Cardiac Anatomy Lecture Powerpoint

Question 1

Ductus arteriosus becomes what at birth?

Answer 1

Ligamentum arteriosum

Question 2

In fetal circulation there is blood shunting from…

Upon birth this changes to…

Answer 2

….right to left because right is higher pressure than left in fetal circulation
….left sided pressure higher than right due to the inflation of the lungs dropping pressure

Question 3

Atrial septal defect (primum and secundum)

Answer 3

Occurs when there is an incomplete closure of the septum wall, primum occurs much lower in the heart wall close to the ventricle while secundum occurs higher closer to the base of the heart

Question 4

Borders of the mediastinum

Answer 4

thoracic inlet superiorally
diaphragm inferiorally
sternum anteriorally
spine posteriorally
pleura laterally left and right

Question 5

The entire posterior face of the heart is the ____ and ___
The entire anterior surface of the heart is the____
The entire right side of the heart is the ____
The entire left side of the heart is the ___

Answer 5

left ventricle, left atrium, right ventricle, Right atrium, left ventricle

Question 6

Where is the AV node located in the heart?

Answer 6

In the intraventricular septum

Question 7

How many pumonary veins are there?

Answer 7

4

Question 8

How many pulmonary arteries are there

Answer 8

2

Question 9

Right coronary artery pathway and what does it supply

Answer 9

Right coronary artery travels in the groove between the right atrium and right ventricle supplying both of them

Question 10

Left coronary artery pathway and what does it supply

Answer 10

divides into LAD and circumflex artery, LAD goes between right ventricle and left ventricle (majority of supply for the left) circumflex goes between groove between left atrium and ventricle around on the posterior side supplying the left atrium

Question 11

Marginal branch vs diagonal branch

Answer 11

Marginal branch comes off the right coronary artery while the diagonal are branches coming off LAD

Question 12

Coronary sinus

Answer 12

Main venous blood return from the entire heart,

Question 13

The arterial vasculature has much ___ smooth muscle layer than the venous side

Answer 13

thicker

Question 14

Vasovasorum

Answer 14

Blood supply to the vessels that travels thru the tunica externa of large vessels in the body

Question 15

3 Great vessels off aortic arch

Answer 15

Brachiocephalic trunk, left common carotid, left subclavian

Question 16

3 vessels that come off anterior side of aorta and are not paired and what they supply

Answer 16

• celiac trunk (stomach liver spleen pancreas duodenum
• superior mesenteric (all of jejunum, ileum, most of ascending and part of transverse colon)
• inferior mesenteric (remainder of transverse colon and descending colon)

Question 17

Blood flow (perfusion) factors

Answer 17

• viscosity (hematocrit)
• cardiac
• local factors
• humoral
• intraluminal factors

Question 18

Fahraeus-lindqvist effect

Answer 18

Idea that viscosity of blood changes inversely with the diameter of the tube it travels thru. In small vessels, the viscosity is lower.

Question 19

Intravascular pressure from aorta to vena cava

Answer 19

Aorta to small arteries is very high,
arterioles see a drop,
capillaries thru vena cava see continuous drop

Question 20

Central venous pressure (CVP)

Answer 20

Pressure in the venous system typically measured as close to the heart as possible, tends to be very similar thru the entire venous system

Question 21

Pulmonary artery capillary wedge pressure (PACWP)

Answer 21

An indirect measure of left atrial pressure that can estimate intravascular volume obtained by using a catheter that travels into the right atrium to right ventricle then to pulmonary vasculature until it is eventually obstructed at a small vessel, with the pressure sensor in it measuring everything downstream and therefore left atrial pressure

Question 22

Mean arterial pressure=

Answer 22

cardiac output x systemic vascular resistance

Question 23

Cardiac output=

Answer 23

Stroke volume x heart rate

Question 24

Stroke volume=

Answer 24

LV end diastolic volume x contractilty

Question 25

Atrial kick adds ___% to EDV

Answer 25

20

Question 26

The fetus lacks ___ circulation

Answer 26

Pulmonary

Question 27

2 pathways the fetal heart shunts blood from the right side of the body to the left side while avoiding the pulmonary circulation

Answer 27

• foramen ovale between right to left atrium

- ductus arteriosus between pulmonary trunk and aortic arch

Question 28

Shear force is most likely to cause a tear in the aorta at this point

Answer 28

The ligamentum arteriosum (start of descending aorta)

Question 29

Where is the SA node located in the right atrium?

Answer 29

At the junction between superior vena cava and right atrium posterior wall

Question 30

The aorta loops….

Answer 30

…anteriorally in front of the right pulmonary artery then travels posterior to the heart and left pulmonary artery (where the ligamentum arteriosum sits) in front of the spine to descend as the thoracic aorta

Question 31

The aortic valve has ___ leaflets

The right and left leaflets have the….

Answer 31

3, openings to the left and right main coronary arteries

Question 32

___% of blood supply to the heart returns to chambers via the myocardium itself

Answer 32

10-20

Question 33

Coronary sinus

Answer 33

Valveless main venous blood return from the entire heart surface, oriface is located at the lower portion of the right atrium just medial to where the vena cava enters

Question 34

Cardiac index

Answer 34

Cardiac output/body surface area, preferred measure than cardiac output for determining adequate blood flow from heart

Question 35

During diastole, mitral and tricuspid valves are ___ and aortic and pulmonic valves are ____

Answer 35

open, closed

Question 36

Atrial kick

Answer 36

Refers to atrial contraction that occurs prior to end of diastole that pushes an extra bolus of blood from atria to ventricles to fill them

Question 37

Isovolumetric contraction

Answer 37

Refers to short period where ventricular pressure rises above atrium that results in mitral and tricuspid valves shutting to prevent backflow (S1), but before the pressure has built enough to exceed the resistance of the aortic and pulmonic valves in which they open

Question 38

When aortic pressure exceeds ventricular pressure in systole, what happens?

Answer 38

The aortic valve closes (S2)

Question 39

Isometric relaxation

Answer 39

Refers to short period where ventricle relaxes and sees a drop in pressure after ejecting blood into the aorta/pulmonary trunk, but before pressure has dropped below atrial pressure to allow mitral/tricuspid valves to open and begin filling again

Question 40

Dicrotic notch

Answer 40

Small downward deflection observed in pressure readings of the ventricle where the aortic valve slams shut indicating end of systole and start of diastole

Question 41

Compliance =

Answer 41

increase in volume/increase in pressure, 24x greater in venous side than arterial, venous acts as a reserve for intravascular volume

Question 42

Preload

Answer 42

The weight of the volume being ejected from the heart that must be overcome to perfuse blood (intravascular volume)

Question 43

Afterload

Answer 43

The weight of the volume of blood in circulation that the heart must eject against in order to overcome and perfuse blood (The peripheral vascular resistance)

Question 44

In order to pump blood, the ventricle must overcome both ___ and ____

Answer 44

preload, afterload

Question 45

Local regulation of blood flow 2 theories

Answer 45

• vasodilator theory: metabolite buildup stimulate local dilation of precapillary tubules
• oxygen demand theory: low O2 stimulates local dilation of precapillary tubules

Question 46

Intra-aortic balloon pump

Answer 46

Sits above renal vessels and below great vessels and inflates and deflates with saline corresponding to ekg allowing for decrease of peripheral resistance but maximize blood flow to coronary vessels that are still open so the heart is not damaged.