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CRAAB 1 > Ach: Heart and Pericardial Sac > Flashcards

Ach: Heart and Pericardial Sac Flashcards

1
Q

What are the 4 subdivisions of the mediastinum?

A

Superior
Middle
Anterior
Posterior

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2
Q

What is the mediastinum? Where is it located? Are the vertebral bodies a part of it?

A

The middle region between the two pleural sacs.

From the superior aperture of the thorax to the diaphragm.

From the sternum/costal cartilages–> 12 thoracic vertebrae behind.

HELL NO

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3
Q

What structures are found in the middle mediastinum?

A

Pericardium
Heart
roots of the great vessels within the pericardial sac (aorta, SVC, IVC, P. arteries and veins)

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4
Q

What structures are found in the superior mediastinum?

A 
great veins
aorta and branches
parts of the trachea
esophagus
vagus nerves
recurrent laryngeal nerves
thoracic duct
thymus
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5
Q

Where is the superior mediastinum located?

A

Above the T4-T5 sternal angle plane

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6
Q

What structures are found in the anterior mediastinum?

A

Thymus gland

present in children, atrophied in adults

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7
Q

Where is the anterior mediastinum located?

A

Anterior to the fibrous pericardium and posterior to the sternum

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8
Q

What structures are found in the posterior mediastinum?

A

esophagus
descending aorta
thoracic duct

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9
Q

What is the pericardium?

A

A fibroserous sac located in the middle mediastinum that encloses the heart and the root of the great vessels.

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10
Q

What are the two layers that compose the pericardium?

A

Outer FIBROUS pericardium

Inner SEROUS pericardium

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11
Q

What does the Fibrous layer look like?

A

Fatty and blends with central tendon of the diaphgram

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12
Q

What does the fibrous layer do?

A

Two important jobs:
It holds the heart in place AND
protects it from overfilling

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13
Q

What innervates the fibrous layer?

A

phrenic nerve

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14
Q

What is the blood supply to the pericardium?

A

pericardiacophrenic arteries

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15
Q

What are the two layers that compose the serous pericardium?

A

Parietal

Visceral

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16
Q

Where is the parietal layer located?

A

It is fused to the fibrous pericardium?

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17
Q

Where is the visceral layer located?

A

It is the layer that surrounds the heart muscle

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18
Q

What is another name for the visceral pericardium?

A

Epicardium

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19
Q

How does the pericardium attach to the diaphragm?

A

By the pericardiacophrenic ligament

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20
Q

What innervates the epicardium?

A

Coronary plexus

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21
Q

What is the blood supply to the epicardium?

A

coronary arteries

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22
Q

What is the pericardial cavity?

A

The POTENTIAL space between parietal and visceral layers of the serous pericardium

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23
Q

What is the purpose of the pericardial cavity? How is it formed?

A

Reduce friction!

It contains a thin film of fluid that is produced by the serous pericardium that keeps the visceral and parietal layers from rubbing together.

The embryonic heart invaginates the wall of the serous sac.

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24
Q

What part of the heart sits on the diaphragm?

A

Mostly the LEFT ventricle.

25
Q

What is pericarditis?

A

Inflammation of the pericardium that usually causes chest pain.

26
Q

What happens during pericarditis?

A

The serous pericardium that is normally smooth becomes rough and is heard upon auscultation as a pericardial friction rub.

(sounds like the rustle of silk)

27
Q

What is a pericardial effusion?

A

A chronic inflamed pericardium or other diseases like congestive heart failure can lead to increased fluid in the heart, which compresses the heart and reduces cardiac output.

28
Q

What is a cardiac tamponade? Is it bad?

A

Compression of the heart d/t accumulation of fluid around the heart that interferes with refilling.

YES–> potentially lethal.

29
Q

What is a pericardiocentesis?

A

Drainage of fluid from the pericardial cavity to relieve tamponade.

30
Q

Where do you perform a pericardiocentesis?

A

5th intercostal space near the sternum. Insert a wide bore needle in the “bare” area of the pericardium using echocardiography to help position needle.

31
Q

What is a pericardiocentesis?

A

Drainage of fluid from the pericardial cavity to relieve the pressure of accumulated fluid on the heart.

32
Q

How are pericardial sinuses formed?

A

By folding of the primitive heart tube at the base of the great vesseels, carrying it’s serous pericardium with it.

33
Q

What are the two pericardial sinuses?

A

Transverse PS- below the SVC, aorta, Pulmonary trunk

Oblique PS-Below the right and left pulmonary veins an adjacent to the IVC

34
Q

What’s the clinical significance of the transverse pericardial sinus?

A

Used in cardiac surgery to clamp the aorta and pulmonary trunk

35
Q

Where does the transverse sinus lie?

A

Between the OUTflow and INflow of the heart.

36
Q

What is the blood and nerve supply to the pericardium?

A

Fibrous- phrenic, pericardiacophrenic arteries

Serous- Coronary plexus, coronary arteries

37
Q

What are the 4 components of the heart wall?

A

Epicardium
Myocardium (heart muscle)
Endocardium (endothelial lining)
Cardiac skeleton (fibrous connective tissue separating the atria and ventricles; surround and support valve orifices

38
Q

What is the coronary sulcus?

A

Separates the atria from the ventricles

39
Q

What is the interventricular sulcus?

A

Separates the ventricles

40
Q

What is the crista terminalis?

A

a muscular ridge internally that separates the primitive atrium from the smooth remnant of the sinus venosus

41
Q

What are features of the right atrium?

A 
Crista terminalis
Pectinate muscles
SVC and IVC
Coronary sinus
Interartrial septum (fossa ovalis and limbus)
Right atrioventricular orifice
42
Q

What does the right atrioventricular orifice do? What valve is active there?

A

Communicates with the right ventricle

Tricuspid valve

43
Q

What valve is located between the right atrium and right ventricle?

A

Tricuspid valve

44
Q

What are the three cusps of the tricuspid valve?

A

septal
posterior
anterior

45
Q

How do the chordae tendinae and papillary muscles relate to the tricuspid valve?

A

both prevent the valve from inverting

the chordae tendineae attach papillary muscle to valve cusp

When the ventricle contracts, the papillary muscles contract and prevent the cusps from being force into the atrium by pulling on the chordae tendineae.

46
Q

What is the pulmonary orifice?

A

Communicates with the pulmonary trunk and is guarded by the pulmonary valve.

47
Q

What are the three cusps of the pulmonary valve?

A

Anterior, right and left

sinus
lunula and nodule

48
Q

What happens to the pulmonary valve during systole and diastole?

A

Systole- cusps are pushed against the wall of the pulmonary trunk by the out-rushing blood

Diastole- blood flows back towards the heart and fills the sinuses to close the orifice

49
Q

The tricuspid valve, pulmonary orifice, trabeculae carneae, septomarginal traveculkae, interventricular septum, and ligamentum ateriosum are all part of what champer?

A

Right ventricle

50
Q

What is the septomarginal trabeculae (moderator band)?

A

Contains part of the conducting system of the heart

51
Q

What is the ligamentum arteriosum?

A

A fibrous remnant of a fetal vessel conveying blood from the pulmonary artery to the aorta

52
Q

Four pulmonary veins open into what atrium?

A

Left atrium

53
Q

The valvule of the foramen ovale and the left atrioventricular orifice open into what atrium?

A

Left atrium

54
Q

What valve is active between the LA and the LV?

A

Mitral

55
Q

What are components of the mitral valve?

A

anterior and posterior cusps

56
Q

What are the 4 structures found in the right ventricle?

A

Mitral valve
Aortic valve
Chordae tendinae and papillary muscles
Trabeculae carneae

57
Q

What are the first branches of the aorta and what do they supply?

A

Right and left coronary arteries

Myocardium and epicardium of the heart

58
Q

What is the impulse conducting system of the heart?

A

An intrinsic system involving specialized cardiac muscle fibers (Purkinje fibers)

59
Q

Describe the path of contraction in the heart.

A

Contraction begins in SA node, spreads across the atria. Stimulates the AV node, transmits electrical impulse to the apex of the ventricles. Contraction occurs from apex to base in a wringing motion.

CRAAB 1 (11 decks)

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