APE 6: The Heart and Central Vasculature

Question 1

What are the functions of the right and left side of the heart?

Answer 1

Right= collecting blood from the body and passing it to the lungs
Left= collecting blood from the lungs and passing it through to the body

Question 2

Which is thicker: ventricles or atria? Why?

Answer 2

Ventricles are thicker because they require blood to be pumped for a greater distance, therefore the blood is at higher pressure. This means the walls need to be thicker to withstand this pressure

Question 3

What is found at the diaphragmatic, sterno-costal and posterior aspects of the heart?

Answer 3

Diaphragmatic= Left and right ventricles
Sterno-costal= Right ventricle
Posterior= Left atrium

Question 4

What are the 4 borders of the heart?

Answer 4

Right, left, superior and inferior

Question 5

What are the 2 auricles of the atrial wall?

Answer 5

Left and right auricles

Question 6

Where are the atrioventricular and the interventricular grooves?

Answer 6

Atrioventricular= between atria and ventricles
Interventricular= between both ventricles

Question 7

What is the major vessel arising from the heart and what is at its base?

Answer 7

Aorta, aortic valve at its base

Question 8

How many cusps does the aortic valve have? What is found above them?

Answer 8

3 cusps, sinuses found above them

Question 9

Which two sinuses do the coronary arteries arise from?

Answer 9

The anterior and left posterior sinuses

Question 10

What is the name for the opening of a sinus?

Answer 10

Ostia

Question 11

What do the atrioventricular grooves contain?

Answer 11

Coronary arteries

Question 12

What is the origin of the right coronary artery?

Answer 12

Between the right auricle and the root of the pulmonary trunk

Question 13

Which arteries supply the heart walls?

Answer 13

Coronary arteries

Question 14

Where does the right coronary artery pass round?

Answer 14

Passes round the diaphragmatic border of the heart and into the posterior interventricular groove

Question 15

What does the right coronary artery supply?

Answer 15

The AV node

Question 16

What does the right coronary artery give rise to?

Answer 16

The posterior descending artery

Question 17

What does the left coronary artery give rise to?

Answer 17

The left anterior descending artery

Question 18

Which artery is most commonly involved in myocardial infarction?

Answer 18

Left anterior descending artery

Question 19

What is the aorta the main trunk of?

Answer 19

Systemic arteries

Question 20

Which way does the arch of aorta curve and then descend?

Answer 20

To the left

Question 21

At which level does the arch of aorta begin and end?

Answer 21

At the level of the ‘trans-thoracic plane’- T4/5

Question 22

What are the three branches of the aortic arch?

Answer 22

Brachiocephalic trunk, left common carotid artery, left subclavian artery

Question 23

What are the two branches of the brachiocephalic trunk?

Answer 23

Right common carotid artery and right subclavian artery

Question 24

Which vertebral level does the arch terminate at and what does it bifurcate into?

Answer 24

L4, bifurcates into the left and right common iliac arteries

Question 25

What drains blood from the upper half of the body to the heart's right atrium?

Answer 25

Superior vena cava

Question 26

What drains blood from the lower half of the body to the right atrium?

Answer 26

Inferior vena cava

Question 27

What is the entry point into the heart of the superior vena cava?

Answer 27

When the right and left brachiocephalic veins meet

Question 28

What is the surface marking of the entry point of the superior vena cava into the heart?

Answer 28

The lower border of the 1st right costal cartilage

Question 29

Where does the inferior vena cava originate?

Answer 29

At the juction of the right and left common iliac veins

Question 30

At which vertebral level does the inferior vena cava enter the heart?

Answer 30

T8

Question 31

What is the position of a normal heart with relation to the vertebral column?

Answer 31

T4-T8

Question 32

What is the heart contained within?

Answer 32

The pericardium

Question 33

What are the surface markings of the pericardium?

Answer 33

Diaphragm, phrenic nerves and major vessels superior to the heart

Question 34

What is cardiac tamponade?

Answer 34

Bleeding into the cardiac sac

Question 35

How can cardiac tamponade be relieved?

Answer 35

Pericardiocentesis- drainage of fluid in pericardial sac

Question 36

What is the relevant surface marking of relieving cardiac tamponade?

Answer 36

Manubriosternal joint

Question 37

What is the name of the outer layer of the pericardium?

Answer 37

Fibrous pericardium

Question 38

What is the name of the inner layer of the pericardium?

Answer 38

Parietal serous pericardium

Question 39

What is the name of the layer of the pericardium that is continuous with the heart?

Answer 39

Visceral serous pericardium

Question 40

What does serous mean and what does it enable?

Answer 40

Serous means that it produces some fluid, allows friction-free movement of the heart inside the sac

Question 41

What are the pulmonary arteries?

Answer 41

Arteries whereby deoxygenated blood passes from the heart to the lungs

Question 42

How many pulmonary arteries are there and where do they arise from?

Answer 42

2, arise from the pulmonary trunk

Question 43

What are the pulmonary veins?

Answer 43

Veins whereby oxygenated blood enters the heart from the lungs

Question 44

Which nerve innervates the diaphragm and at which vertebral level is this?

Answer 44

Phrenic nerve- C3,4,5

Question 45

What causes the heart sounds heard through a stethoscope?

Answer 45

The closure of heart valves

Question 46

Where are sounds from the pulmonary valve best heard?

Answer 46

The 2nd left intercostal space

Question 47

Which chamber forms the apex of the heart?

Answer 47

Left ventricle

Question 48

Where is the pulsations of the apex beat typically felt?

Answer 48

In the 5th left intercostal space, in the midclavicular line

Question 49

Where is the sounds from the mitral valve best heard?

Answer 49

In the 5th left intercostal space, in the midclavicular line

Question 50

What causes enlargement of the heart?

Answer 50

Heart failure

Question 51

Where are sounds from the aortic valve best heard?

Answer 51

2nd right intercostal space

Question 52

What is stenosis and incompetence?

Answer 52

``` Stenosis= valves becoming stiffer/narrowed Incompetence= valves becoming weakened/leaky ```

Question 53

What can stenosis/incompetence lead to? What can be heard/palpated because of this?

Answer 53

Leads to a turbulent flow of blood Murmur can heard Thrill can be felt when apex is palpated

Question 54

What forms the inferior vena cava and at which vertebral level?

Answer 54

Forms by the unuon of the 2 common illiac veins, at L5 level

Question 55

What are the 3 openings of the right atrium?

Answer 55

Superior and inferior caval and coronary sinus

Question 56

What are the musculi pectinati

Answer 56

Ridges in the right atrium of the heart

Question 57

What is the crista terminalis

Answer 57

It is what divides the musculi pectinati

Question 58

What is the fossa ovalis?

Answer 58

The remnant of the fossa ovale in the foetal heart which allows right to left shunting of blood to bypass the lungs

Question 59

When does the fossa ovale close?

Answer 59

When the newborn takes its first breath

Question 60

What is the interatrial spetum?

Answer 60

The solid muscular wall that separates the right and left atrium

Question 61

Which chamber forms most of the anterior (ventral) surface of the heart?

Answer 61

The right ventricle

Question 62

What are the two large openings in the walls of the right ventricle?

Answer 62

The right atrioventricular orifice and the orifice of the pulmonary trunk

Question 63

How many cusps does the right atrioventricular (tricuspid) valve contain?

Answer 63

3

Question 64

What is the cordae tendinae?

Answer 64

The strong fibrous cords

Question 65

What are the cordae tendinae attached to?

Answer 65

The cusps of the tricuspid valve and the papillary muscles

Question 66

Where do the papillary muscles project from?

Answer 66

The ventricular walls

Question 67

What are the trabeculae carnae?

Answer 67

Irregular bundles and bands of muscles

Question 68

Where do the trabeculae carnae project from?

Answer 68

The inner surface of the ventricles

Question 69

What is the infundibulum?

Answer 69

Smooth walled part, lines the right ventricle, leads to the pulmonary trunk

Question 70

How many pulmonary veins does the left atrium receive?

Answer 70

4 altogether, two from each lung

Question 71

What does the left ventricle occupy?

Answer 71

A small part of the sterno-costal surface and about 2/3 of the diapragmatic surface of the heart and the apex

Question 72

What is the orifice leading into the aorta and what is the valve guarding it?

Answer 72

Aortic orifice and semi-lunar valve

Question 73

What is increased resistance in peripheral vasculature usually caused by and what is the cause of this?

Answer 73

Caused by hypertension | Causes hypertrophy of musculature of the left ventricle