Cardiac anatomy Flashcards

1
Q

Differences between right and left appendage

A

Right: Broader, pectinate muscles extend out of the appendage
Left: Finger like, pectinate muscles stay in the appendage

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2
Q

Eustacian vs. Thebesian valve

A

Eustacian valve- IVC to RA
Thebesian valve- Coronary os to RA

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3
Q

What is the Tendon of Todaro?

A

Fibrous band between Eustacian and Thesbian valve

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4
Q

What makes up the Triangle of Koch

A
  1. Tendon of Todaro
  2. Septal leaflet of TV
  3. Coronary sinus os
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5
Q

What is located within the Triangle of Koch

A

The AV node

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6
Q

An ostium secondum ASD is a hole in what structure?

A

Septum primum

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7
Q

A ostium primum ASD is a hole in what structure?

A

Canal septum

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8
Q

What defines an overriding annulus?

A

Drains into both ventricles with normal connections of the valve chordae

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9
Q

What defines an arcade valve?

A

Little to no chordae so the leaflets attach directly to the papillary muscles

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10
Q

Where are the chordal attachments in the RV

A

To the free wall and septum

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11
Q

What is the more coarsely trabeculated ventricle?

A

The right

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12
Q

Closure of which type of VSD can lead to electrical problems

A

Central (membranous)

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13
Q

1st and second most common valve morphology of a truncal valve

A

Most common: Tricuspid
Second most common: Quadricuspid

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14
Q

What is the segmental nomenclature for D transposition?

A

S,D,D
Solitus
D looped
Aorta anterior and rightward

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15
Q

What is the most common segmental nomenclaure for DILV?

A

S,L,L
Solitus
L looped
Aorta anterior and leftward

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16
Q

Most common fusion of leaflets in aortic stenosis

A

Really Likely = Right and left

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17
Q

Second most common fusion of leaflets in aortic stenosis

A

Really Nasty = Right and Non

18
Q

Least likely fusion in aortic stenosis

A

Not Likely = Non and Left

19
Q

What is the crista terminalis?

A

Interface between the SVC and the RA

20
Q

Decipher between a perimembranous VSD with inlet vs. outlet extension

A

Inlet: Tricuspid + Aortic continuity
Outlet: Extends towards the aorta

21
Q

What is the pathologic definition of cardiac situs?

A

Location of the RA (not the apex)

22
Q

What is the typical ventricualr septal: free wall ratio?

A

1.1:1
Increases slowly over time (to age 70) to 1.2:1

23
Q

What venous structure contains contractile myocytes?

A

Proximal pulmonary veins (allows the pulmonary veins to reduce back flow during atrial systole)

24
Q

What is the ligament of Marshall?

A

Remnant of the L-SVC, appears as a ligamentous branch of the coronary sinus
Located between the LPA and the pulmonary veins

25
Q

The valve of the fossa ovalis is derived from..?

A

Ostium primum

26
Q

The limbus of the fossa ovalis is derived from…?

A

Ostium secondium
Can see from the RA

27
Q

What structures are considered intra-pericardial? (not including the atria and ventricles)

A

SVC, MPA, and proximal ascending aorta

28
Q

Describe the anatomy of the pericardium

A

Parietal pericardium is on the outside
There is pericardial fluid in the middle
Visceral pericardium is on the inside

Pericardial reflection: Where the parietal pericardium folds to become the visceral

29
Q

Describe juxtaposition of the atrial appendages. What is left juxtaposition associated with and what is right juxtaposition associated with?

A

When the two atrial appendages are on the same side of the great arteries.

Left- advanced CHD, more common (6:1)
Right - more basic CHD like ASD

30
Q

Describe the 4 different types of AVSDs

A

Partial: ASD only
Transitional: ASD and VSD, two distinct AVV and annuli
Intermediate: ASD and VSD, one annulus with two valves
Complete: ASD and VSD, one annulus, one valve

31
Q

What is the transverse sinus and why is it useful?

A

It is a space between the great arteries and the veins (or atria depending on where you read). It is a space that can be used for orienting and is used for clamping in the OR

32
Q

What is the most common form of HLHS?

A

MA/AA

33
Q

What is the most common aorta/pulmonary position in DILV?

A

Aorta is anterior and leftward (L)

34
Q

What is the most common aorta/pulmonary position in DORV?

A

Aorta and pulmonary are side by side

35
Q

Where may the AV node be located in Tricuspid Atresia

A

Floor of the RA

36
Q

Absent pulmonary arteries in TOF vs Truncus: What side is missing a PA?

A

TOF: most often missing the PA on the opposite side of the arch
Truncus: most often missing the PA on the same side of the arch

37
Q

A secundum ASD is due to a defect in..

A

Septum primum

38
Q

A primum ASD is due to a defect in…

A

Endocardial cushion development

39
Q

Most common associated lesion in DORV

A

Pulmonic stenosis

40
Q

What morphologic feature most reliably identifies the RA?

A

A broad appendage with pectinate extending out of the appendage

Followed by IVC connection (not SVC)

41
Q

Most common anatomic type of subaortic stenosis

A

Discrete membrane