Anatomy

Question 1

The left border of the heart is created primarily by what structures?

Answer 1

Left ventricle and left atrial appendage

The left atrium is border forming in the high posterior, subcarinal region

The left ventricle is border forming inferiorly and posteriorly

Question 2

The right atrium is divided by two portions.

What are these portions?

Answer 2

The smooth posterior wall develops from the sinus venosus, with the attached SVC and IVC in continuity posteriorly.

The trabeculated anterior wall is derived from the embryonic RA.

Question 3

This is a muscular ridge that runs from the mouth of the SVC and fades inferiorly to the mouth of the IVC.

Answer 3

Crista terminalis

Question 4

What divides the two portions of the right atrium?

It corresponds to an external sulcus terminalis.

Answer 4

Crista terminalis

Question 5

The medial or posterior wall of the RA is the interatrial septum, which contains a smooth, central simple called what?

Answer 5

Fossa ovalis

Question 6

Inflow from the SVC, IVC, and coronary sinus enters what portion of the RA?

Answer 6

Smooth posterior portion

Question 7

The SVC has a free opening, whereas the IVC is partially guarded by what structure?

This structure is occasionally absent or perforated (network of Chiari)

Answer 7

Thin eustachian valve

Question 8

The large draining coronary vein or coronary sinus enters the RA anterior and medial to what structure?

Answer 8

Inferior vena cava

Question 9

The coronary sinus opening is guarded by what structure?

It is located between the orifice of the IVC and tricuspid valve.

Answer 9

Thebesian valve

Question 10

The right ventricle is divided into what portions?

Answer 10

The RV is divided into a posterior or inferior (inflow or sinus portion), which is heavily trabeculated, and a less trabeculated anterior or superior portion (outflow or pulmonary conus)

Question 11

The two portions of the RV is divided by what structure?

Answer 11

By the crista supraventricularis, which is a muscular ridge with a septal band called the moderator band

Question 12

This band is present in more than 40% of patients, connects the interventricular septum to the anterior papillary muscle, and contains the right bundle branch.

Answer 12

Moderator band

Question 13

What is the smooth cephalic portion of the RV that leads to the pulmonary trunk?

Answer 13

Infundibulum (conus arteriosus)

Question 14

The ligamentum arteriosum arises from what structure?

Answer 14

From the superior, proximal left pulmonary artery

And crosses through the aortopulmonary window to the floor of the aorta

Question 15

The ligamentum arteriosum is the remnant of what embryological structure?

Answer 15

Ductus arteriosus

Question 16

The ductus arteriosus closes functionally in how many hours and closes anatomically by how many days?

Answer 16

Closes functionally = first 24 hours

Closes anatomically = by 10 days

Question 17

This are strong fibrous cords that extend from the mitral leaflets to the papillary muscles of the LV.

Answer 17

Chordae tendineae

Question 18

Where are the inflow and outflow portions of the LV?

Answer 18

Inflow portion = posterior to the anterior leaflet of the mitral valve

Outflow portion = anterior and superior to the anterior mitral leaflet

Question 19

The interventricular septum has a high membranous portion that is contiguous with what structure?

Answer 19

Aortic root

Question 20

The aortic valve is composed of what cusps?

Answer 20

Right, left and posterior (noncoronary)cusps

Question 21

These are the reservoirs created by the closure of the aortic valve and from which the right and left coronary arteries arises.

Answer 21

Sinuses of Valsalva

Question 22

The posterior and anterior walls of the aorta are continuous to what structures?

Answer 22

Posterior wall = continuous with the anterior leaflet of the mitral valve and more superiorly abuts the anterior wall of the LA

Anterior wall = continuous with the interventricular septum

Question 23

What node consists of a specialised neuromuscular tissue that measures approximately 5 to 20 mm and is located on the anterior endocardial surface of the RA just above the SVC and right atrial appendage junction, near the crista terminalis?

Answer 23

Sinoatrial node

Question 24

What node is a 2 x 5 mm region of neuromuscular tissue on the endocardial surface, along the right side of the interatrial septum, just inferior to the ostium of the coronary sinus?

Answer 24

Atrioventricular node

Question 25

The impulse is collected and delayed approximately how many seconds in the atrioventricular node before passing into the bundle of His?

Answer 25

0.7 seconds

Question 26

It is a 20-mm-long tract which extends down to the right side of the membranous interventricular septum.

Answer 26

Bundle of His

Question 27

The interventricular septum activates from superior to inferior. What areas are the first and last to activate?

Answer 27

Anterior or septal RV being first to activate and the posterior or septal LV being the last to activate.