Basic Sciences - Anatomy of Heart and Major Vessels Flashcards
Layers of the pericardium
Fibrous
Parietal
Visceral
Attachments of the fibrous pericardium
Great vessels
Posterior aspect of sternum
Central tendon of diaphragm
3 cusps of the tricuspid valve
Septal
Inferior
Anterior
Attachments of tricuspid valve
Attached to fibrous atrioventricular ring
Free edges and inferior surfaces attached by chordae tendinae to papillary muscles to RV wall
Lining of right ventricle
Trabeculated muscle
Infundibulum definition
Smooth wall right ventricle outflow tract (RVOT)
Leaflets of mitral valve
Anterior
Posterior
Area of left ventricle which does not have prominent trabeculae
LVOT
(Left ventricular outflow tract)
Conduction pathways of the heart
Internodal tracts exist bit conduction through atria is normally non specific but synchronous
Most common vascular supply to sinoatrial node
Right coronary artery (in 65% of people)
Most common vascular supply to atrioventricular node
Right coronary artery (in 80% of people)
Path of right coronary artery
Arises from anterior aortic sinus
Descends in atriventricular groove
Reaches posterior interventricular groove
Right marginal artery arises from RCA
Source of left coronary arteries
Arises from left posterior aortic sinus
Branches of Left coronary artery
LAD (Left anterior descending artery)
Circumflex
Branches from LAD artery
Diagonal branches
Septal perforating branches
Branches of circumflex artery
Obtuse marginal arteries
Areas supplied by LAD artery
Anterior aspects of both ventricles
Anterior 2/3rds of ventricular septum
Posterior descending artery ‘right dominance’ definition and percentage
Posterior descending artery arises from RCA
85% of people
Posterior descending artery ‘left dominance’ definition and percentage
Posterior descending artery arises from circumflex artery
15% of people
Path of posterior descending artery
Posterior interventricular groove
Coronary vein drainage
75% drain to RA via coronary sinus
Anterior cardiac veins drain anterior part of RV directly into RA
Principle tributaries to the coronary sinus
Great LV cardiac veins
Small LV cardiac veins
Middle LV cardiac veins
Posterior LV cardiac veins
Thebesian veins
Small veins which drain directly into the cardiac chambers
Source of parasympathetic fibres to SA and AV nodes
Vagus and recurrent laryngeal nerve branches via deep and superficial cardiac plexuses
Parasympathetic effects on heart
Decreased heart rate
Decreases force of contraction
Constricts coronary arteries
Dilates systemic arteries
Source of sympathetic fibres to SA and AV nodes
Lateral horns of T1-T4 spinal cord
Post ganglionic fibres arise from the 3 cervical ganglia and upper thoracic sympathetic ganglia
Sympathetic effects on heart
Increases heart rate
Increases force of contraction
Dilates coronary arteries
Constricts systemic arteries
Location of carotid sheath
Deep to sternocleidomastoid muscle
Contents of carotid sheath
Internal / Common carotid artery
Internal jugular vein
Vagus nerve
Femoral triangle
Venous system of the arm
Site of PICC line insertion
Basilic vein or Median cubital vein
Why Cephalic vein not used for PICC line insertion
As cephalic vein joins axillary vein, there is a valve and an acute angle
Makes insertion technically difficult
Locations for arterial cannulation and reasoning why
Radial artery or Dorsalis Pedis artery (as both have collateral flow)
Can us femoral artery or axillary artery (as they are large calibre end arteries)
Which artery to avoid in arterial cannulation and why
Brachial artery
Lacks collateral flow and is not a large calibre end artery
