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Anatomical Sciences > Clinical Anatomy of the Heart > Flashcards

Clinical Anatomy of the Heart Flashcards

1
Q

Where is the heart located?

How is it held in place?

A

The heart is located in the thoracic cavity in the mediastinum.
It is anchored in the mediastinum by the pericardium.

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2
Q

What is the pericardium?

Describe its layers.

A

The pericardium is a double layered sac that protects the heart and major blood vessels.
Fibrous pericardium is the outermost layer. Inside of this is the serous pericardium which can be sub-divided into parietal and visceral pericardium. Between the layers of the serous pericardium is the pericardial cavity which contains pericardial fluid.

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3
Q

Describe the gross anatomy of the heart.

A

The heart is a double, self-adjusting pressure pump.
It contains two atria and two ventricles.
It is anatomically inverted as the bottom of the heart as we look at it is referred to as the apex.

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4
Q

Describe the layers of the heart.

A

Endocardium - Innermost layer
Myocardium - Middle layer containing contractile tissue
Epicardium - Outermost layer, in contact with the visceral layer of the serous pericardium

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5
Q

What are the auricles?

What do they do?

A

Auricles are present on both atria (latin for dogs ear).

They increase the capacity if the atria.

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6
Q

What are the sulci?
What do they represent?
What is the purpose of the coronary sulcus and the anterior interventricular sulcus?

A

Grooves on the surface of the heart that contain variable amounts of fat.
Each sulcus marks the external boundary between two chambers of the heart.
Coronary sulcus - Divides the right atrium and right ventricle.
Anterior interventricular sulcus - Boundary between right and left ventricles.

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7
Q

What are the divisions of the left coronary artery?

A

Circumflex branch - Oxygenated blood to the left atrium and ventricle.
Anterior-interventricular branch.

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8
Q

What are the divisions of the right coronary artery?

A

Marginal branch and the Posterior-interventricular branch both take oxygenated blood to the right ventricle and feed the myocardium on both sides.

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9
Q

Describe the coronary veins.

A

Greater cardiac venous system: Coronary sinus and its tributaries, anterior cardiac veins, atrial veins and veins of the ventricular septum.
The besian vessels: Arteioluminal vessels and venoluminal vessels.

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10
Q

What supplies nerves to the heart?

Which nerves innervate the heart from the parasympathetic and sympathetic nervous systems respectively?

A

The superficial cardiac plexus and the deep cardiac plexus supply nerves to the heart.
Parasympathetic - Vagus nerve
Sympathetic - Superior thoracic and cervical sympathetic ganglia.

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11
Q

Describe the conduction system of the heart.

What happens if there is a disruption to this electrical pathway?

A

SA node, AV node, bundle of his, purkinje fibres.

Disruption leads to arrythmia which can lead to cardiac arrest .

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12
Q

Describe the posterior and anterior surfaces of the right atrium.

A

Posterior - Smooth

Anterior - Rough due to the presence of pectinate muscles

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13
Q

What is between the atria?

What is the fossa ovalis?

A

Interatrial septum is the structure between the atria.

Fossa ovalis is the remnant of the foramen ovale (opening between the septum of the fetal heart)

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14
Q

Which vessels does the right atria receive blood from?

A

Inferior and superior vena cava.

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15
Q

Describe the interior surface of the ventricles.
Through which vessel does blood leave the right ventricle?
What links the right atria and ventricle?
What divides the left and right ventricles?

A

Ridges due to chordea tendineae.
Blood leaves through the pulmonary trunk.
Tricuspid valve.
Interventricular septum

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16
Q

Where is the left atrium located?
Describe the posterior and anterior walls.
Which vessel supplies it with blood?

A

At the base of the heart
Posterior and anterior walls both smooth as there are no pectinate muscles.
Pulmonary veins supply the left atrium with oxygenated blood.

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17
Q

What links the left atria and ventricle?

A

Bicuspid valve

18
Q

Through which vessel does blood leave the left ventricle?

A

Aorta

19
Q

What is the purpose of the valves of the heart?

A

They allow single directional blood flow

20
Q

Which chambers do the pulmonary and aortic valves separate.

A

Pulmonary - Right ventricle/Pulmonary artery

Aortic - Left ventricle/Aorta

21
Q

Describe diastole.

A

Ventricular relaxation and filling

  • Begins with the closing of the aortic and pulmonary valves
  • AV valves then open to allow blood to flow into the ventricles
  • Cardiac conduction passes to the AV node which causes atrial contraction
22
Q

Describe systole.

A

Ventricular contraction and emptying

  • AV valves close
  • Ventricles receive impulses from purkinje fibres
  • Ventricular contraction
  • Aortic and pulmonary valves open
  • Blood is pumped into arteries
  • Valves close to stop backflow
23
Q

What is ascultation?

What do S1 and S2 represent?

A

The process of listening to heart sounds
S1 - Closure of AV valves during systole
S2 - Closure of aortic and pulmonary valves at the end of diastole

24
Q

What is Low, Normal and High blood pressure?

A

Low < 90/60
Normal 90/60-120/80
High > 140/90

25
Q

What is coronary artery disease?

Why does it occur?

A

Blood supply to the heart is interrupted and reduced. This reduces the supply of oxygen to the myocardium.
Primarily due to the build up of fatty deposits in the arteries.

26
Q

List the risk factors associated with coronary artery disease?

A 
Smoking
Diabetes
High blood pressure
High Cholesterol
Age
Obesity
Sedentary lifestyle
Genetic predisposition
27
Q

What are the consequences of coronary artery disease?

A
  • Atherosclerotic plaques build up in the intima of vessels
  • Stenosis of lumen
  • Collateral channels expand to allow the system to maintain its capacity
  • Ischaemia
28
Q

What is angina pectoris?

A

Short term, moderate chest pain. Tightness in thorax. Relieved by rest or treated by sublingual nitroglycerin.

29
Q

What is myocardial infarction?

A

Complete occulsion of a coronary artery. Myocardium is deprived of oxygen. This causes tissue necrosis.

30
Q

What are the implications of tissue necrosis?

A

Causes scarring - Myocardium is replaced with non-contractile tissue.
Heart muscle looses strength
Disruption of the contractile pattern
Can induce ventricular fibrillation

31
Q

What is the treatment for MI?

A

Angioplasty
Stent
Coronary artery bypass graft
Thrombolysis

32
Q

What are arrhythmias?

A

Abnormal rythm.

33
Q

List the causes of arrhythmias?

A
  • Heart stimulants
  • Congenital defects
  • Coronary artery disease
  • MI
  • Hypertension
  • Defective heart valves
  • Rheumatic heart disease
  • Hyperthyroidism
  • Potassium deficiency
34
Q

Describe supraventricular tachycardia.

How can it be treated?

A

Rapid but regular HR that originates from the atria.
Episodes may last from a few minutes to many hours.
May be stopped by maneuvers that stimulate the vagus nerve and slow HR.
Treatment may involve arrhythmic drugs and destruction of the abnormal pathway by radiofrequency ablation.

35
Q

Describe ventricular tachycardia.

A

Arrhythmia originating in the ventricles. Premature ventricular contractions cause the heart to beat too fast.
Sustained VT can be dangerous as ventricles don’t fill properly and do not pump sufficient blood.

36
Q

What is heart block?

A

Damage to the conduction system leads to the ventricles beating too slowly

37
Q

What is fibrillation?

A

Irregular or uncoordinated contractions of muscle fibres in the heart chamber walls. Can be atrial or ventricular.

38
Q

What is valvular disease?

A

Damage or defect to one of the four heart valves.

39
Q

What is an atrial septal defect?

A

Foramen ovale doesn’t close properly after birth. This is only an issue if there is a large defect.

40
Q

What is a ventricular septal defect?

A

Opening between the ventricles. A left to right shunt of blood through the defect increases pulmonary blood flow and can cause pulmonary disease.

41
Q

What is cardiac referred pain?

Why does this occur?

A

A stimuli originating in the heart perceived as pain arising from a superficial body part.
Sensory nerves from the viscera converge at the same spinal cord segments as sensory nerves from the upper left limb

42
Q 
Treatment
What is coronary angioplasty?
What is a coronary bypass graft?
What is a cardiac pacemaker?
What is defibrillation?
A

Catheter with inflatable balloon inserted into artery. Balloon is inflated flattening the plaque against the vessel wall.
Detour around the stenosis
Produces electrical impulses that initiate ventricular contraction at a predetermined rate
Electric shock which stops all cardiac activity, with the aim of allowing the SA node to start functioning again and restart the normal heart beat.

Anatomical Sciences (10 decks)

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