A11 Heart and Pericardium

Question 1

Pericardium

Answer 1

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

Question 2

pericarditis

Answer 2

inflammation of the serous pericardium

results in roughened surgaces that a cant be hdeard rubbing together, two pieces of silk during auscultation

Question 3

cardiac tamponade

Answer 3

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

Question 4

Sinus

Answer 4

Oblique (bottom)

Transverse (top)
- used at site of great vessel ligation

Question 5

Neurovascular supply

Answer 5

pericardiophrenic arety and vein
-of internal thoracic aa
to brachiocephalic vv

Phrenic NN (C3-C5)
-referred pain

Question 6

Epicardium, myocardium, endocardium

Answer 6

visceral pericardium (fat storage)

myo-muscular

endo
-endothelium (adheres to myo and heart valves)

Question 7

Major components

Answer 7

two atria
two ventricle
intraterterial septum (wall)
-surface-interarterial sulci

intraventricular septum (wall)
-interventricular sulcus

Question 8

Blood Path

Answer 8

RA

RV

PC

LA

LV

SC

Question 9

Geography of heat to ribs

Answer 9

Base- T6-T9
- mostly left atrium

Apex -Fifth intercostal space

Question 10

surfaces of heart

Answer 10

Sternocostal: Anterior-mostly right ventricle

diaphragmatic : inferior- mostly left ventricle
-central tendon

• Right Pulmonary- mostly right atrium
• left pulmonary- mosly left ventricle (cardiac impression)

Question 11

Fibrous Skeleton of Heart

Answer 11

Dense Collagen

Anchors Muscle
Supports Valves
Aids Conduction

-add all parts

Question 12

Identify in Right Atrium

Answer 12

Right Auricle

Fossa Ovalis

Sinus Venarum - smooth

Pectinate muscle - rough

Cristae terminalis (ridge)

Coronary Sinus

SVC 3rd costal cartilage
IVC 5th costal cartilage

Question 13

Tricuspid Valve

Answer 13

Drains right atrium to right ventricle

-chordinae tendonae (prevent pullback into right atrium)

Question 14

Identify in Right Ventricle

Answer 14

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

Question 15

Left Atrium

Answer 15

Left auricle
with pectinate muscle

smooth internal surface

thicker walls

valve of fossa ovalis

interarterial septum

mitral valve (TWO CUSPS)

Question 16

Left Ventricle

Answer 16

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

Question 17

Diastole

Answer 17

atria contract, ventricles relax
av valves open, semilunar close
ventricles fill

Question 18

systole

Answer 18

ventricles contract
av valves close, al valves open
blood enters pulmonary and systemic circuit

Question 19

LUB DUB

Answer 19

LUB: closure of AV valves

DUB: closure of semilunar

Question 20

Mitral Valve Prolapse

Answer 20

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

Question 21

Semilular

Answer 21

three cusps each

lunule

nodule

sinuses

RCA

LCA

-holes in two supply right and left coronary on AORTIC

CLOSED IN DIASTOLE

No chordae tendineae

Question 22

arterial supply

Answer 22

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