Cardiac Anatomy Flashcards

1
Q

Normal Range for Central Venous pressure

A

2-6 mmHg

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2
Q

Normal Range for Pulmonary Artery Pressure

A

8-12 mmHg

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3
Q

Normal or abnormal?

A

Abnormal

  • globular shaped heart from pericardial fluid
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4
Q

Normal or abnormal?

A

Normal

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5
Q

Describe what you are examining on a chest x-ray:

  • Heart:
  • Mediastinum:
A
  • Heart:
    • Cardiac size
    • Pulmonary vessels
    • Width of the adult heart should be < half the greatest thoracic diameter, measured from inside the rib cage at its widest point near the level of the diaphragm
  • Mediastinum:
    • Hilar structures
    • Position of trachea
    • Aortic arch
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6
Q

Identify the structures:

A
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7
Q

What are the clinical signs for cardiac tamponade?

A
  • Neck veins distended
  • Distant heart sounds
  • Venous pressures elevated
  • Decreased arterial and pulse pressures often exist
  • Patient in variable degrees of shock or in extremis
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8
Q

Where are the Heart Valve Sounds on Surface Anatomy?

A

All Patients Take Meds

  1. Aortic Semilunar Valve –
    • Intercostal space 2, right of sternum
  2. Pulmonary Semilunar Valve –
    • Intercostal space 2, left of sternum
  3. Tricuspid Valve –
    • just lateral to body of sternum @ below rib 5
  4. Mitral Valve –
    • apex of heart at intercostal space 5
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9
Q

Identify the Structures

A
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10
Q

Identify the Structures

A
  1. Right brachiocephalic
  2. Right subclavian
  3. Right common carotid
  4. Left common carotid
  5. Left subclavian
  6. Right coronary
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11
Q

What are the major arteries for finding a pulse?

A
  • Superficial Temporal Artery
  • Common Carotid Artery
  • Brachial Artery
  • Femoral Artery
  • Dorsalis Pedis Artery
  • Popliteal Artery
  • Radial Artery
  • Subclavian Artery
  • Facial Artery
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12
Q

**Pericardium and Heart: **

  • **Layers: **
  • **Nerves: **
  • **Sinuses: **
A
  • Layers
    1. Visceral layer of serous pericardium
    2. Parietal layer of serous pericardium
    3. Fibrous pericardium
      • thick connective tissue layer
    • Pericardial cavity is between visceral and parietal serous pericardium
  • Nerves: Phrenic n.
    • travel lateral to fibrous ericardium as they descend thru mediastinum
  • Sinuses
    1. Transverse sinus ⇒ open sac and runs btwn great arteries and pulmonary veins; of surgical importance
    2. Oblique sinus ⇒ recess of pericardial cavity ends in cul‐desac surrounded by the pulmonary veins
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13
Q

Layers of the pericardium from superficial to deep:

A
  1. Fibrous pericardium
  2. Parietal layer of the serous pericardium
  3. Visceral layer of the serous pericardium
    • outer layer of the epicardium
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14
Q

When injecting contrast into the arteries of the heart, how would you ensure that the contrast enters the anterior interventricular artery? Why?

A
  • left coronary artery branches into the left circumflex artery and anterior interventricular artery (also known as the left anterior descending artery [LAD]).
  • Therefore, contrast would be injected into the left coronary artery to ensure that it enters the anterior interventricular artery
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15
Q
  • Anterior Interventricular Artery (LAD) travels with _____ _______
  • R. Marginal branch of R. Coronary travels with _____ _______
  • Posterior Interventricular Artery travels with _______ _______
A
  • Anterior Interventricular Artery (LAD) travels with Great Cardiac v.
  • R. Marginal branch of R. Coronary travels with Small Cardiac v.
  • Posterior Interventricular Artery travels with Middle Cardiac v.
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16
Q

Describe the route blood takes through the heart, starting with deoxygenated blood from the body and head.

A
17
Q

What helps keep the tricuspid and mitral valves tightly closed?

A
  • chordae tendinae
  • anterior and posterior papillary muscles
  • moderator band (tricuspid valve)
    • not so much for strength, rather, it helps conduct the electrical signals
18
Q

What are the general hemodynamics of the heart as it moves from diastole to systole?

A
  1. closure of the aortic and pulmonary valvesbeginning of diastole
  2. atrial contraction during final moments of diastole
  3. closure of the AV valves (tricuspid and mitral) ⇒ systole begins very soon afterwards
  4. opening of the aortic and pulmonary valves during systole
19
Q

Diastole or Systole?

A

Systole

22
Q

Diastole or Systole?

A

Diastole

23
Q

What are the different ways to repair a heart valve?

A
  1. Porcine valve
  2. Ball and cage valve
  3. Tilting disk valve
24
Q

When do the coronary arteries perfuse the heart?

A

during DIASTOLE

25
Q

Wigger’s Diagram (fill in the blanks)

A
26
Q

Describe Cardiac Innervation:

A
  1. Cardiac Plexus near tracheal bifurcation & ligamentum arteriosum
  2. Parasympatheticmotor control over HR and SV
  3. Sympatheticpostganglionic fibers come from upper chain ganglia to heart (3 cervical & T1‐T5)
  4. Afferents enter spinal cord T1‐T5
  5. Referred pain – painful sensation mediated by visceral afferent fibers that enter the spinal cord at a particular level is referred to the somatic dermatome corresponding to that vertebral level
27
Q

Dermatomes for Cutaneous Innervation of the Upper Limb:

A
28
Q

Electrical Conduction System of the Heart (PQRST intervals):

  1. SA node corresponds with ⇒
  2. AV node corresponds with ⇒
  3. Common AV bundle (of His) corresponds with ⇒
A
  1. SA node corresponds with ⇒ PR interval
  2. AV node corresponds with ⇒ QRS complex
  3. Common AV bundle (of His) corresponds with ⇒ ST segment
29
Q

Which structure of the heart can compress the esophagus, if hypertrophied?

A

left atrium

30
Q

What are common coronary artery obstructions that can cause clinical manifestations?

A
  1. Anterior interventricular branch (LAD)
  2. Right coronary artery
  3. Left circumflex branch
  4. Left coronary artery
  5. Posterior interventricular branch
31
Q

What is cardiac output?

What does it correlate with?

A
  • Cardiac output = amount of blood pumped by the heart (L/min)
  • Reflection of LV function
32
Q

What can decrease CO?

A
  1. Cardiomyopathy/MI
  2. Pulmonary disorders
  3. Endocrine disorders
  4. Hematological disorders
  5. Surgery/anesthesia
  6. Shock
  7. Allergic response
  8. Medications
33
Q

What can increase CO?

A

SEEdS

  1. Sepsis
  2. Exercise
  3. Endocrine disorders
  4. Shunts
34
Q

What are common causes of heart failure?

A
  • Coronary Atherosclerosis
  • Myocardial Infarction
  • Hypertension
  • Myocarditis
  • Toxins (e.g., alcohol)
  • Idiopathic / Genetic
35
Q

What are risk factors that can lead to coronary artherosclerosis, MI and eventually heart failure?

A
  • Hyperlipidemia
  • Hypertension
  • Diabetes
  • Smoking
  • Aging
36
Q

Systolic HF vs. Diastolic HF PV loops:

A
37
Q

What are two mechanisms for heart failure?

A
  • Inadequate CO
  • Tissue Congestion
38
Q

Signs and Symptoms of Heart Failure:
Right vs. Left Heart

  • Inadequate CO:
  • Tissue Congestion:
A
  • Inadequate Cardiac Output
    • Fatigue
    • Cool extremities
    • Mental obtundation
    • Organ dysfunction (kidneys, liver)
  • Tissue Congestion (due to elevated diastolic pressures)
    • Shortness of breath (dyspnea) - LH
    • Swelling of legs (pedal edema) - RH
    • Swelling of abdomen (ascites) - RH