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CPR Exam 1 > 6. Thoracic Cardiology > Flashcards

6. Thoracic Cardiology Flashcards

1
Q

what seperates superior & inferior mediastinum

A

sternal angle (where manubrium meets with body of sternum)

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2
Q

what are the 3 parts of the inferior mediastinum

A

ant

middle

post

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3
Q

what is the flow of blood thru the heart

A

sup/inf vena cava –> R atrium –> tricuspid valve –> R ventricle –> pul valve –> pul trunk –> lungs –> Pul V –> L atrium –> bicuspid valve –> L ventricle –> aortic valve –> aorta –> body

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4
Q

what occurs after the blood is pushed out of the aorta

A

oxygenated blood thru arterial system -> capillaries for gas exchange –> deoxygenated blook via venous system –> sup/inf vena cava

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5
Q

what seperates the arterial and venous ends (which are together bc of the way the heart folds)

A

transverse pericardial sinus

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6
Q

what are the layers of the heart (innermost to outermost)

A

endocardium

myocardium

visceral serous pericardium (epicardium)

pericardial cavity

parietal serous pericardium

fibrous pericardium

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7
Q

what is the endocardium made of

A

layers of epithelium that seperate blood from M

= thin internal endothelial & subendothelial layer lining the inside change of the heart & valves

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8
Q

what is the result of lack of blood flow to specific areas of the myocardium

A

myocardium infarction

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9
Q

what can lead to a MI

A

coronary arthresclerosis =

build up of lipids on internal walls of coronary As -> decrease size of lumen of vessel –> increase change of embolism or blockage

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10
Q

pt presents w/ SOB & gripping pain in chest and left arm; imaging shows narrowed coronary A. What does this pt likely have

A

angina pectoris

pain in heart usually bc narrow or obstructed coronary A resulting in ischemic myocardium

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11
Q

what is the purpose of the fibrous skeleton of the heart

A
  1. attachment point of all myocardium
  2. attachment point for vales of cuspid valves
  3. support & strengthen AV & semilunar orifices (aortic/pul valve)
  4. electrical insulation barrier btn atria & ventricles
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12
Q

where is the apex of the heart located

A

inf.lat part of L ventricle

predominantly project to L

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13
Q

where is the sternocostal surface

A

R ventricle against ribs & costal cartilage

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14
Q

where is the diphragmatic surface

A

R & L ventricles

sits on thoracic diaphragm

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15
Q

where is the pulmonary surface

A

paired - R atrium & L ventricle

cardiac impression on both lungs

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16
Q

what are the borders of the heart and where are they located

A

Right: R atrium

Left: L ventricle

Superior: R & L atria & pul trunk/aorta

Inferior: R ventricle

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17
Q

what houses the coronary sinus

A

left AV groove

btn L atrium & ventricle

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18
Q

which groove transmits the R coronary A

A

right AV groove

btn R atrium & ventricle

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19
Q

which groove transmit the anterior interventricular A and great cardiac V

A

Ant Interventricular Groove

btn R & L ventricles on ant part of heart

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20
Q

which groove transmits the post interventricular A & middle cardiac V

A

Post Interventricular Groove

btn R & L ventricles on post part of heart

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21
Q

what is the sulcus terminalis

A

external verticle groove corresponding to the internal crista terminalis

at R atrium

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22
Q

what is the embryological remnant of the ductus arteriosus

A

ligamentum arteriosum

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23
Q

pt comes into your office and he cant talk- what N may be hit & what can be the cause

A

left recurrent laryngeal N (rmr loops around aortic arch then ascends to larynx)

aneurysm of ligamentum arteriosum

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24
Q

what was the purpose of the ductus arteriosis embryologically

A

shunted bloodk from pul trunk to arch of aorta to bypass nonfxnal lungs

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25
Q

What contributes to the smooth and rough surface of the R atrium

A

rough : Pectinate M

smooth: Sinus Venarum (thin)

26
Q

what seperates the smooth and rough region in the R atrium

A

crista terminalis

27
Q

where do the vena cavae & coronary sinus empty

A

sinus venarum

28
Q

what is the interatrial septum

A

wall btn 2 atria = part of the smooth wall

contains fossa ovalis: remant of foramen ovalis

29
Q

all blood from heart, out of the myocardium, is drained —

A

into Vs –> that end up in coronary sinus –> that go to R side to get reoxygenated

30
Q

what happens if there is an incomplete closure of the foramen ovale

A

atrial septral defect

hole in wall btn atria

small openings = insig

large openings = sig bc mixing of deoxy & oxy blood

31
Q

what is the R AV Orifice

A

passage from the R atrium to R ventricle

variable occluded by tricuspid valve

32
Q

How many cusps does the tricuspid valve have & what are they

A

3

septal

ant

post

33
Q

what is the purpose of the cusps?

A

cusp attach respective papillary M with chordae tendineae

prevent blood from flowing back from ventricle to atrium

34
Q

what is the pulmonary valve

A

semilunar valve w/ R, L & Ant cusps

seperate R ventricle from pul trunk

contain pul sinuses

35
Q

what is the smooth and rough wall of the R ventricle

A

smooth: Conus Arteriosus (lead into pul trunk)
rough: Trabecula Carnae

36
Q

what is a type of trabecula carnae & what does it do

A

septomarginal trabeculum : run from interventricular septum to base of ant papillary M

transmit R bundle branch of AV bundle to ant papillary M

-for effective contraction

37
Q

what are subendocardial branches

A

N fibers that run thru the trabecula carnae

38
Q

what is the pul sinus

A

space btn wall of pul trunk and cusps of pul valve (= behind cusp)

= part that collapses when blood runs thru the opening of the valve

39
Q

what is cardiac catheterization

A

insertion of catheter into femoral V which then is passed up to the inf vena cava to allow radiographic visualization of R atrium, R ventricle, Pul trunk & Pul As

40
Q

which side of the heart is thicker

A

left

have to pump thru all of body (R only to lungs)

41
Q

what are the R and L auricles

A

contain Pectinate M

-result of two parts pulling apart during heart formation

42
Q

what valve can occlude the L AV orifice

A

bicuspid valve

L atrium –> L ventricle

43
Q

what are the names of the bicuspid valve cusps

A

ant

post

44
Q

what are the smooth and rough regions of the L Ventricle

A

smooth: Aortic Vestibule (least into ascending aorta)
rough: Trabecula Carnae (muscular region)

45
Q

what houses the AV bundle, R & L bundle branches & subendocardial branches

A

interventricular septum

(contain membranous & muscular part)

46
Q

what causes ventricular septal defects

A

embryologically divergent tissues that make up the interventricualr septum

all defects are clincally relevant bc mixture of deoxy & oxy blood

47
Q

what is the aortic valve

A

sep L ventricle from ascending aorta

= semilunar valve w/ R, L & Post (noncoronary) cusps

-prevent backflow & protect coronary As

48
Q

what is the aortic sinus

A

space btn wall of ascending aorta & cusps (= behind cusps)

-R & L aortic sinuses have openings for R & L coronary As

49
Q

what is the pacemaker of the heart

A

sinuatrial nodes

= where sup vena cava meets R atrium = small bundle of cardiac M that initiates and regulates impulses that propogate atrial walls

50
Q

How does the AV node initiate contraction

A

waits for signal from SA node

located in interatrial septum near the openings for coronary sinuses

51
Q

what do AV bundles do

A

cross the electical insulated barrier provided by fibrous skeleton

& distribute impulse from AV node to R & L AV bundle branches - then to subendocardial branches

52
Q

where do subendocardial branches distribute AV nodal impulses

A

from R & L bundle to interventricular septum then papillary Ms then ventricular walls (purkinje fibers)

53
Q

how does an artificial pacemaker fxn

A

electrode inserted thru large V to sup vena cava into R atrium inot endocardium of trabecula carnae of R ventricle

-send signal straight to ventricle

54
Q

what is irregular twitching of atrial cardiac M fibers & how does this affect circulation

A

atrial fibrillation

circulation = satisfactory

55
Q

what is ventricular fibrillation

A

rapid irregular twitching of ventricles –> rendering heart unable to pump blood

56
Q

why does cardiac referred pain occur

A

visceral sensory fibers share spinal ganglion w/ somatic sensory fibers of areas of upper limb & superiolateral chest wall

57
Q

what is anginal pain

A

area innervated by L medial brachial cutaneous N, L substernal area, L pectoral area & medial aspect of L upper limb that lead to referred pain

58
Q

what is the oblique pericaridal sinus

A

wide recess post to base of heart

59
Q

what is the clinical significance of the transverse pericardial sinus

A

space that allows surgeons to access the area posterior to aorta & pul trunk to clamp/insert tubes of bypass machine into large vessels

-get behind aorta & pul trunk but infront of inf vena cava

60
Q

what is pericarditis

A

inflam of pericardium - make it rough & produce friction - observe with a stethoscope

-if untreated it’ll calcify

61
Q

what is cardiac tamponade & what is it often associated with

A

compressed heart trying to beat against fluid

associated with pericardium effusion - bc accumulate fluid/pus in pericardial sac and compress heart

62
Q

what is pericardiocentesis

A

drainage of blood, fluid, or pus from pericardial sac

-do this to relieve cardiac tamponade

CPR Exam 1 (27 decks)

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