Cardiovascular Flashcards
pericardium
fibroserous fluid filled sack surrounds the heart
fibrous pericardium
outtermost layer of pericardium, lines body of heart and roots of vessels
parietal pericardium
lines the fibrous sack
visceral pericardium
lines the heart
serous pericardium
parietal and visceral pericardium
function of the fibrous pericardium
retain the heart in position, limit distension
prevents sudden overfilling
other name for the visceral pericardium
epicardium
where is the heart not associated with the epicardium?
posterior and irregular areas
functions of the pericardium (4)
fixes the heart in place
prevents overfilling
lubrication
protection from infection
what supplies blood to the pericardium?
percardiacophrenic arteries
musculophrenic arteries
branches of the thoractic aorta
what blood supplies only the visceral layer?
coronary arteries
what drains the blood for the pericardium?
pericardiophrenic veins
internal thoracic veins
azygos system
where does the innervation to the fibrous and parietal layers come from
C3-C5
where does the innervation for the visceral layer come from
the cardiac plexus
can the visceral layer feel pain?
No
pericarditis
inflammation of the pericardium
irritated layers rub against one another
pericardial effusion
build up of fluid in the pericardial space
cardiac tamponade
pericardiocentesis
aspiration of fluid from the pericardial space
treatment for cardiac tamponade
is the aorta to the left, right or midline?
midline
the heart runs from ___ to ____intercostal spaces
2nd intercostal to 5th intercostal
where is the apex?
fifth intercostal space
where does venous input come in?
superior vena cava
inferior vena cava
coronary sinus
where does the arterial output go out?
aorta
pulmonary trunks/arteriers
tricuspid valve
between RA and RV
pulmonic valve (semi lunar)
between RV and pulmonary artery
mitral valve
between LV and LV
aortic valve (semi lunar)
between LV and aorta
anterior interventricular groove
anterior view of heart seen separarting the RV and LV
atrioventricular groove
coronary groove
anterior view of heart
seen separating the RA and RV
Where does the pulmonary trunk take blood to? is it oxygenated?
deoxygenated
lungs
If you were stabbed in the chest in the 4th intercostal space which ventricle would you most likely stab?
RV
what are the two parts of the RA
sinus venarum
pecinate muscles
interartial septum
divides RA from LA
fossa ovali found here
sinus venarum
smooth thin wall
VC and coronary sinus is received here
derived from embryonic sinus venosus
pectinate muscles
divided from sinus venarum by crista terminalis
formation of the interartial septum (6)
1-formation of 1st septum (septum primum)
2-formation of opening (ostium primum) before septum primum fuses
3-formation of septum secundum, and ostium secundum (foramen ovale)
4- flap valve created
5- blood bypass lungs by going from RA to LA
6- fetus lungs not inflated (bypass needed)
what does foramen ovale turn into after birth?
fossa ovalis
what is the % of people that have an atrial septal defect?
25%
what does an atrial septal defect cause?
oxygenated blood to be shunted from the LA to the RA and the lungs to be overloaded
RA, RV and pulm trunk enlargement
doorway from RA to RV
right artriventricular orifice (tricuspid valve protects)
trabeculae carneae
irregular muscular elevations on the internal surface of the RV and LV
what are the two parts of the interventricular septum?
muscular part
membranous part that is superior and posterior
what is the shape of blood flow in the RV?
A U shape
What happens to the IV septum during systole (contraction)?
stiffens
what are the three cusps of the tricuspid valve?
anterior cusp
posterior cusp
septal cusp
papillary muscles (3) of tricuspid valve
anterior
posterior
septal
what is special about the anterior papillary muscle?
septomarginal trabculum carries the right branch of the AV bundle to it
Chordae tendineae
attached to papillary muscles and when taunt close the tricuspid valve/mitral valve to prevent backflow when the RV/LV is contracting
Will the tricuspid valve and the mitral valve be open or closed during diastole?
open
What brings the oxygenated blood to the LA?
the four pulmonary veins
interior of the left atrium
smooth except for pectinate muscles in left auricle
doorway from LA to LV
left atrioventricular orifice
mitral valve protects
What is special about the trabeculae carneae in the LV?
finer and more numerous than the RV
Which is thicker and by how much, the RV or the LV?
the LV by two times
aortic vestibule
smooth-walled part that leads to aorta
what is the change in direction for the blood flow from RA to Aorta
180 degrees
what are the two parts of the interventricular septum?
membranour part (superior) muscular part (inferior)
VSD
ventricular septal defect
what percent of congenital heart defects are VSDs?
25%
Do VSDs normally occur in the membranous or muscular portion of the septum?
muscular (spontaneously close)
side note: (membranous are commonly corrected surgically)
what are the cusps of the mitral valve?
anterior cusp
posterior cusp
what are the papillary muscles of the mitral valve?
anterior
posterior
Which valve is the most commonly diseased valve?
mitral valve
nodules form resulting in turbulent flow
prolapse occurs up to 7% of females
erodes endothelial surface and predispose to endocardial infxn
what are two potential results of mitral valve prolapse
predisposition to endocardial infxn
enlargement of the LV
what do the pulmonary and aortic valves have in common
3 cup like cusps that prevent backflow into ventricles during diastoli
how are the semilunar valves formed (3 steps)?
1- early devel. common outflow for both ventricles has 4 cusps (R,L,A,P)
2- division into two vessels (aortic= P,R,L, pulm= A, R,L)
3- partial rotation for final arrangement
sinoatrial node
group of auto depolarizing specialized cardiac muscle cells create rhythm of heart (initiates cardiac muscle contraction and determines heart rate)
where is the SA node located
wall of the RA near opening of SVC
where is the AV node located?
in the interatrial septim superior to the opening of the coronary sinus
AV bundle
passes from the AV node and divides into the right and left bundle branches
what do the left and right bundle branches give rise to?
the purkinje fibers
sympathetic innervation
lateral horn T1-T5
increase HR, impulse conduction, force of contraction, BF to coronary arteries
sym pregang cells
cervical and superior throacic paravertebral ganglia
sym postsyn cells
carried in thoracic splanchnic nerves
contribute to cardiac plexus
SA, AV and coronary arteries
parasym innervation
vagus nerve
decrease HR
decrease force of contraction
constriction of coronary arteries
parasym presyn cells
contribute to cardiac plexus
parasym postgang cells
located in cardiac walls near SA, AV, and coronary arteries
visceral afferent cardiac innervation
follow path of sym backwards
aorticopulmonary (AP) septum
septum separating the aorta and pulmonary trunk
spiral in shape
is the pulmonary trunk anterior or posterior at the base of the AP septum? what about at the top?
anterior (base)
posterior (top)
what are the 3 malformations of the AP septum?
truncus arteriosus
transposition of great arteries (vessels)
tetralogy of fallot (OH FUCK)
truncus arteriosus
no septum formation (shared outflow tract)
1-2% of congenital heart defects
usually seen with a VSD
cyanosis, sign of heart failure
transposition of the great arteries (TGA)
no spiral in septum
RV attaches to aorta
“BLUE BABIES”
arterial switch procedure
remove vessels above valves, switch, reattach and attach coronary arteries to the aorta
tetralogy of fallot (4)
narrow of pulmonary valve
thickening of RV wall
displavement of aorta
VSD
pulmonary stenosis
small valve opening
ductus arteriosus
vascular structure that connects the main pulm artery to the aorta (IN BABES for bypass of lungs)
what does the ductus arteriosus turn into once the baby is born?
ligamentum arteriosum
What nerve runs close to the ligamentum arteriosum?
left recurrent laryngeal nerve= could present as issues with the throat/voice
where are the R/L coronary arteries located?
epicardium
in atrioventricular and interventricular grooves
what do the coronary arteries supply blood to?
epicardium
myocardium
RCA supplies
SA (60%)and AV (80-90%)nodes
RA
RV
posterior 1/3 interventricular septum
when would a person be called right heart dominant?
when the RCA gives off the posterior interventricular
what does the right marginal artery supply?
the RV
does not reach apex
another name for the posterior interventricular
posterior descending
What supplies the AV node with blood?
posterior interventricular
RCA branches
sa node
right marginal
av node
posterior interventricular
LCA branches
circumflex anterior interventricular (LAD)
what are LAD branches that go to the left?
diagonal branches
what are circumflex branches that go to the left?
obtuse branches (left marginal)
what percent of the time does the circumflex supply the AV node? SA node?
AV 10-20%
SA 40%
LCA supplies
LA LV portion of RV interventricular septum anterior 2/3 av node (10-20%) sa node (40%)
codominance
18%, both RCA and LCA give rise to branches that course in or near the post interven groove
right dominant no circumflex
the RCA sends a branch around the aorta and back around the heart in the same pattern at the circumflex
left dominant no RCA
no RCA at all and the left must compensate
common arterial disorders (4)
arteriosclerosis (hardening)
atherosclerosis (fatty build up)
Htn
aneurysms (buldge of vessel)
cardiac infarction and cerebral infarction result from what
occlusion of the blood vessel
atherosclerosis
slow build up of plaque causing restricted blood flow
genetic, high cholesterol, male, old, smoking, Htn
CAD
coronary artery disease caused by atherosclerosis
thrombus
clot that forms on the inside of a vessel
if dislodged can is a emboli
bacteremia
bacteria in the blood
life threatening is called sepsis
myocardial infarction (MI)
occlusion of major artery in heart
tissue becomes necrotic
HEART ATTACK
most veins on the heart empty into
coronary sinus
where do the anterior cardiac veins drain to?
the RA
small cardiac vein runs with what artery
right marginal artery
what does the coronary sinus drain into?
the RA
when do you call the vein the coronary sinus
when the smooth muscle in the vein wall is replaced by cardiac muscle
