Cardiac anatomy Flashcards by Caroline West

Differences between right and left appendage

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

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Eustacian vs. Thebesian valve

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

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What is the Tendon of Todaro?

Fibrous band between Eustacian and Thesbian valve

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What makes up the Triangle of Koch

Tendon of Todaro
Septal leaflet of TV
Coronary sinus os

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What is located within the Triangle of Koch

The AV node

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An ostium secondum ASD is a hole in what structure?

Septum primum

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A ostium primum ASD is a hole in what structure?

Canal septum

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What defines an overriding annulus?

Drains into both ventricles with normal connections of the valve chordae

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What defines an arcade valve?

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

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Where are the chordal attachments in the RV

To the free wall and septum

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What is the more coarsely trabeculated ventricle?

The right

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Closure of which type of VSD can lead to electrical problems

Central (membranous)

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

Most common: Tricuspid
Second most common: Quadricuspid

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What is the segmental nomenclature for D transposition?

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

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What is the most common segmental nomenclaure for DILV?

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

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Most common fusion of leaflets in aortic stenosis

Really Likely = Right and left

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Second most common fusion of leaflets in aortic stenosis

Really Nasty = Right and Non

Least likely fusion in aortic stenosis

Not Likely = Non and Left

What is the crista terminalis?

Interface between the SVC and the RA

Decipher between a perimembranous VSD with inlet vs. outlet extension

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

What is the pathologic definition of cardiac situs?

Location of the RA (not the apex)

What is the typical ventricualr septal: free wall ratio?

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

What venous structure contains contractile myocytes?

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

What is the ligament of Marshall?

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

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

Ostium primum

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

Ostium secondium Can see from the RA

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

SVC, MPA, and proximal ascending aorta

Describe the anatomy of the pericardium

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

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

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

Describe the 4 different types of AVSDs

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

What is the transverse sinus and why is it useful?

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

What is the most common form of HLHS?

MA/AA

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

Aorta is anterior and leftward (L)

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

Aorta and pulmonary are side by side

Where may the AV node be located in Tricuspid Atresia

Floor of the RA

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

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

A secundum ASD is due to a defect in..

Septum primum

A primum ASD is due to a defect in...

Endocardial cushion development

Most common associated lesion in DORV

Pulmonic stenosis

What morphologic feature most reliably identifies the RA?

A broad appendage with pectinate extending out of the appendage Followed by IVC connection (not SVC)

Most common anatomic type of subaortic stenosis

Discrete membrane