Cvs1 - Part 2 Flashcards
What is the most dangerous location in the heart for a clot to block that can lead to a sudden loss of consciousness and eventually death?
The pulmonary artery / trunk
R / l pulmonary
If this locatin is blocked by a clot/etc. it can result in death.
The Pulmonary artery/trunk R/L Pulmonary.
A clot in the pulmonary artery / trunk is called
Saddle embolism
In DVT (deep vein thrombosis) the Patient will present with
claudication (pain in the lower limbs).
Usually is an aftermath of DVT (Deep vein Thrombosis)
Saddle embolism
Turners syndrome
Congenital heart defect
Other clinical features of turners syndrome
a “Webbed neck” and absence of Ovaries.
Following a drop of blood
o Superior Vena Cava → Right Atrium → Tricuspid Valve → Right Ventricle → Pulmonary Semilunar Valve → Pulmonary Artery → Right/Left Pulmonary Arteries →Right/Left Lungs (oxygenation occurs) → Right/Left Pulmonary Veins → Left Atrium → Bicuspid/Mitral Valve → Left Ventricle → Aortic Semilunar Valve → Aorta → Branches of the Aorta →Tissues of the body get perfused with oxygenated blood
• Where is the pericardial cavity located?
Between the parietal and visceral layers of the pericardium
What is present in the pericardial cavity?
Pericardial fluid (serous fluid),
What are the 3 layers of the heart?
Epicardium, myocardium, endocardium
1 in 500 births have
Heart defect
Epicardium is in fact the
Visceral pericardium
Most vascular layer of the heart
Visceral pericardium / epicardium
• The least vascular layer of the heart is the
Endocardium
• Infarction results when
a tissue dies because of cessation of its blood supply.
What is the most common infarction of the heart
Sub endocardial infarction
Why is Sub endocardial infarction the most common
because it receives the least amount of blood supply and gets effected most in case of a blockage of the Coronary arteries and their branches)
What is the type of Infarction in which all three layers of the heart are effected/die/get infarcted?
Transmural infarction
Painless Transmural infarction is observed in:
Diabetics
Elderly
Patients on beta blockers
Substance abusers
Dressler’s syndrome
•secondary form of pericarditis
Most common reason for compression of the Superior Vena Cava?
Pregnancy
Compression of the Superior Vena Cava
what are the side effects
very serious condition. Due to back pressure there is swelling of the veins of the neck.
• If the diameter of the heart is less than 50% of the transverse diameter of the rib cage, then the heart size is?
Normal
If the diameter of the the heart is more than 50% of the diameter of the rib cage
It is enlarged
• is the most common cause of heart enlargement
(Persistent/untreated) high blood pressure
What chamber of the heart forms the right border of the heart?
Right Atrium
Number one cause of Tricuspid Valve Disease?
Intravenous drug use ( main liners )
• Branches of the Arch of the Aorta
Brachiocephalic artery
Left common carotid artery
Left subclavian artery
What is the condition in which the Pulmonary artery is located at the LEFT ventricle instead of the RIGHT ventricle, and the Aorta is located at the RIGHT ventricle instead of the LEFT ventricle?
Transportation of the great vessels
Transportation of the great vessels is most commonly caused by
preexisting diabetes mellitus of an expectant mother)
In order to keep a patient alive with transportation of the great vessels
the Ductus Arteriosus must remain/kept OPEN
What is the medication that will allow the Ductus Arteriosus to remain open?
Prostaglandin E
What medications will/aid the CLOSURE of the Ductus Arteriosus
Advil or aspirin
• Atrioventricular valves – tricuspid/Bicuspid have:
Explain structure
o Chordae tendinae extending out of them which are attached to the
o Papillary muscles
o Cusps/leaflets/Cuspids
What are atrioventricular valves?
Tricuspid
Bicuspid
Semilunar valve
Defining characteristics
Do not have any Chordae tendinae & do not have any papillary muscles. They only have cusps/leaflets/cuspids
Trabeculae carnae
Muscles that form the irregular portion of the ventricular surfaces of the heart
Trabaculae carnae prevent what?
prevent the suction effect and hence help in preventing the blood to adhere to the surface of the wall of the ventricles
Trabeculae carnae overall prevents
prevents clotting of the blood in the heart.
After a myocardial infarction this mechanism is compromised as a portion of the wall of the heart dies and becomes hypokinetic.
Trabecular carnae
What happens If a patients has a portion of their heart that dies
How can death be prevented?
This predisposes the patient to develop clots in the heart.
To prevent this the patient is placed on Anti-coagulants for the rest of their life.
Pectinate muscles
irregular portion of the Atria surfaces of the heart
Pectinate muscles prevent
prevents the suction effect (similar to the Trabeculae Carnae)
The valve’s job (irrespective of its location) is to
• allow the blood to flow in one direction only. The valve prevents the blood to flow in a retrograde direction.
• Veins are the ONLY vessels that have
Valves
What happens in bypass surgery when a vein is used to replace an artery?
Due to exposure to high pressure dynamics, the valves in the vein will degenerate and eventually will cease to exist, transforming the vein into the artery
• Aortic Semilunar Valve lies between
the Left Ventricle and the Aorta
• There are TWO Coronary Arteries that supply blood to our heart:
The RIGHT and LEFT Coronary Arteries
Systole
Contraction of the Cardiac muscle (Ventricles)
blood is pumped out of the ascending Aorta every ?
And forms a?
.8 seconds
Bolus
Stroke volume is?
70ml
Stroke volume blocks
It blocks the ostium of the Coronary arteries (due to their unique architectural location) and the cardiac tissue does not receive blood during systole.
Diastole
• Diastole – Relaxation of the Cardiac muscle (Ventricles):
Blood present in the Arch of the Aorta attempts to return to the heart via the
Ascending aorta
Blood trying to return to the heart via the ascending aorta is blocked by
is denied entry via the closed semilunar valves,
Since the blood is blocked by the semilunar valves it goes where?
naturally flows into the Coronary arteries.
Does the heart receives blood during Diastole.
Yes
Atrioventricular groove/sulcus
Shallow trench like surface feature of the heart
Atrioventricular groove/sulcus marks?
marks the junction between the Atria and the Ventricles.
The Right and the Left Coronary arteires are found in the
Atrioventricular groove/sulcus
• The left coronary artery has TWO branches:
Circumflex artery
Left anterior descending artery
o Circumflex Artery location?
(descends alongside the left border of the heart)
Left Anterior Descending Artery location?
(found in the anterior interventricular sulcus
• What Artery is also called the “Widow Maker”?
Left Anterior Descending (LAD) Artery
• There are TWO branches of the Right Coronary Artery:
Acute marginal artery
Posterior descending artery
o Acute Marginal Artery location?
(descends along the right border of the heart)
o Posterior Descending Artery location
found in the Posterior Interventricular sulcus/groove)
• Coronary circulation dominance –
the artery that supplies the Posterior Descending Artery determines the coronary dominance
Collateral circulation
networking circulation (i.e. Circle of Willis)
• Geriatric patients will have a better chance of survival in cases of heart attacks due to
the natural presence of Collateral Circulation
Turners syndrome provides a increased incidence of?
“Coarctation of the Aorta”
Purpose of pericardial fluid
lubricates the parietal layer and the visceral layer.
Dressler’s syndrome occurs when?
injury to the heart or the pericardium
