Anatomy

Question 1

Trace a drop of blood through the heart (& lungs) beginning with the IVC (include valves).

Answer 1

IVC > right atrium > tricuspid valve > right ventricle > pulmonary trunk valve > pulmonary trunk > lungs > pulmonary veins > left atrium > bicuspid (mitral) valve > left ventricle > aortic valve > aorta

Question 2

Name the three layers surrounding the heart/pericardial cavity.

Answer 2

Fibrous pericardium (1)
Serous pericardium: visceral layer (2) & parietal layer (3)

Question 3

1) What are the surface projections of the superior border of the heart? 2) What structures make up the superior border?

Answer 3

1) The 2nd and 3rd costal cartilages

2) Right and left atrium, aorta, pulmonary trunk

Question 4

What are the sulci of the heart?

Answer 4

Coronary, anterior interventricular, & posterior interventricular (CAP)

Question 5

Lymphatics of the heart: Left region

Answer 5

2 Regions:
Left: LV, small tip of RV, LA > left coronary trunk > tracheobronchial lymph nodes > drain to right subclavian and internal jugular veins (LV-sRV > left coronary trunk > tracheobronchial > RS and IJ)

Question 6

Sympathetic innervation to the heart

Answer 6

T2-T5 > thoracic aortic plexus, pulmonary plexus, cardiac plexus

Question 7

Parasympathetic innervation to the heart

Answer 7

Vagus (CN X) > cardiac plexus

Question 8

Lymphatic of the heart: Right region

Answer 8

RV & portions of the RA > right coronary trunk > along the ascending aorta > junction of left subclavian and internal jugular (RV-RA > RCT > AA > JLS and IJ)

Question 9

Lub

Answer 9

Closure of A-V valves

Question 10

Dub

Answer 10

Closure of semilunar valves

Question 11

Between lub and dub

Answer 11

systole

Question 12

Between dub and next lub

Answer 12

diastole

Question 13

Where does the right atrium receive blood from?

Answer 13

SVC, IVC, Anterior cardiac veins, coronary sinus (SIAC)

Question 14

Blood supply to SA node

Answer 14

Branch to SA node (off of Right coronary)

Question 15

Blood supply to AV node

Answer 15

Branch to AV node (off of Right coronary)

Question 16

Branches of right coronary artery (from proximal to distal)

Answer 16

1) Branch to senatorial node
2) Atrial branch
3) Right marginal branch
4) Posterior inter ventricular branch
5) Conus branch
6) Right posterolateral branch
7) Branch to atrioventricular
8) Interventricular septal branches

(BARPCRBI)

Question 17

Path of Vagus nerve

Answer 17

Leaves medulla oblongota between pyramid and inferior cerebral peduncle, extends through jugular foramen and into the carotid sheath (between internal carotid artery in internal jugular vein).

Question 18

Path of referred cardiac pain

Answer 18

ischemia, accumulation of metabolic products > pain endings in the myocardium stimulated > T1 - T4, T5

Question 19

Ligament between the pulmonary trunk and inferior side of base of aorta

Answer 19

ligamentum arteriosum

Question 20

Where is the area of auscultation for the pulmonary valve?

Answer 20

Between 2nd and 3rd costal cartilages on left side. 2 - 3 centimeters from border of sternum

Question 21

Where is the area of auscultation for the aortic valve?

Answer 21

ICS2 - 2, 3 cm to the left of midline

Question 22

Where is the area of auscultation for the tricuspid valve?

Answer 22

ICS2 - 3, 4 cm to the left of midline

Question 23

Where is the area of auscultation for the bicuspid valve (mitral)?

Answer 23

ICS5 - 5 cm to the left of midline

Question 24

SURFACE PROJECTION: Base of heart

Answer 24

T6 - T9, mostly left atrium

Question 25

SURFACE PROJECTION: Apex

Answer 25

ICS5 - 10 cm to the left of midline

Question 26

SURFACE PROJECTION: Diaphragmatic surface

Answer 26

Inferior portion of heart, rests on diaphragm, formed by both right and left ventricles