CV Anatomy modules 10-18 Flashcards
When is the mitral valve open and aortic valve closed
During:
Rapid ventricular filling
Diastasis
Atrial systole
What valve is open when LA pressure is greater than LV pressure
Mitral valve
What valve is open when LV pressure is greater than aortic pressure
Aortic valve
What happens to the aortic valve when aortic pressure exceeds LV pressure
It closes (producing the second heart sound), then causes retrograde flow from aorta toward aortic valve (Dicrotic notch)
What happens to the mitral valve when LV pressure exceeds LA pressure
It closes producing the 1st heart sound
Identify the status of the mitral valve during each phase of the cardiac cycle: Atrial systole Ventricular ejection Isovolumetric ventricular relaxation Isovolumetric ventricular contraction Rapid ventricular filling
Atrial systole-MV open
Ventricular ejection-MV closed
Isovolumetric ventricular relaxation-MV closed
Isovolumetric ventricular contraction-MV closed
Rapid ventricular filling-MV open
Identify the status of the aortic valve during each phase of the cardiac cycle Atrial systole Ventricular ejection Isovolumetric ventricular relaxation Isovolumetric ventricular contraction Rapid ventricular filling
Atrial systole-AV closed
Ventricular ejection-AV open
Isovolumetric ventricular relaxation-AV closed
Isovolumetric ventricular contraction-AV closed
Rapid ventricular filling-AV closed
What does each element represent in the cardiac PV loop Height Width Corners Area of PV loop
Height = ventricular pressure
Width = ventricular volume
Corners = where valves open and close
Area of PV loop = myocardial workload
What happens to myocardial external workload if the volume axis widens or the pressure axis increases heaight
Each will increase workload
Determine the severity of cardiac dysfunction based on EF >50% 41-49% 26-40% <25%
>50% = normal 41-49% = mild dysfunction 26-40% = moderate dysfunction <25% = severe dysfunction
What alterations affect the morphology of the cardiac PV loop
Preload
Contractility
Afterload
How does preload change the cardiac PV loop
Increased = wider PV loop Decreased = narrower loop
How does a change in contractility affect the cardiac PV loop
Increased = PV loop is wider, taller, and shifts LEFT Decreased = PV loop is narrower, shorter, and shifts RIGHT
How do changes to afterload affect the PV loop
Increased = PV loop is narrower, taller, and shifts ESV to right Decreased = PV loop is wider, shorter, and shifts ESV left
What arteries arise from the LCA
Left anterior descending
circumflex arteries
What does the left anterior descending artery perfuse
Anterolateral and apical wall of LV
Anterior 2/3 of interventricular septum
Perfusion changes caused by the left anterior descending will be seen in which lead
EKG V1-V4
What does the circumflex artery supply?
Left atrium
Lateral and posterior walls of ventricle
Perfusion changes caused by the circumflex artery will be seen in which leads
Leads I, aVL, V5 - 6
What does the right coronary artery perfuse
Right atrium
Right ventricle
Interatrial septum
Posterior third of interventricular septum
Perfusion changes caused by the right coronary artery are seen in which leads
Leads II, III, aVF
What does the posterior descending artery perfuse
Inferior wall
Where is the coronary sinus
The heart’s posterior surface
Where does the coronary sinus return blood
To the right atrium
How is the coronary sinus used during bypass
It can be cannulated to administer retrograde cardioplegia solution
Describe the unique properties of the Thebesian circulation
It returns deoxygenated blood to the left side of the heart
Contributes to small amount of anatomic shunt
When using TEE/TTE, what is the best view for diagnosing myocardial ischemia
Midpapillary muscle level in short-axis
Where do the left and right coronary arteries originate
The aortic root
How is PDA coronary dominance defined
Defined by origin:
right dominance = RCA gives rise to PDA
Left dominance = circumflex
Codominance = RCA and circumflex
What coronary supplies the SA node
RCA
The RCA supplies which cardiac node
SA node
AV node in 80% pts
What coronary artery supplies the AV node
RCA in ~80% of patients
What coronary supplies the Bundle of His
LCA in 75% of pts
What nodes does the LCA supply
Bundle of His
Left and right bundle branches
What coronary supplies the left and right bundle branches
LCA
What are the 3 main coronary veins
Great cardiac vein
Middle cardiac vein
Anterior cardiac vein
What blood drains into the coronary sinus
Most of the blood returning from the LV
Which veins carry most of the blood returning from the right ventricle
Anterior cardiac vein
What type of coronary vessels are the RCA, LAD, and CxA
Epicardial vessels
Describe the function of collateral vasculature in the heart
They provide redundancy of blood flow to poorly perfused areas
They develop from different branches of the same coronary artery or between 2 different coronary arteries
Single fed vessels are at risk if occlusion develops proximal to collateral branch