Cardiac Anatomy Review-Cardiac Function Flashcards
What is a typical BP? what is a typical HR? CVP?
BP: 110/70
HR: 60-100
CVP: 5
WHat can be seen within the mediastinum on a radiograph?
hilar structures
position of trachea and
aortic arch
What things should you observe when looking at a heart radiograph?
cardiac size
pulmonary vessels
What should the width o fthe adult heart be?
less than half the greatest thoracic diameter, measured from inside the rib cage at its widest point near the level of the diaphragm
what wound a penetrating wound left of the sternum hit?
the right ventricle!! it is the most anterior part of the heart.
How can you tell based on anatomy whther you are looking at an AP or PA radiograph?
the heart and aortic arch are left of the midline
WHat is cardaic tamponade? what is the best measure when assessing for cardiac tamponade?
When blood or fluids fill the space between the pericardium and the heart muscle
venous pressure! It will continue to increase until it reaches arterial pressure and then they will both crash otgether
What are the layers of the pericardium from superficial to deep?
Fibrous pericardium
Parietal layer of the serous pericardium
Visceral layer of the serous pericardium
***note the pericardium is non-distenable, artists draw in a pericardial space so we can invision it but really it is just a layer of capillary thinning where the parietal and visceral layers rub against each other with a thin layer of viscous fluid in between
Where do you auscultate for the
- Aortic semilunar valve
- Pulmonary Semilunar valve
- Tricuspid Valve
- Mitral Valve
- Aortic semilunar valve: intercostal space 2, right of the sternum
- Pulmonary Semilunar valve: intercostal space 2, left of the sternum
- Tricuspid Valve: just lateral to the body of the sternum @ below rib 5
- Mitral Valve:apex of the heart at the intercostal space 5
WHat nerve runs along the lateral borders of the heart and what is the significance of that? Also what holds open the inferior vena cava?
Phrenic nerve!
So heart isues can irritate the phrenic nerve and lead to neck pain (bc the phrenic nerve runs up the neck)
Inferior vena cava is held open by the diaphragm
Label the arteries
- Right brachiocephalic
- Right subclavian
- Right common corotid
- Left common carotid
- Left subclavian
- Right coronary
During what part of the heart cycle do the coronary arteries perfuse?
coronary arteries perfuse heart during diastole.
- during systole the cornary arteries are blocked by the semilunar valves
- but during diastole, the blow backflows into the heart and the valves catch and the blood flows into the cornary arteries. This is how you get the sichortic notch on the whitters diagram bc the elastic recoil of the valves as they slap shut
Where are all of the places you acn take a pulse?
Superficial temporal artery
facial artery subclavian artery
radial artery
popliteal artery
dorsalis pedis artery
femoral artery
brachial artery
common carotid artery
Where would you inject the contrast in order to test the patency of the anterior interventricular artery?
Left coronary artery (LAD)
What is the farthest part of the heart to the anterior chest cavity?
Left atrium. it actually sits right in front of the esophagus
WHat does the left coronary artery branch into?
the left circumflex artery and the anterior interventricular artery (also known as the left anterior descending artery LAD)
What vein do the following arteries run with?
Anterior Interventricular Artery (LAD)
Right Marginal Branch of R Coronary
Posterior Interventricular Artery
- Anterior Interventricular Artery (LAD) travels with the Great Cardiac Vein
- Right Marginal Branch of the R coronary travels with the Small Cardiac Vein
- Posterior Interventricular Artery travels with the Middle Cardiac Vein
Describe the flow of blood starting in the body traveling back to the heart
Body
Inferior/Superior Vena Cava
Right Right Atrium
Tricuspid Valve
Pulmonary semilunar valve
Pulmonary artery
Lungs
Pulmonary vein
Left Atrium
Mitral Valve
Left Ventricle
Aortic Semilunar Valve
Aorta
Body
Describe where the SA node is
Describe where the AV node is
SA: Where the superior vena cava and the right atrium meet
AV: In the right atrium, part of th membranous septum
Where is the fossa ovalis?
in the right atrium. it connects the right and left atria.
10% of people have a probe patent atrium. usually doesn’t cause any problems, but coul dlead to a paradoxica embolism. aka a DVT found in an artery in the brain.
WHen does the tricuspid valve close?
when the right ventircular pressure increases. (to be equal to the right atria)
What is the function of the papillary muscles? what would happen if they were damaged due to an MI?
they maintain the competency of the tricuspid valve.
if they were damaged the tricuspid valve would have a foppy leaflet and not be compenetent. this would lead to hearing a murmur. you would hear the valve shut and then hear the bloo dflow back through the valve in the reverse direction
What is the yellow, what is the blue?
yellow is the mirtral valve. this is the valve beteween the left atrium and left ventricle.
blue is the papillary muscles that help maintain the valve
WHat is the purple what is the green
purple=aortic valve
green=formaen ovale
which pairs of valves work together?
Mitral and tricuspid, as well as aortic and pulmonary semilunar valves
How can you tell whther you are lookin at the aorta or the pulmonary valve?
the aorta has the cornoary arteries branching off of it
REVIEW WITTERS
What innervates the heart?
- Cardiac Plexus- near tracheal bifurcation and ligamentum arteriosum
- Parasympathetic-motor control over HR and SV (slowww it down)
- Sympathetic- postganglionic fibers come from upper chain ganglia to heart (3 cervical and T1-T5) (increase!!)
- Afferents enter the spinal cord
*
How does referred pain occur?
painful sensation mediated by visceral afferents enter the spinal cord at a particular level is referrred to the somatic dermatome corresponding with that vertebral level
(the body isnt’ good at sensing visceral pain but it is really good at somatic, so it refers it to somatic)
WHat dermatomes does the pain of a heart attack refer to?
T1-T5
Along the arm (typically left)
Why would GERD pain lead to “heart burn”
bc the esophagus is right up against the left ventricle so the pain refers to the chest wall
a patient has an MI in the septum of the right atrium inferiorly and posteriorly near the ostium of the cornary sinus. Because of the location of the infarct the patient will most likely develop_______
AV node block1
difficulty swallowing with imaging illustrating that the anterior wall of his esophagus in the midthorax region is compressed. Identify the most likely structure resposible for this dysphagia
Left atrium
**Mitra valve stenosis or prolapse would lead to increased left atrium leading it to compress the esophagus
Describe the electrical conduction system of the heart
SA
AV
Bundle of His (common AV)
Left/RIght budle
pukige fibers
How do you do a coronary angioplasty?
- start in the femoral artery
- catheter up to the external iliac to the common iliac to the aorta and around the aortic arch
- then poke into the R or L coronary artery into the location of the occlusion and insert a stent
WHat is the most frequently blocked artery?
LAD
after that would be right main and then the circumflex
WHat region of the heart is most at risk for ischemic damage with a left anterior descending artery blockage
Anterior interventricular septum (it runs right along it)
how do you treat a coronary artery blokage?
a coronary artery bypass graft (CABG technique)
use the internal thoracic aka mamillary artery to connect the left subclavian vein to the LAD
What could cause systolic dysfunction and what would this lead to?
MI
Thinned cardiac muscle and myocarditis
WHat leads to diastoli dysfuntion? and what would this lead to?
Hypertension
-hypertrophic
aging
*narrowing of the aorta causes the left ventricle to work harder. or you could be gentically predisposed. the hypertrophy leads to the internal chammber getting smaller so the SV gets smaller and the heart rate compensates for the decreased SV with an increased HR.
What are the results of Left heart Failure
dyspnea
severe pulmonary congetsion
no increase in central venous presure
(SOB bc you dont clear the lungs fast enough so the bloo dbacks up into the left atrium, pulmonary veins and then lungs themelves)
WHat are the results of right heart failure?
cyanosis, hepatomegaly, edema, ascites, engorgement of the jugular veins. Increased venous pressure
where are the SA and AV nodes in relation to one another?
SA is where the superior vena cava and the right atrium meet.
AV is near the interventricular septum. you see it in the right atrium very close to the opening of the cornary sinus
