ANA 202 Heart

Question 1

Describe the heart

Answer 1

Conical, hollow muscular organ found in the chest between the lungs and surrounded by a membrane called the pericardium

Diameter: 12x9cm
Weight:
Females- 250g
Males - 300g

Question 2

Describe the pericardium

Answer 2

A fibro-serous sac which encloses the heart and the root of the great vessels
Consists of 2 layers
Parietal layer: fused with fibrous pericardium
Visceral layer: fused to the heart

Question 3

Location and position of the heart

Answer 3

It is obliquely behind the body of the sternum

Question 4

Describe the apex of the heart

Answer 4

Formed by left ventricle
Directed downward and forward to the left
At the left 5th intercostal space
3.5 inches lateral to mid sternal line (medial to the left mid clavicular line)

Question 5

Describe the base of the heart

Answer 5

Formed by the left atrium and a small part of the right atrium
Serves as an opening of the pulmonary veins (4)
Forms the posterior surface of the heart

Question 6

Discuss the right atrium

Answer 6

It’s external extension is the right auricle
And it has 3 main openings: the superior vena cava, inferior vena cava and coronary vein

Interior
Smooth posterior part
Rough anterior: pectinate part (muscle pectinate)
Septal wall

The right atrium receives blood from the whole body and pumps it to the right ventricle through the right atrioventricular orifice.

Question 7

Discuss the left atrium

Answer 7

External extension - left auricle
2 pulmonary veins open into the atrium, each side of the posterior wall
Interior: greater part is smooth
The left atrium receives blood from the body and pumps to RV through the left AV orifice

Question 8

Discuss the right ventricle

Answer 8

Right ventricle
Receive blood from the right atrium
Pumps to the lungs through pulmonary artery

Interior:
Rough part (inflowing part): trabecular carneae
-Papillary muscles—finger like projections from the ventricle wall
-Other end connects to cusps of AV valves through chordae tendinae
Smooth part (Outflowing part): Infundibulum

Two orifices: Tricuspid, and pulmonary

Question 9

Discuss the left ventricle

Answer 9

Left ventricle

It forms the apex of the heart
Receive oxygenated blood from the left atrium
Pumps into the aorta

Interior:
Rough part (inflowing part)
Smooth part (Outflowing part): Aortic vestibule

Two orifices: Mitral, and aortic

Question 10

What is a heart murmur

Answer 10

An extra sound in a heartbeat caused by turbulent (rough) blood flow through the heart valves or near the heart

Question 11

What is stenosis? What are the types

Answer 11

Stenosis of the heart includes narrowing of the heart valves and subsequent changes in blood flow and intracardiac pressure
Mitral valve stenosis: causes include rheumatic fever
Aortic valve stenosis: causes include congenital heart defect

Question 12

What is regurgitation of blood?

Answer 12

A backflow of blood caused by failure of the heart’s valve to close tightly.
Symptoms include shortness of breath, fatigue, lightheadedness and a rapid, fluttering heartbeat

Question 13

Whar us the abdomen?

Answer 13

The part of the body between the thorax and pelvis

Question 14

Notable landmarks on the abdomen

Answer 14

Umbilicus: the most visible structure indicating midway between the xiphoid process and pubic symphysis.

Linea alba is a thin band of connective tissue running down the front of your abdomen. It separates the left and right sides of your rectus abdominis. It begins at the lower end of your sternum (breastbone) and ends at the public bone

Semilunar lines aka linea semilunaris: The linea semilunaris is the tendinous intersection that separates the lateral edge of the muscle from the external oblique and internal oblique muscles that lie on the lateral surface of the anterior abdominal wall. It usually extends from tip of the ninth costal cartilage to the pubic tubercle

Question 15

Describe the 2 horizontal and vertical planes dividing the abdomen

Answer 15

Vertical plane (L and R) runs from the mid-clavicular line to the mid-inguinal point
Horizontal plane: The horizontal planes include the subcostal and intertubercular planes. The subcostal plane runs horizontally through the lower border of the tenth costal cartilage on either side. Finally, the intertubercular plane passes through the tubercles of the iliac crest and the body of the fifth lumbar vertebra

Question 16

What are the 4 segments of the abdomen?

Answer 16

the vertical line through linea alba (median plane) crosses horizontal line through the umbilicus (transumbilical plane) -> four quadrants: right upper quadrant (RUQ), right lower quadrant (RLQ), left upper quadrant (LUQ), left lower quadrant (LLQ

Question 17

What are the 9 regions of the abdomen?

Answer 17

right hypochondriac
left hypochondriac
Right fundus/ flank
Left fundus/ flank
right groin/ inguinal region
left groin/ inguinal region
epigastric
umbilicus
hypogastric/pubic region

Question 18

What are in the left and right hypochondriac region?

Answer 18

The left hypochondriac region contains the:
The stomach
The top of the left lobe of the liver
The left kidney
The spleen
The tail of the pancreas
Parts of the small intestine
The transverse colon
The descending colon

The right hypochondriac region contains the:
The liver
The gallbladder
The small intestine
The ascending colon
The transverse colon
The right kidney

Question 19

What are the contents of the epigastric region?

Answer 19

The epigastric region contains the:
The oesophagus
The stomach
The liver
The spleen
The pancreas
The right and left kidneys
The right and left ureters
The right and left suprarenal glands
The small intestine
The transverse colon

Question 20

What are the contents of the left and right flank?

Answer 20

The left flank region contains:
A portion of the small intestine
A part of the descending colon
The tip of the left kidney
Right lumbar region

The right flank region contains the:
The tip of the liver
The gallbladder
The small intestine
The ascending colon
The right kidney

Question 21

What are the contents of the umbilical region?

Answer 21

The umbilical region contains the:
The stomach
The pancreas
The small intestine
The transverse colon
The medial extremities of the right and left kidneys
The right and left ureters
The cisterna chyli

Question 22

What are the contents of the left and right inguinal region?

Answer 22

The left inguinal region contains:
Part of the small intestine
The descending colon
The sigmoid colon
The left ovary and the left fallopian tube in females.

The right inguinal region contains the:
The small intestine
The appendix
The cecum
The ascending colon
The right ovary and right fallopian tube in females

Question 23

What is the contents of the hypogastric region?

Answer 23

The hypogastric region contains:
The small intestine
The sigmoid colon
The rectum
The urinary bladder
The right and left ureters
The uterus, the right and left ovaries and the fallopian tubes can be found in females
The ductus deferens, seminal vesicles and prostate in males

Question 24

Surface projections of the heart

Answer 24

Superior Border
•It extend from the 2nd left costal cartilage (at the level of the sternal angle) to the upper border of the 3rd right costal cartilage.
Lateral Border
•Right lateral border: The right lateral border extends from 3rd right costal cartilage to the 6th costal cartilage.
•Left lateral border: The left lateral border extends from 2nd left costal cartilage to the 5th intercostal space (about 10cm from the midline).
•Inferior Border
•The inferior border extends from the right 6th costal cartilage to the left 5th intercostal space (at the mid clavicular line).

Question 25

SURFACE PROJECTION OF THE PLEURA

Answer 25

Anterior Border
•The lungs extend to the neck (about 2cm above the mid clavicular line on both side).
•It further extend to the level of the 2nd costal cartilage (at the level of the sternal angle).
Left pleura:
•It further extend to the 4th costal cartilage (it branched laterally to the left at this point). And further extend downward to the 6th costal cartilage.
Right pleura:
•On the right, the pleural extends to the 4th and 6th costal cartilage.
Inferior Border
•The pleura extends inferio-laterally, crossing the midclavicular line at the level of the 8th rib
•It crosses the mid axillary line at the level of the 10th rib
•It further cross the 12th rib (closed to 12th thoracic vertebra)

Posterior Border
•Extends from the T12 upward till the apex

Question 26

What are the arteries that supply the heart?

Answer 26

The right coronary artery originates from the right aortic sinus
● the left coronary artery originates from the left aortic sinus

Question 27

What is cardiac dominance

Answer 27

Cardiac dominance
•In about 85% of people, the RCA is said to be ‘dominant’ because it supplies circulation to the inferior portion of the interventricular septum via the posterior interventricular branch of the RCA
•In about 15% of heart, the right coronary artery is rather small and cannot give the posterior interventricular branch
•In this case, the left circumflex artery provides the posterior interventricular branch and also supply the AV node
•In such case, the LCA is said to be dominant

Question 28

Explain the blood supply of the heartv