Anatomy of Heart

Question 1

What are the layers of the pericardium?

Answer 1

1. Fibrous pericardium

2. Serous Pericardium (visceral [epicardium], pericardial cavity, parietal layer)

Question 2

What are the two pericardial reflections and their location?

Answer 2

1. Traverse sinus –> anterior to superior vena cava, posterior to aorta and pulmonary trunk
2. Oblique Sinus –> posterior of heart

Question 3

Where do pericardial effusions originate?

Answer 3

fluids from pericardial capillaries collects in the pericardial cavity

Question 4

What is cardiac tamponade?

Answer 4

excessive fluid accumulation that exerts pressure on the heart, thus affecting heart activity

Question 5

What is the mediastinum?

Answer 5

The mediastinum is the area in the chest between the lungs that contains the heart, part of the windpipe (the trachea), the esophagus, and the great vessels including the ascending aorta.

Question 6

Which side of the hear faces anteriorly?

Answer 6

Right side

Question 7

What sulci separates atrium from ventricle, and anterior from posterior?

Answer 7

Atrium/ventricle: coronary sulci

Anterior/posterior: anterior-posterior intraventricular sulci

Question 8

What are the surfaces of the heart?

Answer 8

1. sternocostal
2. pulmonary
3. diaphragmatic

Question 9

What are the Great Vessels of the heart?

Answer 9

A) Venous (superior, and inferior vena cava)
B) Arterial
1. aortic arch (brachiocephalic trunk [right carotid and subclavin aa], left common carotid artery, and left subclavian)
2. pulmonary trunk

Question 10

List the steps in the circulation of blood:

Answer 10

right atrium (deoxygenated blood) –> tricuspid valve –>
right ventricle –> pulmonary valve –> pulmonary trunk –>
pulmonary arteries –> lungs ! pulmonary veins –> left
atrium (oxygenated blood) –> mitral valve –> left ventricle
–> aortic valve –> ascending aorta –> aortic arch –>
descending aorta –> body tissues –> venous system –>
superior and inferior vena cavae –> right atrium

Question 11

Which septums separate atrias, and ventricles?

Answer 11

Atria –> interatrial septum

Ventricles –> interventricular septum

Question 12

What are some features of the atrioventricular valves?

Answer 12

valves connected by fibrous tissue called chordae tendinae which in turn are held by papillary muscles

Question 13

True or False: atrial walls are thicker than ventricles

Answer 13

false

Question 14

Which ventricle has a thicker wall?

Answer 14

left

Question 15

What are the arteries that supply the heart?

Answer 15

1. Right coronary artery (sinuatrial, marginal, posterior interventricular artery, atrioventricular node artery)
2. Left coronary artery (anterior interventicular artery, circumflex artery)

Question 16

True or False: left dominance for coronary artery distribution dominates

Answer 16

False: right dominant (50%), left dominant (20%), balanced (30%)

Question 17

What does coronary dominance reflect?

Answer 17

reflects the coronary artery that supplies the posterior interventricular artery

Question 18

Where do coronary arteries originate from?

Answer 18

aortic sinus (ie. aortic valve cusp)

Question 19

What are the cardiac veins?

Answer 19

1. Coronary sinus (all major veins drain to it)
2. Great cardiac vein (continuation laterally of the sinus)
3. Middle cardiac vein
4. Small cardiac vein
5. Venae cordae minimae

Question 20

Where are the pre-ganglionionic sympathetic cell bodies are located that innervates the heart.

Answer 20

T1-T5

Question 21

Which ganglia of post-ganglionic neurons innervate the heart?

Answer 21

superior, middle, and posterior cervical ganglia

Question 22

Which parasympathetic nerve innervates the heart and what’s the effect?

Answer 22

fibres carried by the Vagus n. (CN X); decreases the rate and strength of cardiac contraction

Question 23

What is the pacemaker of the heart and where is it located?

Answer 23

sinuatrial node and it is located in the wall of the right atrium

Question 24

True or False: the sinuatrial node receives only parasympathetic input

Answer 24

False: both sympathetic and parasympathetic

Question 25

What consists of the atrioventricular node?

Answer 25

a) atrioventricular bundle (bundle of His)
b) right and left bundle branches
c) moderator band (at the right branch)
d) Purkinje fibres in the ventricular walls

Question 26

What are the two normal heart sounds and what does each represent?

Answer 26

Lub - closure of mitral and tricuspid valves
- represents beginning of ventricular systole
Dub - closure of aortic and pulmonary semilunar valves
- represents the beginning of ventricular diastole

Question 27

Where are the locations of the valves in relation to the thoracic landmarks?

Answer 27

• aortic valve - 2nd intercostal space adjacent to sternum on the right side
• pulmonary valve - 2nd intercostal space adjacent to sternum on the left side
• tricuspid valve - 5th intercostal space adjacent to sternum on either left or right side
• mitral valve - 5th intercostal space, midclavicular line, left side

Question 28

In descending likelihood, which are arteries have higher rate of occlusion?

Answer 28

LAD; RCA; LCX

Question 29

What holds leaflet of valves?

Answer 29

chordae tendinae that are anchored to 2 papillary muscles (anterolateral and posteromedial)

Question 30

Which papillary muscle is prone to ischemia and why?

Answer 30

PM because it has only single blood supply (RCA [orLCX]) as opposed to AL that has two (LAD/LCX)

–> can lead to PM rupture –> severe mitral regurgitation –> acute heart failure

Question 31

Where is the heart located?

Answer 31

mediastinum

Question 32

What consists of the epicardium?

Answer 32

epicardium and visceral layer

Question 33

What are the vessels that perfuse the tunica externa?

Answer 33

vasa vasorum