Clinically relevant anatomy of the heart

Question 1

Where is the phrenic nerve?

Answer 1

Descending across the lateral borders of the pericardium

Question 2

Where is the pericardial cavity?

Answer 2

Between the 2 layers of serous pericardium

Question 3

What is the anterior surface of the heart covered by?

Answer 3

Epicardium

Question 4

What does the epicardium do?

Answer 4

Secretes pericardial fluid into pericardial cavity

Question 5

What happens if the pericardial cavity fills with blood?

Answer 5

The pressure around the heart can prevent cardiac contraction (cardiac tamponade)

Question 6

What is it called when the pericardial cavity fills with blood?

Answer 6

Haemopericardium

Question 7

What does parietal mean?

Answer 7

Something in contact with body walls or organs

Question 8

What is the epicardium also known as?

Answer 8

Visceral serous pericardium

Question 9

3 layers of the pericardium?

Answer 9

Fibrous pericardium
Parietal serous pericardium
Visceral serous pericardium

Question 10

What is pericardiocentesis?

Answer 10

Draining fluid from the pericardial cavity

Question 11

How is the needle inserted in pericardiocentesis?

Answer 11

Via infrasternal angle
Directed superoposteriorly
Aspirating continuously

Question 12

What is the transverse pericardial sinus?

Answer 12

Space within the pericardial cavity, posterosuperiorly

Lies posterior to the pulmonary trunk and ascending aorta

Question 13

What is the transverse pericardial sinus used for?

Answer 13

Cardiac surgeons use it to identify and isolate the great vessels in order to commence cardiopulmonary bypass

Question 14

What does pericardium look like in diagrams?

Answer 14

Grey sack surrounding heart

Question 15

What does pulmonary trunk divide into?

Answer 15

Right and left pulmonary arteries

Question 16

Biggest looking vessel? and ones either side of it

Answer 16

Aorta then pulmonary trunk then superior vena cava

Question 17

What lies inferior to the aorta etc?

Answer 17

Pulmonary veins (4) and then inferior vena cava is a bit more inferior

Question 18

Clinically important surfaces of the heart?

Answer 18

Anterior (sternocostal)
Diaphragmatic (inferior)
Base (posterior)

Question 19

Clinically important borders of the heart?

Answer 19

Right (lateral) border
Left (lateral) border
Inferior border (normally on right ventricle)
Superior border

Question 20

Clinically important point on heart?

Answer 20

Apex

Question 21

Where do you palpate the apex beat?

Answer 21

5th left intercostal space in the mid-clavicular line

Question 22

What are pulmonary trunk and pulmonary arteries carrying?

Answer 22

Deoxygenated blood to lungs

Question 23

What does the brachiocephalic trunk divide into?

Answer 23

Right and left subclavian vein

Question 24

What is an auricle?

Answer 24

Extension of right atrium (it’s like an overfill area)

Question 25

What does the coronary groove show?

Answer 25

Where right atrium becomes ventricle

Question 26

What is on either side of the trachea?

Answer 26

Right and left carotid artery

Question 27

Anterior inter-ventricular groove?

Answer 27

Separates ventricles and a branch of the left coronary artery is in it

Question 28

What is in the coronary groove?

Answer 28

Right coronary artery

Question 29

What does the coronary groove indicate?

Answer 29

Surface marking for the tricuspid valve

Question 30

Base surface?

Answer 30

All of the posterior left atrium

Question 31

What separates base and diaphragmatic surface?

Answer 31

Coronary sinus vein

Question 32

Diaphragmatic surface?

Answer 32

The posterior ventricles

Question 33

Where do the coronary arteries arise from?

Answer 33

Ascending aorta

Question 34

Where is the right coronary artery?

Answer 34

In coronary (right atrioventricular) groove

Question 35

Where is the left (main stem) coronary artery?

Answer 35

In left atrioventricular groove between pulmonary trunk and left auricle

Question 36

After the first branch of the aorta?

Answer 36

Coronary arteries NOT brachiocephalic trunk

Question 37

What does the left coronary artery give way to?

Answer 37

Left anterior descending (LAD)(anterior interventricular artery) and this then branches into the lateral/diagonal branch

Question 38

Where does venous blood ultimately drain back to?

Answer 38

Coronary sinus

Question 39

What is the coronary sinus?

Answer 39

The coronary sinus is a short venous conduit (in the atrioventricular groove posteriorly) which receives deoxygenated blood from most of the cardiac veins and drains into the right atrium

Question 40

What does a septum do?

Answer 40

Divides the heart into right and left side

Question 41

Septum between the 2 atria is called?

Answer 41

Interatrial septum - position indicated by interatrial groove

Question 42

Septum between ventricles is called?

Answer 42

Interventricular septum - indicated by anterior inter-ventricular groove

Question 43

Why a septal defect is bad?

Answer 43

- can allow mixing of arterial and venous blood in the heart - mixed arterial and venous blood reduced oxygen content of systemic arterial blood in the aorta - This is called hypoxaemia

Question 44

How many cardiac valves are there?

Answer 44

4

Question 45

Where generally are the cardiac valves?

Answer 45

One valve at the exit of each cardiac chamber

Question 46

Where is the pulmonary valve?

Answer 46

Between pulmonary trunk and and right ventricle

Question 47

Where is the mitral (bicuspid) valve?

Answer 47

Between left atrium and left ventricle

Question 48

Where is the aortic valve?

Answer 48

Between the left ventricle and the aorta

Question 49

Where is the tricuspid valve?

Answer 49

Between right atrium and right ventricle

Question 50

What valves cause the lub sound?

Answer 50

The tricuspid and mitral

Question 51

What valves cause the dub sound?

Answer 51

Pulmonary and aortic valve

Question 52

Tricuspid cusps?

Answer 52

Anterior, posterior and septal

Question 53

Pulmonary valve cusps?

Answer 53

anterior right and left cusps

Question 54

Aortic valve cusps?

Answer 54

Right, left and posterior cusps and sinuses (spaces within cusps)

Question 55

What arises from the left and right aortic sinuses?

Answer 55

Coronary arteries

Question 56

What side is tricuspid valve on? | Mitral?

Answer 56

Right | Left

Question 57

What is moderator band?

Answer 57

Carries fibres of right bundle branch to the papillary muscle of the anterior cusp.

Question 58

Where would you auscultate the aortic valve?

Answer 58

2nd right intercostal space at sternal edge

Question 59

Where would you auscultate the pulmonary valve?

Answer 59

2nd left ICS sternal edge

Question 60

Where would you auscultate the tricuspid valve?

Answer 60

4th left ICS sternal edge (lower left sternal edge)

Question 61

Where would you auscultate the mitral valve?

Answer 61

5th left ICS midclavicular line