Anatomy: CVS🫀 Flashcards
1
Q
What are the pumps of the heart- structure and function?
A
specialised muscle that’s a closed system of tubes carrying blood to/from the capillary beds
2
Q
What are the 2 circulations in the CVS?CVS
A
pulmonary and systemic
3
Q
What circulation is the first pump associated with?
A
pulmonary
to lungs
4
Q
What circulation is the second pump associated with?
A
systemic
arteries- arterioles- capillaries
5
Q
Describe the journey of blood in the pulmonary circulation:
A
blood from sup/inferior vena cava:
right atrium –> right ventricle –> pulmonary trunk to be reoxygenated in lungs
6
Q
Describe the journey of blood in the systemic circulation:
A
oxygenated blood from pulmonary veins (lungs):
left atrium –> left ventricle –> aorta –> body
7
Q
How many pulmonary veins are there?
A
4 (2 from each lung)
8
Q
Where is the heart located?
A
thoracic cavity - the thorax
then the mediastinum
9
Q
What 2 apertures mark the beginning and end of the thorax?
A
start: superior thoracic aperture
end: inferior thoracic aperture
10
Q
where is the inferior mediastinum located?
A
below plane between sternal angle and vertebrae T4/T5
above diaphragm
11
Q
What structure covers the thoracic aperture?
A
diaphragm
12
Q
How is the thorax split into 2 mediastinum?
A
the imaginary plane between the sternal angle and intervertebral disk between thoracic vertebrae IV and V:
these 2 mediastinum are the superior and inferior mediastinum
13
Q
What is the inferior mediastinum further split into? (3)
A
the anterior, middle and posterior mediastinum
14
Q
Where in the thorax is the mediastinum located? a) anatomical relations to lungs
b) vertebrae
c) sternum
A
median portion of thorax
- located centrally between lungs
- anterior to vertebrae
- posterior to sternum
15
Q
What does the superior mediastinum contain?
A
the great vessels
16
Q
What is the pericardium?
A
fibro-serous, fluid-filled sack that surrounds the muscular body of the heart and the roots of the great vessels (the aorta, pulmonary artery, pulmonary veins, and the superior and inferior vena cavae).
17
Q
What are the 2 layers of pericardium?
A
fibrous pericardium and serous pericardium
18
Q
What is the fibrous pericardium?
A
outer fibrous, tough sleeve protecting the heart from distention and enlargement
19
Q
Which layer of the pericardium denotes the middle mediastinum (middle = division of inferior mediastinum)?
A
the fibrous layer - outer
20
Q
What 2 structures is the fibrous pericardium attached inferiorly to?
A
inferiorly to the diaphragm and sternum, creating a base for the heart
21
Q
What vessels is the fibrous pericardium associated with?
A
the great vessels, as the fibrous pericardium continues the adventitia of great vessels
22
Q
What is the serous pericardium?
A
thinner, more delicate membrane, double layer
23
Q
What are the 2 layers of the serous pericardium?
A
parietal (outer)
visceral (inner) - attached to myocardium of heart
24
Q
hat allows to heart to contract and relax?
A
layers of serous pericardium slide over each other to allow movement during heart beat - allows contract, relax the serum fluid inside
25
What are the parietal and visceral layers of the serous pericardium attached to?
- Parietal attached to fibrous pericardium due to being outer
- Visceral attached to myocardium of heart
26
What are the 3 layers of the heart muscle?
epicardium, myocardium, endocardium
27
What is the epicardium in terms of the pericardium?
the epicardium is the same as the visceral layer of the serous pericardium
28
What is the myocardium?
the musculature of the heart walls, allowing the pump to function
29
What is the endocardium? and whats it in contact with?
the protective inner lining of the heart, in contact with the blood
30
Pick the odd one out: epicardium, pericardium, myocardium and endocardium
pericardium: it isn't a layer of heart muscle but rather the fluid-filled sac that surrounds the heart muscle; only the visceral layer of the serous pericardium is the epicardium
31
What are the 5 surfaces of the heart?
- Base/posterior
- Anterior/sternocostal
- Diaphragmatic
- Left/right pulmonary
- Apex
32
Why is the anterior surface of the heart also known as the sternocostal surface of the heart?
it's in contact with the sternum (sterno) and costal cartilages (costal)
33
What ventricle forms the apex of the heart, and what direction does it inferiorly point to? (same answer)
left - the apex of heart formed by left ventricle points inferiorly to left
34
What structures divide the 4 chambers of the heart?
the sulci
35
What sulcus divides the atrium and ventricle (for both the left and right)? and what artery is found in here?
coronary sulcus and right coronary artery.
36
What blood vessels are found within the sulci?
the coronary arteries and veins
37
What sulci divide the right and left ventricle?
the anterior and posterior interventricular sulci
38
What structure is found within the coronary sulcus and what does it separate?
coronary sinus: separates the atria and ventricles on each side
39
In what mediastinum are the great vessels located?
in the middle mediastinum
40
What are the great vessels of the heart? (4)
Superior and inferior vena cava,
pulmonary artery,
pulmonary veins,
aorta
41
What veins are the first branch that drain into the superior vena cava?
the brachiocephalic veins
42
Where do the brachiocephalic veins come from in body?
- brachio = arm
- cephalic = head
- top-left comes from head and neck, top-right comes from arm
43
What are the 3 branches after the arch of the aorta is formed?
1. Brachiocephalic trunk:
a) right subclavian artery,
b) right common carotid artery
2. left Common Carotid artery
3. left Subclavian artery
(123: alphabetical order/ BCS)
44
How does BCS help you remember the order of the branches of the aorta?
BCS = branches in alphabetical order: Brachiocephalic trunk, left Common carotid artery, left Subclavian artery
45
name the branch of right dominant coronary artery
posterior interventricular artery
46
whats characteristic about the functional end arteries (final branches) of the coronary circulation?
they dont overlap their supply or anastomose (no surgical connection)
47
what would a blockage in the (right marginal branch of right) coronary arteriy lead to?
reduced blood supply to left ventricle
cardiac muscle ischaemia
myocardial infarction (MI) or necrosis- distal
48
where do most cardiac veins drain into? and where does this structure drain into?
the coronary sinus --> drains into right atrium
49
where do the vessels: SVC, IVC and coronary sinus drain into?
right atrium
50
fossa ovalis in right atrium = site of?
septal defects. hole in heart
foramen valve: only in foetus- blood bypasses lungs, therefore affects children
51
what does the crista terminalis in right atrium contain?
SA node at its most superior extent.
| within superior part of CT
52
6 structures in the right atrium?
```
interatrial septum
crista terminalis
oectinate muscle
fossa ovalis
coronary sinus
tricuspid valve
```
53
where is the centre of intrinsic control in right atrium?
SA node in CT/ interatrial septum
54
blood exits the right ventricle via what?
pulmonary valve and trunk
55
what 2 structures in right ventricle prevent reflux to right atrium?
chordae tendinae and papillary muscle
56
role of moderator band (septomarginal trabecula) in right ventricle?
carries right bundle branch of atrioventricular bundle
57
3 cusps: tricuspid valve attached to wall of right ventricle via?
the chordae tendinae
58
what are the 2 pairs vessels in left atrium?
left and right pulmonary veins
59
how does left atrium structure compare with right?
fewer features, smooth wall.
| also valve of formaen ovale is seen on interatrial septum
60
feautures of left ventricle
thicker myocardium: to force blood to circ system.
| larger papillary muscle due to increased pressure
61
where does blood from left ventricle exit by?
aorta and aortic valve
62
name two two:
a) atrioventricular (AV) valves
b) semilunar (S) valves
a) tricuspid valve
bicuspid valve
b) pulmonary valve
aortic valve
63
how do AV valves attach to papillary muscle?
| and their role?
via chordae tendinae in ventricle.
| prevents blood reflux into atrium
64
semilunar valves have how many cusps each?
3
65
where does aortic cusps also direct blood? (Semilunar valves)
also direct blood into left and right aortic sinus and into coronary circulation.
66
5 steps of cardiac conduction system?
1. SA node
2. across atrial cardiac muscle wall
3. AV node
4. L and R AV bundle (Bundle of His)
5. Purkinje fibres
67
what does the cardiac conduction system (5 steps) allow ventricles to do?
ventricles contract from apex towards the semilunar valves
68
neuronal control of heart: what is it modulated by?
ANS
69
whats the intrinsic SA node rate
=100bpm
70
cardiac plexus: parasympathetic input does what?
parasympathetic via vagus nerve
lowers HR and force (60bpm).
constricts coronary arteries
71
cardiac plexus: sympathetic input does what?
(sympathetic trunk) increases HR and force.
72
neuronal control of heart: whats HR modulated by?
Sympathetic nerves from inferior cervical ganglion
73
two circulation in the CVS. what is supplied by the:
a) right side of heart
b) left
a) pulmonary
| b) systemic
74
where is heart located and what surrounds it?
in middle inferior mediastinum
| surrounded by layers of fibrous and serous pericardium
75
where do R and L coronary arteries originate at?
R and L aortic sinus.
coronary veins drain into coronary sinus
76
whats common in all valves: structurally and functionally?
all have 3 cusps (excpet bicuspid) and prevent reflux of blood in heart chambers
77
role of SA node?
where the conduction system of heart coordinates electrical activity from
78
what regulates intrinsic HR of SA node? and normal value?
the ANS. normally 100bpm
79
role of pacemaker cells?
keep heart beating by generating initial spark. generate own AP!
dont need initial stimulus.
intrinsic cardiac conduction system
80
What are the 2 main functional parts of the cardiovascular system?
- conducting: arteries/veins
| - exchange: capillary bed that's continuous w/ ECF
81
what happens in exchange part of CVS?
nutrients waste gases enter ECF and leave cells
82
What exists between arteries and veins to control blood flow in and out of a capillary?
what links capillary with artery and vein?
arterioles and venules
83
What exists between arteries and veins to control blood flow in and out of a capillary?
what links capillary with artery and vein?
arterioles and venules
84
What are the 3 layers of blood vessel walls? (hint: all begin with tunica)
1. tunica externa/adventitia
2. tunica media
3. tunica intima
85
What is the main composition of the tunica externa/adventitia?
collagen (support) and vasa vasorum (vessels supplying these vessels)
86
What is the main composition of the tunica media?
thick smooth muscle/elastin
87
What is the main composition of the tunica intima?
endothelium/subendothelium
88
What can the tunica intima do in the veins?
form infoldings that are valves
89
In what blood vessel is the tunica media the thickest layer and why?
arteries
- arterial system has high BP= needs abundant elastic tissue to expand and recoil
- tunica media made mainly of elastin and thick smooth muscle
90
In what blood vessel is the tunica adventitia the thickest layer and why?
veins
- venous system is low pressure and the vascular walls are thinner
- can have valves in lower body as blood shouldn't pour into legs for example
91
whats the name for vessel wall:
a) expansion
b) return to normal
a) systole
| b) diastole
92
Histological section of blood vessel walls
```
V = vein
A = artery
Ad = tunica adventitia
M = tunica media
- note the thickness of the tunica media in the artery compared to the vein
```
93
histological section: what can be seen regarding lumen and tunica media size in artery?
artery has smaller lumen than vein
thick tunica media of artery
94
What composes the vessel wall of capillaries (beds) and why is it so different to the veins and arteries?
- Endothelial cell layer only
| - 1-cell thick wall creates path for diffusion to cells via extracellular space
95
What vessels control BP and blood flow into the capillary beds and how?
Arterioles - constrict pre-capillary sphincters
| - can do this during hot and cold days
96
The 3 sections of the aorta and what do they supply?
- the ascending aorta: coronary
- the arch of the aorta: head and upper limb
- the descending aorta: GI tract, kidneys
97
What arteries branch off of the ascending aorta?
coronary arteries
98
What 3 arteries branch off the arch of the aorta?
- brachiocephalic trunk (which has branches right subclavian artery and right common carotid artery)
- left common carotid
- left subclavian
BCS/alphabetical
99
At what vertebral level does the descending aorta emerge through the diaphragm at?
T12
100
What are the 3 GI tract branches of the descending aorta?
- Coeliac trunk. foregut
- Superior mesenteric. midgut
- Inferior mesenteric. hindgut
101
What is the non-GI tract branch of the descending aorta that follows the coeliac trunk?
the renal artery
102
At what vertebral level do all the branches of the descending aorta bifurcate to become the common iliac arteries?
L4
103
What are the 3 'gut' sections of the GI tract?
foregut
midgut
hindgut
104
What section of the GI tract is supplied by the
a) coeliac trunk
b) sup mes artery
c) inf mes artery
a) foregut (up to 2nd part of duodenum)
b) midgut (up to distal 2/3 of transverse colon)
c) hindgut (from descending colon up to rectum and upper anal canal)
105
What is the major GI tract vein?
the hepatic portal vein
106
What does the hepatic portal vein drain?
blood from the stomach to the sigmoid colon (SI and LI), passing them to liver for filtration before return to systemic circulation
107
How do 3 of the hepatic portal vein branches become the hepatic portal vein?
- Inferior mesenteric drains into splenic
| - Splenic will merge with superior mesenteric vein to become hepatic portal vein
108
What vein takes the GI tract vein blood back to the heart and through what major vein?
hepatic vein takes it back to inferior vena cava of heart
109
what does the common [main artery of pelvis] branch of to?
main: the iliac arteries
As the common iliac artery that branches off the aorta enters the pelvic brim, becomes the internal and external iliac artery
110
What organ does the internal iliac artery supply?
the bladder
| pelvis
111
When the external iliac artery leaves the pelvis, it passes through the ________ ligament and becomes the _______ artery.
When the external iliac artery leaves the pelvis, it passes through the inguinal ligament and becomes the femoral artery.
(lower limb)
112
What are the 3 upper (arm) proximal major arteries in the limbs?
```
Subclavian (L,R branches)
->
branches become the axillary in the armpit
->
brachial which becomes distal arteries
```
113
What are the 2 upper (arm) distal major arteries in the limbs?
radial and ulnar which is brachial after it has passed over the joints of the elbow
114
What are the 3 pulse points in patients' upper limbs (arms)?
- brachial
- ulnar
- radial
115
What are the 2 lower (leg) proximal major arteries in the limbs?
- femoral (external iliac branch of common iliac which is branch of abdominal aorta)
->
popliteal
116
What are the 2 lower (leg) distal major arteries in the limbs?
- tibial arteries (anterior and posterior) which are continuation of popliteal
- fibular artery
117
What are the 2 pulse points in the lower limbs?
- popliteal artery pulse
| - posterior tibial artery pulse
118
superficial major veins in upper limbs?
cephalic, basilica drain into axillary
119
deep major veins in upper limbs?
ulnar, radial -> brachial -> axillary
120
axillary major veins in upper limbs?
subclavian
121
superficial major veins in lower limbs?
great and small saphenous
122
deep major veins in lower limbs?
anterior, posterior tibial -> popliteal vein
123
where do major veins in lower limbs drain into?
femoral vein
124
deep (vena comitantes) veins vs superficial (subcutaneous)
deep:
- paired/tripicated surround peripheral arteries
- pulse of artery, skeletal muscle contraction aids drainage
superficial:
-important in coronary bypass grafts!!
both have valves.
125
what do varicose deep and superficial veins have?
varicose veins have damaged valves
126
how do internal carotid arteries get to brain?
via carotid canal
127
what do external carotid arteries supply?
neck/face/scalp
| temporalis
128
2 branches given off superficial temporal artery
external carotid
common carotid.
(no major arterial branches)
129
common carotid arteries bifurcate/divide at superior border of ?
thyroid cartilage (C3/C4)
carotid sinus right in middle- within internal carotid (BP).
130
carotid pulse is lateral to?
cricoid cartilage (C5/C6)
131
3 cerebral arteries that supply the brain?
anterior
middle
posterior
132
other than 3 cerebral arteries, what else of arterial 'circle'?
```
internal carotid arteries
vertebral arteries(2ndary backup of supply)
```
133
cause of CVA/ stroke?
limited supply to the cerebral arteries = cor blocked= no supply to brain
134
what (lobe) is supplied by:
a) anterior cerebral artery
b) middle cerebral artery
c) posterior cerebral artery
a) frontal, parietal lobes
b) frontal...
c) occipital.
135
what do the dural venous sinuses drain via?
the internal jugular vein
136
the external jugular vein is superficial to what? and where does it drain into?
sup to sternocleidomastoid muscle.
tributaries: retromandibular vein and posterior auricular.
drainage: subclavian vein
137
what is the internal jugular vein (IJV) located within? and what other 2 things are carried by that structure?
carotid sheath which carries: IJV, common carotid artery, vagus nerve
138
internal jugular vein (IJV) drains into?
brachiocephalic vein
139
what arteries can be blocked during a stroke?
ant, mid, post cerebral arteries of the internal carotid artery
