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IBI Test 2 Leesy > B3.085 - Intro to Anatomy of Heart > Flashcards

B3.085 - Intro to Anatomy of Heart Flashcards

1
Q

What is the oblique pericardial sinus

A

lowest (most dependent) part of pericardial sac when a patient lies on ones back.
Blind pocket dorsal to left atrium formed by pericardial reflections surrounding pulmonary veins and s/i VC

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2
Q

What is cardiac tamponade

A

compression of the heart due to rapid accumulation of fluid in the pericardial sac. Prevents chambers from expanding fully limiting stroke volume.

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3
Q

What are classic indications of cardiac tamponade

A

Jugular venous distention
Distant heart sounds
Hypotension with dyspnea

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4
Q

What is pericardiocentesis

A

Removal of excess fluid from pericardial sac with 18G spinal tap needle
Used to treat cardiac tamponade

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5
Q

How is a pericardiocentesis done

A

With US, needle placed just left of xyphoid angled 45 degrees towards head while pointing towards medial edge of left scapula

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6
Q

What is pericarditis

A

inflammation of the pericardial sac lining typically due to viral or bacterial infections

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7
Q

What is a non infectious cause of pericarditis

A

malignancy

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8
Q

Describe pain due to pericarditis

A

Remains substernal and worsens upon lying down or when inhaling deeply

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9
Q

What is pericardial rub indicative of

A

acute pericaditis

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10
Q

what is pericardial rub

A

if the serous layer of pericardium becomes rough it induces friction and vibrations

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11
Q

What is S2 due to

A

closing of the aortic and pulmonary valves

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12
Q

What is S1 due to

A

Closing of the atrioventricular valves

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13
Q

What valves can you listen to on the body

A

A -Aortic
P - Pulmonary
T - Tricuspid
M - Mitral

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14
Q

Where can you hear the aortic valve best

A

right of sternum at 2nd IC space

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15
Q

Where can you hear Pulmonary valve best

A

left of sternum at 2nd IC space

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16
Q

Where can you hear the tricuspid valve best

A

left of sternum at 5th IC space

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17
Q

Where can you hear the mitral valve best

A

left side at 5th IC space at midclavicular line

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18
Q

What is the clinical relevance of the fibrous skeleton of heart

A

if its stretched the heart valves often fail

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19
Q

How do you close the left atrial appendage

A

Placing an implant designed to close off appendage

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20
Q

What are papillary muscles

A

restrict valve cusp movement during ventricular systole to prevent blood from regurgitating back in

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21
Q

What happens when papillary muscles rupture

A

sometimes in MI, leads to AV valve dysfunction or insufficiency. Regurgitation of blood is often a consequence

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22
Q

How can regurgitation of a valve present clinically

A

as a diastolic murmur

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23
Q

What is left ventricular hypertrophy produced by

A

chronic hypertension or aortic valve stenosis

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24
Q

What does volume overloading cause

A

ventricular hypertrophy and chamber dilation

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25
Q

What happens when the mitral valve everts into the left atrium when left ventricle contracts

A

mitral valve prolapse

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26
Q

what can mitral valve prolapse cause

A

mitral valve regurgitation

27
Q

Why is mitral valve prolapse more common than tricuspid valve prolapse

A

the left ventricle contracts at higher pressure

28
Q

What can cause mitral valve regurgitation

A

rupture of chordae tendineae or papillary muscles

29
Q

how do the aorta and pumonary trunk end up in relation to eachothers position in the body

A

Aorta slightly posterior

pulmonary anterior

30
Q

what is the most common congenital abnormality

A

bicuspid aortic valve

31
Q

what are complications of a bicuspid aortic valve

A

more likely to cause aortic valve stenosis than a normal tricuspid aortic valve

32
Q

what is “right dominant distribution”

A

posterior interventricular artery arising from the right coronary artery

33
Q

What is left dominant distribution

A

circumflex branch of LCA gives off posterior interventricular

34
Q

what is balanced distribution

A

when both right and left coronary arteries supply the posterior interventricular artery

35
Q

what are the top 3 sites of coronary artery blockage

A
  1. Anterior descending
  2. Base of right coronary artery
  3. left circumflex branch
36
Q

what is CABG

A

coronary artery bypass graft

37
Q

how is CABG performed

A

distal end of internal thoracic artery is attached to the existing coronary artery distal to the blockage

38
Q

What are additional arteries and veins harvested for graft

A

radial artery

Great saphenous vein

39
Q

Where does most blood passed through the coronary arteries return ot venous circulatory system

A 
coronary sinus (most)
anterior cardiac veins (less)
40
Q

what is the SA node

A

initiates heartbeats

41
Q

Where is the SA node located

A

in the right atrial wall at superior end of sulcus terminalis near SVC

42
Q

what is the SA node stimulated by

A

sympathetic cardiac nerves

43
Q

What is the SA node decreased by

A

parasympathetic cardiac nerves

44
Q

what do ANF/ANP do

A

affect blood volume

ANP acts on kidney to increase sodium and water excretion to reduce blood volume

45
Q

where is the AV node located

A

inferior aspect of the intraatrial septum near the opening of the coronary sinus

46
Q

ischemia to what artery can fuck up SA and AV node

A

right coronary artery

47
Q

blockage of what artery can cause loss of ventricular contractions

A

LAD

48
Q

if pacemaker cells in ventricles are not stimulated by SA node what happens

A

spontaneous contraction at slower pace

49
Q

Where are pacemakers generally inserted

A

under the skin on anterior chest wall inferior to clavicle while leads are threaded through the venous system down SVC and over to site of SA

50
Q

sympathetic nerves that innervate heath have cell bodies where

A

in sympathetic chain ganglia from C4 down to T5

51
Q

What is ischemic pain caused by

A

inadequate blood flow is carried back to CNS through afferents that run with sympathetic nerves and enter synapse within the spinal cord at C4 to T5

52
Q

major signs of MI in women

A 
chest pain or discomfort
nausea, lightheadedness, tired
pain in jaw, nack or back
pain in arm or shoulder
SOB
53
Q

What are signs of MI in men

A

chest pain or discomfort in arm or shoulder

SOB

54
Q

what is the basis of referred pain caused by

A

convergence of afferent nerves from both viscera and soma onto same dorsal horn neuron

55
Q

There is convergence of both somatic and visceral afferents onto nerves in same dorsal horn nerve in spical cord such that

A

heart pain may be perceived as chest or left arm pain

56
Q

What is a thymoma

A

tumors of the thymus

57
Q

The brachiocephalic veins are formed by union of what

A

subclavian and internal jugular veins

58
Q

What is the sternal angle

A

where the trachea bifurcates into the right and left main bronchus

59
Q

Where does the esophagus pass through the diapragm

A

esophageal hiatus at T10

60
Q

How do you remember the hiatuses

A

8- I - Inferior VC
10- Esophageal
12-Aortic
I 8 10 Eggs At Noon

61
Q

Where does the phrenic nerve arise from

A

C3, C4, C5

62
Q

The phrenic nerve transmit referred pain from diaphragm, pericardium, abdominal cavity and mediastinal pleura back to what dermatones

A

C3, C4, C5 where they present as neck pain

63
Q

where can pain from the diaphragm be referred to

A

T7, 8, 9,10 anteriorly, and T11, 12 posteriorly or C3,C4, C5

64
Q

Which nerve is the vagus nerve

A

10th cranial

IBI Test 2 Leesy (13 decks)

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