CVS anatomy lect 1

Question 1

where do we find the apex beat of the heart

Answer 1

L5icsmcl - the 5th left intercostal space at the mid clavicular line.

Question 2

where do we find the base of the heart

Answer 2

4icsRSE, the 4th intercostal space on the right sternal edge.

Question 3

where would we auscultate for the mitral valve

Answer 3

The Mitral area 5th intercostal space towards the apex

Question 4

where would we auscultate for the tricuspid valve

Answer 4

The Tricuspid area 4th to 5th intercostal space, left sternal border

Question 5

where would we auscultate for the pulmonary valve

Answer 5

The Pulmonary area 2nd intercostal space, left sternal border

Question 6

where would we auscultate for the aortic valve

Answer 6

The Aortic area 2nd intercostal space, right sternal border

Question 7

what are we looking for in a chest radiograph in terms of size

Answer 7

Chest radiographs are the standard way to view the heart anteriorly in the thorax.
If we see a heart that is greater than 50% of the diaphragm diameter when the chest is being inhaled then we have an enlarged heart.
It must be at inhalation as the shape of the radiograph changes in exhalation vs inhalation. As at exhalation we can see a normal heart appearing to be over 50% of the diaphragm width.
Due to the hearts orientation we see that the left atrium is infact the most posterior part of the heart.
in short we want the heart to be less than 50% of diaphragm width

Question 8

why is the surface of the right atrium in two different patterns

Answer 8

part of the inside surface is smooth and part is rough. this is because of different embryonic developments

Question 9

what are the names of the two surfaces in the right atrium

Answer 9

atrium proper - rough part
sinus of vena cavae - smooth part

Question 10

whats the boarder between the atrium proper and the sinus of vena cava called

Answer 10

crista terminalis

Question 11

why is the atrium proper rough in its appearance

Answer 11

because of the musculi pectinati being there.

Question 12

whats the fossa ovalis

Answer 12

it is the closing over of the foramen ovalae which we used to have as a foetus

Question 13

what is the foramen ovale

Answer 13

Fossa ovalis used to be an open passage from the right atrium to the left atrium. This is because in the foetus there was no gas exchange in the lungs - as air couldn’t be inhaled as a foetus, so the oxygenated blood we received from the placenta was then shunted from right atria to left atria. When we are born the shunt closes over and we thus get the Fossa Ovalis in the right atrium.

Question 14

what vessels empty into the right atrium

Answer 14

the inferior vena cava, superior vena cava, the coronary sinus

Question 15

what are the three parts of the tricuspid valve

Answer 15

the anterior cusp, the posterior cusp and the septal cusp

Question 16

what valve is the most anterior of the valves

Answer 16

this is the pulmonary valve. it has an anterior semilunar cusp, right semilunar cusp, left semilunar cusp

Question 17

what is the conus arteriosus and whats it do

Answer 17

There is also a domed portion superiorly in the right ventricle. This exists to ensure that blood flows towards the pulmonary valve during ventricular ejection phase. This structure is called Conus arteriosus / infundibulum/ RV outflow tract.

Question 18

what drains into the left atrium

Answer 18

the left and right superior and inferior pulmonary veins

Question 19

what are the cusps of the mitral valve called

Answer 19

the anterior and posterior valves

Question 20

what are the cusps of the aortic valve called

Answer 20

the left semilunar cusp, right semilunar cusp and the posterior semilunar cusp.

Question 21

what are the three layers of the heart valves

Answer 21

lamina fibrosa, lamina spongiosa, lamina ventricularis

Question 22

describe the histology of the lamina fibrosa and the lamina ventricularis

Answer 22

lamina fibrosa: rich in connective tissues, mainly collagen as this helps to maintain the shape of the cusp
lamina ventricularis: mostly elastic tissues so that the valve is able to recoil back into shape

Question 23

where do the coronary arteries originate from

Answer 23

below the left and right cusps of the aortic valve

Question 24

what are the brancehs off of the right and left coronary arteries

Answer 24

most of the time we have a right dominant heart. so we have the posterior descending artery coming off of the right coronary artery.
then there is the left anterior descending artery and the left circumflex artery from the left coronary artery.