CPR 09 - Heart 1

Question 1

Answer 1

Question 2

At what level does the ascending aorta become the aortic arch?

Answer 2

The transthoracic plane T4/T5

Question 3

What does the pericardium cover besides the heart?

Answer 3

The roots of the great vessels

Question 4

Answer 4

Question 5

Describe the attachments of the pericardium.

Answer 5

Question 6

Describe what the transverse pericardial sinus is and what it is used for.

Answer 6

Question 7

Describe what the oblique pericardial sinus is and what it is used for.

Answer 7

Question 8

Answer 8

Question 9

From which vessels do the pericardiophrenic arteries and veins arise?

Answer 9

Pericardiophrenic artery comes from the internal thoracic artery

Pericardiophrenic vein is a tributary to the brachiochephalic vein

Question 10

Answer 10

Question 11

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Question 12

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Question 13

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Question 14

What structures make up the anterior or sternocostal surface of the heart?

Answer 14

Question 15

What structures make up the inferior and diaphragmatic surfaces of the heart?

Answer 15

Question 16

What chamber makes up the majority of the posterior surface of the heart? What structures make up the rest?

Answer 16

Question 17

What structures make up the base of the heart?

Answer 17

Question 18

What structures make up the right and left pulmonary surfaces of the heart?

Answer 18

Question 19

What structures are found along the right and left borders of the heart?

Answer 19

Question 20

What does the RA receive blood from?

Answer 20

SVC, IVC, and coronary sinus

Question 21

How does the anterior portion of the RA differ from the posterior portion? What separates these areas?

Answer 21

The posterior wall is smooth while the anterior wall is roughened by pectinate muscles. A muscular ridge called the crista terminalis separates the anterior and posterior portions of the RA along the right border of the heart between the SVC and IVC.

Question 22

What exists where the foramen ovale was in an adult?

Answer 22

The fossa ovalis, a depression in the RA that is a remnant of the fibrous sheet the covered the foramen ovale during fetal development.

Question 23

Answer 23

Question 24

What does the LA receive blood from?

Answer 24

4 pulmonary veins (2 left, 2 right)

Question 25

Where is the fossa ovalis in the LA?

Answer 25

On the interatrial surface but towards the anterior portion of the LA

Question 26

Describe the mechanics of the AV valves.

Answer 26

Question 27

What are the names of the leaflets of the AV valves?

Answer 27

Tricuspid - anterior, posterior, and septal

Mitral - posterior and anterior

Question 28

What are trabeculae carnae?

Answer 28

Rounded or irregular muscular columns which project from the inner surface of the right and left ventricles of the heart.[1] These are different from the pectinate muscles, which are present in the atria of the heart.

Question 29

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Question 30

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Question 31

Which ventricle has thicker walls and thicker pectinate muscles?

Answer 31

Only atria have pectinate muscles, ventricles have trabeculae carnae.

The LV has thicker walls but the RV has thicker trabeculae carnae

Question 32

Answer 32

? = impression of the fossa ovalis

Question 33

How many cusps do the aortic and pulmonary trunk valves have? Name these cusps.

Answer 33

Question 34

What is unique about the aortic valve cusps?

Answer 34

The arotic valve has two coronary cusps that contain ostia (openings) for the right and left coronary arteries. Each cusp contains a bowl like sinus, aortic sinuses of valsalva, that fill after ventricular contraction to close the valve and simultaneously fill the right and left coronary artery.

Question 35

What muscles open/close the aortic and pulmonary valves?

Answer 35

There are none. These valves passively open and close

Question 36

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Question 37

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Question 38

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Question 39

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Question 40

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Question 41

Which coronary arteries are most frequently occluded? Which on is nicknamed the “widow maker?” Why?

Answer 41

Question 42

Describe the concept of heart dominance.

Answer 42

A heart is said to be right or left dominant depending upon which coronary artery (righ or left) is the source of the posterior interventricular artery (PIV)

Question 43

Are most hearts right or left dominant? In either case of dominance, how does the coronary artery eventually give off the PIV?

Answer 43

Question 44

Describe how and when a coronary artery bypass graft (CABG) is usually done.

Answer 44

A CABG is done when a coronary artery becomes stenotic (narrowed) to the point that it can’t adequately supply the heart with blood. It is typically done by taking a portion of the radial artery, internal thoracic artery, or great saphenous vein (used most often) and grafting it to either the aorta or left subclavian artery and the stenotic coronary artery just pass the point of stenosis.

Question 45

Which BV is most often used for a CABG and why?

Answer 45

Question 46

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Question 47

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Question 48

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Question 49

What levels of sympathetics and parasympathetics innervate the heart? What plexuses do these nerves travel through? What effect to they have on the heart?

Answer 49

Question 50

Describe the route of the sympathetic nerves to the heart from the CNS, include cell body location.

Answer 50

Question 51

Describe the route the sensory nerve fibers of the heart take back to the brain.

Answer 51

Question 52

What nerve is typically responsible for the referred pain felt during a MI?

Answer 52

Question 53

Describe the route the sensory fibers innervating the pericardium take back to the CNS.

Answer 53

Question 54

Answer 54