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Cardio Pulm > Cardiac Anatomy > Flashcards

Cardiac Anatomy Flashcards

1
Q

Circumflex Artery

A
  • runs along atrioventricular groove
  • 12% cases continues and gives off posterior descending artery
  • has branches called obtuse marginal Aa
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2
Q

RCA

A
  • runs in right atrioventricular groove

- 88% of the time it runs around to become posterior descending artery

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3
Q

Part of blood from right ventricle goes _____ but most goes _____
(baby in utero)

A
  • through pulmonary trunk to lungs

- through ductus arteriosus to descending aorta to rest of body and placenta

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4
Q

Heart Apex

A
  • toward left
  • listen here for CHF
  • medial to midclavicular line at:
  • -5th intercostal space in supine
  • -6th in standing
  • 4th in obese/pregnant
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5
Q

Pericardium

A
  • loose serous sac around heart
  • parietal and visceral layers
  • lubricates moving parts and holds heart in place
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6
Q

Heart Size

A

2 clenched fists

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7
Q

Heart Base

A
  • top, central chest

- at rib 3

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8
Q

Heart Location

A
  • 2/3 on left side

- Rotated: left ventricle toward anterior/axilla

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9
Q

pericarditis

A
  • increased amount of fluid in pericardium
  • especially after MI
  • causes discomfort &/or decreased venous return
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10
Q

Myocardium

A
  • muscle layer of heart
  • thickness in proportion of work done
  • Left ventricle thickest
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11
Q

Foramen Ovale

A
  • valves between L & R atria

- normally closes at birth

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12
Q

Epicardium

A
  • outside surface of heart

- shiny red

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13
Q

Endocardium

A
  • inner most layer of heart

- shiny and smooth

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14
Q

Prenatal Oxygenation of Blood

A

-occurs across placenta, not the lungs

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15
Q

At birth, decreased pressure in R atrium and increase pressure in left atrium cause______

A
  • closing of the foramen ovale

- anatomical closure by 2-3 months

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16
Q

Arterial Supply to Heart

A

-LCA & RCA

branch from base of aorta

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17
Q

Patent foramen ovale

A

-pathology causing foramen ovale to remain open
-results in R to L shunt
(blood flows from R atrium to L atrium)

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18
Q

Sarcoplasmic Reticulum of Myocardium

A

less developed so the heart muscle relies on extracellular Ca++

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19
Q

Autorhythmic Cells

A
  • (create their own action potential)
  • SA/AV nodes
  • Bundle of His
  • Purkinje Fibers
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20
Q

Action Potential of Autorhythmic Cells

A
  • slowly depolarizes until threshold met

- due to slow leak of Na+ into cell that then opens long lasting Ca++ gates

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21
Q

Ductus Arteriorsus After Birth

A
  • closes w/n 15-72 hours
  • due to increased arterial O2 saturation
  • Anatomic closure in 2-3 weeks
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22
Q

Coronary Flow Pattern

when heart muscle gets blood flow

A
  • L & R atria and R ventricle get blood supply to during systole
  • L ventricle gets blood during diastole (b/c pressure too high during systole)
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23
Q

Divisions of LCA

A
  • Left Anterior Descending Artery

- Circumflex Artery

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24
Q

Heart Dominance

A
  • Right Dominant=posterior Descending Artery from RCA (80%)

- Left Dominant=Posterior Descending Artery from LCA–Circumflex Artery (5%)

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25
Q

Part of blood from right atria goes to the______ & other 1/2 goes to the _____
(baby in utero)

A
  • right ventricle

- left atrium via foramen ovale

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26
Q

Patent Ductus Arteriosus

A

-failure of ductus arteriosus to close
-due to hypoxia
-causes L to R shunting
(blood from aorta to pulmonary artery)

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27
Q

LAD

A
  • runs along interventricular groove

- branches into diagonals

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28
Q

Venous Drainage

A
  • most veins drain into coronary sinus to R atrium

- Thebesian Vv drain directly into L & R ventricles

29
Q

Collateral Circulation

A
  • Amount determined by birth
  • collaterals available if arterial supply hindered
  • Ischemia–>opening of collaterals

-(takes 8-24 hours)

30
Q

Action Potential from ______ to cause heart contraction

A
  • SA node
  • AV node
  • Bundle of His
  • Purkinje Fibers
31
Q

Cardiac Muscle Fibers

A
  • striated
  • cells in series with intercalated discs
  • less developed sarcoplasmic reticulum
  • innervated by autonomic NS
  • ventrical myocardium similar to type I fibers but have more mitochondria
32
Q

Depolarization/contraction of heart from _____ to allow ____

A
  • bottom to top

- allow ventricle to squeeze out blood

33
Q

Heart Muscle Depolarization from____

A

Na+ in

34
Q

Heart Muscle Repolarization from _____

A

K+ out

35
Q

Heart Sounds

A
  • S1, S2 (normal)

- S3, S4 (abnormal)

36
Q

M1 & T1 Sounds

A
  • 2 components of S1 sound

- when mitral valve closes slightly before tricuspid

37
Q

A2 and P2 Sounds

A
  • 2 components of S2

- when aortic valve closes slightly before pulmonic valve

38
Q

S3 sound pattern

A
  • Lub Dub-ub
  • 1 2-3

-VOLUME PROBLEM
(CHF)

39
Q

Myocardium action potential plateau from:

A

Na+ in allows Ca++ into cell so lots of (+) going in while less (+) going out (K+)

40
Q

S3 & S4 sounds due to:

A

loss of ventricular compliance

41
Q

Fiber types of ventricles

A

type I but more mitochondria

42
Q

Heart Impulse Pathway

A
  1. SA Node
  2. Bachman’s Bundle & Internodal Tracts
  3. AV Node
  4. Bundle of His
  5. L/R Bundle Branches
  6. Purkinje Fibers
43
Q

Internodal Tracts

A

-deliver impulses directly from SA node to AV node

44
Q

S1

A
  • “Lub”
  • 1st heart sound
  • Loudest at Apex
  • 2 components (M1, T1)
  • Sound from closure of AV valves
45
Q

S2

A
  • “Dub”
  • 2nd heart sound
  • 2 components (A2, P2)
  • Loudest at Aortal Area
  • Sound from closure of semilunar valves
46
Q

S3 sound occurs in

A

middle 1/3 of diastole

47
Q

S4 Sound Pattern

A
  • “du-lub dub”
  • 4-1 2
  • mechanical problem
48
Q

S4 abnormal if:

A
  • there is resistance to ventricular filling

- like with CAD, hypertensive cardiac disease, pulmonic disease, history of MI or CABG

49
Q

S4 normal in:

A

-trained athlete with left ventricular hypertrophy

LVH

50
Q

S3 indicates:

A

loss of ventricular compliance

-key for CHF diagnosis

51
Q

S3

A
  • caused by vibrations in ventricles as it switches from rapid diastolic filling to passive distention
  • VENTRICULAR GALLOP
  • Heart over apex (pt in lateral decubitus; with bell)
  • Key diagnosis of CHF
52
Q

Key Diagnosis of CHF

A

-S3 heart sound

53
Q

S4

A
  • during 2nd phase of diastole due to atrial contraction
  • ATRIAL GALLOP
  • Heard over apex (pt in left lateral decubitus; bell)
  • heard before S1
54
Q

Ventricular Gallop

A

S3

55
Q

Atrial Gallop

A

S4

56
Q

Left Ventricular Diastole

A

-pressure in L atrium > pressure in L Ventricle so Mitral valve is open

57
Q

Isovolumic Systole

A
  • Mitral & Aortic Valve closed
  • mitral closed and aorta yet to open
  • (pressure increased in ventricle)
58
Q

QRS Complex

A

EKG of ventricular contraction

59
Q

Isovolumetric Diastole

A

-aortic and mitral valves closed
-aortic closed, mitral yet to open
(pressure decreased in ventricle)

60
Q

Autorhythmic Cells depolarize due to:

A

Ca++ in

61
Q

Autorhythmic Cells repolarize due to:

A

K+ out

62
Q

SA Node

A
  • top of R atrium
  • pacemaker (depolarizes fastest)
  • 70-80/min
63
Q

AV Node

A
  • 40-60/min

- becomes pacemaker if SA damaged

64
Q

Bachman’s Bundle

A

delivers impulse from R to L atrium

65
Q

Bundle of His and Purkinje fibers

A

20-40/min

66
Q

Circumflex and marginal Aa supply:

A
  • Superior and marginal portions of L ventricle
  • Part of Post L Ventricle
  • L Atrium
  • SA Node (in 40% of people)
67
Q

SA Node blood supply

A
  • Circumflex/Marginal Aa (40% of people)

- RCA (60%)

68
Q

AV Node Blood Supply

A
  • LAD/Diagonals (10% of people)

- RCA (90%)

69
Q

RCA Supplies

A
  • most of R ventricle
  • part interventricular septum
  • R atrium
  • part posterior L ventricle
  • inferior surface of L ventricle
  • SA Node (60%)
  • AV Node (90%)

Cardio Pulm (27 decks)

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