Block 1 - Anatomy - The Heart; Intro to EKGs Flashcards
What is indicated by the arrow in this image?

Pericardial effusion
(medium gray fluid surrounding line of heart wall)
What is the purpose of the pericardium?
To prevent friction;
to secure the heart in place
To what is the pericardium susceptible?
Infection, metastases, effusion
What nerves supply the fibrous and parietal pericardia?
The phrenic nerves
What nerves innervate the visceral pericardium?
The sympathetic trunks and vagus nerves
What does this CXR indicate?
What other signs or symptoms might be present?

Pericardial effusion, possible cardiac tamponade;
Beck’s triad (JVD, hypotension, muffled heart sounds)
Describe the location of the IVC, lower esophagus, and descending aorta in relation to the heart.
IVC (on the right);
esophagus (medial);
descending aorta (lateral)

Why is the abdominal aorta predisposed to abdominal aneurysms?
Lack of vasovasorum that is present in the upper aorta
What are the ABCs of the branching aortic arch?
Aorta, Brachiocephalic, Common carotid (left), Subclavian (left)
To what types of vascular issues is the aorta susceptible?
Atherosclerosis, inflammation, shear stress, and aneurysm formation
What are some clinical sequelae of long-term hypertension?
Cardiac hypertrophy, heart failure
What are some of the signs and symptoms of heart failure?
(ignore left-right distinctions)
Shortness of breath and crackles in lung sounds (pulmonary edema);
pitting edema, JVD, hepatosplenomegaly
What are some deadly potential side effects of chronic hypertension?
AMI, stroke, renal failure
For which cardiac sounds is the diaphragm of the stethoscope ideal?
The pulmonic and aortic regions

For which cardiac sounds is the bell of the stethoscope ideal?
The mitral region

For which cardiac region is the bell or diaphragm of the stethoscope acceptable?
The tricuspid region

What is the most commonly replaced heart valve?
What is the second most commonly replaced?
Aortic;
mitral
What do you suspect after reviewing this X-ray?

Possible aortic dissection
(here is the emergency CT confirmation)

How can an aortic dissection or tear be treated?
With a dacron graft

Proximal aortic dissection should be considered in the differential in what scenarios?
Chest pain that moves to the back;
chest pain in the setting of a wide mediastinum on CXR;
or chest pain associated with an elevated BP
Who is most at risk for aortic dissection?
Older, hypertensive patients;
smokers;
or those with an underlying predisposition (e.g. Marfan’s syndrome)
What are the principal coronary arteries?
Right coronary a. –> Acute marginal a. + posterior descending a.
Left main coronary a. –> left anterior descending a. + circumflex a. + left marginal a.

What vein follows along the circumflex artery and then empties into the coronary sinus?
The great cardiac vein

What vein follows along the inferior portion of the circumflex and ends in the coronary sinus?
The posterior vein of the left ventricle

























