Cardiovascular System Flashcards
Exam 1, MGA, Lectures 17 and 19
1
Q
What are the layers of the pericardium?
A
fibrous
serous (parietal and visceral)
2
Q
What are the three layers of the heart?
A
peri(epi)cardium
myocardium
endocardium
3
Q
Where is the pericardial cavity found?
A
between the two layers (parietal and visceral) of the serous pericardium
4
Q
What is a pericardial effusion?
A
When fluids from the pericardial cavity collect in the pericardium
5
Q
What is the clinical effect of a pericardial effusion?
A
cardiac tamponade - excess fluid accumulation that puts pressure on the heart
6
Q
Where is the bare area of the heart?
A
left portion of the sternocostal aspect of the pericardium
7
Q
What is the clinical significance of the bare area of the heart?
A
it is an optimal area for pericardial puncture since there is no parietal pleura
8
Q
What is attached to the superior portion of the fibrous pericardium?
A
great vessels
9
Q
What is attached to the anterior portion of the fibrous pericardium?
A
sternum
10
Q
What is attached to the posterior portion of the fibrous pericardium?
A
posterior mediastinum
11
Q
What is attached to the inferior portion of the fibrous pericardium?
A
diaphragm
12
Q
What are the three great vessels?
A
brachiocephalic trunk
left common carotid artery
left subclavian artery
13
Q
What structure branches off the left pulmonary artery?
A
ligamentum arteriosum
14
Q
What is the embryological origin of the ligamentum arteriosum?
A
ductus arteriosus
15
Q
What is the function of the ductus arteriosus?
A
to allow fetal oxygenated blood to travel from the right side of the heart to the left without going through the lungs
16
Q
What are the three regions of the aorta?
A
ascending
arch
descending
17
Q
What is the posterior most chamber of the heart?
A
left atrium
18
Q
What is the left most chamber of the heart?
A
left ventricle
19
Q
What is the anterior most chamber of the heart?
A
right ventricle
20
Q
What is the right most chamber of the heart?
A
right atrium
21
Q
What structure separates the atria from the ventricles?
A
coronary sulcus
22
Q
What are the two coronary vessels that branch off the aorta?
A
right coronary artery
left coronary artery
23
Q
What are the two branches of the right coronary artery?
A
right marginal artery
posterior interventricular artery
24
Q
What are the two branches of the left coronary artery?
A
circumflex artery
anterior interventricular artery
25
What structure determines whether a heart is right/left/balanced in dominance?
posterior interventricular artery
26
Are most hearts right/left/balanced in dominance?
right
27
What are the three major cardiac veins?
great
middle
small
28
What is the major vessel that all cardiac veins drain into?
coronary sinus
29
What structure is the coronary sinus found in?
coronary sulcus
30
What cardiac vein travels with the marginal artery?
small cardiac vein
31
Which two cardiac veins drain the apex of the heart?
great
| middle
32
Which cardiac vein is found in the anterior interventricular sulcus?
great cardiac vein
33
Which cardiac vein is found in the posterior interventricular sulcus?
middle cardiac vein
34
Is the small cardiac vein on the anterior or posterior side of the heart?
anterior
35
Is the left marginal vein on the anterior or posterior side of the heart?
posterior
36
Is the coronary sinus on the anterior or posterior side of the heart?
posterior
37
What is the transverse sinus of the heart posterior to?
ascending aorta and pulmonary trunk
38
What is the transverse sinus of the heart anterior to?
superior vena cava
39
Where is the oblique sinus?
in a blind recess posterior to the heart
40
What layer of the mesoderm are the paired endothelial strands and angioblastic cords of the heart found in?
splanchnic mesoderm
41
What structures canalize to form the endocardial tube?
angioblastic cords
42
What is mesenchyme?
embryonic connective tissue
43
What is the primitive streak?
linear band of thickened epiblast that first appears at the caudal end of the embryo and grows cranially
44
What is the primordial node?
at the cranial end
| cells from the primitive streak proliferate
45
What does the pericardial coelom give rise to?
pericardial cavity
46
What does the neural groove give rise to?
neural tube
47
What does the dorsal mesocardium give rise to?
the part of the mesoderm that attaches to the heart
48
What is the dorsal mesocardium a result of?
fusing endocardial heart tubes that does not fully close off the pericardial cavity
49
Where is the heart in relation to the foregut?
ventral (to the front)
50
Where is the heart in relation to oropharyngeal membrane?
caudal (towards the tail)
51
What are the two ends of the heart tube called?
truncus arteriosus
| sinus venosus
52
Is the bulbus cordis the bulge on the side of the long heart tube with the truncus arteriosus or sinus venosus?
truncus arteriosus
53
Is the primitive atrium the bulge on the side of the long heart tube with the truncus arteriosus or sinus venosus?
sinus venosus
54
Where is the primitive ventricle located on the long heart tube?
center
55
What are the two endocardial cushions?
ventral
| dorsal
56
What is the function of the endocardial cushions?
separate the left and right atria
57
What is the name of the first septum that grows between the atria towards the endocardial cushions?
septum primum
58
What is the name of the gap below the first septum that grows between the atria towards the endocardial cushions?
foramen primum
59
What happens to the foramen primum once the septum primum fuses with the endocardial cushions?
the foramen primum is sealed
60
What do the perforations in the septum primum lead to?
foramen secundum
61
What are the structural differences between the septum primum and septum secundum?
septum secundum is more firm and rigid than the membranous septum primum
62
How is the septum secundum involved in the formation of the foramen ovale?
septum secundum grows towards the endocardial cushion but never completely closes the gap, leaving the space (foramen ovale)
63
After birth, what does the foramen ovale become?
fossa ovalis
64
What are the two branches of the sinus venosus?
left horn
| right horn
65
What vessel does the root of the left horn of the sinus venosus give rise to?
coronary sinus
66
What happens to all of the veins of the left horn of the sinus venosus?
they degrade and all that is left is one tube that forms the coronary sinus
67
What structure does the root of the right horn of the sinus venosus give rise to?
smooth part of atrium
68
What structure does the veins of the right horn of the sinus venosus give rise to?
superior vena cava
69
What structure does the primitive right atrium give rise to?
right auricle
70
What structure does the primitive left atrium give rise to?
left auricle
71
What does the bulbus cordis give rise to in the right ventricle?
conus arteriosus
72
What does the bulbus cordis give rise to in the left ventricle?
aortic vestibule
73
How do the orientation of the truncal and bulbar ridges contribute to the structure of the vessels and chambers?
they are at 90 degrees to one another so they form a spiral that makes sure the correct vessels make it to the correct ventricle
74
What structure does the early interventricular septum give rise to?
muscular interventricular septum
75
Where is the early interventricular septum located?
at the base of the primitive ventricle
76
What structure does the base of the primitive ventricle give rise to?
muscular interventricular septum
77
What is the interventricular foramen?
the space between the muscular interventricular septum and the fused endocardial cushions
78
What embryological structures give rise to the membranous part of the interventricular septum?
right and left bulbar ridges
| fused endocardial cushions
79
What are the 5 openings to the right atrium?
```
superior vena cava
inferior vena cava
venae chordae minimae
opening of coronary sinus
tricuspid valve
```
80
What is an auricle of the heart?
ear-shaped projection of the atria
81
What are venae chordae minimae?
tiny vein openings into the atrium
82
What is the embryological origin of the superior vena cava?
anastamosis of veins that drain to the right horn of the sinus venosus
83
What is the sinus venarum?
smooth posterior inner wall of the atrium
84
What is the embryological origin of the sinus venarum?
right horn of sinus venosus
85
What are the margins of the fossa ovalis called?
nimbus fossa ovalis
86
What is the crista terminalis?
the ridge between the rough pectinate muscles and the smooth sinus venarum
87
What are pectinate muscles?
rough thin muscles on the anterior atrial wall
88
What is the embryological origin of the fossa ovalis?
foramen ovale
89
What is the embryological origin of the pectinate muscles?
primitive right atrium
90
What happens to blood flow if the fossa ovalis doesn't close?
oxygenated blood goes from the left to right atrium
91
What happens to the right atrium and ventricle if the fossa ovalis doesn't close?
enlarges
92
What happens to the pulmonary trunk if the fossa ovalis doesn't close?
dilates
93
What is the function of the coronary sinus?
to drain blood from the heart
94
What is the embryological origin of the coronary sinus?
left horn of the sinus venosum
95
What is the surgical use of the auricle?
convenient site for surgical access because there is low movement of blood
96
What blood condition is the auricle susceptible to?
blood clots (because of low movement of blood)
97
What is the embryological origin of the right auricle?
primitive right atrium
98
What is the embryological origin of the left atrium?
root of the pulmonary veins
99
What is the embryological origin of the left auricle?
primitive left atrium
100
Which chamber are the pulmonary veins found in?
left atrium
101
How many pulmonary veins are there?
4 (2 on each side - one superior, one inferior)
102
Embryologically, which structure do the root of the pulmonary veins drain into?
primitive left atrium
103
What digestive structure is located just posterior to the left atrium?
esophagus
104
What structure is found at the apex of the conus arteriosus?
pulmonary valve
105
What is the conus arteriosus?
a funnel-shaped, smooth-walled tube leading up to the pulmonary trunk
106
What is the moderator band?
a muscle connecting the septum to the base of the anterior papillary muscle
107
What is trabeculae carnae?
irregular muscle elevations projecting from ventricular walls
108
What is the function of trabeculae carnae?
to allow the ventricle to contract in sync and maximize ejection volume
109
What are the three papillary muscles in the right ventricle?
anterior
posterior
septal
110
What is the function of papillary muscles?
anchor cusps of the valves via chordae tendineae
111
What would happen if chordae tendineae were not there?
the cusps would flip into the atrium
112
What is the difference in trabeculae carnae of the left and right ventricles?
the trabeculae carnae of the left ventricle are finer and more numerous
113
What is the difference in muscle wall of the left and right ventricles?
the left ventricle is thicker
114
What are the cusps of the pulmonary valve?
right semilunar
left semilunar
anterior semilunar
115
What are the cusps of the aortic valve?
right semilunar
left semilunar
posterior semilunar
116
What are the cusps of the mitral valve?
anterior cusp
| posterior cusp
117
What are the cusps of the tricuspid valve?
anterior cusp
posterior cusp
septal cusp
118
What is the ratio of papillary muscles to cusps on an atrioventricular valve?
1:1
119
How many arteries does a normal umbilical cord have?
2 arteries
120
How many veins does a normal umbilical cord have?
1 vein
121
What is the function of the arteries in the umbilical cord?
carry oxygenated blood from the placenta to the fetus
122
What is the function of the veins in the umbilical cord?
carry deoxygenated blood from the fetus to the placenta
123
What is the pathway to carry deoxygenated blood from the fetus to the placenta?
```
enters the right atrium
flows down into right ventricle
bypasses the lungs
flows through the ductus arteriosus
into the descending aorta
connects to the umbilical arteries
blood flows back into the placenta
carbon dioxide and waste products are released into the mother's circulatory system
```
124
What is the pathway to carry oxygenated blood from the placenta to the fetus?
Oxygen and nutrients from the mother's blood are transferred across the placenta
oxygenated blood from mother enters right atrium
flows across to the left atrium through foramen ovale
moves down into left ventricle
pumped into ascending aorta
sent to body
125
What structures does the aortic sac give rise to?
brachiocephalic artery
| arch of the aorta
126
Which vagus nerve is posterior to the aorta?
left vagus
127
Which vagus nerve is anterior to the aorta?
right vagus
128
Which aortic arch do the vagus nerve and recurrent laryngeal nerves branch?
aortic arch 6
129
What do the embryological vitelline veins become?
hepatic veins
| hepatic portal vein
130
What do the embryological cardinal veins become?
superior vena cava
131
Which two embryological cardinal veins become the superior vena cava?
right anterior and right common cardinal veins
132
What are the three areas in which primitive circulation occurs?
yolk sac
chorion
embryo
133
What are the three major pairs of embryological arteries?
vitelline
dorsal aortae
umbilical
134
What is the function of vitelline arteries?
supplies oxygenated blood to yolk sac
135
What is the function of dorsal aortae?
supplies oxygenated blood to embryo
136
What is the function of umbilical arteries?
carries deoxygenated blood from embryo to placenta
137
What are aortic arches?
arteries which join the heart with the dorsal aortae
138
How are the aortic arches developed?
Cranial truncus arteriosus enlarges to become aortic sac
| Pairs of arteries arise from aortic sac to join with dorsal aortae
139
How many pairs of arteries arise from aortic sac to join with dorsal aortae?
6 pairs
140
Which aortic arches degenerate
1
2
5
141
What does the proximal portion of aortic arch 3 become?
common carotid arteries
142
What does the distal portion of aortic arch 3 and the dorsal aorta become?
internal carotid arteries
143
What does the left aortic arch 4 become?
arch of the aorta
144
What does the right aortic arch 4 become?
proximal part of right subclavian artery
145
What does the proximal portion of aortic arch 6 become?
pulmonary arteries
146
What does the distal portion of aortic arch 6 become?
ductus arteriosus
147
What explains the superior location of the right
| recurrent laryngeal nerve?
Degeneration of the distal right 6th arch
148
What are the three pairs of embryological veins?
cardinal
vitelline
umbilical
149
What is the function of the cardinal veins?
drains deoxygenated blood from embryo
150
What is the function of the vitelline veins?
drains deoxygenated blood from yolk sac
151
What is the function of the umbilical veins?
carries oxygenated blood to embryo from placenta
152
What are the three branches of cardinal veins?
anterior
posterior
common
153
What is the function of the anterior branch of the cardinal veins?
drains cranial portion of embryo
154
What is the function of the posterior branch of the cardinal veins?
drains caudal portion of embryo
155
What is the function of the common branch of the cardinal veins?
drains anterior and posterior cardinal veins
156
What does the embryological vitelline give rise to in the area of the duodenum?
anastamosis forms hepatic portal vein
157
What does the embryological vitelline give rise to in the liver?
hepatic veins
| sinusoids
158
What does the embryological right vitelline give rise to?
hepatic inferior vena cava
159
What does the embryological right umbilical vein give rise to?
degenerates
160
What does the embryological left umbilical vein give rise to?
ligamental teres of the liver after birth
161
What is the function of the left umbilical cord?
carry all blood from placenta
162
What is the function of the embryological of ductus venosus?
shunt between umbilical vein and IVC
163
What does the embryological ductus venosus give rise to?
ligamentum venosum
164
After birth, what two events occur?
closing of foramen ovale
| atrophy of ductus arteriosus
165
What is the pathway of most blood that comes into the fetal heart?
```
Blood enters the superior and inferior vena cave
Drains into the right atrium
Foramen ovale
Left atrium
Left ventricle
Aorta
```
166
What is the pathway of some blood that comes into the fetal heart?
```
Blood enters the superior and inferior vena cave
Drains into the right atrium
Right ventricle
Pulmonary trunk
Ductus arteriosus and into aorta (90%)
Pulmonary circulation (10%)
```
167
Where are the nerve fibers in the heart found?
cardiac plexus
168
What types of nerve fibers does the cardiac plexus contain?
both parasympathetic and sympathetic
169
Where are the pre-ganglionic cell bodies of the sympathetic fibers in the cardiac plexus found?
T1-T5 of the intermediolateral cell column
170
Where are the post-ganglionic cell bodies of the sympathetic fibers in the cardiac plexus found?
superior, middle and inferior cervical ganglia
171
What is the function of the sympathetic fibers on the heart?
increase rate and strength of contraction
172
Where are the pre-ganglionic parasympathetic fibers in the cardiac plexus found?
vagus nerve
173
What is the function of the parasympathetic fibers on the heart?
increase rate and strength of contraction
174
Where is the sinoatrial node?
wall of the right atrium
175
Where is the atrioventricular node?
interatrial septum
176
Where is the bundle of His found?
interatrial septum
177
What is the cause of the first heart beat sound (lub)?
Closure of mitral and tricuspid valves
178
What is the cause of the second heart beat sound (dub)?
Closure of aortic and pulmonary semilunar valves
179
What does lub represent?
the beginning of ventricular systole
180
What does dub represent?
the beginning of ventricular diastole
181
What causes an atrial septal defect?
- Asymmetric pressure between right and left
atria (left > right)
- Causes septum primum to press against
septum secundum
- Eventually adhesions cause the two to fuse
182
Atrial septal defects are commonly seen in what syndrome?
Down’s syndrome
183
What is the most common cardiac defect?
Ventricular septal defect (VSD)
184
Is VSD more commonly membranous or muscular?
membranous
185
How does a VSD affect blood flow?
blood flow from left to right (acyanotic)
186
What is the embryological explanation for VSD?
Failure of tissue from endocardial cushions to fuse with aorticopulmonary septum
187
What is the tetralogy of fallot?
- Pulmonary stenosis: obstruction of right ventricle outflow
- Ventricular septal defect
- Aorta overrides VSD
- Right ventricular hypertrophy
188
How does the tetralogy of fallot affect blood flow?
Blood flow is right to left, infant will be cyanotic
189
How does the tetralogy of fallot affect the shape of the heart?
boot shaped appearance, due to right ventricle hypertrophy
190
What is the embryological explanation for tetralogy of fallot ?
Unequal division of the bulbus cordis by aorticopulmonary septum (resulting in a large aorta and small pulmonary trunk)
191
What is Persistent truncus arteriosus?
Single vessel serves both ventricles
192
What is the embryological explanation for Persistent truncus arteriosus?
Failure of truncal and bulbar ridges to develop
1. Hence no division of vessel
2. No membranous interventricular
septum
193
What happens to the aorta in Transposition of the great vessels?
Aorta arises from right ventricle
194
What happens to the pulmonary trunk in Transposition of the great vessels?
Pulmonary trunk arises from left ventricle
195
What happens to the blood flow of the right side of the heart with Transposition of the great vessels?
From system
To right side of the heart
Back to the system
196
What happens to the blood flow of the left side of the heart with Transposition of the great vessels?
From pulmonary vessels
To left side of the heart
Back to pulmonary vessels
197
In order to survive Transposition of the great vessels, an infant must have what?
Patent ductus arteriosus
Open foramen ovale
VSD
198
What is the embryological explanation for Transposition of the great vessels?
Aorticopulmonary septum does not spiral
199
How does the ductus arteriosus turn into the ligamentum arteriosum?
- Aeration of lungs
- Muscle in wall of ductus arteriosus
contracts
- Ductus arteriosus closed
1) Physiologically within few
hours after birth
2) Anatomically at 3 months
200
What causes patent ductus arteriosus?
Failure of muscle to contract
| properly
201
What are the symptoms of patent ductus arteriosus?
1) Machine murmur
2) Hypertrophy of left ventricle
3) No cyanosis
4) Growth retardation
202
What is dextrocardia?
Heart is situated on the right side
203
What is situs inversus?
the arrangement of the internal organs is a mirror image of normal anatomy
204
Is there greater risk of other cardiac abnormalities if dextrocardia occurs with or without situs
inversus?
without
205
What is coarctation of the aorta?
constriction of the aorta, distal to the origin of the left subclavian artery
206
Where does most coarctation of the aorta occur?
entrance of ductus arteriosus
207
What is the embryological explanation for coarctation of the aorta?
presence of ductus arteriosus tissue in the region of the arch of the aorta
208
What are the symptoms of coarctation of the aorta?
High blood pressure in the upper extremities, low blood pressure
in the lower extremities.
209
What is angina pectoris due to?
progressive
| occlusion of coronary arteries by arteriosclerosis
210
What are some of the sex differences for coronary artery disease?
o males and females may experience different symptoms during a heart attack
o lower prevalence of obstructive CAD in females with angina, more likely to have abnormalities of coronary endothelial function
o sex specific effects of drugs for heart disease
