CVS Anatomy 1: Heart. Flashcards
Definition: double layered fibroserous sac that encloses the heart and the roots of the great vessels?
Pericardium.
Where is the pericardium located?
In the middle mediastinum.
Pericardium is located posterior to what?
The body of sternum and 2nd-6th costal cartilages.
Pericardium is located anterior to what?
T5-T8 vertebrae.
Pericardium is located to the right of what?
1-1.5 cm to the right of the sternum.
Pericardium is located to the left of what?
5-7.5 cm to the left of median plane at the level of 5th intercostal space.
(Midclavicular line) < position of the apex.
List the 2 layers of the pericardium?
1- fibrous pericardium: strong outer layer.
2- serous pericardium: inner transparent membrane.
What is the fibrous pericardium composed of?
Tough fibrous tissue.
list the 2 layers of the serous pericardium?
1- parietal: on the inside of the fibrous layer.
2- visceral layer: on the heart.
Which serous layer is also called the epicardium?
Visceral layer.
What is the function of the fibrous pericardium?
Protects heart against sudden overfilling.
The pericardium is pierced superiorly by what?
Aorta, pulmonary trunk, and superior vena cava.
Becomes fused with these vessels.
The pericardium rest inferiorly on what?
Rests on and is fused with central tendon of the diaphragm.
The pericardium is attached anteriorly to what?
Attached to the sternum by sternopericardial ligaments.
The pericardium is pierced posteriorly by what?
Pierced by pulmonary veins and inferior vena cave.
Becomes fused with these vessels.
Where does the parietal and visceral layers become continuous?
Around the roots of great vessels.
Where is the pericardial cavity located?
Lies between the two serous layers.
What does the pericardial cavity contain?
Contains a thin film of serous fluid.
What is the function of pericardial cavity?
Helps in frictionless movement of the heart.
List the 2 pericardial sinuses?
1- transverse sinus.
2- oblique sinus.
When do the pericardial sinuses develop?
During the folding of embryonic heart.
Which sinus lies posterior to ascending aorta and pulmonary trunk, anterior to superior vena cava?
Transverse sinus.
Which sinus is an inverted U-shaped blind recess lies posterior to the heart extending posterior to the left atrium, and can be entered inferiorly?
Oblique sinus.
Where does the transverse sinus communicates with the main part of pericardial cavity?
At its right and left ends.
How is the oblique sinus produced?
By the reflection of pericardium onto the pulmonary veins and inferior vena cava.
(Left atrium in front, and fibrous layer behind it (parietal)).
What is the main arterial supply of the heart?
Pericardiophrenic and musculophernic arteries, branches of internal thoracic.
The heart is also arterially supplied by what?
Pericardial branches of bronchial, esophageal and superior phrenic arteries.
The visceral layer of the serous pericardium (epicardium) is arterially supplied by what?
The branches of the coronary arteries.
Which veins drain the heart?
Veins are tributaries of azygos system.
Pericardiophrenic veins also drain into the internal thoracic vein.
What is the nerve supply of the fibrous pericardium and the parietal layer of the serous pericardium?
Are supplied by the phrenic nerves (somatic).
What is the nerve supply of the visceral layer of the serous pericardium?
Innervated by branches of the sympathetic trunks and the vagus nerves (autonomic).
List 4 clinical conditions that can affect the pericardium?
1- pericarditis.
2- pericardial effusion.
3- cardiac tamponade.
4- friction rub.
What is pericarditis?
Lower amount of fluids.
(Cardiac rub).
What is pericardial effusion?
Higher amount of fluids.
What is cardiac tamponade?
Blood instead of fluids in pericardial cavity.
Diminished heart sounds.
What is the management of cardiac tamponade?
Pericardiocentesis.
What is pericardiocentesis? And where is it inserted?
A wide-bore needle may be inserted through the left 5th and 6th intercostal space near the sternum (area of cardiac notch).
Where are intracardial injections given?
Left 5th and 6th intercostal space near the sternum (area of cardiac notch).
What is the heart?
Hollow muscular organ, acts as a double pump.
What is the shape of the heart?
Conical.
Where does the heart lie?
Lies free within the pericardium.
The heart is connect superiorly to what?
Connected superiorly to the large vessels.
How many chambers does the heart have and what are they?
4 chambers.
2 atria superiorly.
2 ventricles inferiorly.
How are the 4 heart chambers separated?
Separated from each other by atrioventricular and interventricular grooves.
Atria acts as the ________ chamber, and the ventricles act as the _________ chambers.
Atria act as the receiving chambers.
Ventricles act as the pumping chambers.
The right side of the heart contains ______ blood, and the left side contains _______ blood.
The right side of the heart contains deoxygenated blood.
The left side contains oxygenated blood.
List the 4 surfaces of the heart?
1- sternocostal (anterior) surface.
2- diaphragmatic (inferior) surface.
3- base (posterior surface).
4- apex.
What is the sternocostal surface formed mainly by?
Formed mainly by the right atrium and the right ventricle, separated by a vertical atrioventricular groove.
What separates the right ventricle from the left ventricle on the sternocostal surface?
The anterior interventricular groove.
The diaphragmatic surface is formed mainly by what?
By the right and left ventricles.
What separates the right and left ventricles on the diaphragmatic surface?
Posterior interventricular groove, and a small part of the right atrium, into which the inferior vena cava opens.
The base (posterior surface) of the heart is formed mainly by what?
The left atrium, into which open the 4 pulmonary veins.
What shape is the base (posterior surface) of the heart?
Quadrilateral in shape.
The base faces which direction?
Faces posteriorly, superiorly, and toward the right shoulder.
The apex is formed mainly by what?
Formed by left ventricle.
The apex is directed towards which direction?
Downward, forward and to the left.
What is the location of the apex?
Located posteriorly to the left 5th intercostal space.
Aka, medial to the left midclavicular line.
What is the point of maximal pulsation of the heart?
The apex,
The apex beat can be seen as well as palpated.
What forms the right border of the heart?
The right atrium.
What forms the left border of the heart?
Formed by the left auricle above and the left ventricle below.
What forms the inferior border of the heart?
Formed mainly by the right ventricle, and the apex of the left ventricle.
What forms the superior border of the heart?
Border is where great vessels enter or leave the heart, formed by right and left auricles and superior part of right and left ventricle.
List the anatomical positions of the 4 heart valves?
1- 3rd costal space: pulmonary valve.
2- 3rd intercostal space: aorta.
3- 4th costal space: mitral valve.
4- 4th intercostal space: tricuspid valve.
Where is the best ausculation positions of the 4 heart valves?
1- right 2nd intercostal space: aorta.
2- left 2nd intercostal space: pulmonary.
3- left 5th intercostal space (apex) (midclavicular line): mitral.
4- 4th-5th sternum or lower end intercostal space: tricuspid.
List the 3 blood circulations of the heart?
1- systemic circulation.
2- pulmonary circulation.
3- portal circulation.
List the 3 parts of the right atrium?
1- the posterior (smooth) part.
2- the anterior (rough) part.
3- the septal part.
List the 4 openings of the posterior (smooth) part of the right atrium?
1- receives opening of coronary sinus.
2- opening of superior and inferior vena cava.
3- opening of anterior cardiac veins which opens within the atreal cavity.
4- opening of venae cordis minimi which open within the atreal cavity.
What forms the anterior (rough) part of the right atrium?
Formed of parallel muscular ridges (musculi pectinati) extending to right auricle.
What separates the anterior (rough) part from the posterior wall of the right atrium?
Separated from the posterior wall by a vertical ridge (crista terminalis).
What forms the septal wall of the right atrium?
Formed of an oval depression (fossa ovalis), bounded superolaterally by a margin (annulus ovalis).
List the 2 parts of the right ventricle?
1- the lower (rough) inflowing part.
2- the upper (smooth) outflowing part.
What forms the lower (rough) inflowing part?
Formed of irregular muscular ridges (trabeculae carnae).
What does the lower (rough) inflowing part of the right ventricle contain?
Has 3 papillary muscles (anterior, posterior and septal): with a base attached to ventricular wall and an apex attached to cusps of tricuspid valve by chordae tendinae.
Definition: a muscular ridge extending from interventricular septum to base of anterior papillary muscle.
Moderator band.
What does the moderator band carry?
It carries the right branch of A-V bundle.
What is the upper (smooth) outflowing part of the right ventricle called?
The infundibulum or conus arteriosus, it leads into pulmonary orifice.
List the 2 orifices and valves of right ventricle?
1- right atrioventricular (tricuspid).
2- pulmonary.
Where does the right atrioventricular (tricuspid) valve lie?
Lies between right atrium and ventricle.
What surrounds the right atrioventricular (tricuspid) valve?
Surrounded by a fibrous ring giving attachment to the bases of 3 triangular cusps (anterior, posterior and septal).
What is attached to the adjoining free edges of cusps of right atrioventricular (tricuspid) valves?
Chordae tendinae of papillary muscles.
Where does the pulmonary valve lie?
Lies between infundibulum of right ventricle and pulmonary trunk.
How many cusps does the pulmonary valve consist of?
3 semilunar cusps.
1- anterior cusp.
2- right cusp.
3- left cusp.
Where are the 3 semilunar cusps of the pulmonary valve situated?
Two situated in the anterior wall: anterior and right cusps.
One situated in posterior wall: left cusp.
The wall of the pulmonary trunk is slightly _____ _____ the 3 cusps forming __ ______.
Slightly dilated above the 3 cusps forming 3 sinuses (2 anterior and 1 posterior).
How does the left atrium compare to the right atrium?
1- its cavity is smooth except the left auricle which have musculi pectinati.
2- its posterior wall receives the openings of 4 pulmonary veins (have no valves).
How does the left ventricle compare to the right ventricle?
It’s cavity is circular in shape and 3 times thicker.
What does the lower rough part of the left ventricle contain?
1- trabeculae carnae: are larger and more numerous.
2- papillary muscles: are only 2, larger, has fewer but stronger chordae tendiae.
What is the upper smooth part of the left ventricle called?
Called aortic vestibule, leads into aortic orifice.
Definition: An oblique septum separating the ventricles?
Ventricular septum.
List the 2 parts of ventricular septum?
1- an upper smaller membranous part.
2- a lower larger muscular part.
List the 2 orifices and valves of the left ventricle?
1- left atrioventricular (mitral).
2- aortic.
Where does the mitral valve lie?
Between the left atrium and left ventricle.
How does the mitral valve compare to the tricuspid valve?
1- its orifice is narrower.
2- it has only 2 cusps (anterior and posterior).
3- cusps are larger and stronger.
Where does the aortic valve lie?
Lies between the aortic vestibule of left ventricle and ascending aorta.
How does the aortic valve compare to the pulmonary valve?
1- consists of 3 larger semilunar cusps:
One situated in anterior wall: right cusp.
Two in posterior wall: left and posterior cusps.
2- the wall of aorta is slightly dilated.
3- above the 3 cusps forming 3 sinuses (one anterior and 2 posterior).
