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6902- Cullen > CV anatomy > Flashcards

CV anatomy Flashcards

1
Q

The heart is bound anteriorly by the _____ and the costal cartilage of the __, __, __ ribs and inferiorly by the ______?

A

sternum; 3,4,5; diaphragm

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2
Q

The apex of the heart points ____ and ______ towards the left ______ ________ ________ at the midclavicular line.

A

anteriorly and inferiorly; fifth intercostal space

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3
Q

Superior aspect of cardiac silhouette formed by _______ and _______ ________.

A

transverse and ascending aorta

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4
Q

The right lateral border is composed of the?

A

right atrium

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5
Q

What constitutes most of the inferior border?

A

mass of RV

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6
Q

What comprises the majority of the apex and the lower left lateral border?

A

LV

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7
Q

This lies superior to the LV and to one side of the pulmonary artery?

A

left atrial appendage

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8
Q

Radiographically, where is the left atrial appendage seen?

A

between the LV and the pulmonary outflow tract

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9
Q

The anterior surface of the heart is mostly made up of?

A

RV

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10
Q

The heart is rotated on its?

A

base

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11
Q

What is the most superior portion of the cardiac silhouette?

A

base

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12
Q

This is the fibrous, double walled sac that envelopes the heart?

A

pericardium

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13
Q

What part of the chest is the heart positioned in?

A

mediastinum

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14
Q

What are the parts of the pericardium?

A

visceral part which is in contact w the outer surface of the heart/epicardium; parietal portion which adheres to the pericardium

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15
Q

The pericardium is pierced superiorly by what 3 things?

A

aorta, pulmonary trunk, and SVC

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16
Q

The base of the pericardium is fused with?

A

diaphragm

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17
Q

Pericardial cavity usually contains how many mL of serious fluid?

A

10-25

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18
Q

Pressure in the pericardial cavity can increase how much before tamponade occurs?

A

10 fold

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19
Q

Pericardium receives its arterial blood supply from?

A

branches of internal thoracic arteries and bronchial, esophageal, and superior phrenic arteries

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20
Q

Venous drainage from the pericardium occurs through?

A

azygos system, pericardiophrenic veins

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21
Q

Nervous innervation of pericardium derived from what 3 things?

A

vagus nerve, phrenic nerve, and sympathetic trunks

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22
Q

What separates the atria from the ventricles?

A

coronary sulcus/AV sulcus

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23
Q

This arteries arises from the LCA and travels in the coronary sulcus until it branches posteriorly?

A

circumflex

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24
Q

RV and LV separated by?

A

interventricular sulci

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25
Q

The interventricular sulci are composed of what 2 parts?

A

anterior interventricular sulcus and posterior interventricular sulcus

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26
Q

Which sulcus contains the LAD?

A

anterior interventricular sulcus

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27
Q

Where does the LAD travel?

A

over the interventricular septum and continues in posterior interventricular sulcus

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28
Q

Crux of the heart is the place where what 2 parts meet? Internally it is where?

A

coronary and posterior interventricular sulci; atrial and ventricular septa meet

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29
Q

The anatomic crux is important in determining?

A

coronary artery dominance

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30
Q

What surrounds the AV valves and what is its purpose?

A

tough fibrous rings; act as points of attachment for the valves

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31
Q

Two additional fibrous annuli develop in relation to the bases of the?

A

aorta and pulmonary trunk

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32
Q

The aortic fibrous annulus is connected to the pulmonary annulus by a fibrous band called?

A

tendon of the conus

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33
Q

The aortic annulus is connected to the AV annuli by the small left fibrous trigone and the larger right fibrous trigone, also called the?

A

central fibrous body

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34
Q

What constitutes the fibrous cardiac skeleton?

A

four annuli and their interconnections

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35
Q

What is the fixation point for the cardiac musculature and plays an important role in the structure, function,and efficiency of the heart?

A

annulus fibrosus

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36
Q

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?

A

annulus

37
Q

What element increases the electromechanical efficiency of the heart and helps prevent dysrhythmias?

A

annulus

38
Q

RA muscle wall thickness?

A

2 mm

39
Q

3 places RA receives blood from?

A

SVC, IVC, coronary sinus

40
Q

2 parts of the RA?

A

anterior, thin walled trabeculated portion and posterior, smooth walled portion called sinus venarum

41
Q

The sinus venarum receives blood from (2)?

A

vena cava and coronary sinus

42
Q

Entrance of IVC into RA is protected by a valve called?

A

eustachian valve

43
Q

Entrance from the coronary sinus into the RA is located between?

A

AV orifice and valve of IVC

44
Q

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?

A

thesbian valve

45
Q

What is the remnant of the fetal foramen ovale?

A

fossa ovalis cordis

46
Q

Thickness of RV?

A

4-5 mm

47
Q

Why are the RV walls thicker than RA walls?

A

increased pressure required to generate forward blood flow into the pulmonary circulation

48
Q

Superior portion of RV as it approaches the pulmonary orifice has a conical appearance and is called?

A

conus arteriosus or infundibulum

49
Q

Why does the RV have a rough appearance?

A

papillary muscles and trabeculae carnea

50
Q

What attaches to the ventricular walls and the chordae tendineae?

A

papillary muscles

51
Q

These are attached to the cusps of the tricuspid valve?

A

chordae tendinae

52
Q

What % of an increase in LVEDV does the LA provide?

A

20-30%

53
Q

The LA is located _________ and _________ to the other cardiac chambers?

A

superiorly and posteriorly

54
Q

Walls of LA are how many mm thick?

A

3

55
Q

The atrial septum is smooth but may contain a central depression that corresponds to the location of the?

A

fossa ovalis cordis

56
Q

Difference between RA and LA?

A

LA acts as a pump during systole

57
Q

The apex of the LV is positioned within the mediastinum in an _________ and _________ orientation?

A

anterior and inferior

58
Q

LV wall thickness?

A

8-15 mm

59
Q

Why is LV wall thickest of them all?

A

this additional muscle mass is needed to overcome the SVR/afterload to maintain CO

60
Q

This separates the right and left ventricular cavities?

A

ventricular septum

61
Q

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?

A

trabeculae carneae

62
Q

The ______ ______ of each papillary muscle are attached to the cusps of the mitral valve and prevent eversion of the valve during ventricular systole.

A

chordae tendineae

63
Q

3 layers of myocardium going from outer to inner?

A

epicardium, myocardium, endocardium

64
Q

A cardiologist is able to determine valve gradients using what formula or its correction?

A

Gorlin

65
Q

What are the 3 leaflets of the tricuspid valve?

A

anterior, posterior, septal

66
Q

The tricuspid valve leaflets are attached to the _____ _____, which are attached to the ______ ________?

A

chordae tendinae, papillary muscles

67
Q

What are the mitral valves leaflets?

A

anteriomedial leaflet and posterolateral leaflet

68
Q

The SL valves are situated within what?

A

outflow tracts of their corresponding ventricles

69
Q

Each SL valve has how many cusps?

A

3

70
Q

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?

A

sinus of Valsalva

71
Q

The arterial system of the heart consists of what 2 things?

A

epicardial and subendocardial

72
Q

These vessels are located superficially and most commonly become obstructed at areas of bifurcation where the blood flow is turbulent rather than laminar?

A

epicardial vessels

73
Q

These are the entrance points by which blood flows through the coronary circulation?

A

coronary ostia

74
Q

Where are the coronary ostia located?

A

behind aortic cusps near the superior aprt of hte sinus of Valsalva

75
Q

The ostium of the LCA is _______ and ________ to the right coronary ostium?

A

superior and posterior

76
Q

The left main coronary artery travels _______, ___________, and __________ from the left coronary sinus to emerge from behind the pulmonary trunk?

A

anteriorly, inferiorly, and leftward

77
Q

Besides the LAD and circ, what’s the 3rd branch that is possible for the LCA to divide in to?

A

diagonal

78
Q

Where does the LAD provide blood flow to?

A

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

79
Q

In what direction is the left circumflex artery directed?

A

posteriorly as it travels around the left side of the heart within the left AV sulcus

80
Q

Where does the left circumflex artery supply blood to?

A

left atrial wall, posterior and lateral LV, anterolateral papillary muscle, AV node in 10% of population, SA node in 40-45% of population

81
Q

Where does RCA supply blood to?

A

SA, AV nodes, RA, RV, posterior third of interventricular septum, posterior fascicle of LBB, interatrial septum

82
Q

How is dominance of one coronary artery determined?

A

by location of the coronary artery that crosses the crux and provides blood flow to the posterior descending artery

83
Q

In 50% of the population, the dominant coronary artery is?

A

RCA

84
Q

What are the 3 main venous systems in the heart?

A

coronary sinus, anterior cardiac veins, thesbesian veins

85
Q

Where is coronary sinus located?

A

posterior AV groove near the crux

86
Q

Why is the coronary sinus catheterized when metabolic studies of the LV are performed?

A

it collects 85% of blood from the LV

87
Q

The coronary sinus receives blood from where?

A

great, middle, small cardiac veins, posterior left ventricular veins, and left atrial vein of Marshall

88
Q

The thebesian veins may carry up to what % of blood that is returned to the RA?

A

40%

6902- Cullen (10 decks)

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