38 - Heart and Pericardium Flashcards

1
Q

What is the pericardial sac adherent to?

A

Central tendon of diaphragm

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2
Q

What limits descent of diaphragm in inspiration?

A

Pericardial sac is attached to central tendon

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3
Q

Name for central structure in thorax

A

Mediastinum

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4
Q

Mediasteinum

A

Central part of thoracic cavity, surrounded by connective tissue.

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5
Q

Divisions of mediastinum

A

Superior and inferior. Hear divides inferior mediastinum into anterior and posterir

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6
Q

Where does the heart sit in relation to vertebrae?

A

In front of T5-T8

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7
Q

Divisions of pericardium

A

Fibrous is external sheath. Serous pericardium is divided into parietal (which lines internal aspect of fibrous pericardium) and visceral (lies against heart) pericardium.

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8
Q
A
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9
Q

Left-to-right parts of the heart, if anterior surface is viewed

A

Right atrium, right ventricle, left ventricle

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10
Q
A
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11
Q

What makes up the apex of the heart?

A

Left ventricle

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12
Q

Where is the apex of the heart located?

A

Intersection between mid-clavicular line and 5th T rib.

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13
Q

How to orient heart

A

Auricles (or atrial appendages) face forwards. These look like fingers grasping the great vessels of the heart

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14
Q

Landmarks in right atrium 1) 2) 3) 4) 5) 6)

A

1) SVC and IVC entrances 2) Fossa ovalis in inter-atrial wall 3) Coronary sinus 4) Musculi pectinati cover outer wall. 5) Musculi pectinati terminate at crista terminalis 6) Tricuspid valve

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15
Q

Function of coronary sinus

A

Where venous blood from coronary veins drains to

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16
Q
A
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17
Q

Parts of right ventricle covered by trabeculae carnae

A

All of right atrium, except for small patch near pulmonary artery, which is smooth (infundibulum or conus arteriosus)

18
Q

Arrangement of trabeculae carnae in right ventricle

A

All attach to walls of ventricle, except for three atypical trabeculae carnae. These attach to ventricular wall and project to centre of ventricle, where they join chordae tendinae.

19
Q

Name for three atypical trabeculae carnae in right ventricle

A

Papillary muscles

20
Q

Fibrous skeleton of heart

A
21
Q

Layout of tricuspid valves

A
22
Q

Number of papillary muscles joining to tricuspid valve

A

Three

23
Q

Number of papillary muscles joining to bicuspid valve

A

Two

24
Q

Part of left ventricle which has musculi pectinati

A

Left atrial appendage. Has different embryological origin to the rest of left ventricle

25
Q

How to chordae tendinae attach to cusps of bicuspid and tricuspid valves?

A

One chordae tendon attaches to two cusps. Ensures that all cusps close together.

26
Q

Name for fibrous structure surrounding semilunar valves

A

Coronets in fibrous skeleton

27
Q

Name for fibrous structure surrounding tricuspid and bicuspid valves

A

Rings

28
Q

Where do muscles of the ventricles attach?

A

To the rings of the fibrous skeleton

29
Q

Muscles joining to rings of fibrous skeleton

A

Muscles of the ventricles and muscles of the atria attach to the rings. These muscles are separate, and are electrically-isolated.

30
Q

Difference between atrial and ventricular surfaces of bicuspid and tricuspid valves.

A

Ventricular surface is rough, has attachment of chordae tendinae. Atrial surface is smooth

31
Q

Are there any extra structures (EG: chordae tindinae) associated with semilunar valves?

A

No

32
Q

Where do the coronary arteries begin?

A

Just after the aortic valve. Sit just above aortic sinuses

33
Q

Conduction system of the heart

A
34
Q

Innervation of the heart 1) 2) 3)

A

1) Cardiac plexus situated at base of the heart. 2) Divided into a superficial and deep part 3) Receives branches from vagus and sympathetic trunks

35
Q
A
36
Q
A
37
Q
A
38
Q

Location of AV node

A

In right atrium, between coronary sinus and tricuspid valve

39
Q

Blood supplies of AV and SA nodes

A

~60% of time branch from early right coronary artery supplies SA node

~80% of time right coronary artery supplies AV node

40
Q

Where does the left coronary artery begin?

A

Starts between left atrial appendage and the great vessels of the heart

41
Q

Can anastamoses between coronary ateries compensate if one is occluded?

A

No. The coronary arteries are functionally end arteries.

The anastomoses are at the arteriolar level. Can’t supply enough blood to compensate.