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Exam 1 > Cardiovascular System > Flashcards

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)

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2
Q

What are the three layers of the heart?

A

peri(epi)cardium
myocardium
endocardium

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3
Q

Where is the pericardial cavity found?

A

between the two layers (parietal and visceral) of the serous pericardium

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4
Q

What is a pericardial effusion?

A

When fluids from the pericardial cavity collect in the pericardium

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5
Q

What is the clinical effect of a pericardial effusion?

A

cardiac tamponade - excess fluid accumulation that puts pressure on the heart

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6
Q

Where is the bare area of the heart?

A

left portion of the sternocostal aspect of the pericardium

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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

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8
Q

What is attached to the superior portion of the fibrous pericardium?

A

great vessels

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9
Q

What is attached to the anterior portion of the fibrous pericardium?

A

sternum

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10
Q

What is attached to the posterior portion of the fibrous pericardium?

A

posterior mediastinum

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11
Q

What is attached to the inferior portion of the fibrous pericardium?

A

diaphragm

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12
Q

What are the three great vessels?

A

brachiocephalic trunk
left common carotid artery
left subclavian artery

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13
Q

What structure branches off the left pulmonary artery?

A

ligamentum arteriosum

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14
Q

What is the embryological origin of the ligamentum arteriosum?

A

ductus arteriosus

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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

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16
Q

What are the three regions of the aorta?

A

ascending
arch
descending

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17
Q

What is the posterior most chamber of the heart?

A

left atrium

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18
Q

What is the left most chamber of the heart?

A

left ventricle

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19
Q

What is the anterior most chamber of the heart?

A

right ventricle

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20
Q

What is the right most chamber of the heart?

A

right atrium

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21
Q

What structure separates the atria from the ventricles?

A

coronary sulcus

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22
Q

What are the two coronary vessels that branch off the aorta?

A

right coronary artery

left coronary artery

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23
Q

What are the two branches of the right coronary artery?

A

right marginal artery

posterior interventricular artery

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24
Q

What are the two branches of the left coronary artery?

A

circumflex artery

anterior interventricular artery

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25
Q

What structure determines whether a heart is right/left/balanced in dominance?

A

posterior interventricular artery

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26
Q

Are most hearts right/left/balanced in dominance?

A

right

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27
Q

What are the three major cardiac veins?

A

great
middle
small

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28
Q

What is the major vessel that all cardiac veins drain into?

A

coronary sinus

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29
Q

What structure is the coronary sinus found in?

A

coronary sulcus

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30
Q

What cardiac vein travels with the marginal artery?

A

small cardiac vein

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31
Q

Which two cardiac veins drain the apex of the heart?

A

great

middle

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32
Q

Which cardiac vein is found in the anterior interventricular sulcus?

A

great cardiac vein

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33
Q

Which cardiac vein is found in the posterior interventricular sulcus?

A

middle cardiac vein

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34
Q

Is the small cardiac vein on the anterior or posterior side of the heart?

A

anterior

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35
Q

Is the left marginal vein on the anterior or posterior side of the heart?

A

posterior

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36
Q

Is the coronary sinus on the anterior or posterior side of the heart?

A

posterior

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37
Q

What is the transverse sinus of the heart posterior to?

A

ascending aorta and pulmonary trunk

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38
Q

What is the transverse sinus of the heart anterior to?

A

superior vena cava

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39
Q

Where is the oblique sinus?

A

in a blind recess posterior to the heart

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40
Q

What layer of the mesoderm are the paired endothelial strands and angioblastic cords of the heart found in?

A

splanchnic mesoderm

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41
Q

What structures canalize to form the endocardial tube?

A

angioblastic cords

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42
Q

What is mesenchyme?

A

embryonic connective tissue

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43
Q

What is the primitive streak?

A

linear band of thickened epiblast that first appears at the caudal end of the embryo and grows cranially

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44
Q

What is the primordial node?

A

at the cranial end

cells from the primitive streak proliferate

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45
Q

What does the pericardial coelom give rise to?

A

pericardial cavity

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46
Q

What does the neural groove give rise to?

A

neural tube

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47
Q

What does the dorsal mesocardium give rise to?

A

the part of the mesoderm that attaches to the heart

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48
Q

What is the dorsal mesocardium a result of?

A

fusing endocardial heart tubes that does not fully close off the pericardial cavity

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49
Q

Where is the heart in relation to the foregut?

A

ventral (to the front)

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50
Q

Where is the heart in relation to oropharyngeal membrane?

A

caudal (towards the tail)

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51
Q

What are the two ends of the heart tube called?

A

truncus arteriosus

sinus venosus

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52
Q

Is the bulbus cordis the bulge on the side of the long heart tube with the truncus arteriosus or sinus venosus?

A

truncus arteriosus

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53
Q

Is the primitive atrium the bulge on the side of the long heart tube with the truncus arteriosus or sinus venosus?

A

sinus venosus

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54
Q

Where is the primitive ventricle located on the long heart tube?

A

center

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55
Q

What are the two endocardial cushions?

A

ventral

dorsal

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56
Q

What is the function of the endocardial cushions?

A

separate the left and right atria

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57
Q

What is the name of the first septum that grows between the atria towards the endocardial cushions?

A

septum primum

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58
Q

What is the name of the gap below the first septum that grows between the atria towards the endocardial cushions?

A

foramen primum

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59
Q

What happens to the foramen primum once the septum primum fuses with the endocardial cushions?

A

the foramen primum is sealed

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60
Q

What do the perforations in the septum primum lead to?

A

foramen secundum

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61
Q

What are the structural differences between the septum primum and septum secundum?

A

septum secundum is more firm and rigid than the membranous septum primum

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62
Q

How is the septum secundum involved in the formation of the foramen ovale?

A

septum secundum grows towards the endocardial cushion but never completely closes the gap, leaving the space (foramen ovale)

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63
Q

After birth, what does the foramen ovale become?

A

fossa ovalis

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64
Q

What are the two branches of the sinus venosus?

A

left horn

right horn

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65
Q

What vessel does the root of the left horn of the sinus venosus give rise to?

A

coronary sinus

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66
Q

What happens to all of the veins of the left horn of the sinus venosus?

A

they degrade and all that is left is one tube that forms the coronary sinus

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67
Q

What structure does the root of the right horn of the sinus venosus give rise to?

A

smooth part of atrium

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68
Q

What structure does the veins of the right horn of the sinus venosus give rise to?

A

superior vena cava

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69
Q

What structure does the primitive right atrium give rise to?

A

right auricle

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70
Q

What structure does the primitive left atrium give rise to?

A

left auricle

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71
Q

What does the bulbus cordis give rise to in the right ventricle?

A

conus arteriosus

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72
Q

What does the bulbus cordis give rise to in the left ventricle?

A

aortic vestibule

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73
Q

How do the orientation of the truncal and bulbar ridges contribute to the structure of the vessels and chambers?

A

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

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74
Q

What structure does the early interventricular septum give rise to?

A

muscular interventricular septum

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75
Q

Where is the early interventricular septum located?

A

at the base of the primitive ventricle

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76
Q

What structure does the base of the primitive ventricle give rise to?

A

muscular interventricular septum

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77
Q

What is the interventricular foramen?

A

the space between the muscular interventricular septum and the fused endocardial cushions

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78
Q

What embryological structures give rise to the membranous part of the interventricular septum?

A

right and left bulbar ridges

fused endocardial cushions

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79
Q

What are the 5 openings to the right atrium?

A 
superior vena cava
inferior vena cava
venae chordae minimae
opening of coronary sinus
tricuspid valve
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80
Q

What is an auricle of the heart?

A

ear-shaped projection of the atria

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81
Q

What are venae chordae minimae?

A

tiny vein openings into the atrium

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82
Q

What is the embryological origin of the superior vena cava?

A

anastamosis of veins that drain to the right horn of the sinus venosus

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83
Q

What is the sinus venarum?

A

smooth posterior inner wall of the atrium

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84
Q

What is the embryological origin of the sinus venarum?

A

right horn of sinus venosus

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85
Q

What are the margins of the fossa ovalis called?

A

nimbus fossa ovalis

86
Q

What is the crista terminalis?

A

the ridge between the rough pectinate muscles and the smooth sinus venarum

87
Q

What are pectinate muscles?

A

rough thin muscles on the anterior atrial wall

88
Q

What is the embryological origin of the fossa ovalis?

A

foramen ovale

89
Q

What is the embryological origin of the pectinate muscles?

A

primitive right atrium

90
Q

What happens to blood flow if the fossa ovalis doesn’t close?

A

oxygenated blood goes from the left to right atrium

91
Q

What happens to the right atrium and ventricle if the fossa ovalis doesn’t close?

A

enlarges

92
Q

What happens to the pulmonary trunk if the fossa ovalis doesn’t close?

A

dilates

93
Q

What is the function of the coronary sinus?

A

to drain blood from the heart

94
Q

What is the embryological origin of the coronary sinus?

A

left horn of the sinus venosum

95
Q

What is the surgical use of the auricle?

A

convenient site for surgical access because there is low movement of blood

96
Q

What blood condition is the auricle susceptible to?

A

blood clots (because of low movement of blood)

97
Q

What is the embryological origin of the right auricle?

A

primitive right atrium

98
Q

What is the embryological origin of the left atrium?

A

root of the pulmonary veins

99
Q

What is the embryological origin of the left auricle?

A

primitive left atrium

100
Q

Which chamber are the pulmonary veins found in?

A

left atrium

101
Q

How many pulmonary veins are there?

A

4 (2 on each side - one superior, one inferior)

102
Q

Embryologically, which structure do the root of the pulmonary veins drain into?

A

primitive left atrium

103
Q

What digestive structure is located just posterior to the left atrium?

A

esophagus

104
Q

What structure is found at the apex of the conus arteriosus?

A

pulmonary valve

105
Q

What is the conus arteriosus?

A

a funnel-shaped, smooth-walled tube leading up to the pulmonary trunk

106
Q

What is the moderator band?

A

a muscle connecting the septum to the base of the anterior papillary muscle

107
Q

What is trabeculae carnae?

A

irregular muscle elevations projecting from ventricular walls

108
Q

What is the function of trabeculae carnae?

A

to allow the ventricle to contract in sync and maximize ejection volume

109
Q

What are the three papillary muscles in the right ventricle?

A

anterior
posterior
septal

110
Q

What is the function of papillary muscles?

A

anchor cusps of the valves via chordae tendineae

111
Q

What would happen if chordae tendineae were not there?

A

the cusps would flip into the atrium

112
Q

What is the difference in trabeculae carnae of the left and right ventricles?

A

the trabeculae carnae of the left ventricle are finer and more numerous

113
Q

What is the difference in muscle wall of the left and right ventricles?

A

the left ventricle is thicker

114
Q

What are the cusps of the pulmonary valve?

A

right semilunar
left semilunar
anterior semilunar

115
Q

What are the cusps of the aortic valve?

A

right semilunar
left semilunar
posterior semilunar

116
Q

What are the cusps of the mitral valve?

A

anterior cusp

posterior cusp

117
Q

What are the cusps of the tricuspid valve?

A

anterior cusp
posterior cusp
septal cusp

118
Q

What is the ratio of papillary muscles to cusps on an atrioventricular valve?

A

1:1

119
Q

How many arteries does a normal umbilical cord have?

A

2 arteries

120
Q

How many veins does a normal umbilical cord have?

A

1 vein

121
Q

What is the function of the arteries in the umbilical cord?

A

carry oxygenated blood from the placenta to the fetus

122
Q

What is the function of the veins in the umbilical cord?

A

carry deoxygenated blood from the fetus to the placenta

123
Q

What is the pathway to carry deoxygenated blood from the fetus to the placenta?

A 
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
Q

What is the pathway to carry oxygenated blood from the placenta to the fetus?

A

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
Q

What structures does the aortic sac give rise to?

A

brachiocephalic artery

arch of the aorta

126
Q

Which vagus nerve is posterior to the aorta?

A

left vagus

127
Q

Which vagus nerve is anterior to the aorta?

A

right vagus

128
Q

Which aortic arch do the vagus nerve and recurrent laryngeal nerves branch?

A

aortic arch 6

129
Q

What do the embryological vitelline veins become?

A

hepatic veins

hepatic portal vein

130
Q

What do the embryological cardinal veins become?

A

superior vena cava

131
Q

Which two embryological cardinal veins become the superior vena cava?

A

right anterior and right common cardinal veins

132
Q

What are the three areas in which primitive circulation occurs?

A

yolk sac
chorion
embryo

133
Q

What are the three major pairs of embryological arteries?

A

vitelline
dorsal aortae
umbilical

134
Q

What is the function of vitelline arteries?

A

supplies oxygenated blood to yolk sac

135
Q

What is the function of dorsal aortae?

A

supplies oxygenated blood to embryo

136
Q

What is the function of umbilical arteries?

A

carries deoxygenated blood from embryo to placenta

137
Q

What are aortic arches?

A

arteries which join the heart with the dorsal aortae

138
Q

How are the aortic arches developed?

A

Cranial truncus arteriosus enlarges to become aortic sac

Pairs of arteries arise from aortic sac to join with dorsal aortae

139
Q

How many pairs of arteries arise from aortic sac to join with dorsal aortae?

A

6 pairs

140
Q

Which aortic arches degenerate

A

1
2
5

141
Q

What does the proximal portion of aortic arch 3 become?

A

common carotid arteries

142
Q

What does the distal portion of aortic arch 3 and the dorsal aorta become?

A

internal carotid arteries

143
Q

What does the left aortic arch 4 become?

A

arch of the aorta

144
Q

What does the right aortic arch 4 become?

A

proximal part of right subclavian artery

145
Q

What does the proximal portion of aortic arch 6 become?

A

pulmonary arteries

146
Q

What does the distal portion of aortic arch 6 become?

A

ductus arteriosus

147
Q

What explains the superior location of the right

recurrent laryngeal nerve?

A

Degeneration of the distal right 6th arch

148
Q

What are the three pairs of embryological veins?

A

cardinal
vitelline
umbilical

149
Q

What is the function of the cardinal veins?

A

drains deoxygenated blood from embryo

150
Q

What is the function of the vitelline veins?

A

drains deoxygenated blood from yolk sac

151
Q

What is the function of the umbilical veins?

A

carries oxygenated blood to embryo from placenta

152
Q

What are the three branches of cardinal veins?

A

anterior
posterior
common

153
Q

What is the function of the anterior branch of the cardinal veins?

A

drains cranial portion of embryo

154
Q

What is the function of the posterior branch of the cardinal veins?

A

drains caudal portion of embryo

155
Q

What is the function of the common branch of the cardinal veins?

A

drains anterior and posterior cardinal veins

156
Q

What does the embryological vitelline give rise to in the area of the duodenum?

A

anastamosis forms hepatic portal vein

157
Q

What does the embryological vitelline give rise to in the liver?

A

hepatic veins

sinusoids

158
Q

What does the embryological right vitelline give rise to?

A

hepatic inferior vena cava

159
Q

What does the embryological right umbilical vein give rise to?

A

degenerates

160
Q

What does the embryological left umbilical vein give rise to?

A

ligamental teres of the liver after birth

161
Q

What is the function of the left umbilical cord?

A

carry all blood from placenta

162
Q

What is the function of the embryological of ductus venosus?

A

shunt between umbilical vein and IVC

163
Q

What does the embryological ductus venosus give rise to?

A

ligamentum venosum

164
Q

After birth, what two events occur?

A

closing of foramen ovale

atrophy of ductus arteriosus

165
Q

What is the pathway of most blood that comes into the fetal heart?

A 
Blood enters the superior and inferior vena cave
Drains into the right atrium
Foramen ovale
Left atrium
Left ventricle
Aorta
166
Q

What is the pathway of some blood that comes into the fetal heart?

A 
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
Q

Where are the nerve fibers in the heart found?

A

cardiac plexus

168
Q

What types of nerve fibers does the cardiac plexus contain?

A

both parasympathetic and sympathetic

169
Q

Where are the pre-ganglionic cell bodies of the sympathetic fibers in the cardiac plexus found?

A

T1-T5 of the intermediolateral cell column

170
Q

Where are the post-ganglionic cell bodies of the sympathetic fibers in the cardiac plexus found?

A

superior, middle and inferior cervical ganglia

171
Q

What is the function of the sympathetic fibers on the heart?

A

increase rate and strength of contraction

172
Q

Where are the pre-ganglionic parasympathetic fibers in the cardiac plexus found?

A

vagus nerve

173
Q

What is the function of the parasympathetic fibers on the heart?

A

increase rate and strength of contraction

174
Q

Where is the sinoatrial node?

A

wall of the right atrium

175
Q

Where is the atrioventricular node?

A

interatrial septum

176
Q

Where is the bundle of His found?

A

interatrial septum

177
Q

What is the cause of the first heart beat sound (lub)?

A

Closure of mitral and tricuspid valves

178
Q

What is the cause of the second heart beat sound (dub)?

A

Closure of aortic and pulmonary semilunar valves

179
Q

What does lub represent?

A

the beginning of ventricular systole

180
Q

What does dub represent?

A

the beginning of ventricular diastole

181
Q

What causes an atrial septal defect?

A
  • 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
Q

Atrial septal defects are commonly seen in what syndrome?

A

Down’s syndrome

183
Q

What is the most common cardiac defect?

A

Ventricular septal defect (VSD)

184
Q

Is VSD more commonly membranous or muscular?

A

membranous

185
Q

How does a VSD affect blood flow?

A

blood flow from left to right (acyanotic)

186
Q

What is the embryological explanation for VSD?

A

Failure of tissue from endocardial cushions to fuse with aorticopulmonary septum

187
Q

What is the tetralogy of fallot?

A
  • Pulmonary stenosis: obstruction of right ventricle outflow
  • Ventricular septal defect
  • Aorta overrides VSD
  • Right ventricular hypertrophy
188
Q

How does the tetralogy of fallot affect blood flow?

A

Blood flow is right to left, infant will be cyanotic

189
Q

How does the tetralogy of fallot affect the shape of the heart?

A

boot shaped appearance, due to right ventricle hypertrophy

190
Q

What is the embryological explanation for tetralogy of fallot ?

A

Unequal division of the bulbus cordis by aorticopulmonary septum (resulting in a large aorta and small pulmonary trunk)

191
Q

What is Persistent truncus arteriosus?

A

Single vessel serves both ventricles

192
Q

What is the embryological explanation for Persistent truncus arteriosus?

A

Failure of truncal and bulbar ridges to develop
1. Hence no division of vessel
2. No membranous interventricular
septum

193
Q

What happens to the aorta in Transposition of the great vessels?

A

Aorta arises from right ventricle

194
Q

What happens to the pulmonary trunk in Transposition of the great vessels?

A

Pulmonary trunk arises from left ventricle

195
Q

What happens to the blood flow of the right side of the heart with Transposition of the great vessels?

A

From system
To right side of the heart
Back to the system

196
Q

What happens to the blood flow of the left side of the heart with Transposition of the great vessels?

A

From pulmonary vessels
To left side of the heart
Back to pulmonary vessels

197
Q

In order to survive Transposition of the great vessels, an infant must have what?

A

Patent ductus arteriosus
Open foramen ovale
VSD

198
Q

What is the embryological explanation for Transposition of the great vessels?

A

Aorticopulmonary septum does not spiral

199
Q

How does the ductus arteriosus turn into the ligamentum arteriosum?

A
  • 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
Q

What causes patent ductus arteriosus?

A

Failure of muscle to contract

properly

201
Q

What are the symptoms of patent ductus arteriosus?

A

1) Machine murmur
2) Hypertrophy of left ventricle
3) No cyanosis
4) Growth retardation

202
Q

What is dextrocardia?

A

Heart is situated on the right side

203
Q

What is situs inversus?

A

the arrangement of the internal organs is a mirror image of normal anatomy

204
Q

Is there greater risk of other cardiac abnormalities if dextrocardia occurs with or without situs
inversus?

A

without

205
Q

What is coarctation of the aorta?

A

constriction of the aorta, distal to the origin of the left subclavian artery

206
Q

Where does most coarctation of the aorta occur?

A

entrance of ductus arteriosus

207
Q

What is the embryological explanation for coarctation of the aorta?

A

presence of ductus arteriosus tissue in the region of the arch of the aorta

208
Q

What are the symptoms of coarctation of the aorta?

A

High blood pressure in the upper extremities, low blood pressure
in the lower extremities.

209
Q

What is angina pectoris due to?

A

progressive

occlusion of coronary arteries by arteriosclerosis

210
Q

What are some of the sex differences for coronary artery disease?

A

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

Exam 1 (8 decks)

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