Cardiac Anatomy Pt. I Flashcards by J L

The THORAX

Surrounded by the the bony thoracic cage, the thorax contains two
PULMONARY CAVITIES
separated by a midline soft tissue partition, the ____

mediastinum

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The pulmonary cavities are found on either side of the mediastinum
in the thorax

Each cavity is filled with a fibroserous
____
that lines both the cavity and the lung contained within

pleural sac

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The
mediastinum
extends from ____ to the diaphragm

superior thoracic aperture

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The plane of the ____ or ____… (T4/5)

…divides the mediastinum into

superior and inferior positions

manubriosternal joint

sternal angle

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This plane is also significant in regard to mediastinal viscera and vasculature:

* \_\_\_\_ bifurcation
* Divisions of the \_\_\_\_

tracheal

thoracic aorta

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Contents of the MEDIASTINUM

TABLE!

YAY

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The SUPERIOR MEDIASTINUM contains an abundance of neurovascular and visceral structures with which you are familiar, transitioning between the thorax and the root of neck through the ____

Note that the fibrous pericardial sac is continuous with the ____ of the great vessels

superior thoracic aperture

tunica adventitia

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The MIDDLE MEDIASTINUM contains the FIBROUS PERICARDIAL SAC and its contents:

* \_\_\_\_
* Coronary arteries
* \_\_\_\_
* Roots of the great vessels

heart

cardiac veins

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The FIBROUS PERICARDIAL SAC

Collagenous and ____

Firmly attached to the central ____ of the diaphragm

The sac is lined with a parietal layer of ____

non-distensable
tendon
mesothelial serous pericardium

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Do you remember the PHRENIC NERVES, arising as branches of the cervical plexus?

* \_\_\_\_ innervate the diaphragm
* \_\_\_\_ innervate the parietal layer of serous pericardium

____ is painful and diagnostically “problematic”

somatic efferents
somatic afferents
pericarditis

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The surface of the heart is lined with a ____ LAYER of ____ PERICARDIUM

This layer of tissue is also known as ____

Parietal and Visceral layers are continuous with each other around the ____ of the great vessels

visceral
serous
epicardium
roots

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Between the parietal and visceral layers of the serous pericardium lies the ____ normally filled with a thin layer of serous fluid

Pericardial effusion
leads to ____

* \_\_\_\_
* Dyspnea
* Compromised \_\_\_\_ efficiency
* Heart failure
* Increased \_\_\_\_ by pressure noted by \_\_\_\_ vein distention

pericardial cavity
cardiac tamponade
pain
cardiac
venous pressure
jugular

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FIBROUS SKELETON of the heart
This dense connective tissue network reinforces the myocardium ____ and anchors the ____.

Collagen and elastin fibers form ____ rings surrounding all cardiac valves like two pairs of ____.

internally
myocardial fibers
four
handcuffs

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Fatigue resistant
ventricular myocardium
has traditionally been described as being
arranged \_\_\_\_ around the fibrous
skeleton...

The myocardium extends to the ____ of the great vessels

…particularly at the ____

helically
roots
vortex

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Where is the heart located and how is it oriented in relation to the thoracic wall and other thoracic viscera?

Right: ____
Left: ____

1/3

2/3

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STERNOCOSTAL surface of the heart

RIGHT BORDER
____

INFERIOR BORDER
____, R. ventricle, l____

LEFT BORDER
____, auricle of left atrium

The borders of the heart delineate the “____” seen on standard PA chest radiographs

right atrium
right atrium
left ventricle
left ventricle

cardiac shadow

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The heart may be though of as shaped like a child’s spinning top…

…with a ____ and an APEX…

…and for additional surfaces

base

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The apex of the heart is normally found in the ____ intercostal space along the mid-clavicular line

Apex may deviate further to the left in larger people - ____

left 5th

cardiomegaly

A posterior view of the heart shows us…

The BASE formed primarily by the ____

The DIAPHRAGMATIC (INFERIOR) SURFACE
formed by the \_\_\_\_

left atrium

ventricles

The atria are separated from the ventricles
by a deep ____

The ventricles are separated from each other by a shallow ____

These grooves carry major ____ and cardiac veins

coronary (atrioventricular) sulcus
interventricular sulcus
coronary arteries

The sulci transmit the major coronary arteries responsible for perfusion of the ____, as well as ____

In life, these vessels
lie in a plane between the ____ and myocardium… Embedded in variable amounts of ____…

Significant when considering when the filling of these vessels occurs during the ____

myocardium
cardiac veins

epicardium
fat

In most individuals, TWO coronary arteries arise from the ____, a dilation
of the vessel at the base of the ____ aorta

aortic sinus

ascending

The CRUX of the heart is where the two sulci meet branches of the two ____ may anastomose here variably

coronary arteries

Note the abundance of vessels descending toward the ____

apex

The blood supply to the larger, thicker ____ is of particular concern, given the chamber's role in pumping blood through the systemic circulation ``` Ventricular myocardium will contract sequentially: • from the ____ toward the base • from deep (____) to superficial ```

apex | IV septum and papillary muscles

Commonly, the left ventricle receives oxygenated blood from branches of both coronary arteries, a so-called ____ distribution, however...

balanced

Coronary artery "dominance" is defined in terms of which coronary artery supplies the ____ ``` The implications are obvious when considering the potential consequences of ____ ```

posterior descending (posterior interventricular) artery/PDA coronary artery disease (CAD)

Although the distal coronary arteries are connected by structural ____, they are best considered as ____ arteries from a functional standpoint Note: gradual occlusion of these vessels does allow for development of ____ circulation circumventing the narrowed segment

anastomoses end collateral

Coronary Artery Disease • Coronary circulation is not ____: although there are structural anastomoses between blood vessels supplying the myocardium, sudden occlusion of a coronary artery will ____, or deny blood to an area of myocardium, ultimately leading to ____. • The most common cause of compromised coronary circulation is athersclerosis of the ____ which causes a progressive narrowing of the lumina due to accumulation of plaque-like deposits, reducing cardiac blood flow and causing ischemic heart disease. • Partial occlusion of a coronary artery resulting in myocardial ischemia may produce the pain of ____, initially induced by ____ but eventually persisting at rest.

redundant infarct necrosis coronary arteries angina pectoris physical exercise

The ____ is often referred to as "the widow maker" The ____ is the #1 site for coronary artery occlusion due to the accumulation of atherosclerotic plaque

anterior interventricular (LAD) LAD

Percutaneous coronary intervention such as ____ and ____ may open narrowed coronary arteries

balloon angioplasty | stenting

The CORONARY SINUS lies in the left coronary sulcus, superficial to the ____ Sinus? Sinus was defined by the fact that they had no ____ in their veins The CORONARY SINUS receives deoxygenated blood from virtually all ____ draining the myocardium and returns it to the ____ So three significant vessels drain into the ____…

circumflex artery smooth muscle cardiac veins right atrium right atrium

Venous blood from the head, neck and upper extremities drains into the ____ Venous blood from abdominopelvic viscera and the lower extremities drains into the ____

superior vena cava | inferior vena cava

The coronary sinus is formed by the confluence of the ____ and the ____ ____ uniquely drain the free wall of the right ventricle directly into the right atrium

great cardiac vein oblique vein of the left atrium anterior cardiac veins

THEBESIAN VEINS return blood from the capillary bed in the muscular cardiac wall directly into all chambers of the heart via openings in the ____

endocardium

The atria are separated by a thin ____ The ventricles are separated by an ____ with thin membranous and thick muscular parts

interartrial septum | interventricular septum

Deoxygenated blood enters the right atrium from: • ____ • ____ • ____

superior vena cava inferior vena cava coronary sinus

The RIGHT ATRIUM 1. Has a smooth walled portion continuous with the vena cavae (____) 2. Has a corrugated part- the ____ - continuous with the auricle 3. The parts are separated by the ____ 4. The interatrial septum features the ____ 5. Most venous blood drained from the myocardium enters the atrium through the ____ 6. Blood passes out of the right atrium through the ____ and enters the…

sinus venarum pectinate muscle crista terminalis fossa ovalis ostium of the coronary sinus right atrioventricular orifice

FOSSA OVALIS is a remnant of the ____, which shunted foetal blood, primarily entering the heart through the ____, around the non-functional pulmonary circulation As we will discuss in our next lecture… establishment of the pulmonary circulation with the ____ normally leads to "functional closure of the foramen ovale

foramen ovale IVC breath

``` The RIGHT VENTRICLE 1. Features a thick wall with an irregular endocardial surface formed by the ____ ``` 2. Contains the structures of the ____ guarding the ____ atrioventricular orifice 3. The ____ (moderator band) 4. Tapers into a smooth ____ (infundibulum) directing blood to the base of the pulmonary trunk and the pulmonary valve

trabeculae carnae tricuspid valve right septomarginal trabecula conus arteriosus

The three thin, elastic cusps of the right atrioventricular (TRICUSPID) valve attach to a ____ surrounding the orifice Papillary muscles are attached to the cusps via the ____

``` fibrous ring (anulus) chordae tendinae ```

The chordae are tensed by the contraction of the ____ and the free wall of the ____, to prevent ____ of the cusps into the right atrium during ventricular contraction

papillary muscles ventricle prolapse

The pulmonary (pulmonic) valve is one of two ____ valves found in the heart

semilunar

The pulmonary trunk courses ____ and ____ before bifurcating into the left and right pulmonary arteries

superiorly | posteriorly