Circulation, chambers, conducting system Flashcards

1
Q

What are the 3 cusps of the aortic valve?

A
  1. anterior
  2. left posterior
  3. right posterior - non-coronary artery associated cusp
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2
Q

What are the branches of the Right Coronary ARtery

A
  • synoatrial 60%
  • marginal
  • avinode
  • Posterior Interventricular (descending artery) (85%)
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3
Q

What are the branches of the left coronary artery

A
  • circumflex
  • anterior interventricular branch
  • sinoatrial node (40%)
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4
Q

Do the arteries anastomose?

A

No. only at the capillary level, but not sufficient to supply the heart if a major artery is blocked.

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5
Q

Which artery maintains the electrical signal to the heart?

A

the Right coronary artery

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6
Q

The coronary sinus opens into what part of the heart?

A

the right atrium

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7
Q

What are the tributaries to the coronary sinus?

A

the great cardiac vein, the middle cardiac vein, and the small cardiac vein

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8
Q

Where do the small veins of the heart drain?

A

They drain where they are- so yes sometimes unoxegenated blood is flowing into the left side of the heart, but it’s miniscule in comparison to the remainder of the blood coming from the pulmonary veins, so it’s insignificant

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9
Q

What are the veins of the heart?

A

oblique cardiac vein

great cardiac vein

coronary sinus

anterior cardiac vein

middle cardiac vein

small cardiac vein

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10
Q

what is the thickest walled chamber?

A

The Left Ventricle

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11
Q

Why do valves open and close?

A

Valves open due to the increased pressure on one side of the cusp

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12
Q

What is the texture of the anterior wall of the right atrium? How about the posterior wall?

A

anterior wall = rough - pectinate muscles

posterior wall = smooth- sinus venosus

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13
Q

what separates the rough anterior surface of the right atrium from the smooth posterior surface of the right atrium?

A

the “Crista Terminalis”

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14
Q

What valve sits between the right atrium and the right ventricle?

A

Tricuspid valve

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15
Q

What is the “fossa ovalis”?

A

embryological foramen ovale - which sits in the right atrium and allowed blood to move from the right atrium to the left atrium

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16
Q

What is it called when the fossa ovalis fails to close during development?

A

Atrial Septal Defect

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17
Q

What are the ridges called in the ventricles?

A

Trabeculations (latin for slab)

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18
Q

What muscles make up part of the wall of the ventricle?

A

papillary muscles - connected to atrioventricular valves by chordae tendineae

19
Q

What is the purpose of Chordae Tendineae?

A

“heart strings” they prevent the valves from opening backwards under systolic pressure - note that these cords do NOT pull the valve shut, they passively restrict their motion

20
Q

What are the three cusps of the tricuspid valve?

A

anterior

septal

posterior

21
Q

What are the two atrioventricular valves?

A

Tricuspid and mitral (bicuspid) valves

22
Q

What are the two semilunar valves?

A

pulmonary and aortic valves- they are located between the ventricles and their corresponding arteries

23
Q

What are the two cusps of the bicuspid/Mitral valve?

A

anterior and posterior cusps

24
Q

The atrioventricular valves close at the start of what type of contraction?

A

systole contraction or ventricular contraction

25
Q

during what action do the semilunar valves close?

A

They close at the beginning of ventricular relaxation (diastole)

26
Q

What are the three cusps of the pulmonary valve?

A

two anterior and one posterior

27
Q

what are the cusps of the aortic valve?

A

one anterior and two posterior (one of which is non-coronary)

28
Q

what is aortic stenosis?

A

Aortic stenosis refers to narrowing of the aortic valve, restricting the flow of blood leaving the heart. The main three causes are:

Age-related calcification

Congenital defects

Most commonly a bicuspid aortic valve, which predisposes the valve to calcification later in life.

Rheumatic fever

29
Q

which heart section is most posterior?

A

The left Atrium

30
Q

an enlarged left atrium can effect what other structure?

A

it can interfere with the esophagus- so you can diagnose an enlarged left atrium with a barium swallow

31
Q

What are trabeculae Carneae?

A

part of the right/left ventricle, they give the chamber a sponge like appearance

they consist of ridges, bridges and pillars (papillary muscle)

32
Q

Are the Atria and ventricles separated?

A

yes, by fibrous tissue

33
Q

Describe the conduction of electrical signals through the heart

A

sinoatrial node starts the signal - contracts the atrium,

then the atrioventricular node (which has been delayed to allow for atrial contraction) causes the ventricles to contract

34
Q

what is the single most useful way to determine normal functioning of the heart?

A

Take a damn pulse for goodness sake

35
Q

what are the parts of the conduction system?

A
  • sinoatrial node
  • atrioventricular node
  • bundle of His (right and left branches)
  • purkinje fibres
    *
36
Q

the only electrical path from the atria to the ventricles is via what structure?

A

the bundle of His

37
Q

how long does the atrioventricular node delay the electrical signal?

A

0.12-0.2 seconds to allow the atria to contract before the ventricles

38
Q

What are the borders of the heart on surface anatomy?

A

remember 3,6 - 2,5

3rd CC

6th CC

2nd CC

5th ICS

39
Q

What is the definition of the apex

A

the lowest most lateral point on the chest wall where you can feel the heart beating-

Normally in the 5th intercostal space in midclavicular line

40
Q

What are the surface anatomy positions of the valves?

A

pulmonary = 3rd CC

aoritc = 3rd ICS

Mitral = 4th CC

Tricuspid = 4th ICS

41
Q

Where can you listen to the valves of the heart?

A

Pulmonary = 2nd ICS left of sternum

Aortic = 2nd ICS right of sternum

Mitral = 5th left ICS MCL

Tricuspid = 5th ICS Left of sternum

42
Q

What size should the heart not surpass normally?

A

It shouldn’t be any larger than 1/2 of the diameter of the chest

43
Q

What is Stenosis?

A

narrowing of the valve

44
Q

What is ‘regurgitation’ related to valves?

A

regurgitation= problem with valve closing - furthermore leaking blood into the heart