CP Cardiology Flashcards
What separates the superior mediastinum from the anterior, posterior, and middle mediastinum?
The line behind the sternal angle
What is the other name for the epicardium?
Visceral serous pericardium
What is the other name for the inferior border of the heart?
Right margin
Where are the crista / sulcus terminalis found?
Right atrium
What embryological structure becomes the ligamentum arteriosum?
Ductus arteriosus
What two vessels did the ductus arteriosus gap?
Aorta and the Pulmonary Trunk
What nerve can be compressed in an aortic aneurysm at the spot of the ligamentum arteriosum?
Left recurrent laryngeal nerve
(Runs under the weak spot in the aorta created by the ligamentum arteriosum)
What is the smooth wall of the right atrium called?
Sinus venarum
How will we know if the interatrial septum is pinned?
There will be a pin near to, but not on, the fossa ovalis.
What differentiates a papillary muscle from trabecula carnae?
The attachment of chordae tendonae to the papillary muscles.
(If something has no chordae tendonae attached to it, don’t label it a papillary muscle!)
What is the smooth wall before the pulmonary valve called?
Conus arteriosus
What is the other name for the moderator band?
Where is it located?
Septomarginal trabeculum
Right ventricle
What do we call the space behind the pulmonary semilunar valve?
Pulmonary Sinus
Where is the only place you can find pectinate muscle in the left atrium?
The left auricle
What sinus exists behind the outflow vessels?
Transverse pericardial sinus
What are the names of the two pericardial sinuses?
Oblique and transverse pericardial sinus.
What is the initial consequence of a pericardial effusion?
Cardiac tampenade (Increased pressure on the heart muscle)
Where is the needle inserted for pericardiocentesis?
In the paraxiphoid area (just below and to the side of the xiphoid process)
Describe the flow of blood in systemic circulation
left atrium
bicuspid valve
left ventricle
aortic valve
aorta
arterial system
capillaries
venous system
heart via inferior/superior vena cava
Describe the flow of blood in pulmonary circulation
superior/inferior vena cava
right atrium
tricuspid valve
right ventricle
heart via pulmonary valve
pulmonary trunk
right and left lungs
heart via pulmonary veins
CN: Myocardial Infarction
lack of blood flow to a specific area of myocardium, usually due to blockage in a coronary a.
CN: Angina Pectoris
Chest pain originating in the heart, often caused by result of narrow/obstructed arteries causing ischemia
What is important about the fibrous skeleton of the heart?
atachment points for the myocardium
attachment points for cuspid valves
supports/opens atrioventricular and semilunar valves
provides electrically insulated barrier between atria and ventricle
What is the ligamentum arteriosum?
the adult remnant of the ductus arteriosus
the left recurrent laryngeal n. and vagus n. loop around aortic arch and ligamentum arteriosum
(aneurysm there can cause hoarseness)
CN: Atrial Septal Defects
incomplete closure of the foramen ovale.
estimated that 15-20% of people have it
large openings in the interatrial septum can allow mixing of oxygen rich and oxygen depleted blood
the right atrium leads to the right ventricle via which space and which valve?
right atrioventricular orifice, tricuspid valve
How are the cusps of the tricuspid valve connected to the heart?
Each cusp is connected to a chorda tendoni and then to a papillary muscle of the same name (anterior, posterior, septal)
ex: anterior cusp to chorda tendoni to anterior papillary m. (most likely cusp to be tagged)
(same as bicuspid valve, except with only anterior and posterior)
What is the name of the rough, muscular surface of the right ventricle?
Trabecula Carnae
The aorta sinus and pulmonary sinus can be defined as
the space behind the cusp of the valve
ex: pulmonary sinus is the space behind the cusp of the pulmonary valve
CN: Cardiac Catheterization
insertion of a catheter into the femoral vein which is then passed up to the inferior vena cava allowing radiographic visualization of the right atrium, right ventricle, pulmonary trunk and pulmonary arteries
What is the smooth surface of the left ventricle called?
aortic vestibule
rough wall is the same: trabeculae carnae
What is the interventricular septum?
myocardial wall separating the two ventricles, houses the atrioventricular bundle, right and left bundle branches, subendocardial branches (purkinje fibers)
described as having a membranous (fibrous) part that belongs to the fibrous skeleton of the heart and a much larger muscular part
CN: Ventricular Septal Defects
due to the embryologically divergent tissues that make up the interventricular spetum that structure is particularly susceptible to defects
all defects are clinically relevant as they allow the mixing of oxygen rich and oxygen low blood
What is the sinuatrial node?
“pacemaker”
located in myocardium where superior vena cava meets right atrium
initiates it’s own action potential and propagates impulse thru atrial wall, producing diastole
What is the atrioventricular node?
bundle of cardiac muscle fibers in the interatrial septum responding to impulse from SA node and distributes signal through ventricles
does not make it’s own AP
Artificial Cardiac Pacemaker
produces a regular electrical impuse that is carried to the ventricles via electrodes
Atrial Fibrillation
irregular twitching of atria, circulation usually remains satisfactory
CN: Ventricular Fibrillation
rapid irregular twitching of ventricles, unable to pump blood.
shock and hope the heart restarts
CN: Cardiac referred pain
ischmia stimulates visceral pain fibers in the heart of the ANS and often share a spinal ganglion with the somatic sensory nerve fibers for the upper extremity
typically referred to area innervated by left medial brachial cutaneous nerve, left substernal area, left pectoral area and medial left arm
CN: Surfical significance of the transverse pericardial sinus
space allows cardiac surgeons to access the area posterior to the aorta and pulmonary trunk to clamp or insert the tubes of a bypass machine into these large vessels.
CN: Pericarditis
inflammation of the pericardium which can make the pericardium rough and produce friction. causes rub which can be heard with steth. Can cause pericardium to calcify
CN: Pericardial Effusion
inflammation of the pericardium can result in the accumulation of fluid or pus in the pericardial sac which can compress the heart-aka cardiac tamponade
CN: Pericardiocentesis
drainage of blood, fluid, pus from the pericardial sac, usually to treat cardiac tamponade
What is the oblique pericardial sinus?
What is the transverse pericardial sinus?
wide recess posterior to the base of the heart
transverse passage traversing the origins of the great vessels
