A11 Heart and Pericardium Flashcards
Pericardium
Sac around the heart
Fibrous
- outermost layer
- tough/inelastic
- limits filling capacity
- part of pericardiophrenic ligament:near diaphragm
Serous: single sheet of mesothelium
- parietal-adherent to fibrous
- Visceral-adherent to heart
pericardial cavity-between parietal and visceral
-fluid for lubrication
pericarditis
inflammation of the serous pericardium
results in roughened surgaces that a cant be hdeard rubbing together, two pieces of silk during auscultation
cardiac tamponade
potentially fatal excessive fluid buildup (from pericarditis) in pericardial cavity can prevent heart from expanding
use pericardiocentesis to drain, needle at cardiac notch of the left pleura
-5th or 6th intercostal space
Sinus
Oblique (bottom)
Transverse (top)
- used at site of great vessel ligation
Neurovascular supply
pericardiophrenic arety and vein
-of internal thoracic aa
to brachiocephalic vv
Phrenic NN (C3-C5) -referred pain
Epicardium, myocardium, endocardium
visceral pericardium (fat storage)
myo-muscular
endo
-endothelium (adheres to myo and heart valves)
Major components
two atria
two ventricle
intraterterial septum (wall)
-surface-interarterial sulci
intraventricular septum (wall) -interventricular sulcus
Blood Path
RA
RV
PC
LA
LV
SC
Geography of heat to ribs
Base- T6-T9
- mostly left atrium
Apex -Fifth intercostal space
surfaces of heart
Sternocostal: Anterior-mostly right ventricle
diaphragmatic : inferior- mostly left ventricle
-central tendon
- Right Pulmonary- mostly right atrium
- left pulmonary- mosly left ventricle (cardiac impression)
Fibrous Skeleton of Heart
Dense Collagen
Anchors Muscle
Supports Valves
Aids Conduction
-add all parts
Identify in Right Atrium
Right Auricle
Fossa Ovalis
Sinus Venarum - smooth
Pectinate muscle - rough
Cristae terminalis (ridge)
Coronary Sinus
SVC 3rd costal cartilage
IVC 5th costal cartilage
Tricuspid Valve
Drains right atrium to right ventricle
-chordinae tendonae (prevent pullback into right atrium)
Identify in Right Ventricle
Conus Arteriousus (pulmonary trunk)
Trabeculae carneae -rough
chordae tendonae
papillary muscle
interventricular septum
septomarginal trabecula (moderator band) - part of conducting system- sustains papillary muscle
Pulmonary orifice
pulmonary valve - 3rd costal cartilage
Left Atrium
Left auricle
with pectinate muscle
smooth internal surface
thicker walls
valve of fossa ovalis
interarterial septum
mitral valve (TWO CUSPS)
Left Ventricle
Blood from left atrium via mitral valve
Apex
THicker walls
trabeculae carneae (smaller more fibers)
2 papillary mm
chordae tendinae (prevent blowback, roots)
aortic vestibule- leads to aortic hole and valve that contains it
aortic orifice/valve
-associated with third costal cartilage
Diastole
atria contract, ventricles relax
av valves open, semilunar close
ventricles fill
systole
ventricles contract
av valves close, al valves open
blood enters pulmonary and systemic circuit
LUB DUB
LUB: closure of AV valves
DUB: closure of semilunar
Mitral Valve Prolapse
insufficiency of atriventricular valves - typically due to one or both leaflets being too large (backflow into the left atrium and results in audible murmer during auscultation)
1 in 20
degenerative
elongation of cusps and chordae tendinae cause prolapse
Semilular
three cusps each
lunule
nodule
sinuses
RCA
LCA
-holes in two supply right and left coronary on AORTIC
CLOSED IN DIASTOLE
No chordae tendineae
arterial supply
fg
