Chapter 2: Thorax (continued 3) Flashcards
What are the 3 layers of the pericardium?
- the outer fibrous layer
- a double layered parietal and visceral serous layer
What is the transverse pericardial sinus?
a space posterior to the ascending aorta and pulmonary trunk and anterior to the superior vena cava and pulmonary veins
separates the great arteries from the great veins
What is the oblique pericardial sinus?
is the blind, inverted, U-shaped space posterior to the heart and bounded by reflection of serous pericardium around the 4 pulmonary veins and inferior vena cava as they enter the heart?
What is cardiac tamponade?
the pathological accumulation of fluids serous or blood within the pericardial cavity.
How is pericardiocentesis performed?
with a needle at the left infrasternal angle through the cardiac notch of the left lung
The right border of the heart mainly is formed by which part of the heart?
right atrium
The left border of the heart is mainly formed by which part of the heart?
The left ventricle
The apex of the heart is mainly formed by which heart structure?
the left ventricle
The anterior (sternocostal) surface of the heart is mostly formed by which structure?
the right ventricle
The posterior surface of the heart is mostly formed by which structure?
left ventricle
What are the 3 main sulci of the heart?
coronary
anterior interventricular
posterior interventricular
The upper right aspect of the heart is deep to which costal cartilage?
3rd right costal cartilage
The lower right aspect of the heart is deep to which costal cartilage?
6th right costal cartilage
The upper left aspect of the heart is deep to which costal cartilage?
the left second costal cartilage
The apex of the heart is in which intercostal space?
left fifth intercostal space at the midclavicular line
The right border of the heart lies between which structures of the rib cage?
the third right costal cartilage to the sixth right costal cartilage just to the right of the sternum
The left border of the heart extends between which parts of the rib cage?
between the fifth left intercostal space to the second left costal cartilage
The inferior border of the heart extends between what structures of the rib cage?
between the sixth right costal cartilage to the fifth left intercostal space at the midclavicular line
The superior border of the heart extends to between which structures of the rib cage?
the inferior margin of the second left costal cartilage to the superior margin of the third right costal cartilage
Describe the auricle of the heart ?
part of the right atrium that includes rough myocardium known as pectinate muscles
Describe the sinus venarum.
the smooth-walled portion of the atrium which receives blood from the superior and inferior venae cavae. Derived from sinus venosus
What is the crista terminalis?
the vertical ridge that separates the smooth from the rough portion (pectinate muscles) of the right atrium
Which valve is on the left side of the heart separating the atria from the ventricles?
the mitral or bicuspid valve
What are the ridges of myocardium in the ventricular wall?
trabeculae carneae
This structure projects into the cavity of the ventricle and attaches cusps of the AV valve by the strands of the chordae tendineae?
papillary muscle
What is the function of the chordae tendineae?
fibrous cords between the papillary muscles and the valve leaflets that control closure of the valve during contraction of the ventricle
What is infundibulum?
the smooth area of the right ventricle leading to the pulmonary valve
What is another name for septomarginal trabecula?
moderator band
What is the septomarginal trabeculae?
band of cardiac muscle between interventricular septum and anterior papillary muscle
The first heart sound occurs at the closure of which valves?
at the closure of the atrioventricular valves at the beginning of systole
The second heart sound occurs at the closure of what occurrence of the heart?
at the closure of aortic and pulmonary semilunar valves
Which valves are more commonly involved in valvular disease?
aortic and mitral
T/F. A heart murmur is heard downstream from the valve. Thus stenosis is retrograde and insufficiency is orthograde.
false; stenosis is orthograde and insufficiency is retrograde
What type of valvular dysfunction is heard in the right upper sternum?
systolic:
aortic stenosis
What types of valvular dysfunction is heard in the right lower sternum?
systolic:
tricuspid insufficiency
What type of murmur is heard in the upper left lateral chest wall?
systolic:
mitral insufficiency
What type of murmur is heard at the apex of the heart?
diastolic:
mitral stenosis
aortic insufficiency
In MI which artery is obstructed in 50% of cases?
anterior descending artery
In MI which artery is obstructed 30% of the time?
the right coronary
Which artery is obstructed in 20% of cases of MI?
circumflex artery
What are the main branches of the right coronary artery?
SA nodal artery
AV nodal artery
posterior interventricular artery
What is the 1st branch of the right coronary artery?
SA nodal artery
Which part of the right coronary artery would the AV nodal artery be found?
arises from the distal end of the right coronary artery as it forms the posterior interventricular artery
Which sulcus does the posterior interventricular artery lie??
lies in the posterior interventricular sulcus
What are the 2 branches of the left coronary artery?
anterior interventricular or left anterior descending artery and circumflex artery
What is the most common site of coronary occlusion?
LAD
Which sulcus does the coronary sinus lie?
posterior coronary sulcus
Where does the coronary sinus drain?
to an opening in the right atrium
What is the main tributary of the coronary sinus?
the great cardiac vein
Which artery supplies the SA node?
right coronary artery
Which artery supplies the AV node?
right coronary artery
The bundle of His is supplied by what artery?
the LAD
Nerves that sense pain associated with coronary artery ischemia (angina) follow the sympathetic pathways back into which spinal cord segments?
T1-T5
What is the cause of herniation of abdominal contents into the pleural cavity in congenital diaphragmatic hernia?
failure of the pleuroperitoneal membranes to develop properly
What is an esophageal hiatal hernia?
a herniation of the stomach into the pleural cavity due to an abnormally large esophageal hiatus to the diaphragm
What phase of the heart cycle would you hear A-V valve insufficiency?
systolic murmur
What phase of the heart cycle would you hear A-V valve stenosis
diastole
What phase of the heart cycle would you hear pulmonic and aortic valve stenosis?
systolic murmur
What phase of the heart cycle would you hear pulmonic and aortic valve regurgitation?
diastolic murmur
What part of the heart does the right marginal artery supply?
supplies right ventricle
Which parts of the heart does the posterior descending artery PDA aka posterior interventricular artery supply?
- AV node
- posterior 1/3 of interventricular septum
- posterior 2/3 of walls of ventricles
- posteriomedial papillary muscle
Which parts of the heart does the LAD supply?
- anterior 2/3 of interventricular septum
- anterolateral papillary muscle
- anterior surface of left ventricle
What area of the heart does the left circumflex artery supply?
- supplies lateral and posterior walls of the left ventricle
- anterolateral papillary muscle