8. Anatomy of Circulation II - conduction system and peripheral vessels (HARC) Flashcards
4 parts of CONDUCTION SYSTEM
- SINU-ATRIAL NODE
- ATRIOVENTRICULAR NODE
- ATRIOVENTRICULAR BUNDLE (RIGHT and LEFT BRANCHES)
- SUBENDOCARDIAL PLEXUS of CONDUCTION CELLS (PURKINJE FIBRES)
where is the SAN (cardiac pacemaker)
at the SUPERIOR END of CRISTA TERMINALIS
at the JUNCTION of the SVC and RIGHT ATRIUM
where is the AV NODE found
in the ATRIOVENTRICULAR SEPTUM - TRIANGLE OF KOCH
AV NODE is located in the ATRIOVENTRICULAR SEPTUM in the region known as the…
TRIANGLE OF KOCH
BOUNDARIES of the TRIANGLE OF KOCH
- SEPTAL CUSP of the TRICUSPID VALVE
- OPENING of the CORONARY SINUS
- TENDON OF TODARO
AV NODE found where in the TRIANGLE OF KOCH
APEX
which CUSP of the TRICUSPID VALVE is a boundary of the TRIANGLE OF KOCH
SEPTAL CUSP
ATRIOVENTRICULAR BUNDLE aka BUNDLE OF HIS is a direct CONTINUATION of the…
AV NODE
ATRIOVENTRICULAR BUNDLE (BUNDLE of HIS) follows along the LOWER BORDER of the …. before splitting into left and right branches
MEMBRANOUS PART of the INTERVENTRICULAR SEPTUM
BUNDLE BRANCHES from the ATRIOVENTRICULAR BRANCH conduct the IMPULSE to the…
PURKINJE FIBRES of right and left ventricles
Boundary of TRIANGLE OF KOCH is the TENDON OF…
TODARO
the LEFT BUNDLE BRANCH continues along the left side of the MUSCULAR INTERVENTRICULAR SEPTUM towards the APEX of the LEFT VENTRICLE
- gives off branches that eventually become continuous with the…
PURKINJE FIBRES
the RIGHT BUNDLE BRANCH continues along the right side of the INTERVENTRICULAR SEPTUM towards the APEX of the right ventricle.
how does it reach the BASE of the ANTERIOR PAPILLARY MUSCLE? (via..)
By entering the SEPTOMARGINAL TRABECULA to reach the base of the anterior papillary muscle
where does the RIGHT BUNDLE BRANCH divide and become continuous with the PURKINJE FIBRES
at the BASE of the ANTERIOR PAPILLARY MUSCLE
what is the benefit of the RIGHT BUNDLE BRANCH entering the SEPTOMARGINAL TRABECULA in order to reach the Base of the ANTERIOR PAPILLARY MUSCLE (shortcut)
ensures EQUAL CONDUCTION TIME in the LEFT and RIGHT VENTRICLES
- for COORDINATED CONTRACTION of anterior papillary muscle
what is the SUBENDOCARDIAL PLEXUS OF CONDUCTION CELLS
the PURKINJE FIBRES
where are the PURKINJE FIBRES LOCATED in the VENTRICLES
in the SUBENDOCARDIAL SURFACE of ventricular WALLS
- TERMINATE at the MYOCARDIAL CELLS
PURKINJE FIBRES are ABUNDANT with.. and have EXTENSIVE…
abundant with GLYCOGEN
have EXTENSIVE GAP JUNCTIONS
what do EXTENSIVE GAP JUNCTIONS of the PURKINJE FIBRES allow
to RAPIDLY TRANSMIT ACTION POTENTIALS from AV BUNDLE to MYOCARDIUM of VENTRICLES
- rapid conduction allows co-ordinated ventricular contraction
AUTONOMIC NERVOUS SYSTEM influences:
- HEART RATE
- FORCE of CONTRACTION
- CARDIAC OUTPUT
branches from both the PARASYMPATHETIC and SYMPATHETIC systems contribute to the…
CARDIAC PLEXUS
- Superficial part of cardiac plexus is between the aortic arch and pulmonary trunk
- Deeper part is between the aortic arch and trachea bifurcation
branches affect nodal tissue and other components of the conduction system, coronary blood vessels and atria and ventricular musculature
AFFECT of SYMPATHETIC NERVOUS SYSTEM
INCREASES FIRING RATE of SAN
- INCREASES HEART RATE
- INCREASES FORCE of Contraction
SYMPATHETIC FIBRES reach the CARDIAC PLEXUS though which nerves
CARDIAC NERVES from the SYMPATHETIC TRUNK
AFFECT of PARASYMPATHETIC NERVOUS SYSTEM
- DECREASES HEART RATE
- REDUCES FORCE of CONTRACTION
& CONSTRICTS CORONARY ARTERIES
PARASYMPATHETIC FIBRES reach the HEART AS CARDIAC BRANCHES from which nerve
RIGHT & LEFT VAGUS NERVES
VISCERAL AFFERENT FIBRES convey … and … FIBRES from the HEART
REFLEXIVE and NOCICEPTIVE fibres
VAGAL AFFERENTS associated with VAGAL CARDIAC NERVES (PARASYMPATHETIC) are primarily concerned with…
CARDIAC REFLEXES
ie BLOOD PRESSURE, BLOOD CHEMISTRY
VAGAL AFFERENTS associated with CARDIAC NERVES FROM SYMPATHETIC TRUNKS (Sympathetic) conduct…
PAIN SENSATION FROM the HEART
where does patient PERCIEVE PAIN FROM HEART (in which Dermatomes)
T1-T4
(visceral sensory and somatic afferent nerves are both at t1-t4 so brain cannot distinguish between them)
which NERVOUS SYSTEM enables HEART PAIN SENSATION
SYMPATHETIC
- CARDIAC NERVES FROM SYMPATHETIC TRUNKS
name the GREAT VESSELS
AORTA
PULMONARY ARTERIES
PULMONARY VEINS
SUPERIOR VENA CAVA
INFERIOR VENA CAVA
ASCENDING AORTA (transports oxygen rich blood from left ventricle) is contained within the PERICARDIAL SAC.
It is one of the contents of the … MEDIASTINUM
MIDDLE MEDIASTINUM
ASCENDING AORTA begins at the Aortic Orifice of the Left Ventricle, Ascends and MOVES TO THE…
(right or left)
RIGHT
when is the ASCENDING AORTA known as the ARCH OF THE AORTA
at the level of the STERNAL PLANE as it enters the SUPERIOR MEDIASTINUM
BRANCHES of the ASCENDING AORTA:
LEFT & RIGHT CORONARY ARTERIES
in what DIRECTION does the ARCH OF THE AORTA arch?
POSTERIORLY and to the LEFT
THREE BRANCHES arise from the SUPERIOR BORDER of the ARCH OF THE AORTA:
- BRACIOCEPHALIC TRUNK (largest)
- LEFT COMMON CAROTID ARTERY
- LEFT SUBCLAVIAN ARTERY
what is the remnant found on the INFERIOR aspect of the ARCH OF THE AORTA
LIGAMENTUM ARTERIOSUS
- Remnant of the DUCTUS ARTERIOSUS (connects pulmonary trunk to the arch to bypass lungs)
what are the branches of the BRACIOCEPHALIC TRUNK
- RIGHT COMMON CAROTID
- RIGHT SUCLAVIAN
the DESCENDING AORTA is the Continuation of the ARCH OF AORTA at which level
at STERNAL PLANE
- VERTEBRAL LEVEL T4
DESCENDING AORTA descends the Thorax in the … MEDIASTINUM
POSTERIOR MEDIASTINUM
how does the DESCENDING AORTA move in relation to the VERTEBRAL BODIES
BEGINS to the LEFT of the Vertebral Bodies
moves ANTERIOR to the Vertebral Bodies
at which level does the DESCENDING AORTA pass through the DIAPHRAPGM (through AORTIC HIATUS) to become the ABDOMINAL AORTA
T12
AORTA ARCHES POSTERIORLY and then to the right or left
LEFT
which vessel BEGINS as the MOST ANTERIOR of the GREAT VESSELS
PULMONARY TRUNK
(venous blood from right ventricle to lungs)
as the PULMONARY TRUNK ASCENDS it MOVES … and to the … of the ASCENDING AORTA
POSTERIORLY
and to the LEFT of the ASCENDING AORTA
PULMONARY TRUNK BIFURCATES in LEFT & RIGHT PULMONARY ARTERIES (to left and right lungs) at which VERTEBRAL LEVEL
T5
PULMONARY VEINS transport OXYGEN RICH blood from the Lungs to the LEFT ATRIUM.
how many pulmonary veins do we have?
4
SUPERIOR LEFT & RIGHT
INFERIOR LEFT & RIGHT
SUPERIOR VENA CAVA (SVC) transports VENOUS BLOOD FROM … to the right atrium
HEAD, NECK, UPPER LIMBS and INTERCOSTAL VEINS
(all structures superior to diaphragm except heart and lungs)
SCV is formed by the UNION of which VEINS
RIGHT & LEFT BRACHIOCEPHALIC VEINS
RIGHT & LEFT BRACHIOCEPHALIC VEINS form the SVC.
braciocephalic veins are formed by the UNION of which VEINS
INTERNAL JUGULAR VEINS
SUBCLAVIAN VEINS
does the SVC have VALVES
NO - VALVELESS
- as blood flowing in direction of gravity (down)
SVC BEGINS POSTERIOR to the … COSTAL CARTILAGE and DESCENDS until the … COSTAL CARTILAGE
1ST RIGHT COSTAL CARTILAGE
until the 3RD COSTAL CARTILAGE
INFERIOR VENA CAVA (IVC) transports VENOUS BLOOD FROM..
the ABDOMEN, PELVIS, LOWER LIMBS (region below diaphragm)
IVC passes through the CENTRAL TENDON / CAVAL HIATUS of the DIAPHRAGM at which VERTEBRAL LEVEL
T8
(vena cava = 8
oesophagus = 10
aortic hiatus = 12)
which PORTION of the IVC is SHORT
THORACIC PORTION
- passes through the PERICARDIUM
does the IVC have VALVES
NO - VALVELESS
as forward flow of blood to heart is driven by differential pressure created by normal pressure
Which part of the CARDIAC CONDUCTION SYSTEM PASSES through the SEPTOMARGINAL TRABECULA
RIGHT BUNDLE BRANCH
VISCERAL AFFERENT FIBRES associated with the VAGAL CARDIAC NERVES are concerned with….
CARDIAC REFLEXES
the RIGHT PULMONARY ARTERY passes POSTERIOR to which 2 VESSELS
ASCENDING AORTA
& SVC
which part of the AORTA is within the MIDDLE MEDIASTINUM
ASCENDING AORTA
which part of the AORTA is within the POSTERIOR MEDIASTINUM
DESCENDING AORTA
the HEART is found in the … MEDIASTINUM
MIDDLE MEDIASTINUM