6. Cardiology

Question 1

What are the 6 layers of the heart in order from outside to inside?

Answer 1

Fibrous pericardium
Parietal serous pericardium
pericardial cavity
Visceral serous pericardium (EPICARDIUM)
Myocardium
Endocardium

Question 2

What can occur in the myocardium during a myocardial infarction?

Answer 2

A certain part of the muscle of the heart does not get blood due to a blockage/blood clot in the artery, heart stops working

Question 3

What is agina pectoris?

Answer 3

Radiation of pain to area on the left limb, which is due narrowing or blocked coronary arteries in the myocardium

Question 4

What are the different surfaces of the heart? (3)

Answer 4

Sternocostal surface
Diaphragmatic surface
Pulmonary Surface (left and right)

Question 5

What is another name for the right inferior border?

Answer 5

Right margin

Question 6

Where is the crista terminalis and what does it make on the outside of the heart?

Answer 6

Crista (crest/ridge) terminalis is inside the right atrium, and forms the depression near the right border of the heart called the sulcus terminalis

Question 7

What is ligamentum arteriosum and what does it form from?

Answer 7

As child, all blood comes from mother, so the ligamentum arteriosum was the ductus arteriosus, which took blood from pulmonary trunk to the aortic arch to bypass nonfunctional lungs. Once baby is breathing on own, it degrades and turns into ligamentum arteriosum

Question 8

What can occur at the ligamentum arteriosum due to the area being naturally weakened?

Answer 8

An aneurysm can occur at this area, and this is where the recurrent laryngeal N is, the the pressure from the aneurysm will block the nerve, leading to a hard time to talk

Question 9

What is the difference between pectinate muscle and sinus venarum inside the right atrium?

Answer 9

The sinus venarum is smooth walled while the pectinate muscle is rough walled

Question 10

The fossa ovalis is called the foramen ovalis as a child because it is used for what?

Answer 10

As a baby there is a hole connecting the right atrium to the left atrium for the proper distribution of blood. When you grow up and breath on your own, the hole closes and becomes the fossa ovalis

Question 11

What can happen if the foramen ovalis does not close all the way?

Answer 11

Atrial septal defects: When there is a LARGE opening (small will do nothing) which allows the mix of O2- and O2+ blood

Question 12

What connects to cusps in order for the papillary Mms to be able to contract them?

Answer 12

The cusps are connect by chordae tendineae, little ligaments

Question 13

What consists of the tricuspid valve in the right ventricle (5)?

Answer 13

Septal Cusp
Anterior cusp
Posterior cusp
Chordae Tendineae
Papillary M (anterior,septal,posterior)

Question 14

What occurs during cardiac catheterization and why?

Answer 14

Insertion of a catheter into the femoral vein which is passed up the inferior vena cava allowing visualization of the right atrium, right ventricle, pulmonary trunk and pulmonary arteries

Question 15

What consists of the bicuspid valve in the left ventricle (4)?

Answer 15

Anterior cusp
posterior cusp
chordae tendineae
papillary M (anterior/posterior)

Question 16

Where is the membranous part of the interventricular septum?

Answer 16

in the interventricular septum of the left ventricle

Question 17

What is a common ventricular septum defect?

Answer 17

embryological divergent tissues of the septum can cause ‘holes’ in the septum, leading to mixture of deoxygenated and oxygenated blood

Question 18

What is important of the aortic valve and where is it?

Answer 18

in the aorta, consists of aortic sinuses-space between the wall of the ascending aorta and the cusps

Question 19

Where is the sinuatrial node and what does it do?

Answer 19

Located in the myocardium, where superior vena cava meets the right atrium, produces own AP and sends electrical signal to the Atrioventricular node

Question 20

What is the electric signaling once a signal from the sinuatrial node has been made to the atrioventricular node?

Answer 20

AV node is located in the interatrial septum, signals to atrioventricular bundles (bundle of hiss), which signal to subendocardial branches (purkinje fibers), which transmit the signal

Question 21

How does an artificial cardiac pacemaker work?

Answer 21

Produces electrical impulse that is carried to ventricles via electrodes inserted into superior vena cava, through right atrium, right ventricle, into endocardium of travecula carnae

Question 22

What occurs during irregular twitching of the atrial cardiac muscle fibers, to which the ventricles respond at irregular intervals?

Answer 22

Atrial fibrillation

Question 23

What occurs when there is rapid twitching of the ventricles, rendering the heart unable to pump, need electric shock!

Answer 23

Ventricular Fibrillation

Question 24

What is the surgical significance of the transverse pericardial sinus?

Answer 24

this space allows access to area posterior to aorta and pulmonary trunk to clamp/ insert tubes of a bypass machine to the vessels

Question 25

What occurs when there is inflammation of the pericardium, which can make the pericardium rough and produce friction, can be heard by stethoscope?

Answer 25

Percarditis

Question 26

What occurs when inflammation of the pericardium results in accumulation of fluid/pus in pericardiac sac?

Answer 26

Pericardial Effusion

Question 27

What do you do during pericardiocentesis?

Answer 27

Drain blood, fluid or pus from the pericardial sac, relieving cardiac tamponade (heart compression)