C0- Into To Echo And Cardiac Anatomy Flashcards
What are the two systems of the heart?
Systemic (whole body)
Pulmonary (lungs)
Which systems do the right and left heart pump?
Left: systemic
Right: pulmonary
What are the four layers of vessels from inner to outer?
Endothelium
Tunica intima
Tunica media
Tunica adventitia
What happened when the tunica media get too thick?
the vessel gets stiff and doesn’t work as well
What is the location of the heart with reference to the R and L of the body?
2/3 to the left
1/3 to the right
What is the orientation of the apex?
It points inferior, anterior and left
What are the two sulci of the heart?
Interventricular sulcus
Atrioventricular sulcus
The IV-sulcus and the AV-sulcus align with which structures of the heart?
The interventricular septum and
Atrioventricular septum
What is the crux of the heart?
Where both the IVS and the AVS meet (seen in the apical four chamber view)
The AV sulcus contains which arteries?
Anterior:
Circumflex artery (CXM) (on the left)
Right coronary artery (on the right)
Posterior:
Coronary sinus
The IV-sulcus contains which arteries?
Anteriorly:
Left descending artery
Great cardiac vein
Posteriorly:
Posterior descending artery
Middle cardiac vein
Where are the pulmonary veins found?
The posterior side of the L atrium
Where is the superior mediastinum found?
Surrounding the great vessels
What are the main coronary arteries and their branches?
Left main coronary artery:
- left anterior descending artery
- circumflex artery (can give rise to PDA)
Right coronary artery:
Marginal Artery
-posterior descending artery (70-80% of the time)
Where does the L main coronary artery branch from?
The L coronary cusp of the AO
Where does the R coronary artery branch from?
R coronary cusp of the AO
When do the coronary arteries fill?
During diastole
Where is the coronary sinus located?
Posterior to the R atrium
Coronary sinuses branch into which veins?
Great cardiac vein
Middle cardiac vein
Small cardiac vein
The middle cardiac vain follows which structure?
The IV septum
How thick should the LV walls be for M & W
M: 6-10 mm, <11mm
W: 6-9mm, <10mm
How much blood is ejected each time by the LV?
70 ml
What are the three layers of the heart?
Endocardium
Myocardium
Epicardium/visceral pericardium
Describe the endocardium layer
Inner most layer
Think layer between the blood and myocardium
Describe the myocardium (including thickness for the LV and RV)
Thick middle layer
Striated muscle
LV: 6–10mm
RV: 3-5mm
Describe the epicardium/pericardium
Outermost layer Echogenic Has two layers: -fibrous pericardium -serous pericardium
Describe the fibrous pericardium. What is its function?
Outermost layer
Function:
Prevents over distension of the heart
Describe the serous pericardium
Serous pericardium has two layers…
Parietal and visceral
There is 20-50ml of fluid between the two layers for lubrication
How can you tell if excessive pericardial fluid is acute or chronic?
It depends on the rate of accumulation of the fluid
Why is the RV crescent shaped?
Due to higher pressure in the LV
What is the moderator band and where is it found?
It’s the anterior papillary muscle that connect the side pap muscles
Found in the right ventricle ONLY
What is the infundibulum of the heart and where is it found?
It’s a ridge of smooth muscle
Found between the RVOT and the LVOT
How are the 4 pulmonary veins further subdivided?
Into 2 upper and 2 lower
RUPV, RLPV, LUPV, LLPV
In the LA, where is a common site of thrombus?
LA appendage
where does the R coronary cusp of AO valve face?
faces towards the RV
origin of the RCA
where does the L coronary cusp of AO valve face?
The pulmonary artery
origin of L main CA
where does the noncoronary cusp of AO valve face?
the IAS
do the cusps of the AO valve overlap? what is this zone called?
Yes
coaptation zone
what are the leaflets of the MV? what are the pap-mules in the LV called?
leaflets: anterior and posteior
pap: anterolateral and posteromedial
what does stretching of the annulus cause?
regurgitation
What are the scallops of the MV leaflets and how are they labeled?
Numbered from lateral to medial
The AMVL have no true divisions but the PMVL do, use the same landmarks to divide
anterior MV leaflet: A1, A2, A3
posterior MV leaflet: P1, P2, P3
3 cusps of TV?
anterior
posterior
septal
what are the most common types of abnormalities with the PV?
tend to be congenial rather than acquired
3 cusps of PV?
anterior
left
right
what are the 2 major parts of the IVS?
membranous septum: thin and most common site for ventricular septal defect
muscular septum: thicker, less common site of VSD
which ventricle does the muscular septum mostly belong to?
the LV
what are the 3 segments of the IAS numbered in order of formation?
- septum primum (bottom section)
- septum secundum (top section)
- foramen ovale (with covering flap)
another word for pericardium?
epicardium
What does the middle mediastinum contain
The pericardium and the heart
What is the eustachian valve?
Directs fetal flow from RA to LV
How many pap muscles does the TV have?
3
In what % of people does the posterior descending A come from the RCA? What does this indicate and what other artery can is arise from
70-80%
Indicated R dominant heart, can arise from circumflex
From which vessel do the main branches of the coronary arteries originate?
From the AO
Which part of the IVS closes last?
Membranous
The heart is spurring by which sac?
Pericardial sac
Which cardiac vein follows the RCA?
Small cardiac vein
What are the blood volume sin the LV at end diastole and end systole?
End diastole: 100ml
End systole: 30ml
What’s another term for the visceral layer of the serous pericardial?
Epicardium
Where is the RAtrial appendage located?
Superior in the R atrium
Where do the coronary sinus drain into the RA?
Inferiorly near the entrance of the IVC
How does the LV muscle appear?
Trabeculated
