CPR Cardiology Flashcards
What separates the superior mediastinum from the inferior mediastinum?
sternal angle
divisions of the inferior mediastinum
anterior (ant to heart)
middle (HEART)
posterior (post to heart)
What is the other name for the epicardium?
visceral serous pericardium
Describe systemic circulation
from LA past bicuspid valve into LV, out of heart thru aortic valve and into aorta, through arterial system, thru capillaries, thru venous system and back into heart thru SVC and IVC
Describe pulmonary circulation
from SVC & IVC into RA, past tricuspid valve into RV & out of heart thru pulmonary valve into pulmonary trunk, thru R & L lungs, back towards heart thru pulmonary veins
What are the 4 main layers of the heart?
fibrous pericardium
epicardium
myocardium
endocardium
Myocardial infarction
lack of blood flow to specific area of myocardium (usually b/c blockage in coronary A)
coronary atherosclerosis in walls of coronary As decreases lumen of vessel & increases likelihood that vessel is blocked entirely
Angina pectoris
pain that originates in heart & produces strangling pain of chest
usually from narrow or obstructed coronary arteries that produces ischemia of myocardium
Where are the crista/sulcus terminalis found?
right atrium
What is the other name for the inferior border of the heart?
right margin
What embryological structure becomes the ligamentum arteriosum?
Ductus arteriosus
What two vessels did the ductus arteriosus gap?
Aorta & Pulmonary Trunk
What nerve can be compressed in an aortic aneurysm @ the spot of the ligamentum arteriosum?
Left recurrent laryngeal nerve
runs under the weak spot of the aorta created by the ligamentum arteriosum
Describe the endocardium
thin internal endothelial (& subendothelial layer in ventricles) that lines the inside of the chambers of the heart & its valves
Roles of fibrous skeleton of heart
produces attachment points for myocardium
produces attachment points for valves
supports & strengthens atrioventricular & semilunar orifices
provides electrically insulated barrier btwn artia & ventricles
What is considered the apex of the heart?
inferolateral part of the LV (points left)
What is considered the base of the heart?
posterior portion (near L atrium)
Which surface is made up of the R & L ventricles?
diaphragmatic surface
What makes up the sternocostal surface of the heart?
Right ventricle
What makes up the pulmonary surface of the heart?
Right atrium & left ventricle (occupies cardiac impression on both lungs)
Describe the borders of the heart
Right=Right atrium
Inferior=Right ventricle
Left=left ventricle
Superior=R & L atria
right atrioventricular groove
btwn R atrium & R ventricle
transmits R coronary A
left atrioventricular groove
btwn L atrium & L ventricle
houses coronary sinus
anterior interventricular groove
btwn R & L ventricles on anterior aspect of heart
transmits anterior interventricular A & great cardiac V
posterior interventricular groove
btwn R & L ventricles on posterior aspect of heart
transmits posterior interventricular A & middle cardiac V
sulcus terminalis
external vertical groove that corresponds to internal crista terminalis
What is the ligamentum arteriosum?
embryological remnant of ductus arteriosus (was communication btwn pulmonary trunk & aorta)
What was the embryological significance of the ductus arteriosus?
shunted blood from pulmonary trunk to aorta to bypass the nonfunctional luns
What nerve is close to aortic arch & ligamentum arteriosum?
How can the nerve be affected?
left recurrent laryngeal N of the vagus N
can be impacted by aneurysm in nearby structures (aorta & pulm trunk)
What is the underlying cause of atrial septal defects?
incomplete closure of the foramen ovale (larger openings in the interatrial septum can cause issues if mixing of O2 rich & depleted blood)
Where do the SVC, IVC, and coronary sinus empty?
into the sinus venarum of the right atrium (posterior & smooth, thin wall region)
What is the crista terminalis?
internal ridge separating the smooth & rough regions of the R atrium
What is the purpose of the right atrioventricular orifice?
passage from right atrium to the right ventricle
variably occluded by tricuspid valve
Internal features of right atrium
sinus venarum pectinate muscle crista terminalis interatrial septum opening for the coronary sinus
Where is the fossa ovalis located?
in between the R & L atria (interatrial septum)
embryonic remnant of the foramen ovalis
Internal features of right ventricle
tricuspid valve
trabecula carnae
conus arteriosus
pulmonary valve
Cusps of the tricuspid valve
separates R atrium & R ventricle
anterior cusp
posterior cusp
septal cusp
What is the purpose of the chorda tendineae?
attach free edges of the 3 cusps of the tricuspid valve to the 3 corresponding papillary muscles
What is the trabecula carnae?
in R ventricle
from interventricular septum to base of anterior papillary muscle
transmits right bundle branch of AV bundle to ant papillary m
What is the pulmonary valve?
aka the semilunar valve
has R, L & ant cusps…separates R ventricle from pulmonary trunk
What are the pulmonary sinuses?
space btwn wall of pulmonary trunk & cusps of pulmonary valve
What is cardiac catheterization?
insertion of a catheter into the femoral vein which is passed up to the IVC
allows radiographic visualization of the RA, RV, pulmonary trunk & pulmonary arteries
What is the conus arteriosus?
in the R ventricle (smooth wall before the pulmonary valve)
smooth wall cavity that leads from R vent into pulmonary trunk
Internal features of Left Atrium
left auricle
openings for 4 pulmonary v
interatrial septum
**thicker wall compared to R atrium
What is the left atrioventricular orifice?
passage from L atrium to L ventricle
occluded by bicuspid valve
What is the bicuspid valve?
separates the L atrium from the L ventricle
AKA mitral valve
Internal features of Left ventricle
bicuspid valve trabecula carnae aortic vestibule interventricular septum aortic valve
How is the bicuspid valve different from the tricuspid valve?
only has anterior & posterior cusps
Components of bicuspid valve
ant cusp post cusp chorae tendineae ant pap m post pap m
What is the aortic vestibule?
leads into ascending aorta from L vent
What is the interventricular septum?
myocardial wall separating the 2 ventricles
houses the AV bundle, R & L bundle branches & subendocardial branches
Ventricular septal defects
IV septum is susceptible to defects b/c made of embryologically divergent tissues
all defects are relevant b/c allow mixing of O2 rich & depleted blood
What is the aortic valve?
separates L ventricle from ascending aorta (aka semilunar valve)
What are the aortic sinuses?
space btwn wall of ascending aorta & cusps of aortic valves
house the R & L coronary arteries
What is the conducting system of the heart?
consists of cardiac muscle cells, specialized conducting fibers & 2 bundles of nodal tissue responsible for coordinating the cardiac cycle
What is an artificial cardiac pacemaker?
produces a regular electrical impulse that is carried to the ventricles via electrodes inserted thru large vein to SVC, into R atrium & past tricuspid valve into endocardium of trabecula carnae of R vent
Define atrial fibrillation
irregular twitching of atrial cardiac muscle fibers, ventricles then respond @ irregular intervals
not much affect on circulation
Define ventricular fibrillation
rapid irregular twitching of ventricles, renders heart UNABLE TO PUMP BLOOD
administer electric shock from electrodes to stop cardiac movement so heart ma begin beating regularly again (defibrillation)
What is cardiac referred pain?
ischemia of cardiac muscle that stimulates visceral pain sensory fibers of ANS w/ in heart
these fibers share ganglion w/ somatic sensory fibers of UE & lateral chest wall
Surgical significance of transverse pericardial sinus
this space allows cardiac surgeons to access area posterior to aorta & pulmonary trunk to clamp or insert tubes of a bypass machine into these vessels
Pericarditis
inflammation of pericardium that makes it rough & produces friction (can lead to calcification of pericardium)
Pericardial effusion
inflammation of pericardium can lead to accumulation of fluid/pus in pericardiac sac
can compress the heart
What is cardiac tamponade?
compression of heart due to fluid accumulation in pericardium
Pericardiocentesis
process to drain blood, fluid or pus from pericardial sac (to relieve cardiac tamponade)
Components of pericardium
serous
fibrous
oblique pericardial sinus
transverse pericardial sinus
What does the parietal serous pericardium adhere to?
fibrous pericardium
What does the visceral serous pericardium adhere to?
the heart itself
aka the epicardium
Where is the oblique pericardial sinus?
Where is the transverse pericardial sinus?
recess posterior to base of heart
transverse passage across origins of great vessels
What is the vascular supply of the cardiac conducting system?
R & L coronary arteries
Where is the only place you can find pectinate muscle in the L atrium?
the left auricle
What sinus exists behind the outflow vessels?
transverse pericardial sinus
