Cardiac Anatomy Pt. II Flashcards
The functional segmentation of each lung is reflected in the branching of the left and right ____ which arise at the bifurcation of the PULMONARY TRUNK
pulmonary arteries
With the ____ removed, the bifurcation of the pulmonary trunk may be visualized
more clearly
pericardial sac
Each PULMONARY ARTERY enters the lung at the ____ on the ____ SURFACE of the organ
hilum or root
mediastinal
Pulmonary arterioles are continuous with a \_\_\_\_ in intimate contact with the air sacs (alveoli) of the lung, which are in turn drained by tributaries of the \_\_\_\_
capillary network
pulmonary veins
Paired superior and inferior Pulmonary Veins return oxygenated blood to the ____
left atrium
The LEFT ATRIUM
• Receives the drainage
of the ____
• Has a smooth relatively featureless wall, marked only by the ____
• Delivers blood to the left ventricle through the left atrioventricular orifice,
guarded by the ____
pulmonary veins
fossa ovalis
bicuspid (mitral) valve
The LEFT VENTRICLE • Has the \_\_\_\_ wall of all the chambers • Has prominent \_\_\_\_ • Normally features two robust \_\_\_\_ anchoring the cusps of the \_\_\_\_ valve
Significantly, the larger ____ cusp of the valve is immediately adjacent to, and continuous with, the wall of the aorta
thickest trabeculae carnae papillary muscles bicuspid (mitral) valve anterior
Bicuspid (mitral) valve in systole
as the blood flowing through the atrio- ventricular orifice makes a sharp turn and flows into the \_\_\_\_ during ventricular systole
ascending aorta
The openings (ostia) of the left and right coronary arteries are associated with the ____ adjacent to the left and right cusps of the aortic ____ valve
sinuses of valsalva
semilunar
Both the AORTIC and PULMONARY valves are ____, with cusps opening passively and closing passively… … as the aortic valve closes, blood in the aortic sinuses fills the ____
Diastole - pressure drop > blood falls back to LV, and moves cusps away form circumference of vessel > aortic pockets > sinuses of valselva
semilunar
coronary arteries
ATRIOVENTRICULAR VALVES (with atria removed)
IN VENTRICULAR DIASTOLE…
The ventricular wall
is ____, the valves are open and blood
flows from the atria to the ____
THEN…
As the ventricles fill, the thin, elastic cusps rise toward the ____, the cusps appose and the valves are ____ passively
THEN…
IN VENTRICULAR SYSTOLE…
contraction of the myocardium raises the ventricular pressure & tightens the ____ to keep the valves ____
relaxed ventricles atrio-ventricular orifices closed chordae closed
SEMILUNAR VALVES
IN VENTRICULAR SYSTOLE…
Contraction of the ventricle pumps blood toward the ____ and ascending aorta, separating the thin, elastic semilunar cusps, ____ the valves
THEN…
IN VENTRICULAR DIASTOLE…
As the ventricles relax, pressure descreases in the aorta and pulmonary trunk, blood falls back toward the ____ and… the cusps are forced away from the vessel walls and into apposition, ____ the valves.
pulmonary trunk
opening
heart
closing
Valvular Heart Disease
• Valvular insufficiency results from a poorly functioning (incompetent) valve that cannot ____
completely, producing regurgitation
- Valvular stenosis is the pathological narrowing of an ____ as the result of the inability of the valve to open completely, leading to back-up and increased upstream risk of ____
- Both ____ and ____ cause turbulence in blood flow through the valve which produces vibrations audible as murmurs
- Acquired valvular disease may result from ____ and subsequent ____ of the valves produces scarring which thickens and rigidifies the elastic cusps
close
orifice
clot formation
stenosis
regurgitation
bacterial infection
inflammation
Common scenarios:
– Rheumatic heart disease triggered by an autoimmune reaction to infection with ____ …may lead to ____ or ____ valve damage
– Bacterial endocarditis – results from spread of bacteria entering the bloodstream either as the result of poor ____ or during ____, particularly in individuals with pre-existing cardiac conditions and other specific risk factors.
group A streptococci
mitral
aortic
oral hygiene
dental procedures
Auscultation of the valves requires placement of the stethoscope not directly OVER the surface projections of the valves but rather ____ from them
To position ourselves, in normal person:
• Heart lies in thorax with ____ to left of mid-sagittial plane and ____ to right of mid-sagittal plane
• Apex of heart in mid-clavicular line of 5th intercostal space
We have good sense of where 4 valves project onto anterior thoracic wall, however we put bell of stethoscope just downstream location of valve to listen to fluid that has just passed through it
downstream
2/3
1/3
AORTIC VALVE
Parasternally in ____ intercostal space
TRICUSPID VALE
Parasternally in ____ intercostal space
PULMONARY VALVE
Parasternally in ____ intercostal space
MITRAL VALVE
____ intercostal space ca. ____ lateral to the sternum
right 2nd left 4th or 5th left 2nd left 5th 6 cm
Cardiac nerves derived from both divisions of the ____ commingle in the ____, travel along the ____, and
serve to modify the rate and strength of the heart beat…
… but they neither initiate nor maintain it!
ANS
cardiac plexus
coronary plexus
The atria and ventricle contract in normal sequence before nerves contact the embryonic heart… and the same is true when the ____ is severed from the nervous connections.
transplanted heart
