CV anatomy Flashcards
The heart is bound anteriorly by the _____ and the costal cartilage of the __, __, __ ribs and inferiorly by the ______?
sternum; 3,4,5; diaphragm
The apex of the heart points ____ and ______ towards the left ______ ________ ________ at the midclavicular line.
anteriorly and inferiorly; fifth intercostal space
Superior aspect of cardiac silhouette formed by _______ and _______ ________.
transverse and ascending aorta
The right lateral border is composed of the?
right atrium
What constitutes most of the inferior border?
mass of RV
What comprises the majority of the apex and the lower left lateral border?
LV
This lies superior to the LV and to one side of the pulmonary artery?
left atrial appendage
Radiographically, where is the left atrial appendage seen?
between the LV and the pulmonary outflow tract
The anterior surface of the heart is mostly made up of?
RV
The heart is rotated on its?
base
What is the most superior portion of the cardiac silhouette?
base
This is the fibrous, double walled sac that envelopes the heart?
pericardium
What part of the chest is the heart positioned in?
mediastinum
What are the parts of the pericardium?
visceral part which is in contact w the outer surface of the heart/epicardium; parietal portion which adheres to the pericardium
The pericardium is pierced superiorly by what 3 things?
aorta, pulmonary trunk, and SVC
The base of the pericardium is fused with?
diaphragm
Pericardial cavity usually contains how many mL of serious fluid?
10-25
Pressure in the pericardial cavity can increase how much before tamponade occurs?
10 fold
Pericardium receives its arterial blood supply from?
branches of internal thoracic arteries and bronchial, esophageal, and superior phrenic arteries
Venous drainage from the pericardium occurs through?
azygos system, pericardiophrenic veins
Nervous innervation of pericardium derived from what 3 things?
vagus nerve, phrenic nerve, and sympathetic trunks
What separates the atria from the ventricles?
coronary sulcus/AV sulcus
This arteries arises from the LCA and travels in the coronary sulcus until it branches posteriorly?
circumflex
RV and LV separated by?
interventricular sulci
The interventricular sulci are composed of what 2 parts?
anterior interventricular sulcus and posterior interventricular sulcus
Which sulcus contains the LAD?
anterior interventricular sulcus
Where does the LAD travel?
over the interventricular septum and continues in posterior interventricular sulcus
Crux of the heart is the place where what 2 parts meet? Internally it is where?
coronary and posterior interventricular sulci; atrial and ventricular septa meet
The anatomic crux is important in determining?
coronary artery dominance
What surrounds the AV valves and what is its purpose?
tough fibrous rings; act as points of attachment for the valves
Two additional fibrous annuli develop in relation to the bases of the?
aorta and pulmonary trunk
The aortic fibrous annulus is connected to the pulmonary annulus by a fibrous band called?
tendon of the conus
The aortic annulus is connected to the AV annuli by the small left fibrous trigone and the larger right fibrous trigone, also called the?
central fibrous body
What constitutes the fibrous cardiac skeleton?
four annuli and their interconnections
What is the fixation point for the cardiac musculature and plays an important role in the structure, function,and efficiency of the heart?
annulus fibrosus
What acts as an insulator to prevent aberrant electrical conduction from the atria to the ventricles so that AV conduction moves through one pathway only?
annulus
What element increases the electromechanical efficiency of the heart and helps prevent dysrhythmias?
annulus
RA muscle wall thickness?
2 mm
3 places RA receives blood from?
SVC, IVC, coronary sinus
2 parts of the RA?
anterior, thin walled trabeculated portion and posterior, smooth walled portion called sinus venarum
The sinus venarum receives blood from (2)?
vena cava and coronary sinus
Entrance of IVC into RA is protected by a valve called?
eustachian valve
Entrance from the coronary sinus into the RA is located between?
AV orifice and valve of IVC
The opening from the coronary sinus into the RA which is located between the AV orifice and the valve of the IVC is protected by which valve?
thesbian valve
What is the remnant of the fetal foramen ovale?
fossa ovalis cordis
Thickness of RV?
4-5 mm
Why are the RV walls thicker than RA walls?
increased pressure required to generate forward blood flow into the pulmonary circulation
Superior portion of RV as it approaches the pulmonary orifice has a conical appearance and is called?
conus arteriosus or infundibulum
Why does the RV have a rough appearance?
papillary muscles and trabeculae carnea
What attaches to the ventricular walls and the chordae tendineae?
papillary muscles
These are attached to the cusps of the tricuspid valve?
chordae tendinae
What % of an increase in LVEDV does the LA provide?
20-30%
The LA is located _________ and _________ to the other cardiac chambers?
superiorly and posteriorly
Walls of LA are how many mm thick?
3
The atrial septum is smooth but may contain a central depression that corresponds to the location of the?
fossa ovalis cordis
Difference between RA and LA?
LA acts as a pump during systole
The apex of the LV is positioned within the mediastinum in an _________ and _________ orientation?
anterior and inferior
LV wall thickness?
8-15 mm
Why is LV wall thickest of them all?
this additional muscle mass is needed to overcome the SVR/afterload to maintain CO
This separates the right and left ventricular cavities?
ventricular septum
The upper third of the septum is smooth endocardium. The remaining 2/3 of the septum and the rest of the ventricular wall are covered with?
trabeculae carneae
The ______ ______ of each papillary muscle are attached to the cusps of the mitral valve and prevent eversion of the valve during ventricular systole.
chordae tendineae
3 layers of myocardium going from outer to inner?
epicardium, myocardium, endocardium
A cardiologist is able to determine valve gradients using what formula or its correction?
Gorlin
What are the 3 leaflets of the tricuspid valve?
anterior, posterior, septal
The tricuspid valve leaflets are attached to the _____ _____, which are attached to the ______ ________?
chordae tendinae, papillary muscles
What are the mitral valves leaflets?
anteriomedial leaflet and posterolateral leaflet
The SL valves are situated within what?
outflow tracts of their corresponding ventricles
Each SL valve has how many cusps?
3
Above the AV, is a dilation known as the ______ _______ _______, which allows the valve to open efficiently without occluding the coronary ostia or openings that communicate with the coronary arteries?
sinus of Valsalva
The arterial system of the heart consists of what 2 things?
epicardial and subendocardial
These vessels are located superficially and most commonly become obstructed at areas of bifurcation where the blood flow is turbulent rather than laminar?
epicardial vessels
These are the entrance points by which blood flows through the coronary circulation?
coronary ostia
Where are the coronary ostia located?
behind aortic cusps near the superior aprt of hte sinus of Valsalva
The ostium of the LCA is _______ and ________ to the right coronary ostium?
superior and posterior
The left main coronary artery travels _______, ___________, and __________ from the left coronary sinus to emerge from behind the pulmonary trunk?
anteriorly, inferiorly, and leftward
Besides the LAD and circ, what’s the 3rd branch that is possible for the LCA to divide in to?
diagonal
Where does the LAD provide blood flow to?
anterior 2/3 of the interventricular septum, r and l BB, anterior and posterior papillary muscles of MV, and anterior lateral and apical walls of LV , collateral circ to anterior wall of RV
In what direction is the left circumflex artery directed?
posteriorly as it travels around the left side of the heart within the left AV sulcus
Where does the left circumflex artery supply blood to?
left atrial wall, posterior and lateral LV, anterolateral papillary muscle, AV node in 10% of population, SA node in 40-45% of population
Where does RCA supply blood to?
SA, AV nodes, RA, RV, posterior third of interventricular septum, posterior fascicle of LBB, interatrial septum
How is dominance of one coronary artery determined?
by location of the coronary artery that crosses the crux and provides blood flow to the posterior descending artery
In 50% of the population, the dominant coronary artery is?
RCA
What are the 3 main venous systems in the heart?
coronary sinus, anterior cardiac veins, thesbesian veins
Where is coronary sinus located?
posterior AV groove near the crux
Why is the coronary sinus catheterized when metabolic studies of the LV are performed?
it collects 85% of blood from the LV
The coronary sinus receives blood from where?
great, middle, small cardiac veins, posterior left ventricular veins, and left atrial vein of Marshall
The thebesian veins may carry up to what % of blood that is returned to the RA?
40%
