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Cardiopulm > cardiac anatomy > Flashcards

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
Q

Auricles

A

small earlike extensions on R atrium that expand its volume

26
Q

What is the location of the SA node

A

in the myocardial layer just lateral to the junction where SVC enters R atrium

27
Q

T/F: in SA node, parasympathetic fibers > sympathetic fibers

28
Q

Tricuspid (AV) valve

A

one way valve from RA to RV

29
Q

Structures found in R ventricle

A
  • papillary muscle
  • chordae tendinae
  • pulmonary valve
30
Q

Pulmonary valve

A
  • 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
Q

RV “inflow tract”

A
  1. tricuspid valve
  2. chordae tendinae
  3. papillary muscles
  4. base of R ventricular chamber
32
Q

RV “outflow tract”

A
  1. R ventricular free wall
  2. ventricular septum
  3. conus arteriosus (infundubulum)
33
Q

Pressures within R ventricle

A

Diastolic: 0-8 mmHg
Systolilc: 15-30 mmHg

34
Q

What leads to cor pulmonale

A

increased pulmonary pressures which increase work load on RV

35
Q

Clinically apparent rheumatoid heart disease vs autopsy series

A

clinically apparent = 25-40%

autopsy = 80%

36
Q

Common misdiagnoses for rheumatoid heart disease

A 
pericarditis
myocarditis
valvular HD
atherosclerotic CAD
coronary arteritis
aortitis
cor pulmonale
conduction disturbances
37
Q

T/F: sole presence of rheumatoid arthritis is considered a primary pathogenic factor for premature atherosclerosis

A

True

increases CV events X3

38
Q

Left Atrium

A
  • Lies just below the 2nd rib
  • Lies dorsally, opposite thoracic vertebrae 5-7
  • Separated from the vertebral column by the esophagus and aorta
39
Q

Left Ventricle features

A
  • 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
Q

LV “inflow tract”

A 
funnel shaped
surrounded by:
mitral valve annulus
leaflets
chordae tendinae
41
Q

LV “outflow tract”

A
  1. smooth basal portion of IV septum

2. anterior ventricular wall and anterior mitral leaflet

42
Q

Cardiac activation times:

A

Atrial: .09 s
AV node: .16 s
Ventricular mass activation: .23

43
Q

Conduction velocity altered by:

A
  1. sympathetic stim (increases)
  2. Vagal stim (decreases)
  3. Ischemia/Hyoxia (decreases)
  4. Drugs (adrenergic and cholinergic)
44
Q

Aortic Root of coronary arteries

A
  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
Q

Aortic sinus/space

A
  1. contained in valve leaflets
  2. contains origins of coronary arteries
  3. posterior sinus doesn’t have a coronary artery
46
Q

When do coronary arteries receive blood

47
Q

at rest, how much oxygen is extracted from CA blood?

48
Q

T/F: increased amount of time in diastole decreases efficiency of myocardial perfusion

A

False

decreased time in diastole

49
Q

T/F: Increased work of heart can reduce perfusion

A

True

Think uncontrolled HTN

50
Q

RCA pathway

A
  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
Q

RCA perfuses:

A
  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
Q

LCA branches

A
  1. Anterior Interventricular artery

2. circumflex artery

53
Q

Anterior Interventricular artery

A
  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
Q

Circumflex Artery pathway

A
  1. coronary sulcus between LA and LV.
  2. L margin of heart
  3. Posterior to longitudinal sulcus and helps form post IV artery
55
Q

Circumflex artery perfuses

A
  1. posterior and lateral aspects of LV
  2. papillary muscles
  3. SA node
56
Q

Which primary bronchi runs more vertically

A

Right runs more vertically

it is also longer

57
Q

what are some issues with mediastinum contents during cancer treatment

A
  1. often irradiated during radiation treatment, especially for cancer in the L breast.
  2. lymphatic abnormalities from lymphoma
58
Q

What part of the heart is deep to the 5th rib

A

tip of LV (apex)

59
Q

T/F: volume of the heart decreases as a result of the central tendon pulling on the heart

A

False

volume increases

60
Q

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?

61
Q

what risk of pathology do the auricles present

A

can be a location of compromised or static blood flow.

=clots

Cardiopulm (20 decks)

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