta
           aortic semilunar valve
29
Q

how many cusps are there in aortic valve and what are their key features

A

openings for left and right coronary artery.

the cusp with no opening is called the non-coronary aortic sinus

30
Q

what does the Right coronary artery anastomose with

A

RCA anastomoses with circumflex LCA after RCA branches to posterior interventricular

31
Q

what does the Left anterior descending artery anastomose with

A

LAD loops around apex and anastomoses with post inter ventricular artery.

32
Q

most MI occur due to blockage in which artery

A

Left anterior descending artery (LAD) off LCA (40-50%)
RCA (30-40%)
circumflex of LCA (15-20%)

33
Q

which artery supplies SA and AV nodes

A

RCA. so damage there like isechemia can lead to heart block

LAD supplies septal branches which supply AV node

34
Q

what’s a heart block

A

if atria and ventricles beat at different times, out of synchrony

35
Q

where do coronary veins drain to

A

coronary sinus

36
Q

where does coronary sinus empty

A

right atrium direct

37
Q

what’s the fibrous skeleton of the heart

A

Dense CT which electrically isolates atria and ventricles
insertion of cardiac muscle bundle
prevents valves outstretching
supports valves

38
Q

when do valves open

A

when ventricular pressure is lower than atrium pressure
so ventricles are relaxed
chordae tendinae are slack
papillary muscles are relaxed

39
Q

when do valves close

A

when ventricular pressure is higher than atrium pressure
so ventricles contract
chordae tendinae are pulled tight
papillary muscles are taut tight

40
Q

what separates the atrial and ventricular networks (in terms of conducting system)

A

fibrous skeleton of the heart

41
Q

explain the process of heart contraction

A

SA node generates impulse
atria contract
impulse pauses 0.1s so ventricles can fill
AV bundle branches conduct impulse through inter ventricular septum
Purkinje fibres stimulate the contractile cells of both ventricles starting at apex then up

42
Q

how many impulses does SA node generate per minute

A

70-80

43
Q

what supplies heart innervation

A

cardiac plexus

44
Q

where is the cardiac plexus located

A

anterior of bifurcation of trachea and posterior to arch of aorta

45
Q

what kinds of neurones does the cardiac plexus contain

A

sympathetic (from sympathetic trunk)
parasympathetic (from vagus)
visceral sensory afferent

46
Q

what structure is referred to as the cardioaccelerator and cardioinhibitor

A

medullary reticular formation

47
Q

what nerve does cardiac pain stimulate

A

visceral sensory afferent nerve endings in myocardium

48
Q

where would pain be felt for a infarct on inferior wall

A

epigastrium

49
Q

why is pain generally referred

A

bc it comes from somatic areas

Cardioresp (23 decks)

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