Anatomy of the Heart I & II Flashcards
pericardium:
pericardial sac: ___
posterior to ___ & ___
anterior to ___
composed of two portions: ___ & ___
fibroserous sac that encloses the heart & roots of the great vessels
body of sternum, 2nd - 6th ribs
T5 - T8
fibrous pericardium, serous pericardium
fibrous pericardium:
firmly attached infererioly to ___ & anteriorly to ___ via ___
blends superiorly w/ ___
the ___ nerves & the ___ vessels are embedded in its surface & pass in ___ of the roots of the lungs
functions: ___
central tendon of diaphragm, sternum, sternopericardial ligaments
outer coats of the great vessels passing through it
phrenic, pericardiophrenic, front
anchors the heart & limits distention
serous pericardium:
___ layered ___ sac
parietal layer (parietal pericardium):
- inner lining of the ___
- reflected around the ___ to become continuous with the ___
visceral layer (visceral pericardium, epicardium):
- closely applied to the ___
- potential space exists b/n the ___ & ___ layers which contains a small amount of ___ fluid
function: ___
double, serous
fibrous pericardium
roots of the great vessels, visceral pericardium
heart
parietal, visceral, lubricating serous
lubricates the moving surfaces of the heart
sinuses:
located on the ___
consist of enlargements of the ___ created by ___
posterior surface of the heart
pericardial cavity, reflections of the serous pericardium around the vessels
transverse sinus:
space b/n the ___ & the ___
passage from the ___ to the ___
aorta/pulmonary trunk, superior vena cava
right, left side of the pericardial cavity
oblique sinus:
___ rather than a passageway created by ___
lies ___
cul-de-sac, reflections of the serous pericardium around the six major veins entering the heart
behind the left atrium
surface of heart: apex:
location: ___
points ___
found in ___
tip of left ventrical
anteriorly, inferiorly, & to the left
left 5th intercostal space, approximately 8-10 cm from the midline
surface of heart: sternocostal surface
mostly right atrium & right ventricle
small part of left ventricle
surface of heart: diaphragmatic surface
mostly left ventrical
smaller part of right ventricle
surface of heart: base
mostly left atrium
smaller portion of right atrium (most superior part of the heart)
right border of heart
SVC
right atrium
IVC
left border of heart
arch of aorta
pulmonary trunk
left auricle
left ventricle
superior border of heart
great vessels
inferior border of heart
right ventricle
part of left ventricle
right atrium:
partially divided internally into two main parts by the ___
smooth muscular ridge commencing on ___ just in front of ___& extending ___
cavity posterior to the crista terminals is the ___ which receives the ___ & has ___ walls
walls of anterior half of atrium, including auricle, are ridged by the ___ (comb-like) which fan out from the crista terminalis into the auricle
crista terminalis
roof of atrium, opening of the superior vena cava, downward to the anterior lip of the inferior vena cava
sinus venarum, superior & inferior vena cava, smooth
pectinate muscles
right atrium: atrium proper
anterior half of chamber including right auricle
right atrium: sulcus terminalis
position of the crista terminalis is represented on the surface of this groove which extends between the superior & inferior vena cava
openings into the right atrium: superior vena cava
opens into the superior, posterior, part of the right atrium
openings into the right atrium: inferior vena cava
opens into the inferior, posterio part of the right atrium almost in line w/ the SVC
contains a non-functioning valve of embryonic importance
openings into the right atrium: coronary sinus
opens into the right atrium b/n the orifice of the inferior vena cava & the right atrioventricular orifice
contains a non-functioning valve (Thebesian valve) of embryonic origin
openings into the right atrium: right atrioventricular orifice
lies anterior to the orifice of the IVC, guarded by the tricuspid valve
right atrium: fossa ovalis:
depression in the ___
marks the location of the ___
has a prominent upper margin called the ___
interatrial septum just above the opening of the inferior vena cava
embryonic foramen ovale (aperture for right to left shunting of embryonic blood)
limbus fossa ovalis
right ventricle:
communicates w/ the ___ via the ___ & w/ the ___ via the ___
partially divided into ___ & ___ by the smooth muscular crest ___
right atrium, right atrioventricular orifice, pulmonary trunk, pulmonary orifice
inflow tract (posterior), outflow tract (anterior), supraventricular crest
right ventricle: outflow tract
has a funnel-shaped surface appearance & is called the ___ or ___
internal walls are ___
infundibulum, conus arteriosus
smooth
right ventricle: inflow tract
behind the ___
contains prominent fleshy ridges called ___ which give rise to column-like or nipple-like projections called ___
crista supraventricularis
trabeculae carnae, papillary muscles
right ventricle:
three sets of papillary muscles named according to the location of their bases: ___
from the apex of each papillary muscle, several fibrous cords extend to the cusps of the tricuspid valve: ___
anterior, posterior, septal
chordae tendinae
right ventricle: anterior papillary muscle
most constant & most prominent
right ventricle: septal papillary muscle
may be absent, in which case, the chordae tendinae spring directly from the wall of the septum
right ventricle: posterior papillary muscles
there may be several small ones
right ventricle: papillary muscles & chordae tendinae
prevent eversion of the atrioventricular valve into the atrium during ventricular systole
right ventricle: tricuspid valve (right atrioventricular valve):
composed of ___
bases of the cusps are secured to the ___
anterior, posterior, & septal cusps
fibrous ring of the heart
right ventricle: septomarginal trabeculae (moderator band)
specialized trabeculae carnae running from the interventricular septum to the base of the anterior papillary muscle
carries right branch of the bundle of His to the anterior papillary muscle
right ventricle: pulmonary valve
composed of ___
one cusp is ___ placed, the other two are situated to the ___ & named accordingly
center of the free margin of each cusp: ___
thin margins on each side of the above: ___
in the “pocket” of each cusp is a ___ of the pulmonary trunk
the cusps attach along the ___ of each sinus
backflow of blood during ___ fills the sinuses & causes ___ preventing ___
three delicate cup-shaped cusps (valvules)
anteriorly, right & left posteriorly
nodule
lunula
“sinus” or dilation
curved, inferior margins
ventricular diastole, approximation of the edges of the cusps, regurgitation of blood
left atrium:
similar to the right with ___, but there is ___
posterior portion which receives the ___ has ___ walls
anterior wall & left auricle contain ___ as in the right atrium
in contact posteriorly w/ the ___ through the ___ & ___
two internal sections, no definite line of demarcation
four pulmonary veins, smooth
musculi pectinati
esophagus, oblique sinus, pericardium
left ventricle:
walls are approximately ___ as thick as the right ventricle
the ___ are not as well developed as those of the right ventricle
the ___ is the outflow tract of the left ventricle & corresponds to the ___ of the right ventricle
three times
trabeculae carnae
aortic vestibule, conus arteriosus
left ventricle: interventricular septum (two portions)
thick muscular portion (pars muscularis)
thin membranous portion (pars membranacea) - above the muscularis & close to the atrioventricular orifices
left ventricle: mitral valve
guards the ___
two cusps: ___ & ___
anterior cusp is ___ & intervenes b/n the ___ & ___
two large ___ muscles (anterior & posterior) attach to the free margins of the valve cusps by ___
each muscle is attached by ___ to ___ cusps
left atrioventricular orifice
anterior & posterior
larger, atrioventricular, aortic orifices
papillary, chordae tendinae
chordae tendinae, both
left venctricle: aortic valve
guards the ___
contains ___ cusps similar to those of the ___
arranged w/ one lying ___ & left & right ___ cusps
sinuses are located ___ as in the pulmonary cusps
the right & left coronary arteries arise from the right & left ___
the posterior aortic sinus lacks a ___, so the posterior sinus & cusp are referred to as the ___
aortic orifice
three, pulmonary valve
posteriorly, anterior
above the bases of the cusps
aortic sinuses
coronary artery, noncoronary sinus & cusp
cardiac skeleton:
consists of ___ which forms the ___
four fibrous rings provide ___
the rings help reduce ___
fibrous connective tissue, central support of the heart
attachment for the valvules & cusps of the heart vavles & the bundles of atrial & ventricular muscle fibers
excessive valve stretching & give origin to the myocardial muscle bundles
physiological significance of cardiac skeleton:
the ___ are attached to the upper borders of the rings
the ___ are attached to the lower borders of the rings
therefore, the two sets of muscle bundles are ___ except through the ___
atrial bundles
ventricular bundles
electrically separated, specialized conducting system
right coronary artery:
arises from the ___ & emerges on the ___
runs through the ___ b/n the ___ & ___
right aortic sinus, right side of the pulmonary trunk
right coronary sulcus, right atrium, right ventricle
right coronary artery: branches
sinuatrial nodal branch: ___
right marginal branch (___): ___
AV nodal branch: ___
posterior interventricular branch (___) - ___
usually given off from atrial branch near the origin of RCA
acute marginal, supplies right border
given off at crux of the heart
posterior descending artery (PDA), runs in the posterior interventricular sulcus
summary of right coronary artery supply
right atrium right ventricle (most) part of left ventricle (diaphragmatic surface) posterior 1/3 of IV septum SA & AV nodes (most of the time)
left coronary artery:
arises from the ___ & emerges on the ___
shortly after its origin usually while it is still behind the left auricle, it branches into the ___ & ___
left aortic sinus, left side of the pulmonary trunk
anteior interventricular branch (left anterior descending (LAD)), circumflex branch
left coronary artery: anterior interventricular artery
descends toward the apex in the anterior interventricular sulcus
left coronary artery: circumflex artery:
runs to the left in the ___ b/n the ___ & ___ & then continues onto the ___
usually doesn’t reach the ___, but when it does, it may give rise to the ___
left coronary sulcus, left auricle, left ventricle, posterior of the heart
posterior interventricular sulcus, posterior interventricular artery
left coronary artery: left coronary dominance
approximately 10% of cases
the left coronary artery (by way of the circumflex branch) gives rise to the posterior interventricular artery
left coronary artery: branches of the circumflex artery
left marginal branch (obtuse marginal) - supplies left border
SA & AV nodal branches (occasionally)
summary of left coronary artery supply
left atrium left ventricle (most) part of right ventricle anterior 2/3 of IV septum including the bundle of His SA & AV node (occasionally)
cardiac veins: coronary sinus:
lies in the ___
receives ___
left coronary sulcus from the left margin of the heart to its orifice in the right atrium
most of the veins of the heart
cardiac veins: great cardiac vein:
lies in the ___ & passes ___
becomes continuous w/ the ___ after receiving the ___
anterior interventricular sulcus, upward & to the left in the left coronary sulcus
coronary sinus at the left margin of the heart, oblique vein of the left atrium
cardiac veins: middle cardiac vein:
runs in the ___
empties into the ___
posterior interventricular sulcus
coronary sinus on posterior surface of heart
cardiac veins: small cardiac vein:
parallels the ___
passes in the ___ & drains into the ___
right marginal artery
right coronary sulcus to the posterior of the hear, coronary sinus
cardiac veins: anterior cardiac veins
arise on the ___, pass across the ___, & penetrate the ___
anterior surface of the right ventricle
right coronary sulcus
anterior wall of the right atrium directly
cardiac veins: least cardiac veins (venae cordis minimis):
minute veins in the ___ that empty directly into the ___
most numerous in the ___ & least numerous in the ___
muscular walls of the heart, cardiac chambers
wall of the right atrium, wall of the left ventricle
cardiac plexus:
diffuse network of ___ extending in front of the ___ to the ___
receives ___ input
delicate nerve fibers
trachea
aortic arch, pulmonary trunk, & ligamentum arteriosum
both sympathetic & parasympathetic
sympathetic cardiac branches: three cervical cardiac nerves
superior cervical - from superior cervical ganglion
middle cervical - from middle cervical ganglion
inferior cervical - from inferior cervical ganglion
sympathetic cardiac branches: thoracic cardiac nerves
from upper four or five thoracic ganglia of the sympathetic trunk
sympathetic cardiac branches:
sympathetic fibers of plexus are all ___
preganglionic fibers for all of the sympathetic cardiac nerves arise in the ___
postganglionic
upper four or five thoracic segments of the spinal cord
sympathetic cardiac branches: functions
accelerate heart rate
increase force of heart beat
dilate the coronary arteries
parasympathetic cardiac branches: arise from the ___
vagus nerves
parasympathetic cardiac branches:
two cervical cardiac nerves
arise from the ___
superior cervical & inferior cervical
vagus nerves in the neck
parasympathetic cardiac branches: several thoracic cardiac branches arise from ___
either the vagal trunks or from the recurrent laryngeal branches of the vagus
parasympathetic cardiac branches: parasympathetic fibers of the plexus originating from the vagi are ___ & synapse w/ ___ within the ___
preganglionic
small ganglia
plexus or in the walls of the heart
parasympathetic cardiac branches: functions
decrease the heart rate
reduces the force of contraction
constricts the coronary arteries
afferent (sensory) fibers of the plexus:
visceral afferents from the heart join the ___ & pass along the ___
the vagal afferents are concerned w/ ___
the afferents in the sympathetic cardiac nerves are concerned w/ ___
cardiac plexus, sympathetic & vagal cardiac branches
cardiac reflexes
the conduction of pain sensations from the heart
afferent (sensory) fibers of the plexus: cardiac afferents conducting “pain”
the fibers travel from the heart w/ ___ fibers to spinal cord levels ___
all pain afferents enter the ___ of the ___nerves (the same spinal cord segments giving rise to ___ efferent fibers)
sympathetic, T1 - T5
dorsal roots, upper four or five thoracic, preganglionic
afferent (sensory) fibers of the plexus: cardiac afferents conducting “pain”
because visceral afferent fibers concerned w/ ___ terminate in the ___ of the same spinal cord segments as ___ in upper thoracic spinal nerves, the pain of ___ may be “referred” along the dermatomes supplied by these upper thoracic spinal nerves
the patient often interprets pain along the ___ (dermatomes T1 & T2) & the ___ (dermatomes T2 - T5)
cardiac pain, dorsal horns, somatic afferents, angina pectoris
ulnar border of the upper limb, upper part of the thorax
conducting system of the heart: components
sinuatrial node
atrioventricular node
atrioventricular bundle (of His)
conducting system of the heart: sinuatrial node (Pacemaker):
structure
location
crescent-shaped structure (5-8 mm in length), occupying whole thickness of the wall of the right atrium
located on the anterior lip of the superior vena cava orifice near the top of the crista terminalis
conducting system of the heart: atrioventricular node:
embedded in the ___ close to the ___
it rests on the ___ close to the attachment of the ___
within the septum, the node extends ___
its cells continue anteriorly into the ___
interatrial septum, opening of the coronary sinus
fibrous atrioventricular ring, septal cusp of the tricuspid valve
forward from the opening of the coronary sinus
atrioventricular bundle
conducting system of the heart: atrioventricular bundle:
commences as the forward continuation of the ___
the only connection b/n the ___
the bundle runs downward & forward into the ___ & then ___ where it divides into ___
atrioventricular node
myocardium of the atria & ventricles
membranous, muscular interventricular septa, right & left bundle branches
conducting system of the heart: atrioventricular bundle:
the right bundle branch runs beneath the ___ & enters the ___ to supply the ___ & then breaks up into fine fibers which supply the remainder of the ___
the left bundle follows a similar course beneath the ___ in the ___, but breaks up into branches which reach the ___ along several ___
the fine terminal branches of each bundle end in ___ of specialized conducting cells called ___ which are continuous with ___ muscle fibers
endocardium
septomarginal trabecula
papillary muscles
right ventricle
endocardium
left ventricle
ventricular wall
trabeculae carnae
subendocardial plexus
Purkinje fibers
ventricular myocardial
