9/1 Anatomy Flashcards
what is the anotomical orientation of the heart in an axial CT picture of the heart
remember radiographs are from fee to head! therefore the right atrium would be far to the left of the picture, and the right ventricle would be superior to that and the most superior. the left atrium would be the most posterior, and the left ventricle would be the larges section to the farthest right of the image.
where is the left and right on an axial CT
the right is on the left and the left is on the right so the image is from the feet up.
how could we find the back of the heart and the location of the left atrium
the pulmonary veins go in the back of the heart
how could we find the left side of the heart and the left ventricle.
the left ventricle would have more myocardium and a larger size
how could be locate the back of the heart and the left atrium
the aorta flows down the back of the heart next to the left ventricle.
what is another name for an axial picture?
horizontal; transverse
how can we identify systole?
the ventricles are contracting (the source of the name) so the smaller triscupid
what is the orientation of the valves of the heart
when looking down from the top when the heart is oriented to the front: the tricuspid valve of the right ventricle is to the lower right, the bicuspid valve of the left ventricle is to the lower left and the valve from the left ventricle is in the middle and the valve from the right ventricle is in the front
what is diastole?
the contraction of the atriums: with the bicuspid and tricuspid valves open
what is the name of the smaller tricuspid valves?
the semi lumanar valves
what is the collection of the blood from the coronary system back into the heart
The coronary sinus
what is the standard view for anatomical sections:
from head to foot
what is the sorce of the S1 sound that the heart makes
the closure of the AV valves (the bicuspid and the tricuspid valves)
what is the source of the S2 sound in the heart?
the closure of the semi-lumar valves. and the blood hitting those valves close.
what is systole
the contraction of the ventricles (and the opening of the similuminar valves
what is the sound interval for systole?
between the S1 and S2 sounds
what is the sound sequance for distole
between the S2 and S1 sound (this is the larger period) and when the ventricle fills with blood
what are the two other heart sounds?
S3 and s4?
what is the source of S3 and S4?
turbulent blood in the chamber.
what is the sequence when the blood is being squeezed out?
the Systole part of the cycle and between S1 and S2
aa 56 year old man is going to have surgery for insufficient aortic valve: identify the chamber of the heart that the regurgitating blood will most likely enter:
left ventricle during diastole
where is the aortic valve?
between the left ventricle and the arotic arch
what does albuterol do to the smooth muscle of the lungs and whhy?
it activvates the b-adernergic recelptors on the airway of the smooth muscle wich is the receptor for adrenaline or epinepherine.
what is the synapse for the pre-arotic chain fo the sympathetic?
the belly and the gut and the pelvis
a man preents with BMI of 32, a 30 year pack history and angina. explain the angina (the referred pain). The
the visceral sensory information comes to the same dorsal horn gray matter as the somatic nervous system dermatomes T1 to T4. This is the same region of sympathetic inervation to the heart, which is the same path taken by the visceral sensory nerves.
what is the somatic sensory
the sensory to the skin….pain temp, touch, vibration etc.
what is the viseral sensory
sensory from the visceral organs that go to the same spinal region as the accompanying autonomic nerves (the sympathetic motor nerves or parasympathetic motor nerves)
do you have refered pain with the parasympathetic nervous system
not really, you could have nauseousness etc.
what encloses the heart?
a three layered pericardial sack
what does the three layered pericardial sack do for the heart?
protects it from over filling and produces a lubricating fluid.
what are the three layers of the pericardial sack
All three layers together are the Serous membranes. The first two layers are called the parietal pericardium, and they are parietal Fibrous pericardium, and the Parietal Serous pericardium. The third layer is the Serous Visceral pericardium!
what is the purpose of the fibrous pericardium? (outside layer)
to attach to the diaphragm and prevent the heart from over-filling.
how is the Serous pericardium unique in its morphalogy
it is actually folded up on itself so that it creates two layers (outer parietal layer and inner Visceral layer.)
where is the fibrous layer paricardium
surounding the heart, it is the outside fiberous layer of the serous membranes.
what lies between the two inside layers of serous membrane of the paricardium
The pericardial space, filled with pericardial fluid.
What three methods exist for blood entering the right side of the heart?
Superior vena cava from the lower half of the body, Inferior vena cava from the lower half, and the coronary sinus that returns coronary blood.
what is an alternate name for the right AV vlave
Tricuspid valve.
what brings blood back from the lungs
pulmanary viens.
what are the names of then bicuspid valve
mitral valve left AV vilve
what part of the heart touches the sternum?
The right ventricle.
what lies on the diaphragm for the heart
the apex of the left ventricle
what part of the heart touches the esophagus
the left atrium
what are the caval veins
the IVC and SVC
how do the large valves of the heart avoid undergoing prolapse during systolie
the papilary muscles pull on the chordae tendinae to prevent the cusps of the valve from opening in the wrong direction
how can the coronary arteries identify the aorta?
The right coronary artery and the left coronary arteries come off of the aorta, while there are no small vessels off of the pulmonary arteries.
why does the heart need its own circulatory system?
the force velocity of the blood and the thickness of the muscles prevents the blood from oxygenating the heart form the inside.
why are coronary arteries considered end arteries?
supply with out overlap or anastomoses from other arteries. (there is no retrograde flow)
what event(s) would lead to ischemia of heart muscle cells
this is cell death and could be caused by lack of blood flow due to a heart attack (coronary, cardiac arrest, or myocardial infarction)
where is the opening for the right coronary artery
the right anterior cusp of the aortic valve.
where does the right coronary artery course
from the aortic valve around the right atrium to the back of the heart. (like a crown)
where does the SA nodal go and where
it goes from the begging of the right coronary artery and dives under the adipose, over the top of the right atrium to the SA node.
where does the right marginal artery go?
it is right and courses along the right margin. (it is also called the acute marginal artery after the acute angle with the right coronary artery
where is the posterior descending artery
the PDA is near the end of the right coronary artery and courses down the septum between the right and left ventricles in the back (also called the posterior inter ventricular artery
what is coronary dominance?
defined by which coronary artery gives rise to the PDA. Mostly right dominant! some time left and very small chance it is co-dominant
where is the crux of the heart?
the intersection of the PDA and the coronary artery
what is located at the crux at the heary
AV nodal arery, and goes to the AV node
left coronary artery
This is very short and biforcates into the LAD and the LCX soon after leaving the heart from the Left anterior cusp of the aortic valve.
what is the heart’s LAD
left anterior descending artery. it is also called the anterior interventricular artery.
what is the heart’s LCX
the left circumflex artery it is the left curving artery around the left coronary sulcus,
what is the L. Marginal artery.
branch from the LCX that is also the obtuse marginal artery.
what are the three divisions of cardiac veins?
Great, middle, and small cardiac veins
where do all of the viens of the cardiac system lead?
to the coronary sinus
describe the path of the great cardiac vein
arises from the apex of the heart and courses along the anterior interventicular septum, then around the coronary sulcus and into the sinus. parallels the LAD and drains the left coronary arterie
Middle cardiac vein
up the posterior interventicular septum, and then to the coronary sinus.
small cardiac viens
arise on the right ventricle and feed into the coronary sinus
how does the blood from the right coronary artery get back to the right atrium?
through the middle and small cardiac viens and back into the coronary sinus to the atrium
how is the coronary blood system controlled?
through local metabolites (hypoxia, adenosine). minor role of the sympathetic and parasympathetic.
how does sympathetic innervation affect the heart?
increase heart rate and increase the force of contraction
what section of the sympathetic spinal chord level specifically innervates the heart?
T1-T4 levels (sometimes T5) and the gagleons next to them, as well as the upper middle and lower cervical ganglions in the sympathetic chain.
describe the path of the sympathetic innervation of the heart:
the preganglionic neurons synapses in the lateral horn of the spinal chord gray matter then travels out the ventral root, thorugh the trunk and the ventral ramus to the white ramus communicon to the sympathetic chain where it synapses with the post ganglionic sympathetic neuron, the post ganglionic then travels to the heart
what are the postganglionic sympathetic nerves to the heart also known as?
the thoracic sympathetic cardiac nerves or the cardiopulmonary splanchnic nerves. or the ones from the cervical ganglions are the cerviacl sympathetic cardiac nerves.
how would loss of a cervical ganglion result in sympathetic innervation changes to the heart?
Higher, middle,and lower ganglions of the sympathetic chain in the cervical region innervate the heart.
what is the purpose of parasympathetic innervation to the heart?
decrease heart rate and decrease force of contraction.
where does parasympathetic innervation come from to go to the heart?
medula oblengota, and then goes down the vegas nerve to the heart where it synapses an intramural gangleon.!
describe the path of heart contraction initiation
SA node to the atrium, and to the AV node. then down the bundle of His, the left and right bundle branches and down the perking fibers.
where are visceral sensory affarent pathways found from the heart?
along both the parasympathetic and sympathetic tracks (the vegas nerve and the T1 to T4 sympathetic nerves.)
how is the visceral sensory associated with the path of the vegas nerve associated with homeostasis?
this nerve is responsible for sensing changes in BP and blood chemistry and deal with cardiac reflexes.
how are the sympathetic nerve pathways associated with referred pain?
T1-T4 sympathetic chain gangeon, as well as the middle and lower cervical ganglion serve as paths for the visceral sensory neurons from the heart. These also share a spinal chord section with the T1 to T4 dermitomes in the chest. This may be why chest pain is associated with heart attacks.
