Anatomy Of The Heart Flashcards by Vickie Kimandi

Right atrium

▪️forms right border of the heart 
▪️receives blood from SVC, IVC, coronary sinus 
▪️anatomy
-crista terminalis
-pectini muscles 
-fossa ovale
-atrioventricular orifice 
-right auricle

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Crista terminalis

▪️ridge on the inside between atrium and auricle
▪️runs from SVC to IVC
▪️behind ridge walls are smooth

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Musculi pectinati

▪️anterior to crista terminalis

▪️roughened walls-bundles of muscular fibres

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Fossa ovale

▪️marks location of embryonic foramen ovale which allowed blood to bypass the lungs in feral circulation

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Atrioventricular orifice

▪️communication with atria and ventricle

▪️closed by tricuspid/bicuspid valve

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Right auricle

▪️ear like muscular pouch

▪️overlaps bottom of aorta

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Right ventricle

▪️anterior to RA so blood moves horizontally forward 
▪️blood exits through pulmonary trunk 
▪️anatomy 
-tricuspid valve 
-chrodae tendinae
-trabeculae carnae 
-papillary muscles 
-septomarginal trabecula (moderator band)
-conus arteriosus (infundibulum)
-pulmonary valve

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Tricuspid valve

▪️in atrioventricular orifice
▪️food of endocardium and connective tissue
▪️3 cusps-A,P, septal

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Chrodae tendinae

▪️tendon-like fibrous cords that connect cusps to papillary muscles

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Trabeculae carnae

▪️muscular irregular columns on wall of ventricle

▪️collection of TC are papillary muscles

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Papillary muscles

▪️projects of a collection of trabeculae carnae
▪️R
-anterior (largest), posterior, septal (inconsistent)
▪️L (larger)
-anterior, posterior
▪️attached to chrodae tendinae and prevent cusps from turning inside out due to pressure increase -contract when ventricle contracts

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Septomarginal trabecula (moderator band)

▪️bridge between lower interventricular septum and base of anterior papillary muscle
▪️carries proportion of cardiac conduction system to anterior wall

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Left atrium

▪️most of bast of heart 
▪️blood enters from 4 pulmonary veins
▪️mostly smooth walls except for auricle (pectini muscles)
▪️anatomy 
-left auricle 
-valve of feral foramen ovale 
-mitral valve (bicuspid)
- 4x pulmonary veins

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Valve of fetal foramen ovale

▪️before birth blood moves from R-L
▪️when first breath is taken, pressure changes means that pressure in L is larger than R so blood tries to move back in to R
▪️the valve gets forced to close and prevent this
-takes a while to close, not immediate

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Left ventricle

▪️anterior to left atrium 
▪️wall is 3x thicker than RV
▪️exits into aorta
▪️forms A, diaphragmatic, left pulmonary and apex surfaces 
▪️anatomy 
-mitral valve 
-papillary muscles
-chordae tendinae
-trabeculae carnae 
-aortic valve

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Mitral valve

▪️in atrioventricular orifice
▪️food of endocardium and connective tissue
▪️2 cusps-A,P

Aortic valve

▪️semilunar valve at entrance of aorta
▪️3 cusps- R, P, L
▪️R and L both have an opening to the R and L coronary arteries
-as blood recoils after ventricular contraction it fills the sinuses, blood is then forced into the arteries

Pulmonary valve

▪️semilunar valve at entrance of pulmonary truck
▪️3 cusps- L, R, A
-prevent blood flowing back into ventricle

Conus arteriosus (infundibulum)

▪️smooth walled entrance to pulmonary trunk

Cardiac skeleton

▪️dense, fibrous tissue in rings which interconnect in a plane between the atria and ventricles
▪️surround AV orifices, aortic orifice and opening of pulmonary trunk
▪️maintains integrity of openings and attachments of cusps
▪️separates muscular wall of A from V therefore isolating V
-AV bundle connects muscles of A and V

Right coronary artery

▪️arises from aorta and runs between PT and right auricle
▪️descends vertically in coronary sulcus (AV groove)
▪️gives off:
- marginal branch- runs along inferior border
-posterior interventricular branch-posteriorly
-R PI is 80-90% dominant
▪️it may anastomose with the left artery

Left coronary artery

▪️arises from aorta
▪️asses between PT and left auricle
▪️larger than right
▪️divides when it reaches coronary sulcus into
-anterior interventricular branch-runs toward apex then goes posterior at inferior border
-circumflex branch- turns left and runs in sulcus posteriorly and gives off marginal branch and PI branch (20% dominant)

Areas supplied by coronary artery

▪️RCA
-RA
-most of RV
-diaphragmatic part of LV
- posterior 1/3 of interventricular septum 
-60% of SAN
▪️LCA
-LA
-most of LV
-partially RV
-anterior 2/3 of interventricular septum 
-40% SAN 
-AVN and bundle

Venous drainage of the heart

▪️coronary sinus receives blood from

anterior cardiac veins- small part anterior of RV
small cardiac vein
great cardiac vein
middle cardiac vein
left marginal vein
left post ventricular vein

Pericardium

``` ▪️fibro-serous sac that encloses hear and roots of great vessels -restricts excessive movements of heart ▪️fibrous pericardium attached -below to central tendon of diaphragm -to adventitia of great vessel -to sternum by sternopercardial ligaments ▪️serous pericardium -visceral (epicardium) -parietal -pericardial cavity with lubricant ```

What can go wrong with pericardium?

``` ▪️pericardial effusion -build up of fluid in pericardial cavity -heart is compressed and effective ▪️pericarditis -inflammation of pericardium ```

Wave of excitation movement

▪️SAN depolarises and sends a wave of excitation which causes the atria to contract together ▪️this stimulates the AVN (opening of coronary sinus in the AV septum) ▪️AVN sends this wave down the AV bundle which splits off into L and R -R continues to apex of RV down the septomarginal trabecula to anterior papillary muscle, it then continues as the purkinje fibres which goes up and around the apex -L passes to the left side of IV septum into LV which then divides in to PF going up and around the apex

Cardiac plexus

▪️mixture of PNS and SNS ▪️deep -between aortic arch and carina of trachea ▪️superficial -inferior to aortic arch and superior to pulmonary trunk

Aortic dissection

▪️wall of aorta slits vertically creating a false channel ▪️common between tunica intima and tunica media ▪️dissection in ascending aorta can lead to less blood getting to brain and coronary arteries therefore may lead to myocardial infarction or stroke ▪️dissection in abdominal aorta can lead to ischaemia to kidneys

Transposition of the great arteries

▪️aorta and pulmonary arteries switch places ▪️oxygenated blood keeps returning to lungs ▪️deoxygenated blood cycles body- not enough oxygen to tissues ▪️atria septal or ventricular septal defects allows mix of oxygenated and deoxygenated can prolong survival ▪️also a patent ductus arteriosus mixes blood

Types of blood vessels

▪️resistance -arterioles and small arteries ▪️capacitance (storage areas) -venues and small veins

Blood vessel must...

▪️withstand changes in pressure | ▪️be flexible enough to move with underlying tissues and organs

Arteries

▪️elastic, muscular, resistance ▪️elasticity of aorta helps smooth out fluctuations in BP and allow for efficient gas exchange ▪️tunica intima- inside layer, grows with age, arteriosclerosis ▪️tunica media- thickest layer, smooth muscle, elastin ▪️tunica adventitia- thin connective tissue (prevent from stretching beyond threshold) -vasa vasorum- artery too thick for gas exchange

Skeletal muscle pumps

▪️valve in veins prevent backflow of blood ▪️contacting muscles compress veins (between valves) forcing the blood towards the heart ▪️not as smooth as arteries