Cardiology CPR

Question 1

what is the flow of both systemic and pulmonary circulation

Answer 1

Pulmonary:
suuperior and inferior vena cava to the Right atrium then through the tricuspid valve into the right ventricle then out of the heart through the pulmonary valve into the pulmonary trunk to the pulmonary arteries to the lungs then back from the lungs via the the pulmonary veins

Systemetic: blood from the left atrium past the bicuspid valve into the left ventricle then past the aortic valve into the aorta and through the atrial system, through the capillaries, and back via the venous system and into the heart via the inferior and superior vena cava

Question 2

What are the four layers of of heart tissue

Answer 2

Epicardium (outermost layer and made up of Visceral serous pericardium)

Myocardium (thick muscular layer made up of spiriling overlapping layers of cardiac muscle)

Endocardium (thin internal endothelial and subendothelial layer lining the inside chambers of the heart and valves)

Fibrous skeleton of the heart (dense collagenous fibers)

Question 3

What are the 4 functions of the Fibrous skeleton of the heart

Answer 3

Produces attachment points for the myocardium

Produces attachment points for the valves of the cuspid valves

Supports and strengthens the atrioventricukar and semilunar orifices

Provides an electrically insulated barrier between the atria and the ventricles

Question 4

Myocardial Infraction

Answer 4

Lack of blood flow to a specific area of the myocardium usually the result of a blockage in a coronary A

can be caused by coronary atherosclerosis thus decresing the size of the vessels

Question 5

Angina Pectoris

Answer 5

Pain that originates in the heart that produces a strangling pain of the chest

usually due to a obstructed coronary arteries that produces ischemia

Question 6

What are the three surfaces and 4 borders of the Heart

Answer 6

Surfaces:

• Sternocostal (right ventricle)
• Diaphragmatic (right and left ventricles)
• Pulmonary (paired, right atrium and left ventricle occupying the cardiac impression on both lungs)

Borders:

• Right (right atrium)
• Inferior (right ventricle)
• Left (left ventricle)
• Superior (right and left atria and the exit point for the aorta and pulmonary trunk)

Question 7

what are the 4 grooves of the heart and what do they house

Answer 7

Right Atrioventricular groove: btwn right atrium and ventricle, transmits the right coronary A

Left atrioventricular groove: btwn the left atrium and ventricle, transmits the coronary sinus

Anterior interventricular groove: between the right and left ventricles on anterior aspect, transmits the anterior and interventricular A and great cardiac V

Posterior interventricular groove: btwn the right and left ventricles on the posterior aspect, transmits the posterior interventricular A and middle cardiac V

Question 8

What is the sulcus terminalis

Answer 8

External vertical groove corresponding to the internal Crista terminalis

Question 9

What is the Ligmentum Arteriosum

Answer 9

travels from the superior aspect of the pulmonary trunk to the inferior concave border of the Aortic Arch

it is the adult remnant of the Embryological Ductus Arteriosus which shunts the blood from the pulmonary trunk to the aorta to bypass the nonfunctional lungs

the left recurrent laryngeal N of the vagusloops around the Aortic Arch and Ligmentum arteriosum

Question 10

What are the Five Internal features of the Right Atrium

Answer 10

Sinus Venarum (smooth thin wall where the venae Cavae and coronary sinus empty)

Pectinate Muscle (Rough muscular wall, has a right Auricle)

Crista Terminalis (internal ridge separating the smooth and rough regions)

Interatrial septum (wall between the two atria, contains the Fossa Ovalis, remnants of the Foramen Ovalis)

Opening for the Coronary Sinus

Question 11

Atrial Septal Defects

Answer 11

usually involves an incomplete closure of the Foramen Ovalis

allowing for mixture of oxygen rich and Oxygen depleted blood

Question 12

What is the name of the passage between the Right Atrium to the right Ventricle and what is the valve that allows this

Answer 12

Right Atrioventricular Orifice

the Valve is the Tricuspid Valve

Question 13

what are the 4 internal features of the Right Ventricle

Answer 13

Tricuspid Valve

Trabecula Carnae: rough muscular region
-contains the Septomarginal Trabeculum (Moderator band that travels from the Interventricular septum to the Anterior papillary M

Conus Arteriosus: smooth walled and leads into the pulmonary trunk

Pulmonary Valve: Semilunar valve that has a right, left, and anterior cusps
-Pulmonary sinuses

Question 14

What are the name of the three cusps of the tricuspid valve and their corresponding Papillary muscles

Answer 14

Anterior cusp: Anterior papillary muscle

Posterior Cusp: Posterior Papillary Muscle

Septal cusp: Septal Papillary Muscle

all of these are joined together by Chordae Tendineae

Question 15

Cardiac Catheterization

Answer 15

insertion of a catheter into the femoral vein that passes up into the Inferior Vena Cava to visualize the heart and the pulmonary circulation

Question 16

what are the three internal features of the left atrium

Answer 16

Left auricle (contains pectinate M)

Openings for the 4 Pulmonary Veins

Interatrial septum

Question 17

what is the name of the passage between the Left atrium and left ventricle and the valve that is associated with the opening

Answer 17

Left atrioventricular Orifice (passage from the left atrium to the left ventricle)

Bicuspid Valve

Question 18

What are the five internal features of the left ventricle

Answer 18

Bicuspid (Mitral valve)

Trabecula Carnae (rough muscular region)

Aortic Vestibule (smooth wall leading into the ascending aorta

Interventricular septum (mycardial wall separating the two ventricles

Aortic valve: semilunar valve
-aortic sinuses to drain into the coronary arteries

Question 19

What are the two cusps of the bicuspid valve and what are their corresponding muscles

Answer 19

Anterior cusp: Anterior papillary muscle

Posterior cusp: Posterior papillary muscle

all connected by Chordae Tendineae

Question 20

Ventricular Septal Defects

Answer 20

openings in the ventricular septum allowing for the mixture of oxygenated and non oxygenated blood

Question 21

What is the conducting system of the heart

Answer 21

Cardiac muscle cells

specialized conducting fibers and two bundles of nodal tissue responsible for coordinating the cardiac Cycle

Question 22

Sinuatrial Node

Answer 22

located in the mycocardium where the superior vena cava meets the right atrium

these specialized cardiac muscle fobers initiate and regulate impulses that propagates through the atrial walls via the Myogenic conduction, thus producing Diastole

it is the pacemaker of the heart

Question 23

Atrioventricular Node

Answer 23

Small bundle of specialized Cardia muscle fibers located in the Interatrial Septum near the opening for the Coronary sinus

this responds to the impulse from the Sinuatrial node that is distributed through the wall of the atrium and distributes that signal through the ventricles

sends signal through the Atrioventricular bundle

and the Subendocardial Branches

Question 24

Atrial Cardiac Pacemaker

Answer 24

Produces a regular electrical impulse that is carried to the ventricles via electrodes into the Endocardium of the Trabecula Carnae of the right ventricle

Question 25

Atrial Fibrillation

Answer 25

Irregular twitching of the Atrial cardiac muscle fibers to which the ventricles respond at irregular intervals

Circulation usually remains satisfactory

Question 26

Ventricular Fibrillation

Answer 26

Rapid Irregular twitching of the ventricles rendering the heart unable to pump blood

an electric shock administered by electrodes can ease all cardiac movement (defibrillation) in the hopes that the heart may begin beating regularly after a period of time

Question 27

Cardiac referred pain

Answer 27

Ischemia stimulates visceral pain sensory fibers in the heart of the ANS

these visceral sensory fibers share a spinal ganglion with the somatic sensory fibers of the areas such as the upper limb, superior lateral chest

Anginal pain is typically referred to the area innervated by the left medial brachial cutaneous nerve, left substernal area, left pectoral area, and medial aspect of the left upper limb

Question 28

What are the three pericardium layers

Answer 28

Serous Visceral pericardium, adheres to he heart and makes up the epicardium

Serous Parietal pericardium, adhere to the fibrous pericardium

Fibrous pericardium (outermost and is tough and fibrous)

Question 29

What are the two sinuses located outside the heart

Answer 29

Oblique Pericardial sinus (wide recess posterior to the base of the heart)

Transverse Pericardial sinus (transverse passage traversing the origins of the great vessels)

Question 30

Surgical significance of the transverse Pericardial sinus

Answer 30

space allows cardiac surgeons to access the area posterior to the aorta and pulmonary trunk to clamp or insert the tubes of a bypass

Question 31

Pericarditis

Answer 31

inflammation of the pericardium, this makes the pericardium rough and produce friction

this friction can be observed with a stethoscope, and if not treated can calcify

Question 32

Pericardial Effusion

Answer 32

Inflammation of the Pericardium that can result in accumulation of fluid or pus in the pericardial sac which can compress the heart

heart compression is known as Cardiac Tamponade

Question 33

Pericardiocentesis

Answer 33

Drainage of blood, fluid or pus from the pericardial sac

this is done to relieve cardiac tamponade