Cardiology Flashcards by Nick Vossenberg

What are the boundaries of the mediastinum

Superior thoracic aperture
Diaphragm
Anterior - sternum
Posterior - thoracic vertebrae

How well did you know this?

Not at all

Perfectly

Above what is the superior mediastinum

Sternal angle (inferior border)

How well did you know this?

Not at all

Perfectly

What are the three parts of the inferior mediastinum and what are contained in each

Anterior - nothing
Middle - heart and roots of GV
Posterior - descending aorta

How well did you know this?

Not at all

Perfectly

What is contained in the superior mediastinum

The arotic arch and GV

How well did you know this?

Not at all

Perfectly

What are the two layers of the pericardium

Fibrous pericardium

Serous pericardium

How well did you know this?

Not at all

Perfectly

Describe the fibrous pericardium and its function. What is it continuous with?

Tough external part

Continuous with central tendon of the diaphragm

Prevents the heart from overdialating

How well did you know this?

Not at all

Perfectly

What does the fibrous pericardium continue with superiorly

Tunica adventitia (perivascular CT)

How well did you know this?

Not at all

Perfectly

How is the fibrous pericardium attached to the sternum

Sternopericardial L.’s

How well did you know this?

Not at all

Perfectly

What is the internal layer of the fibrous pericardium

Parietal layer of serous pericardium

How well did you know this?

Not at all

Perfectly

What layer covers the heart

The visceral layer of serous pericardium which is also the epicardium

How well did you know this?

Not at all

Perfectly

What is the visceral layer of serous pericardium mainly composed of

Mesothelium

How well did you know this?

Not at all

Perfectly

Define the pericardial cavity

Potential space between parietal and visceral serous pericardium that contains a small amount of pericardial fluid which helps heart beat freely

How well did you know this?

Not at all

Perfectly

Define the transverse pericardial sinus

Transverse passage in the serous pericardium between aorta and pul. Trunk and the great veins of the heart

How well did you know this?

Not at all

Perfectly

How is the transverse pericardial sinus formed

Formed in the primordial heart when the primordial atrial and venous ends come together

How well did you know this?

Not at all

Perfectly

Define the oblique pericardial sinus

The passage in the serous pericardium between the veins of the heart

How well did you know this?

Not at all

Perfectly

Why does the oblique pericardial sinus form

From vein expansion

How well did you know this?

Not at all

Perfectly

What A. Supplies the pericardium and what V. Empties it

The pericadiacophrenic A. And V.

How well did you know this?

Not at all

Perfectly

What is the sensory and motor N.’s of the

Sensory - phrenic N.

Motor - sympathetic trunks

How well did you know this?

Not at all

Perfectly

Define the LUB

1st sound heard
Blood from atria to vent.

closing of the AV valves

How well did you know this?

Not at all

Perfectly

Define the dub

2nd sound

Ventricles expel blood

Closing of semi-lunar valves

How well did you know this?

Not at all

Perfectly

What are the three layers of the heart and what are they made up of

Epicardium - most superficial made up of visceral serous pericardium/mesothelium
Myocardium - middle layer of thick spiraling muscles
Endocardium - thin internal layer of endothelial cells

How well did you know this?

Not at all

Perfectly

When ventricles contract, what type of motion do they make

A wringing motion, tightening the spiral muscles

How well did you know this?

Not at all

Perfectly

How does heart contract in general

From apex to base and base to apex

How well did you know this?

Not at all

Perfectly

What is the cardiac muscle anchored to

The fibrous skeleton of the heart

How well did you know this?

Not at all

Perfectly

What is the fibrous skeleton of the heart made up of

Dense collagenous fibers

What does the fibrous skeleton o f the heart surround

All four valves with a ring

What are the three functions of the fibrous skeleton of the heart

1. Attachment points for myocardium 2. Attachment point for cuspid valves 2. Provides insulation for electrical conduction

What part specifically of the fibrous skeleton provides insulation for. Electrical conduction

The membranous part of the interarterial and interventricular septum

What forms the apex

The inferolateral part of the LV

What are the three surfaces of the heart and what occupies them

1. Sertnocostal - RV 2. Diaphragmatic - LV and RV 3. Pulmonary - RA and LV respectively

What are the 4 borders of the heart and what occupies them

1. Right - RA 2. Inferior - RV 3. Left - LV 4. Superior - R and L atria

What separates the RA and the RV and what does it transmit

R atrioventricular Groove with RCA

What separates the LA from the LV and what is with it

L atrioventricular groove with the coronary sinus

What separates the LV and RV on the anterior aspect and what runs with it

Anterior interventricular groove with the anterior interventricular A. (LAD) and the great cardiac V.

What separates the Lv and RV on the posterior side and what runs with it

Posterior interventricular groove with the posterior interventricular A. And the middle cardiac V.

Define the sulcus terminalis

External vertical groove corresponding to the internal crista terminalis

What do the sulcus terminalis (external) and crista terminalis (internal) divide

Divides the sinus vernaum and the pectinate muscle from each other within the RA

Define the ligamentum arteriosum

The embryological remnant of the ductus arteriosus Is a connection between the pulmonary trunk and the Aortic Arch

Define the sinus venarum

Smooth muscle of the RA

What empties into the sinus Venarum

IVC/SVC/Coronary sinuses

Define pectinate M.

Rough muscle of the RA

Define the interatrial septum

Wall between the two atria

What is the passage called from the RA to the RV

R atrioventricular orifice

What valve guards the R atrioventricular orifice

The tricuspid valve

What attaches to the cusps of each AV valve (muscle and tendon)

The chordae tendonae which are attached to papillary muscles

What cusps do the anterior, posterior, and septal papillary muscles attach to respectively

Anterior Posterior Septal

Define trabecula carnae

The rough muscle region of the RV and LV

The papillary muscles are attached to what part of the RV

Trabecula carnae

Define the septomarginal trabeculum and its function

Part of the trabecula carnae Transmits the RBB to the anterior papillary M.

Define the conus arteriosus

Smooth walled part of RV which leads into the pulmonary trunk

What valve leads to the pulmonary trunk/arteries

Pulmonary semilunar valve

What is smooth muscle walls called in the LA

Sinus venarum

What contains the pectinate M.’s in the LA

The left auricle

What is the passage from the LA to the LV called and what guards it

The left atrioventricular orifice guarded by the mitral (bicuspid) valve

What is the rough and smooth muscle wall regions of the LV called

Rough - trabeculae carnae | Smooth - aortic vestibule

What does the interventricular septum house

The AV Bundle, LBB, RBB

Where are the purkinjie fibers and LBB and RBB located

Endocardium, V. Deep

What is the division between the superior and inferior mediastinum

Transverse thoracic plane

When is widening of the mediastinum noted

Observed after trauma to the chest after a laceration to the great vessels Malignant lymphoma Hypertophy due to CHF

What space is used for a cross clamping of the aorta and pulmonary trunk in a bypass surgery

Transverse pericardial sinus

What is pericarditis

Inflammation of the pericardium which can cause a friction rub

Define pericardial effusion

Fluid from the pericardial capillaries leaks into the pericardial space, compressing the heart

Define cardiac tamponade and what can it result from

Due to accumulation of fluid in the pericardial space Can result from pericardial effusion, pneumo, MI, or pneumopericardium

Define a pericardiocentesis and the procedure itself

Draining of fluid from the pericardial sac Large-bore needle is inserted into the 5th or 6th ICS near the sternum or via the xiphocostal angle

Define dextrocardia and what causes it

Misplacement of the heart to the right instead of the left Caused by misfolding of the embryonic heart tube to the left

# Define isolated dextrocardia and dextrocardia with situs inversus Which one is more serious?

ID = just heart switched ID w/SI = transposition of abdominal viscera as well ID is more serious

What part of the adult heart represents the primordial atrium

Right auricle

The coronary sinus is a derivative of what

Sinus venous

The foramen ovale closes when

The baby takes its first breath, causing back pressure in the left atrium to increase, closing the shunt

A patent foramen ovale is called what

Atrial septal defect

A patent foramen ovale that is serious can cause what

Hypertrophy of the R atrium and R ventricle

What does a VSD cause

Blood flow between Ventricles and cardiac hypertrophy

Where is cardiac percussion perfomed

3rd, 4th, and 5th ICS

Define valvular heart stenosis

Failure of the valve to open fully which slows blood flow into the chamber

Define valvular heart insufficiency

A failure of the valve to close completely usually due to scaring on the cusps

Both stenosis and insufficiency can produce what

Turbulence and audible murmurs

What is the cause of insufficiency

Acutely - by a pathology of the valve structure itself Chronically - by scaring or retraction

What is the cause of stenosis

A result of a valve abnormality and is always a chronic process

Define a prolapsed mitral valve

An insufficient valve with one or both leaflets enlarged and floppy, causing it to extend back into the atrium during systole

What occurs due to a mitral valve insuddiciency

Blood regurgitates into the left atrium during systole Usually seen in young females

Define pulmonary valve stenosis

The valve cusps are fused together

Define infundibular pulmonary stenosis

The conus arteriosus is underdeveloped

What do pulmonary valve stenosi cause

A restricted RV outflow

Define pulmonary valve incompetence

Results in a back-rush of blood under high pressure into the RV during diastole

What is the most frequent valve stenosis

Aortic valve stenosis

What is the result of aortic valve stenosis

Left ventricular hypertrophy

What does aortic valve insufficiency cause

Back-rush of blood into the left ventricle, producing a heart murmur and a collapsing pulse

The ligamentum arteriosum travels from where to where

From the superior aspect of the pulmonary trunk to the inferior concave border of the aortic arch

What did the ductus arteriosus do

Shunted blood from the pulmonary trunk to the aorta to bypass the lungs

What N. Loops around the ligamentum arteriosum

The left recurrent laryngeal N. Of the Vagus N.

Where does the electrode of a pacemaker implanted

In the trabecula carnae of the RV