Cardiac Anatomy Pt. I Flashcards
The THORAX
Surrounded by the the bony thoracic cage, the thorax contains two
PULMONARY CAVITIES
separated by a midline soft tissue partition, the ____
mediastinum
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
The
mediastinum
extends from ____ to the diaphragm
superior thoracic aperture
The plane of the ____ or ____… (T4/5)
…divides the mediastinum into
superior and inferior positions
manubriosternal joint
sternal angle
This plane is also significant in regard to mediastinal viscera and vasculature:
* \_\_\_\_ bifurcation * Divisions of the \_\_\_\_
tracheal
thoracic aorta
Contents of the MEDIASTINUM
TABLE!
YAY
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
The MIDDLE MEDIASTINUM contains the FIBROUS PERICARDIAL SAC and its contents:
* \_\_\_\_ * Coronary arteries * \_\_\_\_ * Roots of the great vessels
heart
cardiac veins
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
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
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
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
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
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
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
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
The heart may be though of as shaped like a child’s spinning top…
…with a ____ and an APEX…
…and for additional surfaces
base
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)
- 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
