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cardiac anatomy Flashcards

1
Q

Cardinal symptoms of cardiac dysfunction?

A

FACES

  1. Fatigue
  2. Activity limitation/Exercise intolerance
  3. Congestion/fluid in lungs with dyspnea
  4. Edema
  5. SOB
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2
Q

Structure groups in Thoracic Cavity

A
  1. CV system
  2. Digestive tract
  3. Endocrine glands/cells in lungs
  4. Nervous system
  5. Lymphatics
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3
Q

Bony Thorax traits

A
  • Covers/protects major organs of CP system
  • Provides skeletal framework for the attachment of muscles
  • Conical at superior and inferior aspects
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4
Q

Skeletal boundaries of the thorax

A

Dorsal: 12 thoracic vertebrae
Lateral: ribs
Ventral: Sternum

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5
Q

of intercostal spaces

A

11

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6
Q

How are ICs numbered?

A

according to rib forming superior border

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7
Q

What is the angle of Louis?

A

anterior angle formed by junction of manubrium and body of sternum

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8
Q

What all happens at the angle of Louis?

A
  1. surface landmark for bifurcation of trachea into R/L main stem bronchi
  2. arch of aorta starts and ends
  3. Descending aorta begins
  4. Cardiac plexus at this level
  5. Pulm trunk divides into 2 pulm arteries just inferior to this level
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9
Q

What organs are found in the mediastinum?

A
  1. hearts and its vessels
  2. esophagus
  3. trachea
  4. phrenic and cardiac nerves
  5. thoracic duct

(also, space between lungs)

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10
Q

what forms the borders of the mediastinum

A 
Superior: Thoracic outlet
Anterior: Chest wall
Lateral: Lungs
Posterior: vertebral column
inferior: diaphragm
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11
Q

What direction do mediastinum contents move in supine

A

superior

abdominal viscera pushes superior

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12
Q

T/F: Contents of mediastinum can’t be shifted

A

False

can be shifted by air trapped in pleural space or following lung removal

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13
Q

Orientation of heart in mediastinum

A

2/3 L of sternum
points anteriorly
2nd-5th IC space

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14
Q

anterior axillary line

A

imaginary line starting from lateral end of clavicle, lateral edge of pec major muscle

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15
Q

midaxillary line

A

imaginary line between anterior axillary line and posterior axillary line

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16
Q

posterior axillary line

A

marked by posterior axillary fold (lats and teres major)

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17
Q

midclavicular line

A

imaginary line parallel to long axis of body.

passes through midpoint of clavicle and ventral surface of body

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18
Q

Fibrous Pericardium

A
  • prevents overfilling of heart
  • posterior to sternum and 2nd-6th costal cartilage. Anterior to T5-8
  • Attaches inferiorly to central tendon of diaphragm and superiorly to tunica externa
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19
Q

Serous Pericardium

A
  • doubles back on itself

- allows oscillation. expansion is allowed from fluid in serous membrane

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20
Q

What conditions can be found at the serous pericardium?

A

pericarditis

cardiac tamponade

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21
Q

Epicardium

A

same as visceral pericardium

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22
Q

Myocardium

A

Thickest region of the heart, contains myocytes

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23
Q

Endocardium

A

Thin connective tissue. Covers valves and continues with endothelium layer of vessels

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24
Q

What does the R atrium collect blood from?

A
  1. SVC
  2. IVC
  3. coronary sinus

(also receives lymphatic flow from lymphatic duct)

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25
Auricles
small earlike extensions on R atrium that expand its volume
26
What is the location of the SA node
in the myocardial layer just lateral to the junction where SVC enters R atrium
27
T/F: in SA node, parasympathetic fibers > sympathetic fibers
True
28
Tricuspid (AV) valve
one way valve from RA to RV
29
Structures found in R ventricle
- papillary muscle - chordae tendinae - pulmonary valve
30
Pulmonary valve
- Separates RV from the pulmonary trunk - Lies at the apex of the conus arteriosus at the level of the 3rd costal cartilage - Has three semilunar cusps which project into the pulmonary trunk - Prevents retrograde flow of blood during ventricular diastole
31
RV "inflow tract"
1. tricuspid valve 2. chordae tendinae 3. papillary muscles 4. base of R ventricular chamber
32
RV "outflow tract"
1. R ventricular free wall 2. ventricular septum 3. conus arteriosus (infundubulum)
33
Pressures within R ventricle
Diastolic: 0-8 mmHg Systolilc: 15-30 mmHg
34
What leads to cor pulmonale
increased pulmonary pressures which increase work load on RV
35
Clinically apparent rheumatoid heart disease vs autopsy series
clinically apparent = 25-40% | autopsy = 80%
36
Common misdiagnoses for rheumatoid heart disease
``` pericarditis myocarditis valvular HD atherosclerotic CAD coronary arteritis aortitis cor pulmonale conduction disturbances ```
37
T/F: sole presence of rheumatoid arthritis is considered a primary pathogenic factor for premature atherosclerosis
True | increases CV events X3
38
Left Atrium
- Lies just below the 2nd rib - Lies dorsally, opposite thoracic vertebrae 5-7 - Separated from the vertebral column by the esophagus and aorta
39
Left Ventricle features
- Walls are approximately 3X thicker than those of the RV - Separated from the RV by the Interventricular septum - Apex is normally the thinnest portion of the left ventricle
40
LV "inflow tract"
``` funnel shaped surrounded by: mitral valve annulus leaflets chordae tendinae ```
41
LV "outflow tract"
1. smooth basal portion of IV septum | 2. anterior ventricular wall and anterior mitral leaflet
42
Cardiac activation times:
Atrial: .09 s AV node: .16 s Ventricular mass activation: .23
43
Conduction velocity altered by:
1. sympathetic stim (increases) 2. Vagal stim (decreases) 3. Ischemia/Hyoxia (decreases) 4. Drugs (adrenergic and cholinergic)
44
Aortic Root of coronary arteries
1. begins at base of heart 2. continuous with LV outflow tract 3. Forms bridge between LV and ascending aorta 4. contains aortic valve
45
Aortic sinus/space
1. contained in valve leaflets 2. contains origins of coronary arteries 3. posterior sinus doesn't have a coronary artery
46
When do coronary arteries receive blood
diastole
47
at rest, how much oxygen is extracted from CA blood?
60-70%
48
T/F: increased amount of time in diastole decreases efficiency of myocardial perfusion
False | decreased time in diastole
49
T/F: Increased work of heart can reduce perfusion
True | Think uncontrolled HTN
50
RCA pathway
1. R cusp of aortic valve 2. between auricular appendage of RA and pulm trunk 3. AV groove 4. R margin of heart 5. posterior IV sulcus 6. posterior descending artery
51
RCA perfuses:
1. The wall of the RV 2. Interventricular septum 3. 25-35% of the LV 4. SA node 5. Contributes to the perfusion of the AV node
52
LCA branches
1. Anterior Interventricular artery | 2. circumflex artery
53
Anterior Interventricular artery
1. Follows the anterior interventricular groove 2. Supplies blood to the anterior and septal aspects of the LV, apex, and IV septum 3. Perfuses approx. 70% of the LV 4. “Widow maker”
54
Circumflex Artery pathway
1. coronary sulcus between LA and LV. 2. L margin of heart 3. Posterior to longitudinal sulcus and helps form post IV artery
55
Circumflex artery perfuses
1. posterior and lateral aspects of LV 2. papillary muscles 3. SA node
56
Which primary bronchi runs more vertically
Right runs more vertically it is also longer
57
what are some issues with mediastinum contents during cancer treatment
1. often irradiated during radiation treatment, especially for cancer in the L breast. 2. lymphatic abnormalities from lymphoma
58
What part of the heart is deep to the 5th rib
tip of LV (apex)
59
T/F: volume of the heart decreases as a result of the central tendon pulling on the heart
False | volume increases
60
A patient c/o chest pain and notices that pain increases with exertion and that he can feel it with his heart beat. What do you suspect the patient has?
pleurisy
61
what risk of pathology do the auricles present
can be a location of compromised or static blood flow. =clots

Cardiopulm (20 decks)

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