Cardiac Anatomy Flashcards
1
Q
Recieves blood from the superior vena cava and coronary sinus
A
Right atrium
2
Q
Most anterior chamber and abuts the sternum
A
Right ventricle
3
Q
Subcarinal chamber and midline in the thorax, being supplied by the right and left superior and inferior pulmonary veins
A
Left atrium
4
Q
Right border of the cardiac silhoutte is formed primarily by the
A
Right atrium
5
Q
Left border of the heart is created primarily by the
A
Left ventricle and left atrial appendage
6
Q
In the lateral projection, it is the chamber border forming anteriorly adjacent to the sternum, with its outflow tract extending superiorly and posteriorly
A
Right ventricle
7
Q
Chamber that forms the posteroinferior border of cardiac silhouette
A
Left ventricle
8
Q
Two portions of the right atrium
A
Smooth posterior wall and trabeculated anterior wall
9
Q
Portion of the right atrium that develops from the sinus venosus, with the attached SVC and IVC in continuity posteriorly
A
Smooth posterior wall
10
Q
Wall of the right atrium that is derived from the embryonic RA
A
Trabeculated anterior wall
11
Q
Extends superiorly and medially from the SVC opening
A
RA appendage
12
Q
Muscular ridge that runs from the mouth of the SVC and fades inferiorly to the mouth of IVC
A
Crista terminalis
13
Q
Medial or posterior wall of RA which contains a smooth, central dimpled area called the fossa ovalis
A
Interatrial septum
14
Q
Inflow from the SVC, IVC and coronary sinus enters what portion of RA
A
Smooth posterior portion
15
Q
Free opening part of vena cava
A
Superior vena cava
16
Q
Part of vena cava that is guarded by a thin eustachian valve, which is occasionally absent or perforated (network of chiari)
A
Inferior vena cava
17
Q
The large draining coronary vein or coronary sinus enters the RA at what border of IVC
A
Anterior and medial to the IVC
18
Q
The RA opening is guarded by the _______ Valve, which is between the orifice of IVC and tricuspid valve
A
Thebesian valve
19
Q
Lies anterior to the left ventricular outflow tract and wraps around it and to the left
A
Right ventricle
20
Q
Trabeculated part of right ventricle
A
Posterior or inferior portion (inflow or sinus portion)
21
Q
The outflow tract or pulmonary conus of right ventricle which is less trabeculated is seen
A
Anterior or superior portion
22
Q
The 2 portions of the right ventricle is divided by the _______ which is a muscular ridge with a septal band called the moderator band
A
Crista supraventricularis
23
Q
This band is present in more than 40% of patients and connects the interventricular septum to the anterior papillary muscle and contains the right bundle branch
A
Moderator band
24
Q
Smooth cephalic portion of the RV that leads to the pulmonary trunk
A
Infundibulum (conus arteriosus)
25
Extends to the semilunar, tricuspid pulmonary valve, with the pulmonary trunk extending superiorly and to the left
Muscular pulmonary conus
26
Extends posteriorly as a continuation of the main PA, coursing over the top of the left main stem bronchus then descending posteriorly
Left PA
27
Extends horizontally to the right, bifurcates within the pericardial sac and exits the right hilum as the truncus anterior and interlobar arteries
Right PA
28
Hyparterial (lies below pulmonary artery)
Left mainstem bronchus
29
Eparterial (lies next to right PA)
Right bronchus
30
Arises from the superior, proximal left PA and crosses thru the aorticopulmonary window to the floor of the aorta
Ligamentum arteriosum
31
Remnant of ductus arteriosus, which closes functionally in the first 24 hours and closes anatomically by 10 days
Ligamentum arteriosum
32
Highest and most posterior chamber
Left atrium
33
Small pouch that projects superiorly and to the left and is smoother and longer than the right atrial appendage
Left atrial appendage
34
Its inferior margin is a remnant of the septum primum and may be somewhat scalloped
Foramen ovale
35
Conduit for blood flow from LA to LV
Mitral valve
36
Strong fibrous cords that extend from the mitral leaflets to the papillary muscles of LV
Chordae tendineae
37
Has a high membranous portion that is contiguous with the aortic root
Interventricular septum
38
Reservoir created by the closure of the aortic valve and from which the right and left coronary arteries arise
Sinuses of Valsalva
39
Posterior wall of the aorta is continuous with the
Anterior leaflet of mitral valve and more superiorly abuts the anterior wall of LA
40
The anterior wall of the aorta is continuous with the
Interventricular septum
41
After coursing superiorly and then to the left, the aorta gives off the
Right innominate artery, left common carotid artery and left subclavian artery
42
Consists of specialized neuromuscular tissue that measures approximately 5-20 mm and is located on the anterior endocardial surface of the RA just above the SVC and right atrial appendage junction, near crista terminalis
Sinoatrial node
43
Recorded as the P wave on an electrocardiogram
Atria via purkinje-like fibers
44
A 2x5 mm region of neuromuscular tissue on the endocardial surface, along the right side of interatrial septum, just inferior to the ostium of the coronary sinus
Atrioventricular node
45
A 20mm long tract which extends down the right side of the membranous interventricular septum
Bundle of His
46
Arborizes thru the 2 ventricles via Purkinje system
Bundle of His
47
First to activate in conduction system
Anterior or septal RV
48
Last to activate in the conduction system
Posterior or basal LV
49
Left-sided catheterization is normally accomplished via
Arterial puncture in the femoral or brachial artery
50
Used for aortography, coronary and coronary bypass gradt angiography, ventriculography and evaluation for patent ductus arteriosus
Left-sided catheterization
51
Right-sided catheterization is typically accomplished by
Venous puncture in femoral or brachiocephalic vein
52
Used for pulmonary angiography, catheterization of RA and RV, or evaluation of shunt lesions such as an ASD
Right-sided catheterization
53
Nomal right atrial pressure and oxygen saturation
2-5 mmHg
| O2 sat of 65-75%
54
Normal right ventricular pressures
25 systolic and 0-5 diastolic mmHg
55
Seen with right heart failure, decreased compliance, and tricuspid valve disease
Elevated right atrial pressure
56
A 7% greater increase in saturation from the IVC to the RA is considered evidence of a
Left to right shunt
57
Seen with pulmonary hypertension, pulmonic valve stenosis and congenital heart lesions such as transposition and truncus arteriosus
Elevated systolic pressure (RV)
58
Elevated with right heart failure
Diastolic pressure (RV)
59
A 5% increase in saturation from RA to RV suggests what condition
VSD
60
Normal pulmonary arterial pressures
25 systolic and 10 diastolic with a mean pressure of 15 mmHg
61
A significant pressure gradient of more than 10 mmHg across the valve implies what condition
Pulmonic valve stenosis
62
Normal pulmonary arterial saturation
Same as right ventricular and right atrial saturation (65-75%)
63
Normal pulmonary capillary wedge pressure
2-8 mmHg
64
Approximates the left atrial pressure unless there is evidence of pulmonary venous obstruction
Pulmonary capillary wedge pressure
65
Elevations in pulmonary capillary wedge pressure are usually seen in
Mitral stenosis and left-sided congestive heart failure
66
Normal left atrial saturation
94%
67
Normal left ventricular pressure
Approx 120 systolic and 0-5 mmHg diastolic
68
Decreased LV systolic pressure are seen in
Shock and congestive heart failure
69
Elevated LV systolic pressure is seen in
Systemic hypertension or outlet obstruction
70
Decreased saturation in LV level would imply a
Right to left shunt
71
Normal aortic pressure
120 systolic and 80 diastolic
72
Mean pressure of aortic valve
70-100 mmHg
73
Average stroke volume of each ventricle
70 ml of blood
74
End diastolic volume for LV
125-150 nlang
75
End diastolic volume for RV
165 ml
76
A normal cardiac output is
4-5 L/min
77
Normal cardiac index
2.8 to 4.0 L/min/m2 of body surface area
78
Normal ejection fraction for Lv
50-75%
79
Normal ejection fraction for RV
45-55%
80
Total end diastolic volume for RA
57ml
81
Normal end diastolic volume for LA
50ml
82
Coronary blood flow averages approximately
224 ml/min
83
Coronary blood flow increases up to _____fold during exercise
6
84
Normal aortic valve orifice
3 cm2
85
Aortic stenosis is when the aortic valve orifice is less than
0.7 cm2
86
Aortic valve orifice is less than ____ if there is both stenosis and insufficiency
1.5 cm2
87
Mild aortic stenosis is indicated by a pressure gradient of greater than _____
Moderate _____
Severe ______
25
40-50
80 mmHg
88
Normal diameter of mitral valve orifice
4-6 cm2
89
Mild mitral stenosis if orifice is less than ____
Moderate ____
Severe _____
1. 5
1. 0
0. 5 cm2
90
Pulmonic stenosis is considered significant if the right ventricular systolic pressure exceeds
70 mmHg
91
Defined as a mean PA pressure of more than
25 mmHg
92
Cardiothoracic ratio should not exceed
0. 5 in a 72 inch PA radiograph or
| 0. 6 on a portable AP examination
93
Lengthening and rounding of the left heart border with a downward extension of the apex resulting from left ventricular enlargement
Left ventricular “Shmoo” configuration
94
Typically results from increased afterload
Hypertrophy
95
Occurs with failure or diastolic overload
Dilatation
96
Straightening of the left heart border is seen with
Rheumatic heart disease and mitral stenosis
97
Refers to the left mediastinal outline beginning at the aortic knob
Moguls of the heart
98
First mogul
Aortic knob
99
Second mogul is
Main PA segment
100
Excessive convexity of 2nd mogul is seen with
Poststenotic dilatation, COPD, PA hypertension, left-to-right shunts and pericardial defects
101
Severe concavity of 2nd mogul suggests
Right to left shunts
102
3rd mogul
Left atrial appendage
103
Prominence of this mogul indicates prior rheumatic carditis
3rd mogul
104
Fourth mogul
Bulge just above the cardiophrenix angle
105
Prominence of this mogul is seen with infarction or ventricular aneurysm
4th mogul
106
5th mogul
Cardiophrenic angle
107
Bulge on this mogul is caused by pericardial cysts, prominent fat pads or adenopathy
5th mogul
108
Composed of one continuous fibrous membrane that is folded back on itself, creating 2 layers surrounding the heart
Pericardium
109
The inner layer of pericardium which is thinner and is closely attached to the myocardium and subepicardial fat
Visceral pericardium or epicardium
110
Thicker layer of pericardium
Parietal pericardium
111
Perfusion scans with thallium or new technetium agents are useful for diagnosing
Coronary ischemia and myocardial infarcts
112
Nuclear cardiac scans are accomplished during rest, with controlled exercise or with pharmacologic stress with what drug
IV dipyridamole
113
Electrocardiogram-gated myocardial blood pool studies examine _______ and allow left ventricular ejection fraction calculations
Wall motion
114
Can access cardiac metabolism as well as perfusion, enhancing its ability to evaluate cardiomyopathies, ischemia, infarction and hibernating or viable myocardium
PET
115
Uses a nasogastric probe with a steerable ultrasonic beam that views the heart and aorta from the close posterior position provided by the esophagus
Transesophageal echocardiography
116
The left coronary artery generally requires ____ cc of contrast at _____cc/sec
7-9 cc of contrast at 4-6 cc/sec
117
The right coronary artery generally requires ____ cc of contrast at _____cc/sec
6-8 cc at 3-5 cc/sec
118
Right coronary artery arises from the
Right coronary cusp
119
Left coronary artery arises from the
Left coronary cusp
120
Supplies the posterior descending artery and the posterior and inferior surface of the myocardium in 85 %
Right coronary artery
121
The left coronary artery divides where
Beneath the left atrial appendage
122
LCA branch that extends anteriorly in the interventricular groove
Left anterior descending artery
123
LCA branch that extends laterally and posteriorly under the left atrial appendage to the atrioventricular groove
Circumflex artery
124
An occassional 3rd branch of LCA which extends as a first diagonal branch or a first marginal branch
Ramus intermedius
125
Branch of LAD that occasionally comes off after the first septal branch and extends to the right ventricular infundibulum
Conus branch
126
Supplies the lateral wall of the left ventricle
Circumflex artery
127
Coronary artery that passes anterior and to the right between the PA and RA
Right coronary artery
128
First branch of RCA
Conus branch
129
Second branch of RCA
sinus node branch
130
Coronary arteries that extend into the right ventricular myocardium
Muscular branches of RCA
131
Supplies branches to the diaphragmatic myocardium and posterior 1/3 of the interventricular septum
Right coronary artery
132
Useful in evaluating aortic aneurysms, aortic dissections, aortic injuries, vascular anomalies, central pulmonary emboli, intracardiac masses and thrombi, pericardial thickening, fluid collections and pericardial calcifications
MDCT
133
Coronary calcification is defined as
An area with greater than 130 HU And larger than 2 mm2
134
Agatston scoring of coronary calcification
1: 130-200 HU
2: 201-299 HU
3: 300- 399 HU
4: 400 HU or greater
135
Black blood appearance can be seen in what MR sequence
Spin echo T1WI
136
White blood appearance can be seen in what sequence
Gradient-echo or fast-field echo
137
Excellent MR technique for visually assessing LV function
Steady-state free precession (SSFP)
138
Tissue characterization of the myocardium is accomplished using what MR sequences
T1WI and T2WI, contrast enhancement and spectroscopy
139
MR Imaging that can provide functional information including wall motion analysis, systolic wall thickening, chamber volumes, stroke volumes, right and left ventricular ejection fractions
CMR motion
140
Places virtual marker within the heart through the manipulation of magnetic field to facilitate visualisation and quantification of regional function, including rotational and translational motion that has bern previously difficult to analyze
Myocardial tagging
