Applied anatomy of the heart Flashcards
- What are 4 different branches of innervation to the heart? [3]
- What are the vertebral levels for the above? [1]
- VN
- Sympathetic nerves: T1-T5
- General visceral afferent nerves: T1-T5
- Somatic afferents: T1-T5
Why is cardiac pain experienced in somatic region and not near the organ? [1]
The brain is unable to distinguish between visceral and somatic sensation [1]
What is this an image of? [1]
Circumflex artery
LAD
Marginal branch
Posterior interventricular artery
Right coronary artery

]What is this an image of? [1]
Circumflex artery
LAD
Marginal branch
Posterior interventricular artery
Right coronary artery
The RCA usually supplies which two componenets of the cardiac conduction system? [2]
Which arteries supply the bundle branches? [1]
The RCA usually supplies which two componenets of the cardiac conduction system? [2]
SAN [1]
AVN [1]
Which arteries supply the bundle branches?
Interventricular arteries
What does the term ‘left / right dominant heart’ refer to? [1]
Which is more common? [1]
What is the significance of left dominant heart? [1]
What does the term ‘left / right dominant heart’ refer to? [1]
If posterior descending artery comes from RCA or LCA
Which is more common? [1]
Right dominant heart = ~ 70% cases
What is the significance of left dominant heart? [1]
Left dominant heart means that the entire interventricular septum arises from the LCA
Is this heart right dominated or left dominated? [1]

right dominated

Explain what bundle branch block is [1]
Which part of ECG can see bundle branch block occur in? [1]
Explain what bundle branch block is [1]
Disruption to the electrical signal that causes your heart to beat [0.5]
Causes altered pathways for depolarisation [0.5]
Which part of ECG can see bundle branch block occur in? [1]
Prolongs QRS
Which artery is commonly used for coronary artery bypass? [1]
internal thoracic artery [1]

Which views of the heart are seen by each type of ECG lead on a standard 12-lead ECG? [4]
- *S**eptal: V1, V2
- *A**nterior: V3, V4
- *L**ateral: V5, V6, AVL, I
- *I**nferior: II, III, AVF
AVR: neutral

Which areas of the myocardium match up with each of the coronary arteries? [4]
Left co

Label A-D

A: Pulmonary
B: Aortic
C: Tricuspid
D: Mitral

# Define stenosis [1] Define regurgitation [1]
- *Stenosis:** heart valves do not open properly
- *Regurgiation:** heart valves do not close properly
What are the characteristics of aortic stenosis?
What are the characteristics of aortic regurgitation?
Aortic stenosis:
- Turbulence as blood has to be pushed through stenotic aortic valve
- Systolic (typically mid-systolic)
- Heart at right second IC space
Aortic Regurgitation:
- Sound can be complex and often absent
- Decreased cardiac output due to regurgitation
- Elevates pre-load and afterload
- LVH – typically very dilated

Describe the characteristics of mitral stenosis
Describe the characteristics of mitral regurgitation
Mitral stenosis:
- Rarely produces a soft rumbling diastolic murmur
- Mainly rheumatic in origin
Mitral Regurgitation:
- Heard at Apex
- Mitral Valve closed all the way through systole

Define preload and afterload [1]
Preload: Volume of blood in ventricles at the end of diastole
Afterload: Resistance ventricle must overcome to circulate blood
What is concentric hypertrophy characterised by visually? [1]
How does concentric hypertrophy occur? [1]
When does concentric hypertrophy occur? [2]
What does concentric hypertrophy cause to happen and why? [1]
What is concentric hypertrophy characterised by visually? [1]
- Increased wall thickness / reduced lumen of ventricle
How does concentric hypertrophy occur? [1]
- New sarcomeres produced
When does concentric hypertrophy occur? [1]
- Aortic stenosis
- Chronic hypertension
What does concentric hypertrophy cause to happen and why? [1]
- Decreases pre-load due to reduction in compliance (stiff)

Eccentric hypertrophy:
- Caused by? [4]
- Characterised by? [2]
Eccentric hypertrophy:
Caused by? [1]
- Aortic and mitral regurgitation
- Systolic dysfunction (loss of cardiac inotrophy
- -Volume overload (hypervolaemia due to ventricular or renal failure)
- Alcohol / cocaine
Characterised by? [2]
- Chamber dilation - lumen gets bigger, wall gets smaller: cant contract properly

What causes atrial englargement? [1]
What can increased atria size lead to? [1]
What causes atrial englargement? [1]
Persistant change in atrial structure
What can increased atria size lead to? [1]
Atrial fibrillation (ectopic firing) - absecence of P waves
Which is characterised by the following?
Mitral stenosis
Mitral regurgitation
Aortic stenosis
Aortic regurgitation

Which is characterised by the following?
Mitral stenosis
Mitral regurgitation
Aortic stenosis
Aortic regurgitation

Which is characterised by the following?
Mitral stenosis
Mitral regurgitation
Aortic stenosis
Aortic regurgitation

Which is characterised by the following?
Mitral stenosis
Mitral regurgitation
Aortic stenosis
Aortic regurgitation

Which is characterised by the following?
Mitral stenosis
Mitral regurgitation
Aortic stenosis
Aortic regurgitation

Which is characterised by the following?
Mitral stenosis
Mitral regurgitation
Aortic stenosis
Aortic regurgitation

Which is characterised by the following?
Mitral stenosis
Mitral regurgitation
Aortic stenosis
Aortic regurgitation

Which is characterised by the following?
Mitral stenosis
Mitral regurgitation
Aortic stenosis
Aortic regurgitation
