anatomy exam 2 Flashcards
what part of the body makes up the area between the neck and abdomen, includes the cavity enclosed by the ribs, sternum, dorsal vertebrae, and contains the chief organs of circulation and respiration?
thorax (made up of mediastinum and L/R pleural compartments)
what is the floor of the thorax made up of and it is convex or concave?
- respiratory diaphragm
- convex superiorly
what are the 4 functions of the thorax?
- protect vital thoracic / abdominal organs from external forces
- resists the negative internal pressure created by the elastic recoil of the lungs
- provides attachments for and support the weight of the upper limbs
- provide the origin for some upper limb muscles and attachments for muscles of the abdomen, neck, back, and respiration
what vertebrae make up the TRUE ribs and what are they characterized by?
- ribs 1-7
- attach vertebrae to sternum via costal cartilage
what vertebrae make up the FALSE ribs and what are they characterized by?
- ribs 8-10
- have cartilage attached to the cartilages of ribs superior (rib 7)
what vertebrae make up the FLOATING ribs and what are they characterized by?
- ribs 11, 12
- have cartilage ending in the posterior abdominal wall musculature
what are the cartilages of ribs 7-10 joined to form?
infrasternal angle
what are ribs and costal cartilages separated by?
intercostal space
what structure of the thorax is bounded by the 1st thoracic vertebrae, 1st pair of ribs, and superior border of manubrium?
superior thoracic aperture
what structure of the thorax is closed by the diaphragm and makes it so that structures must pass through the diaphragm or behind it?
inferior thoracic aperture
where does the head of a rib atriculate?
articulates with inferior and superior costal facets of adjacent thoracic vertebrae (vertebrae with same number as rib and number above it)
where does the tubercle of a rib articulate?
articulates with facets on transverse process of vertebrae (same as number of rib)
where are intercostal vessels running along a rib?
costal groove
what can supernumerary (cervical) ribs cause?
thoracic outlet syndrome
NOTE - cause compression, injury, or irritation of the brachial plexus and/or subclavian vessels in the lower neck and upper chest
what is scoliosis generally described as being?
abnormal lateral curvature of the spine
what are the 4 types of scoliosis and what are they caused by?
- congenital scoliosis - bone abnormality present at birth
- neuromuscular scoliosis - abnormal muscles or nerves (frequently seen in people with various conditions that can result in paralysis)
- degenerative scoliosis - result from traumatic bone collapse, back surgery, osteoporosis
- idiopathic scoliosis - most common type (strong evidence suggests its inherited)
how does each type of ribs (true, false, and floating) move within costotransverse joints?
- upper ribs (1-7) - rotate at the costotransverse joints
- lower ribs (8-10) - glide at the costotransverse joints
- ribs (11, 12) - do not articulate with transverse processes
what type of joints are primary cartilaginous joints and do not usually experience movement?
costochondral joints
what muscles occupy the intercostal spaces and function during respiration and what is their function?
- intercostal muscles
- move the ribs and help to keep the intercostal spaces rigid
what are the three types of intercostal muscles?
- external intercostals
- internal intercostals
- innermost intercostals
- subcostal
- transverse thoracis
in which direction do the fibers of external intercostals run?
- infero-anteriorly
(hands in pockets - run downward and inward)
what muscles function to elevate ribs during forced inspiration?
external intercostals
what muscles function to depress the ribs during forced respiration?
internal and innermost intercostals
what layers of intercostal muscles do intercostal vessels (nerve, vein, artery) run between?
internal and innermost intercostals
what intercostal muscles run in the same orientation and blend with internal and innermost intercostals (also likely have same function)?
subcostalis
what intercostal muscle is located on the sternum and functions to depress ribs?
transversus thoracis
what are the three muscles that we do not usually used for quiet breathing but can be recruited and used in struggled breaths?
- levator costae
- serratus posterior superior
- serratus posterior inferior
what rami do intercostal nerves become?
ventral rami
what is the term used to describe an area of skin supplied by nerves from a single spinal root?
- dermatome
NOTE - tiger stripes follow dermatomes
what is the term for a surgical procedure where a surgical opening is made through the thoracic wall to access the lungs, heart, esophagus, diaphragm, and thoracic aorta?
thoracotomy
what is the term used to describe a procedure to remove fluid from the space between the lining of the outside of the lungs (pleura) and the wall of the chest?
thoracentesis
NOTE - needle going OVER TOP of rib
where is a needle inserted when administrating a intercostal nerve block?
BELOW the rib
what is the term for a procedure used primarily diagnose the specific source of nerve root pain and for therapeutic relief of low back / leg pain
nerve root block
what is the spatial relationship of the intercostal vessels in the intercostal space?
- vein
- artery
- nerve
muscles raise the ribs during _______?
inspiration
what do we see when we have an increase in thoracic volume and a decrease in pressure?
air flows IN
what do we see when we have a decrease in thoracic volume and an increase in pressure?
air is pushed OUT
what muscles are working during inspiration?
- external intercostals contract
- diaphragm contracts
NOTE - chest wall and lungs expand, expansions of ribs moves sternum upward and outward
what muscles are working during expiration?
- interna/ innermost intercostals and abdominals contract
- diaphragm relaxes
NOTE - chest cavity and lungs contract, ribs and sternum depress
where is the primary blood supply to the thoracic wall derived from?
derived from branches of the aorta and subclavian arteries (which are also branches of aorta)
where do internal thoracic arteries arise from and what do they give rise to?
- arise from subclavian artery near its origin
- give off anterior intercostal 1-6
what does the internal thoracic artery divide into after ending at the 6th costal cartilage?
musculophrenic and superior epigastric arteries
where do the anterior intercostals 7-10 arise from?
musculophrenic arteries
_______ will drain back to the musclophrenic or internal thoracic veins
intercostal veins
what do anterior intercostal arteries anastomose with in the intercostal space?
posterior intercostal arteries from the descending thoracic aorta
where does venous drainage from the right side of the body drain into?
azygous vein (goes to superior vena cava)
where does venous drainage from the left side of the body drain into?
hemiazygous and accessary hemiazygous veins
EXCEPTION - left superior intercostal
what part of the thoracic cavity is a movable median partition of the thoracic cavity that extends superiorly to the thoracic outlet/ root of the neck and inferiorly to the respiratory diaphragm… it extends anteriorly to the sternum and posteriorly to the vertebral bodies?
mediastinum
what part of the thoracic cavity is made up of skeletal muscle and lined by pleura (superiorly) and peritoneum (inferiorly) that separates the thoracic and abdominal viscera?
respiratory diaphragm
what two parts is the mediastimum divided into (imaginary plane runs from the sternal angle to the T4 vertebrae)?
superior and inferior mediastinum
what compartment of the mediastinum is bounded anteriorly by the manubrium and posteriorly by vertebral bodies of T1-T4?
superior mediastinum
what compartment of the mediastinum is bounded anteriorly by the body of the sternum and posteriorly by the vertebral bodies of the lower 8 thoracic vertebrae (can be further divided into other compartments)?
inferior mediastinum
what compartment of the mediastinum makes up the space between the pericardium and the sternum?
anterior mediastinum
what compartment of the mediastinum is made up of the pericardium and heart?
middle mediastinum
what compartment of the mediastinum is between the pericardium and the vertebral column?
posterior mediastinum
what structure in the thoracic cavity separates the thoracic cavity from the abdominal cavity?
respiratory diaphragm
what three structures pass between the thorax and abdomen and pierce the diaphragm?
- inferior vena cava
- aorta
- esophagus
what is the most important muscle in respiration?
respiratory diaphragm
what is the term for the musculotendinous bands that arise from the anterior surface of L1-3/ IVDs and the anterior longitudinal ligament… which one is longer?
- cura (singular = crus)
- right crus is larger and longer (L1-L3/4)
- left crus (L1-L2/3)
the median arcuate ligament united the crura and forms the ________?
aortic hiatus
what is the term for the thickening of fascia (psoas major) in reference to attachments of the respiratory diaphragm?
medial arcuate ligament
what is the term for the thickening of fascia (quadratus lumborum) in reference to attachments of the respiratory diaphragm?
lateral arcuate ligament
what is the mnemonic for knowing the structures that pierce through the diaphragm and where their respective openings are?
“I ate ten eggs at noon”
- (inferior) caval hiatus - T8
- esophageal hiatus - T10
- aortic hiatus - T12
what is the respiratory diaphragm innervated by?
somatic motor - phrenic nerve (C3-5)
what types of sensory information can the phrenic nerve carry?
pain and proprioception
peripheral parts of the diaphragm can receive some sensory innervation from _______?
lower intercostal nerves
what occurs (size-wise) to thoracic cavity during inhalation?
- rib cage expands as rib muscles contract (volume increased)
- diaphragm contracts and moves down (height increased
- NOTE - pressure is DECREASED (AIR FLOWS IN)
what occurs (size-wise) to thoracic cavity during exhalation?
- rib cage gets smaller as rib muscles relax (volume decreased)
- diaphragm relaxes (height decreased
- NOTE - pressure is INCREASED (AIR FLOWS OUT)
what branches from the internal thoracic artery and thoracic aorta give rise to arterial supply on the superior surface of the respiratory diaphragm?
- internal thoracic artery - musculophreic and pericardiacophrenic
- thoracic aorta - superior phrenic
what branches from the abdominal aorta give rise to arterial supply on the superior surface of the respiratory diaphragm?
- abdominal aorta - inferior phrenic
where do musculophreic and pericardiacophrenic veins drain into for venous drainage on the superior surface of the respiratory diaphragm?
drain into internal thoracic vein
where does the right superior phrenic vein drain into for venous drainage on the superior surface of the respiratory diaphragm?
drains into inferior vena cava
where do veins from the posterior curvature drain into on the superior surface of the respiratory diaphragm?
drain into azygous and hemi-azygous veins
where does the R inferior phrenic vein and the L inferior phrenic veins drain into on the inferior surface of the respiratory diaphragm?
- R inferior phrenic vein - inferior vena cava
- L inferior phrenic vein - inferior vena cava or L supareal vein
which pleura layer is adhered to lung, continuous with parietal pleura at root of lung?
visceral pleura
which pleura layer line the thoracic cavity?
parietal pleurae
what is the term for the potential space between layers of pleura that contains a small amount of serous pleural fluid?
pleural cavity
what is the function of serous pleural fluid?
- lubricates pleural surfaces
- allows layers to slide smoothly over one another during respiration
what is the term for when we change from one area of parietal pleura to another?
reflection
what do we call the areas where the lung does not completely fill the pleural cavity and where parietal pleurae can appose each other (occupied by the lungs only on forced, deep inspirations)?
pleural recesses
what are the two consistently present pleural recesses and from which one are we more likely to take a sample from?
- costodiaphragmatic - slit like space between costal and diaphragmatic pleurae, along the inferior border of the lung which enters through it in deep inspriation
- costomediastinal - slit like space between costal and mediastinal pleurae, along the anterior border of the lung which enters into it in deep inspiration (blood can pool here - samples taken from this area)
what is the term used to describe a procedure done to remove excess fluid from the pleural space to help you breathe better?
pleural effusion
what is the term used to describe pus in the pleural space?
empyema
what is the term used to describe blood in the pleural space?
hemothorax
what is the term used to describe air between the layers of partial pleura lining the chest wall and the visceral pleura covering the lung?
pneumothorax
what are symptoms of tension pneumothorax?
- chest pain
- shortness of breath
- rapid heart rate
- shallow breathing
- anxiety
- blue or ashen skin
what sources provide the arterial supply for the visceral pleura?
branches of the bronchial and pulmonary arterial systems
where do veins drin into when talking about blood supply/ drainage to the visceral pleura?
drain into the azygous/ hemiazygous veins and some to the pulmonary vein
where do bronchial arteries arise from?
thoracic aorta (1-2 for each lung)
what do bronchial arteries supply oxygenated blood to?
non-respiratory tissues of the lung and visceral pleura
where do bronchial veins carry blood to?
- 13% of bronchial venous blood to systemic venous circuit
- 87% of bronchial venous blood drains to pulmonary venous circuit desaturated the left atrium blood by 1%
NOTE - pulmonary vein carries OXYGENATED BLOOD
what type of vessels supplies the cervical and costal pleura (in terms of blood supply)?
intercostal vessels
what type of vessels supplies the diaphragmatic and mediastinal pleura (in terms of blood supply)?
- diaphragmatic pleura- intercostal vessels (periphery) and percardiacophrenic vessels (central tendon)
- mediastinal pleura - percardiacophrenic vessels
what would be the pattern of venous drainage from the parietal pleura?
companion veins of the arterial supply
what nerve supply is provided to the viscera pleura?
NO NERVE SUPPLY - it is not innervated
what innervates the cervical and costal pleural of parietal pleura?
intercostal nerves
what innervates the diaphragmatic and mediastinal pleura?
- diaphragmatic pleura - intercostal nerves and phrenic nerves (central tendon)
- mediastinal pleura - phrenic nerves
what are 5 functions of the respiratory system?
- conducts and conditions inspired air
- gas exchange between air and blood
- olfaction
- phonation
- defense (role in immune system)
development of the respiratory system beings in week 4 with the appearance of _______
respiratory (or laryngeotracheal) diverticulum
what do the primary bronchi develop into?
right and left lungs
what do the secondary or lobar bronchi develop into?
number of lobes (right = 3 & left = 2)
what is the pleural cavity made up of that surrounds each lung?
formed by visceral and parietal pleura
what part of the lung is covered by cervical pleura and projects 2-3 cm through the superior thoracic aperture into the root of neck?
apex
what part of the lung is against the dome of the diaphragm?
diaphragmatic surface of base
what part of the lung is adjacent to the sternum, costal cartilages, ribs, and vertebrae?
costal surface
what part of the lung is adjacent to the mediastinum?
mediastinal surface
what part of the lung is where costal and mediastinal surfaces meet anteriorly and overlap the heart (inferior border)?
anterior border
what part of the lung is where costal and mediastinal surfaces meet broad and rounded?
posterior border
how many lobes does the right lung have and what fissures separate them?
3 lobes (superior, middle, inferior)
- oblique fissure between middle/ inferior
- horizontal fissure between superior/ middle
how many lobes does the left lung have and what fissures separate them?
2 lobes (superior and inferior)
- separated by oblique fissure
what two unique features are characteristics of the left lung?
- cardiac notch
- lingula
what term refers to the structures contained in the pulmonary sleeve and entering the hilum of the lung?
root of the lung
what term refers to the area where the structures forming the root of the lung actually touch lung tissue?
hilum of the lung
what is the term for where the mediastinal pleura passes laterally from the mediastinum to the visceral surface of the lung (becomes visceral pleura)?
pulmonary ligament
what type of blood do pulmonary arteries carry?
deoxygenated blood (taking blood from the heart to lungs to pick up oxygen)
what type of blood do pulmonary veins carry?
oxygenated blood
what type of tissue lines primary bronchi?
respiratory epithelium - pseudostraitifed columnar epithelium with goblet cells
in what bronchi do aspirated items tend to fall into?
right main bronchi
what is the term used to describe the anatomical, functional, and surgical unit (subdivision) of the lungs?
bronchopulmonary segments
what are the two main functions of bronchopulmonary segments?
- can limit spread of infection
- more easily removed
where is the primary site of gas exchange within the respiratory system?
alveoli
what types of innervation are found in the lungs?
sympathetic, parasympathetic, visceral afferent (sensory)
where is parasympathetic innervation derived from?
vagus nerve
NOTE - contraction of bronchial smooth muscle and vasodilation of pulmonary vessels
where is sympathetic innervation derived from in regard to the pericardium?
thoracic splanchnic nerves (cardiopulmonary)
NOTE - relaxation of the bronchial smooth muscle, vasoconstriction of the pulmonary vessels
how are visceral afferents/ sensory received in regard to the lungs?
conduct pain impulses to the sensory ganglion of the vagus nerve
what medical condition is due to an overactive parasympathetic system?
asthma
NOTE - treatments minimic what sympathetics do
order of lymphatic drainage
- lymph drains
- pulmonary nodes in lung
- bronchopulmonary nodes (hilum)
- tracheobronchial nodes
- L/R bronchomediastinal trunks
what medical condition is due to an infection in the alveoli and reduces capacity for gas exchange?
pneumonia
what medical condition is a smoking-related disease that is characterized by the loss of alveoli available for gas exchange due to destruction of elastic tissue and the inability to stretch and recoil?
emphysema
what is a visible characteristic of emphysema?
barrel chest
where does lung cancer originate?
in epithelium
what can the inferior mediastinum be divided into?
- anterior mediastinum
- middle mediastinum
- posterior mediastinum
where is the thymus in children located?
superior mediastinum
what organ contributes to the development and maintenance of the immune system in children?
thymus
what is the thymus replaced by as we age?
fatty tissue
what arteries supply blood to the thymus?
internal thoracic arteries
what veins drain blood from the thymus?
- internal thoracic veins
- L/R brachiocephalic veins
what do the left and right brachiocephalic veins come together to form?
superior vena cava
name the (three) great vessels of the heart and identify where they lie
- arch of aorta
- pulmonary trunk
- superior vena ava
- lie within superior mediastinum and main branches arise before passing through superior thoracic aperture
the superior vena cava returns blood from all structures superior of the diaphragm except for the ______ and _______
lungs and heart
what are the 4 tributaries of the superior vena cava?
- brachiocephalic veins : draining blood from the upper body
- left superior intercostal vein : collects blood from 2nd and 3rd intercostal vein, drains into left brachiocephalic vein
- supreme intercostal vein : drains the vein from first intercostal space into brachiocephalic veins
- azygous vein : receiving blood from the right posterior intercostal veins
what 2 veins come together to form the brachiocephalic veins?
internal jugular and subclavian
what structure exists from the right ventricle and bifurcates into the L/R pulmonary arteries?
pulmonary trunk
what structure branches into the L/R coronary arteries and gives rise to brachiocephalic artery, left common carotid, and left subclavian artery?
aorta
what does the right brachiocephalic artery give rise to?
- right common carotid
- right subclavian
what is the anatomical (lateral vs medial) difference between vagus and phrenic nerves?
- lateral = phrenic nerves
- medial = vagus nerve
what do the left and right vagus nerves give rise to?
left and right recurrent laryngeal nerves
which recurrent laryngeal nerve hooks around right subclavian artery and ascends between the trachea and esophagus to supply the brain?
right recurrent laryngeal
which recurrent laryngeal nerve arises from left vagus nerve as it passes the aortic arch… loops under the arch to the left of the ligamentum arteriosum before continuing up to the larynx?
left recurrent laryngeal
what veins and arteries do the vagus nerve travel along in the neck?
- internal jugular veins
- common carotid arteries
which side (left vs right) is the anterior vagal trunk continuous with?
left
NOTE - vagus goes through diaphragm with esophagus at T10
which side (left vs right) is the posterior vagal trunk continuous with?
right
NOTE - vagus goes through diaphragm with esophagus at T10
which recurrent laryngeal nerve does NOT enter the mediastinum?
right recurrent laryngeal (hooks around the right subclavian artery)
which recurrent laryngeal nerve is more likely to be affected if disease process present in thoracic cavity?
left recurrent laryngeal
what structure is a fibrous remnant of the fetal blood vessel that connects the left pulmonary artery to the descending aorta (ductus arteriosus)?
ligamentum arteriosum
what type of innervation do the phrenic nerves supply?
- motor to diaphragm
- sensory to mediastinal and diaphragmatic pleura
what nerve that supplies the mediastinum enters the superior mediastinum lateral to the great vessels and then descends anteriorly to the hilum of the lungs?
phrenic nerve
what nerves originate from the superior, middle, and inferior cardiac ganglia and form the superficial/ deep plexuses in the superior mediastinum?
cardiac nerves
- superior plexus : sits between aortic arch and right pulmonary vein
- deep plexus : lies on the surface of the trachea at the point of bifurcation
what nerve structure runs bilateral the the vertebral bodies along the entire length of the vertebral column?
sympathetic trunk
what respiratory structure descends anterior to the esophagus, ends at the level of the sterna angle, and divides into the L/R primary brochi?
trachea
what structures are located within the posterior mediastinum?
- oesophagus
- descending thoracic aorta
- thoracic duct
- azygous and hemiazygous veins
- sympathetic trunk
what structure begins at the inferior border of T4 and becomes the abdominal aorta after passing through the aortic hiatus (T12)?
thoracic aorta
what areas does the thoracic aorta supply?
- intercostal spaces
- thoracic viscera
what structure sits posterior to the arch of the aorta and passes through the esophageal hiatus (digestive function)?
esophagus
what duct is the largest lymphatic duct channel in the body?
thoracic duct
where does the thoracic duct originate from?
cisterna chyli
where does the thoracic duct drain into?
union of left internal jugular veins and subclavian veins
where does the thoracic duct drain lymph from?
whole body EXCEPT right side of head/ neck, right upper limb, and right side of thorax/ upper surface of liver
where does lymph from the right side of head/ neck, right upper limb, and right side of thorax/ upper surface of liver drain into?
right jugular, subclavian, and broncomediastinal trunks which enter veins on the right side of the neck as the right lymphatic duct
where do the superficial tissues of the chest wall drain into (lymphatic drainage)?
axillary and internal thoracic nodes
where do deeper tissues of the chest wall drain into? (lymphatic drainage)
internal thoracic intercostal and diaphragmatic nodes… subsequently into the thoracic duct
where does the heart drain into (lymphatic drainage)?
lymphatic vessels that follow the coronary arteries and ultimately drain into the inferior tracheobronchial nodes
NOTE - both sides draining… danger of metastasis of cancer from one side of the body to the other
where do deep lymphatics of the lungs drain into (lymphatic drainage)?
follow air passages
what is the term for the fibrous sac surrounding the heart?
pericardium
what are the 3 attachment (fusion) sites of the pericardium and what do these sites help to prevent?
- fuses superiorly with tunica adventitia of SVC, ascending aorta, and pulmonary arteries
- fused inferiorly with central tendon of the diaphragm
- reinforced by 2 sternopericardial ligaments that attach the pericardium to the tracheal bifurcation and main bronchi
- keep the heart in position and limit cardiac distention
the pericardium contacts the posterior surface of the sternum and ____________
4th and 5th intercostal space
where are the phrenic nerves located in relationship to the mediastinal pleura and pericardium?
in between the layers
what is the outer layer of dense connective tissue covering the heart called?
fibrous pericardium
what are the two layers below the fibrous pericardium of the heart?
parietal and visceral pleura
what is the term for the enclosed sac with a potential space between the parietal and visceral layers?
pericardial cavity
what is the function of the fluid located within the pericardial cavity?
enables the heart to beat in a relatively frictionless environment
what function does the pericardium serve?
prevents sudden overfilling
what is another term for the visceral layer of the serous pericardium?
epicardium
what are the two sinuses of the heart called?
- transverse sinus - separates the venous and arterial ends
- oblique sinus - gives smooth area for frictionless movement within the pericardial cavity
name the structures that supply blood to the pericardium
- pericardiacophrenic arteries
- musculophrenic arteries
- branches of the thoracic aorta
- coronary arteries (visceral layer only)
name the sites of venous drainage from the pericardium
- pericardiacophrenic veins
- internal thoracic veins
- tributaries of the azygous system
what type of innervation is supplied to the fibrous and parietal layers of the pericardium via the phrenic nerves?
somatic sensory
what type of innervation is supplied to the epicardium via the cardiac plexuses?
visceral sensory
NOTE - epicardium is insensitive to pain
what is the term used to describe inflammation what occurs when the irritated layers of the pericardium rub against each other?
pericarditis
what is the term used to describe the presence of an abnormal amount of fluid and/or abnormal character to fluid in the pericardial space?
pericardial effusion
what is the term used to describe a build-up of fluid around heart than applies pressure and may prevent the heart from pumping effectively?
cardiac tamponade
what are the filling chambers of the heart?
artia
what are the pumping chambers of the heart?
ventricles
if you were stabbed on the left side of the chest in the 4th intercostal space, what area of the heart is most likely damaged?
right ventricle
what venous structure carries deoxygenated blood from the heart muscle back to the right atrium?
coronary sinus
what is the smooth walled part of the right atrium that received the venae cavae and coronary sinus?
sinus venarum
what muscle makes up the rough looking wall within the right ventricle made up of?
pectinate muscles
what separates the pectinate muscles from the sinus venarum?
crosta terminalis
what occurs as a result of a patent foramen ovale?
- allows oxygenated blood to be shunted to the right atrium
- the right atrium, right ventricle, and pulmonary trunk will become enlarged
the right ventricle receives blood from the right atrium via the ________
right AV valve OR tricuspid valve
what are the irregular muscular elevations on the internal surface of the right ventricle termed?
trabeculae carneae
what are the names of the cusps that makeup the tricuspid valve?
- anterior cusp
- posterior cusp
- septal cusp
what is the connection from the anterior cusp that extends to the interventricular septum termed and why is it important?
- septomarginal trabeculum
- part of the internal conduction system runs through the septomarginal trabeculum
what structure helps to hold AV valves closed during contraction to prevent prolapse?
chordae tendineae
explain what is occurring with the AV and semilunar valves during ventricular diastole?
- AV: open
- semilunar: closed
NOTE - heart is filling, NOT contracting
explain what is occurring with the AV and semilunar valves during ventricular systole?
- AV: closed
- semilunar: open
NOTE - heart is contracting to pump blood to body
where does the left atrium receive oxygenated blood from?
the lungs via four pulmonary veins
the left ventricle receives blood from the left atrium via the ________
left AV valve OR mitral (bicuspid) valve
the wall of the left ventricle is 2x as ______ as the wall of the right ventricle
thick
what is the area called that leads into the aorta (hint- smooth walled)?
aortic vestibule
what is the term used to describe an opening between the left and right ventricles associated with shunting of blood?
ventricular septal defects
most VSDs occur in ________ portion (these spontaneously close)
muscular
________ ________ in VSDs are more commonly corrected surgically
membranous defects
what are the two cusps that make up the mitral (bicuspid) valve?
- anterior cusp
- posterior cusp
what valve is the MOST COMMON diseased valve of the hart?
mitral (bicuspid) valve
what can prolapse result in?
- enlargement of the left atrium due to blood leakage during contraction
what is a defining characteristic of semilunar valves that makes them different from AV valves (what do semilunar valves NOT have)?
- papillary muscles
- chordae tendineae
how many cusps do the pulmonary and aortic valves have?
3 cusps which help to prevent backflow into the ventricles during ventricular relaxation
what is the term for the point at the midpoint of its free edge in a semilunar valve cusp?
nodule
what is the term for the thin connective tissue area on either side of the nodule of semilunar valve?
lunule
what arises from the aortic sinuses within the semilunar valve in the aorta?
coronary arteries
what are the cusps positions for the aortic semilunar valve?
right, left, and posterior
what are the cusps positions for the pulmonary semilunar valve?
right, left, and anterior
what parts of the heart do the coronary arteries supply?
myocardium and epicardium
what do the right and left coronary arteries arise from?
right and left aortic sinuses
what does the right coronary artery give rise to?
- right marginal artery
- posterior interventricular artery (gives rise to the AV nodal artery)
what does the left coronary artery give rise to?
- circumflex artery
- anterior interventricular artery (left anterior descending artery)
what type of anastomoses do coronary arteries create to help protect heart in case of emergency?
- intercoronary arteries (branches between left and right coronary arteries)
- intracoronary arteries (branches from same artery)
what are the 4 branches of the right coronary artery?
- SA nodal (60%)
- right marginal artery
- AV nodal
- posterior interventricular
what parts of the heart does the right coronary artery supply?
- right atrium
- right ventricle
- posterior 1/3 interventricular septum
- SA and AV nodes
what are the 2 branches of the left coronary artery?
- anterior interventricular (left anterior descending)
- circumflex (gives rise to left marginal)
what parts of the heart does the left coronary artery supply?
- left atrium
- left ventricle
- portion of right ventricle
- interventricular septum (anterior 2/3)
- AV node
- SA node (40% - from circumflex)
what section of the left coronary artery gives rise to these structures:
- left atrium
- left ventricle
- SA node (40%
- AV node (10-15%)
where does the right coronary artery run?
coronary sulcus
what does the right marginal artery supply?
supplies right ventricle (does not reach apex)
what is the most common occluded coronary artery?
anterior interventricular (left anterior descending)
how is dominance defined?
by the artery that gives rise to the posterior interventricular artery
what is the term used to describe when the RCA and LCA both give branches that course in or near the posterior interventricular groove (18%)
co-dominance
what is the term used to describe lipid deposits in the lining of the coronary arteries?
coronary atherosclerosis
what is the term used to describe the sudden occlusion of a major artery?
myocardinal infarction
how does a myocardial infarction affect the tissue of the heart supplied by that artery?
infarcted (bloodless) and necrotic (tissue death)
what is the most common cause of a myocardial infarction?
coronary artery insufficiency from atherosclerosis
what is the heart drained by that empties into the right atrium?
coronary sinus
what small veins from the heart can drain directly into the right atrium?
anterior cardiac veins
what are the three main veins that drain into the coronary sinus and ultimately the right atrium?
- great cardiac vein
- middle cardiac vein
- small cardiac vein
what artery does the great cardiac vein run with?
anterior interventricular (left anterior interventricular)
what artery does the middle cardiac vein run with?
posterior interventricular
what artery does the small cardiac vein run with?
right marginal artery
what structure/ part of the heart initiates cardiac muscle contraction and determined heart rate?
SA node
what is the flow of cardiac conduction?
- SA node
- AV node
- bundle of His
- purkinje fibers (L/R bundles)
what is the SA and AV nods made up of?
modified cardiac myocytes
where are preganglionic sympathetic cell bodies located in the spinal cord?
lateral horns of spinal cord in T1-T5 segments
where are postganglionic cell bodies located in regard to sympathetic innervation to the heart?
cervical and superior thoracic paravertebral ganglia
what is the term for postsynaptic fibers that innervate the heart?
cardiopulmonary (thoracic) splanchnic nerves
what type of innervation is responsible for increasing heart rate, impulse conduction, force of heart beat, and blood flow in the coronary arteries?
sympathetic innervation
what gives rise to parasympathetic innervation via preganglionic fibers to the heart?
vagus nerve
where are postganglionic cells located in regard to parasympathetic innervation for cardiac tissue?
within cardiac tissue
what type of innervation is responsible for decreasing heart rate, force of contraction, and constricting coronary arteries?
parasympathetic innervation
what pathway does visceral pain pathways for the heart follow back?
sympathetic pathways backward
visceral sensory pathways that lower blood pressure and slow the heart rate are carried by the _______ _______
vagus nerve
in fetal circulation, what structures are branches of the internal iliac arteries and carry unoxygenated blood AWAY from the fetus?
2 umbilical arteries
in fetal circulation, what structures carry oxygenated blood from the placenta to the fetus?
1 umbilical vein
in fetal circulation, blood from the IVC flows into the right atrium toward the ________ _________ and into the left atrium
foramen ovale
in fetal circulation, blood from the SVC flows into the right atrium toward the tricuspid valve and into the right ventricle pulmonary trunk
blood in the pulmonary trunk is shunted to the aorta via the ______ ________
ductus arteriosus
