Anatomy Flashcards
Right coronary artery supplies:
right ventricle
Posterior descending/interventricular artery supplies:
posterior 1/3 of intercentricular septum
posterior walls fo ventricles
posteromedial papillary muscle
left anterior descending artery supplies
anterior 2/3 of interventricular septum
anterolateral papillary muscle
anterior surface fo left ventricle
left circumflex artery
lateral and posterior walls of left ventricle
anterolateral papillary muscle
blood supply of SA and AV nodes please
RCA
infarct - bradycardia or heart block
describe normal splitting of S2
on inspiration, thoracic pressure drops resulting in increased VR and increased RV filling - increase RV stroke volume and increased RV ejection time ultimately leading to delayed closed of the pulmonic valuve
the capacitance of the pulmonary circulation also increases in inspiration so there is less resistance to its fillign so dereased pressure to close the pulmonic valve from the circulation side of thigns
describe wide splitting
seen in conditions that delay RV emptying = pulmonic stenosis or RBB
causes delayed pulmonic sound regardless of breath
describe fixed splitting
ASD: left to right shunt - increased RA and RV volumes - increasd flow through pumonic value so that regardless of breath, P2 is greatly delayed
describe paradoxical splitting
seen in conditions that delay aortic valve closure – aortic stenosis or LFF
expiration - will get P2 before A2
inspiration - since everything is okay on right side, P@ will move closer to A2 as in normal splitting of S2
what do you listen to at the aortic region
systolic aortic stenosis
flow murmur
aortic valve sclerosis
what do you listen to at the pulmonic region
systolic pulmonary stenosis flow murmur (phsyio and ASD)
what do you listen to at the tricuspid area
pansystolic tricuspid regurgitation and VSD
diastolic - tricuspid stenosis and ASD
what do you liste ot at the mitral area
systolic mitral regurgitation
diastolic mitral stenosis
what do you listen to at the left sternal border?
diastolic aortic and pulmonary regurgitation
systolic hypertrophic cardiomyopathy
what do you listen to at the left infraclavicular border?
PDA
describe what happens to murmors on inspiration?
right sided increased
increased VR to RA
what happesn to murmours during handgrip?
increased afterload
increases MR, AR, VSD
decreased hypertrophic cardiomyopathy
delays click in MVP
what happens to murmors in valsalva II and standing
decreased preload
decreases all mumrurs, even AS
icnreaseds hypertrophic cardiomyopathy
earlier click in MVP
what happens to murmurs on squatting?
increased VR and increased preload
increased AS
decreased hypertrophic cardiomyopathy
later click in MVP
describe aortic stenosis
systolic cres-decres ejection murmur
radiates to carodis
pulsus parvus and pulsus tardus
syncope, angina, dyspnea on exertion
cxpx of aortic stenosis
syncope, angia, dyspnea on exertion
what causes aortic stenosis
age related calcification or early onset calcification of bicuspid aortic avlave (turner)
describe mitral regurgitation
holosystolig high pitched blowing
radiates towards axilla
what causes mitral regurgitation
ischaemic heart disease - post mi
mvp
LV dilatation
describe tricuspid regurgitation
holosystolic, high pitched blowing
radiates to right sternal border
what causes tricuspid regurgitation
RB dilatiation
what can cause mitral/tricuspir regurgitation?
dilatiation of respective ventricles
rheumatic fever
infective endocarditis
describe mitral alve prlapse
late systolic crescendo murmur with midsystolic click due to sudden tensing of chordae tendiane
most frequent
loudest just before S2
what causes MCP
myxomatous defeneratio @ ct dissease, rheumatic fever, chordae rupture
describe VSD murmur
holosystolic
hard sounding
loudest at tricuspid
describe aortic regurgitation
pulsus bisferesns, water hammer, hyperdynamic pulse
high pitched, blowing, early diastolic decrescendo murmur
long diastolic
what causes aortic regurgitation
aortic root dilation,
bicuspid aortic valve
endocarditis
rheumatic fever
what dose aortic regurgitation lead to?
LHF
describe mitral stenosis
follows opening snap, delayed rumbling late diastolic murmur
how do judge severity of mitral stensosis
decreased interval between S2 and opening smap corrlates with increase severity
describe relationship between LA and LV pressure sdurign diatstole
LA»»>LV
what causes mitral stenosis?
secondary to rheumatic fever
what can chronic mitral stenosis cause?
LA dilatation
describe PDA murmur
continuous machine like murmur
loudest at S2
what causes PDA murmur?
congenital rubella
prematurity
