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Cardiac > Cardiac Anatomy > Flashcards

Cardiac Anatomy Flashcards

1
Q

Recieves blood from the superior vena cava and coronary sinus

A

Right atrium

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2
Q

Most anterior chamber and abuts the sternum

A

Right ventricle

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3
Q

Subcarinal chamber and midline in the thorax, being supplied by the right and left superior and inferior pulmonary veins

A

Left atrium

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4
Q

Right border of the cardiac silhoutte is formed primarily by the

A

Right atrium

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5
Q

Left border of the heart is created primarily by the

A

Left ventricle and left atrial appendage

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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

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7
Q

Chamber that forms the posteroinferior border of cardiac silhouette

A

Left ventricle

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8
Q

Two portions of the right atrium

A

Smooth posterior wall and trabeculated anterior wall

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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

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10
Q

Wall of the right atrium that is derived from the embryonic RA

A

Trabeculated anterior wall

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11
Q

Extends superiorly and medially from the SVC opening

A

RA appendage

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12
Q

Muscular ridge that runs from the mouth of the SVC and fades inferiorly to the mouth of IVC

A

Crista terminalis

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13
Q

Medial or posterior wall of RA which contains a smooth, central dimpled area called the fossa ovalis

A

Interatrial septum

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14
Q

Inflow from the SVC, IVC and coronary sinus enters what portion of RA

A

Smooth posterior portion

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15
Q

Free opening part of vena cava

A

Superior vena cava

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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

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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

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18
Q

The RA opening is guarded by the _______ Valve, which is between the orifice of IVC and tricuspid valve

A

Thebesian valve

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19
Q

Lies anterior to the left ventricular outflow tract and wraps around it and to the left

A

Right ventricle

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20
Q

Trabeculated part of right ventricle

A

Posterior or inferior portion (inflow or sinus portion)

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21
Q

The outflow tract or pulmonary conus of right ventricle which is less trabeculated is seen

A

Anterior or superior portion

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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

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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

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24
Q

Smooth cephalic portion of the RV that leads to the pulmonary trunk

A

Infundibulum (conus arteriosus)

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25
Q

Extends to the semilunar, tricuspid pulmonary valve, with the pulmonary trunk extending superiorly and to the left

A

Muscular pulmonary conus

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26
Q

Extends posteriorly as a continuation of the main PA, coursing over the top of the left main stem bronchus then descending posteriorly

A

Left PA

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27
Q

Extends horizontally to the right, bifurcates within the pericardial sac and exits the right hilum as the truncus anterior and interlobar arteries

A

Right PA

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28
Q

Hyparterial (lies below pulmonary artery)

A

Left mainstem bronchus

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29
Q

Eparterial (lies next to right PA)

A

Right bronchus

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30
Q

Arises from the superior, proximal left PA and crosses thru the aorticopulmonary window to the floor of the aorta

A

Ligamentum arteriosum

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31
Q

Remnant of ductus arteriosus, which closes functionally in the first 24 hours and closes anatomically by 10 days

A

Ligamentum arteriosum

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32
Q

Highest and most posterior chamber

A

Left atrium

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33
Q

Small pouch that projects superiorly and to the left and is smoother and longer than the right atrial appendage

A

Left atrial appendage

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34
Q

Its inferior margin is a remnant of the septum primum and may be somewhat scalloped

A

Foramen ovale

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35
Q

Conduit for blood flow from LA to LV

A

Mitral valve

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36
Q

Strong fibrous cords that extend from the mitral leaflets to the papillary muscles of LV

A

Chordae tendineae

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37
Q

Has a high membranous portion that is contiguous with the aortic root

A

Interventricular septum

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38
Q

Reservoir created by the closure of the aortic valve and from which the right and left coronary arteries arise

A

Sinuses of Valsalva

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39
Q

Posterior wall of the aorta is continuous with the

A

Anterior leaflet of mitral valve and more superiorly abuts the anterior wall of LA

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40
Q

The anterior wall of the aorta is continuous with the

A

Interventricular septum

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41
Q

After coursing superiorly and then to the left, the aorta gives off the

A

Right innominate artery, left common carotid artery and left subclavian artery

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42
Q

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

A

Sinoatrial node

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43
Q

Recorded as the P wave on an electrocardiogram

A

Atria via purkinje-like fibers

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44
Q

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

A

Atrioventricular node

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45
Q

A 20mm long tract which extends down the right side of the membranous interventricular septum

A

Bundle of His

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46
Q

Arborizes thru the 2 ventricles via Purkinje system

A

Bundle of His

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47
Q

First to activate in conduction system

A

Anterior or septal RV

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48
Q

Last to activate in the conduction system

A

Posterior or basal LV

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49
Q

Left-sided catheterization is normally accomplished via

A

Arterial puncture in the femoral or brachial artery

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50
Q

Used for aortography, coronary and coronary bypass gradt angiography, ventriculography and evaluation for patent ductus arteriosus

A

Left-sided catheterization

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51
Q

Right-sided catheterization is typically accomplished by

A

Venous puncture in femoral or brachiocephalic vein

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52
Q

Used for pulmonary angiography, catheterization of RA and RV, or evaluation of shunt lesions such as an ASD

A

Right-sided catheterization

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53
Q

Nomal right atrial pressure and oxygen saturation

A

2-5 mmHg

O2 sat of 65-75%

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54
Q

Normal right ventricular pressures

A

25 systolic and 0-5 diastolic mmHg

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55
Q

Seen with right heart failure, decreased compliance, and tricuspid valve disease

A

Elevated right atrial pressure

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56
Q

A 7% greater increase in saturation from the IVC to the RA is considered evidence of a

A

Left to right shunt

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57
Q

Seen with pulmonary hypertension, pulmonic valve stenosis and congenital heart lesions such as transposition and truncus arteriosus

A

Elevated systolic pressure (RV)

58
Q

Elevated with right heart failure

A

Diastolic pressure (RV)

59
Q

A 5% increase in saturation from RA to RV suggests what condition

A

VSD

60
Q

Normal pulmonary arterial pressures

A

25 systolic and 10 diastolic with a mean pressure of 15 mmHg

61
Q

A significant pressure gradient of more than 10 mmHg across the valve implies what condition

A

Pulmonic valve stenosis

62
Q

Normal pulmonary arterial saturation

A

Same as right ventricular and right atrial saturation (65-75%)

63
Q

Normal pulmonary capillary wedge pressure

A

2-8 mmHg

64
Q

Approximates the left atrial pressure unless there is evidence of pulmonary venous obstruction

A

Pulmonary capillary wedge pressure

65
Q

Elevations in pulmonary capillary wedge pressure are usually seen in

A

Mitral stenosis and left-sided congestive heart failure

66
Q

Normal left atrial saturation

A

94%

67
Q

Normal left ventricular pressure

A

Approx 120 systolic and 0-5 mmHg diastolic

68
Q

Decreased LV systolic pressure are seen in

A

Shock and congestive heart failure

69
Q

Elevated LV systolic pressure is seen in

A

Systemic hypertension or outlet obstruction

70
Q

Decreased saturation in LV level would imply a

A

Right to left shunt

71
Q

Normal aortic pressure

A

120 systolic and 80 diastolic

72
Q

Mean pressure of aortic valve

A

70-100 mmHg

73
Q

Average stroke volume of each ventricle

A

70 ml of blood

74
Q

End diastolic volume for LV

A

125-150 nlang

75
Q

End diastolic volume for RV

A

165 ml

76
Q

A normal cardiac output is

A

4-5 L/min

77
Q

Normal cardiac index

A

2.8 to 4.0 L/min/m2 of body surface area

78
Q

Normal ejection fraction for Lv

A

50-75%

79
Q

Normal ejection fraction for RV

A

45-55%

80
Q

Total end diastolic volume for RA

A

57ml

81
Q

Normal end diastolic volume for LA

A

50ml

82
Q

Coronary blood flow averages approximately

A

224 ml/min

83
Q

Coronary blood flow increases up to _____fold during exercise

A

6

84
Q

Normal aortic valve orifice

A

3 cm2

85
Q

Aortic stenosis is when the aortic valve orifice is less than

A

0.7 cm2

86
Q

Aortic valve orifice is less than ____ if there is both stenosis and insufficiency

A

1.5 cm2

87
Q

Mild aortic stenosis is indicated by a pressure gradient of greater than _____
Moderate _____
Severe ______

A

25
40-50
80 mmHg

88
Q

Normal diameter of mitral valve orifice

A

4-6 cm2

89
Q

Mild mitral stenosis if orifice is less than ____
Moderate ____
Severe _____

A
  1. 5
  2. 0
  3. 5 cm2
90
Q

Pulmonic stenosis is considered significant if the right ventricular systolic pressure exceeds

A

70 mmHg

91
Q

Defined as a mean PA pressure of more than

A

25 mmHg

92
Q

Cardiothoracic ratio should not exceed

A
  1. 5 in a 72 inch PA radiograph or

0. 6 on a portable AP examination

93
Q

Lengthening and rounding of the left heart border with a downward extension of the apex resulting from left ventricular enlargement

A

Left ventricular “Shmoo” configuration

94
Q

Typically results from increased afterload

A

Hypertrophy

95
Q

Occurs with failure or diastolic overload

A

Dilatation

96
Q

Straightening of the left heart border is seen with

A

Rheumatic heart disease and mitral stenosis

97
Q

Refers to the left mediastinal outline beginning at the aortic knob

A

Moguls of the heart

98
Q

First mogul

A

Aortic knob

99
Q

Second mogul is

A

Main PA segment

100
Q

Excessive convexity of 2nd mogul is seen with

A

Poststenotic dilatation, COPD, PA hypertension, left-to-right shunts and pericardial defects

101
Q

Severe concavity of 2nd mogul suggests

A

Right to left shunts

102
Q

3rd mogul

A

Left atrial appendage

103
Q

Prominence of this mogul indicates prior rheumatic carditis

A

3rd mogul

104
Q

Fourth mogul

A

Bulge just above the cardiophrenix angle

105
Q

Prominence of this mogul is seen with infarction or ventricular aneurysm

A

4th mogul

106
Q

5th mogul

A

Cardiophrenic angle

107
Q

Bulge on this mogul is caused by pericardial cysts, prominent fat pads or adenopathy

A

5th mogul

108
Q

Composed of one continuous fibrous membrane that is folded back on itself, creating 2 layers surrounding the heart

A

Pericardium

109
Q

The inner layer of pericardium which is thinner and is closely attached to the myocardium and subepicardial fat

A

Visceral pericardium or epicardium

110
Q

Thicker layer of pericardium

A

Parietal pericardium

111
Q

Perfusion scans with thallium or new technetium agents are useful for diagnosing

A

Coronary ischemia and myocardial infarcts

112
Q

Nuclear cardiac scans are accomplished during rest, with controlled exercise or with pharmacologic stress with what drug

A

IV dipyridamole

113
Q

Electrocardiogram-gated myocardial blood pool studies examine _______ and allow left ventricular ejection fraction calculations

A

Wall motion

114
Q

Can access cardiac metabolism as well as perfusion, enhancing its ability to evaluate cardiomyopathies, ischemia, infarction and hibernating or viable myocardium

A

PET

115
Q

Uses a nasogastric probe with a steerable ultrasonic beam that views the heart and aorta from the close posterior position provided by the esophagus

A

Transesophageal echocardiography

116
Q

The left coronary artery generally requires ____ cc of contrast at _____cc/sec

A

7-9 cc of contrast at 4-6 cc/sec

117
Q

The right coronary artery generally requires ____ cc of contrast at _____cc/sec

A

6-8 cc at 3-5 cc/sec

118
Q

Right coronary artery arises from the

A

Right coronary cusp

119
Q

Left coronary artery arises from the

A

Left coronary cusp

120
Q

Supplies the posterior descending artery and the posterior and inferior surface of the myocardium in 85 %

A

Right coronary artery

121
Q

The left coronary artery divides where

A

Beneath the left atrial appendage

122
Q

LCA branch that extends anteriorly in the interventricular groove

A

Left anterior descending artery

123
Q

LCA branch that extends laterally and posteriorly under the left atrial appendage to the atrioventricular groove

A

Circumflex artery

124
Q

An occassional 3rd branch of LCA which extends as a first diagonal branch or a first marginal branch

A

Ramus intermedius

125
Q

Branch of LAD that occasionally comes off after the first septal branch and extends to the right ventricular infundibulum

A

Conus branch

126
Q

Supplies the lateral wall of the left ventricle

A

Circumflex artery

127
Q

Coronary artery that passes anterior and to the right between the PA and RA

A

Right coronary artery

128
Q

First branch of RCA

A

Conus branch

129
Q

Second branch of RCA

A

sinus node branch

130
Q

Coronary arteries that extend into the right ventricular myocardium

A

Muscular branches of RCA

131
Q

Supplies branches to the diaphragmatic myocardium and posterior 1/3 of the interventricular septum

A

Right coronary artery

132
Q

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

A

MDCT

133
Q

Coronary calcification is defined as

A

An area with greater than 130 HU And larger than 2 mm2

134
Q

Agatston scoring of coronary calcification

A

1: 130-200 HU
2: 201-299 HU
3: 300- 399 HU
4: 400 HU or greater

135
Q

Black blood appearance can be seen in what MR sequence

A

Spin echo T1WI

136
Q

White blood appearance can be seen in what sequence

A

Gradient-echo or fast-field echo

137
Q

Excellent MR technique for visually assessing LV function

A

Steady-state free precession (SSFP)

138
Q

Tissue characterization of the myocardium is accomplished using what MR sequences

A

T1WI and T2WI, contrast enhancement and spectroscopy

139
Q

MR Imaging that can provide functional information including wall motion analysis, systolic wall thickening, chamber volumes, stroke volumes, right and left ventricular ejection fractions

A

CMR motion

140
Q

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

A

Myocardial tagging

Cardiac (8 decks)

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