Cardiology anatomy

Question 1

What are the 2 layers of the pericardium?

Answer 1

Fibrous and serous

Question 2

What is the fibrous pericardium continuous with?

Answer 2

Central tendon of the diaphragm

Question 3

Which layer of the pericardium is the tough, external layer?

Answer 3

Fibrous pericardium

Question 4

What is the purpose of the fibrous pericardium being non-distensible?

Answer 4

Rigid structure prevents rapid over-filling of the heart.

Question 5

What are the 2 subdivisions of the serous pericardium?

Answer 5

Outer parietal layer and inner visceral layer

Question 6

What is the internal visceral layer also known as?

Answer 6

Epicardium

Question 7

The outer parietal layer lines what?

Answer 7

The internal surface of the fibrous pericardium

Question 8

The inner visceral layer forms what?

Answer 8

The outer layer of the heart

Question 9

Where is the pericardial cavity?

Answer 9

Between the outer parietal and inner visceral layers of the serous cavity

Question 10

What is the function of the serous fluid within the pericardial cavity?

Answer 10

Minimises friction generated by the heart as it contracts.

Question 11

What are the 4 main functions of the pericardium?

Answer 11

Fixes the heart
Prevents overfilling
Lubrication
Protection from infection

Question 12

What is the innervation of the pericardium?

Answer 12

C3 - C5 (why you get shoulder pain with pericarditis)

Question 13

What is the order of the layers of the pericardium from most external to most internal?

Answer 13

Fibrous layer
Parietal layer
Serous fluid
Visceral layer

Question 14

Where is the SAN located?

Answer 14

Upper wall of right atrium at the junction where the superior vena cava enters.

Question 15

What does the sympathetic nervous system do to the firing rate of the SAN?

Answer 15

Increases firing rate = increased HR

Question 16

What does the parasympathetic nervous system do to the firing rate of the SAN?

Answer 16

Decreases firing rate = decreased HR

Question 17

Where is the AVN located?

Answer 17

Within AV septum, near the opening of the coronary sinus

Question 18

Why does the AVN delay impulses by ~120miliseconds?

Answer 18

To ensure the atria have enough time to fully eject blood into the ventricles before ventricular systole

Question 19

What is the standard approach for pericardiocentesis?

Answer 19

Subxiphoid approach

Question 20

Why does a patient need to be sat at 30-45 degrees for pericardiocentesis?

Answer 20

To allow pericardial fluid to pool inferiorly.

Question 21

Where should a needle be inserted for pericardiocentesis?

Answer 21

1cm below the left xipho-costal angle.

Question 22

What angle should the needle be inserted at for pericardiocentesis and where should it be aimed?

Answer 22

Inserted at a 30 degree angle and aimed at the midpoint of the left clavicle.

Question 23

Where are the aortic sinuses?

Answer 23

Small openings found within the aorta behind the left and right flaps of the aortic valve.

Question 24

Which areas of the heart are supplied by the LAD?

Answer 24

RV
LV
Anterior 2/3rds IV septum

Question 25

Which areas of the heart are supplied by the left marginal artery?

Answer 25

LV

Question 26

Which areas of the heart are supplied by the left circumflex artery?

Answer 26

LA LV

Question 27

Which areas of the heart are supplied by the RCA?

Answer 27

RA SAN AVN Posterior IV septum

Question 28

Which areas of the heart are supplied by the right marginal artery?

Answer 28

RV Apex

Question 29

Which areas of the heart are supplied by the posterior inter ventricular artery?

Answer 29

RV LV Posterior 1/3rd of IVS

Question 30

Which ECG leads correspond to the inferior region of the heart?

Answer 30

II, III, aVF

Question 31

Which ECG leads correspond to the anterolateral region of the heart?

Answer 31

I, aVL, V5, V6

Question 32

Which ECG leads correspond to the anteroseptal region of the heart?

Answer 32

V1, V2

Question 33

Which ECG leads correspond to the anteroapical region of the heart?

Answer 33

V3, V4

Question 34

Which ECG leads correspond to the extensive anterior region of the heart?

Answer 34

I, aVL, V2-V6

Question 35

Which ECG leads correspond to the posterior region of the heart?

Answer 35

Tall R in V1

Question 36

ECG changes in leads II, III and aVF suggest blockage in which artery?

Answer 36

RCA

Question 37

ECG changes in leads I, aVL, V5 and V6 suggest blockage in which artery?

Answer 37

Left circumflex

Question 38

ECG changes in leads V1, V2 suggest blockage in which artery?

Answer 38

LAD

Question 39

ECG changes in leads V3, V4 suggest blockage in which artery?

Answer 39

Distal LAD

Question 40

ECG changes in leads I, aVL and V2-V6 suggest blockage in which artery?

Answer 40

Proximal LCA

Question 41

The LCA gives rise to which coronary arteries?

Answer 41

LAD Lcx Left marginal

Question 42

The RCA gives rise to which coronary arteries?

Answer 42

Right marginal

Question 43

What is the nerve supply to the fibrous pericardium?

Answer 43

Phrenic nerve

Question 44

Which layer of the serous pericardium is supplied by the phrenic nerve?

Answer 44

Parietal layer