Cardiac anatomy Flashcards
Differences between right and left appendage
Right: Broader, pectinate muscles extend out of the appendage
Left: Finger like, pectinate muscles stay in the appendage
Eustacian vs. Thebesian valve
Eustacian valve- IVC to RA
Thebesian valve- Coronary os to RA
What is the Tendon of Todaro?
Fibrous band between Eustacian and Thesbian valve
What makes up the Triangle of Koch
- Tendon of Todaro
- Septal leaflet of TV
- Coronary sinus os
What is located within the Triangle of Koch
The AV node
An ostium secondum ASD is a hole in what structure?
Septum primum
A ostium primum ASD is a hole in what structure?
Canal septum
What defines an overriding annulus?
Drains into both ventricles with normal connections of the valve chordae
What defines an arcade valve?
Little to no chordae so the leaflets attach directly to the papillary muscles
Where are the chordal attachments in the RV
To the free wall and septum
What is the more coarsely trabeculated ventricle?
The right
Closure of which type of VSD can lead to electrical problems
Central (membranous)
1st and second most common valve morphology of a truncal valve
Most common: Tricuspid
Second most common: Quadricuspid
What is the segmental nomenclature for D transposition?
S,D,D
Solitus
D looped
Aorta anterior and rightward
What is the most common segmental nomenclaure for DILV?
S,L,L
Solitus
L looped
Aorta anterior and leftward
Most common fusion of leaflets in aortic stenosis
Really Likely = Right and left
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
