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Anatomy II > Cardiac Anatomy > Flashcards

Cardiac Anatomy Flashcards

1
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2
Q

Describe what would be visualized in a standard CT view of the chest (supine, caudal-cranial, transverse plane)

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3
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4
Q

What occurs as a result of the pericardium being fused inferiorly to the diaphragm?

A
  • as you breathe, diaphragm moves up and down
  • when it moves up and down, heart will also have movement while breathing
  • creates healthier blood flow through the heart
  • enough movement in there that the heart can move with its contractions
  • if it’s contracting more vigorously it can still do this while being surrounded by pericardium
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5
Q

What are the great vessels?

A
  • largest vessels in body
  • 2 outflow ones: aorta (off of LV) and pulmonary trunk (off of RV) which bring blood from heart to body tissue and lungs
  • 1 outflow one: superior vena cava (drains blood from upper body regions to heart)
  • inferior vena cava (returns blood from bottom of body to heart)
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6
Q

What major components are located in the middle mediastinum?

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  • heart
  • ascending aorta
  • pulmonary trunk
  • phrenic nerves
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7
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A

*5th rib lines up with sternal angle

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8
Q

What is the significance of the heart being located between two bony structures?

A
  • protected
  • allows you to put pressure on it whichallows you to do CPR
  • heart has one-way valves so we can press on the sternae and compress the heart which forces blood to move through the heart and get to the body (one way valves prevent backflow so blood goes where it needs to)
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9
Q

What significant structures are located in the anterior mediastinum?

A
  • thymus gland
  • larger when you are a child because of its involvment in immune development (T cells) but it atrophies as you age since the function is not needed
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10
Q

What major structures are located in the posterior mediastinum?

A
  • descending aorta
  • esophagus
  • lymph nodes
  • vagus nerves
  • thoracic duct
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11
Q

What major structures are located in the superior mediastinum?

A
  • aortic arch
  • esophagus
  • trachea
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12
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13
Q

What is the auricle?

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  • muscular pouch attached to the atrium
  • thought to play a role in allowing atria to expand their volume
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14
Q

Where is the ascending aorta coming from?

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-arises from left ventricle then forms arch and falls behind for the descending aorta

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15
Q

Where does the pulmonary trunk come from?

A

-branches from the right ventricle

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16
Q

What are the sulci of the heart?

A
  • protect coronary circulation
  • deliver oxygen and nutrients to heart and remove CO2/waste products
  • coronary sulcus: between atria and ventricles, runs like a crown
  • interventricular sulcus: between right and left ventricles (runs from anterior of heart to posterior side
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17
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18
Q

Where does left coronary artery arise from?

A
  • comes off of ascending aorta
  • if pulmonary trunk is intact on specimen, may need to pull it back to see it
  • branches quickly into circumflex and left anterior descending interventricular artery
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19
Q

What does the circumflex artery supply?

A
  • lines coronary sulcus
  • supplies LA and LV
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20
Q

What does left anterior descending interventricular artery (LAD) supply?

A
  • supplies LV and RV
  • lies in anterior interventricular sulcus
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21
Q

Where does right coronary artery come from?

A
  • arises from arch of aorta
  • has other branches that supply RA
  • branches further down into marginal artery and posterior descending interventricular artery
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22
Q

What does the posterior descending interventricular artery supply?

A

-LV and RV (posterior portion)

23
Q

What does marginal artery supply?

A

-RV (and RA)

24
Q

What occurs with an atherosclerotic buildup of plaque in the LAD?

A
  • limits blood flow to tissues (myocardial infarction)
  • can cause death of left side of heart
  • this can be more severe because the left side of heart is responsible for pumping blood to the body tissues
25
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26
Q

Where does the great cardiac vein originate?

A
  • travels in IV sulcus with LAD towards coronary sulcus then travel in coronary sulcus with circumflex artery
  • drains LA, RV, LV
  • at the end of the vein, drains into coronary sinus
27
Q

What do the small, anterior, and middle cardiac veins drain?

A
  • small: RA, RV
  • anterior: RV, opens directly into RA

-middle: LV, RV

28
Q

What is the coronary sinus?

A
  • thin walled portion of the venous system
  • no smooth muscle
  • can’t contract
  • dilatation of venous system
  • can fill with blood
  • very large
  • drains into RA
29
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30
Q

What are the layers of the pericardium?

A
  • fibrous pericardium
  • parietal pericardium
  • visceral pericardium
31
Q

Describe the layers of the pericardium

A
  • fibrous: dense irregular connective tissue, protects and anchors the heart, fused to diaphragm
  • serous pericardium has 2 layers; parietal and visceral
  • parietal secretes serous fluid and adheres to fibrous layer
  • visceral (epicardium) also secretes serous fluid and is part of heart wall
  • serous fluid found in pericardial cavity
  • important in lubricating heart and preventing friction during cardiac cycle
32
Q

What are the layers of the heart wall?

A
  • epicardium
  • myocardium: help heart beat
  • endocardium (similar to endothelial layer of BVs, smooth- nonthrombogenic so should’t get blood clots but not always the case)
33
Q

Describe pericarditis.

A

-fluid, pus accumulation

34
Q

Describe myocarditis

A
  • viral infection
  • rheumatic fever
  • radiation
  • meds
35
Q

Describe endocarditis

A
  • often bacterial
  • heart valves affected
  • potentially fatal if not treated
36
Q

Describe cardiac tamponade in terms of piercing injury

A
  • something pierces chest and causes bleeding into pericardial cavity
  • causes compression of the heart and reduced cardiac filling
  • buildup of blood prevents heart from being able to fully dilate and contract
  • fibrous pericardium prevents stretching of the pericardial cavity which compresses heart
  • needle is inserted into chest to draw blood from pericardial space to allow heart to beat
37
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38
Q

What side of the heart is larger?

A
  • left side has more muscular composition because the left side pumps blood to body tissues so it works harder
  • pumps against greater distance and resistance
39
Q

What are the key valves between the ventricles and atria? (fibrous skeleton)

A
  • bicuspid (L)
  • tricuspid (R)
  • aortic semilunar valve between ventricles and great vessels
  • pulmonary semilunar valve between ventricles and great vessels
40
Q

What is the role of the fibrous skeleton?

A
  • provides structural foundation for heart valves
  • maintains valve diameter (prevents overstretching)
  • serves as an attachment site for muscle fibres
  • electrically separates the atria from ventricles
41
Q

What is the role of the chordae tendinae and papillary muscles?

A
  • chordae tendinae come down from the valve cusp and attach to papillary muscles (muscle extensions from bottom of ventricle)
  • set up so that valves are one way
42
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A
43
Q

What occurs during ventricular diastole vs systole?

A
  • ventricular diastole: ventricles are relaxed, heart is in relaxed state, valve is open- blood moves from atria into ventricle, papillary muscles are relaxed
  • ventricular systole: heart contracts, pushes blood out to body, ventricle starts to contract which pushes blood up towards the valves it catches behind the cusps of the valves and closes it, papillary muscles contract and pull on chordae tendinae to keep valve cusps closed
  • called the subvalvular apparatus
44
Q

How do semilunar valves operate?

A
  • no subvalvular apparatus
  • located at aorta and pulmonary trunk
  • ventricles contract, pressure of blood pushing against valves opens them and lets blood flow into great vessels
  • in diastole, pressure initially pushing blood out has dropped so you get blood in great vessels drops down and gets behind the cusps to close them
45
Q

Describe closure of venous entry points

A
  • pulmonary veins, SVC, IVC
  • no valve structures here
  • because the openings are not as rigid, when atria contracts this is enough to close these openings to prevent the backflow
46
Q

Where do heart sounds come from?

A
  • blood with laminar flow moving smoothly through the body has no sound
  • turbulent flow causes sound
  • when you get closure of valves or abnormalities that cause turbulent blood flow it generates heart sounds
47
Q

Which valves are best heard in the 2nd intercostal space?

A
  • aortic valve on the right
  • pulmonary valve on the left
48
Q

Where is the bicuspid valve heard?

A

-5th intercostal space in midclavicular line

49
Q

Where is the tricuspid valve heard?

A
  • near sternal border at 5th intercostal space
  • lower left sternal border
50
Q

What are 2 valve disorders?

A
  • stenosis (narrowing): bicuspid, pulmonic, aortic, tricuspid
  • prolapse: valves start to go back into atria, mitrial valve prolapse, otherwise known as insufficiency or incompetence
51
Q

What happens to coronary blood flow when heart is relaxing and contracting?

A

-it is greater during diastole

*check this

52
Q

What is a consequence of a heart attack that injured a papillary muscle? How might blood flow be altered?

A
  • incompetence/insufficiency of valves (mitral valve prolapse)
  • severe mitral valve regurgitation and subsequent cardiogenic shock and pulmonary edema
  • causes backflow of blood that leads to right sided or left sided heart failure
  • hear murmur because blood is flowing back to atrium
53
Q

What are the trabeculae carnae?

A
  • “fleshy logs”
  • located in ventricles
  • 2-3 different types
  • papillary muscles are thought to be a type of trabeculae carnae
  • most lie along the ventricle
  • 3rd type that is attached to the ventricle but protrude into the ventricle
54
Q

Why are the papillary muscles not involved in the closure of the AV valves?

A
  • the closure of the valves is triggered because ventricle contracts and pushes blood against the valves
  • the blood catches at the cusps of the valves which causes the closure
  • papillary muscles are there to keep the valves closed

Anatomy II (30 decks)

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