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101 Cardiovascular Physiology 1 Fall 2013 > CVT 101 Cardiac Anatomy (tristyn notecards) > Flashcards

CVT 101 Cardiac Anatomy (tristyn notecards) Flashcards

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1
Q

Fossa Ovalis

A

Fetal circulation- Interaptal septum mode up of 3 different layers (very thin)

Patent Fossa Ovalis: Patients fossa ovalis never closed; causes blood flow between atriums (PFO)

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2
Q

Sulcus Terminalis

A

Groove located outside right atrium

located anterior to SCV

Responsible for Nodal Artery Protection

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3
Q

What are the 3 bands of muscle part of RVOT?

A

Moderator band: connects medial and posterior cusps
Parietal Band:
Septal Band: connects anterior cust of TV

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4
Q

RVIF

A

Right ventricular in flow

In flow from tricuspid valve to apex

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5
Q

Right Ventricle

A

pumps venus blood to lungs
Normal pressure: 25-30mmHg systolic
0-5mmHg diastolic
Normal SvO2: 74-76%

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6
Q

Preload

A

volume in ventricle after diastole

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7
Q

Papillary Muscle

A 
connects the tricuspid valve
Anterior pap muscle: off moderator band
     -connects posterior cusp of TV
Posterior Pap muscle: off moderator band
     -connects medial cusp of TV
Medial Pap muscle: off septal band
       -connects anterior cusp of TV
*pap muscles contract! Supports TV cordae
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8
Q

RVOF

A

Right ventricle outflow

outflow from apex to pulmonic valve

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9
Q

Infundibulum

A

AKA: RVOF

Infundibular stenosis: pulmonic stenosis

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10
Q

Trabeculation

A

striations in ventricular myocardium surface inside chamber.

most of RV is tribeculated
*Only anterior portion of RA where SVC and IVC meet is smooth

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11
Q

Crux of the heart

A

Located posteriorly

Where coronary sinus, posterior interventricular sulcus and right atrioventricular sulcus meets

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12
Q

Pulmonary Veins

A 
4 pulmonary veins
1. Right superior
2. Left superior
3. Right inferior
4. Left inferior
-Continuous flow, no valves
-Transports oxygenated blood from the lungs to the LA
Normal pressure: 9-15mmHg
Normal SaO2: 97-99%
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13
Q

Pulmonary Artery

A

(2) Right and Left
-Pumps venous blood to the lungs thru PV
-Rises from the left ventricle
-more anterior than the aorta
-main pulmonary trunk branches into Right and Left pulmonary branches
Normal Pressure: 25-30mmHg systolic
5-10mmHg diastolic
Normal SaO2: 74-76%

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14
Q

Right Main Coromary artery

A

2 branches:

  1. Anterior Right artial branch
    • lays underneath RAA
  2. Nodal Artery
    • Supplies SA Node

Continues posteriorly and rises to posterior decending artery
Supplies: RA, RV, and LV (right dominate)

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15
Q

Thoracic Cavity

A

Occupies upper portion of thoracic cage above diaphragm

Contains: 2 pleural cavities, 2 plural sacs that encase the lungs, mediastinal and pericardial

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16
Q

Left Atrioventricular sulcus

A 
Divides LA and LV
contains:
1. Left Coronary (Main)
2. Circumflex Arteries
3. Great Cardiac Vein
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17
Q

Anterior Interventricular sulcus

A

Divides LV and RV on anterior side
Contains:
1. Anterior interventricular sulcus (LAD) (Decending) Artery
2. Great Cardiac Vein

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18
Q

Azygos System

A

Azygos Veins drain into SVC and IVC

Longitudinal vessels on each side of body that drain blood from body wall and move it superiorly to empty into SVC

*Pathway for venous return from lower extremities to heart if IVC gets blocked.

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19
Q

Carotid Sheath

A

Fibrous Connective tissue that surrounds the brachial plexus

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20
Q

Lower Esophogeal Veins

A

Venous return from esophagus to IVC

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21
Q

Pulmonary Artery Wedge pressure

A
  • Indirect estimate of left arterial pressure
  • Directly measures pulmonary artery pressure
  • Swan-Ganz catheter thru RA, RV, PV, PA and wedged into pulmonary branch
  • Normal Pressure: 9-15mmHg
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22
Q

Atrial-Septal Defect (ASD)

A

Hole between RA and LA

causes right side failure due to volume and pressure overload in RA which causes too high pressure going to lungs

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23
Q

Ductus Arterious/

Ligamentum Arteriosum

A

In fetal circulation, ductus arterius is located between the Ao and Pulmonary artery

Left and Right shunt

Once closed (72 hours after birth) then known in adulthood as ligamentum arteriosum

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24
Q

What is normal Ao Root size?

A

3.8 cm

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25
Q

Ao Dilation

A

Large Ao wall

At risk for Ao rupture or dissection

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26
Q

Aorta

A

Located posterior to the manubrium and arches left. Part of pericardial and mediastinal cavities.

Semi-lunar valve

Gives rise to the 3 head vessels:

  1. Brachiocephalic (innominate) Artery
  2. Left common carotid
  3. Left subclavian

Acending to Transverse to Decending to Abdominal

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27
Q

Artery Dissection

A

Tear in the intima/media wall of artery

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28
Q

What does Aorta do when heart contracts?

A

Moves anteriorally to promote stroke volume

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29
Q

Aortic Wall Layers

A

Intima: Innermost layer composed of active endothelial cells; susceptible to clot formations

Media: middle myscular layer
*takes the most “grunt” from pressure

Adventitia: Outside layer

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30
Q

Vaso Vasorum

A

The arterial and venous supply to larger arteries

Example: Aorta and Coronary arteries

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31
Q

Aorta Pressure and sats

A

Normal Pressure:
120-129 systolic
60-80 diastolic
Normal SaO2: 95-97%

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32
Q

Bracial Plexus

A

Anatomical Region for vascular access

  • contains jugulars, carotids, nerves, veins, and arteries
  • protected by the scalene muscles, the carotid sheath and the sternocleidomastoid muscle
  • located behind the first rib
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33
Q

Sternoceidomastoid muscle

A

Neck muscle connects top of manubrium to mastoid process of temporal bone

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34
Q

Phrenic Nerve

A

Supplies motor and sensory innervation to the diaphragm

  • Arises off 3rd and 4th spinal nerves
  • sympathetic NS
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35
Q

Vagus Nerve

A

Para sympathetic NS

Innervates the SA node and HR

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36
Q

What are 2 atrioventricular valves?

A

Tricuspid (right) and Mitral (left)

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37
Q

How many leaflets does the mitral valve have?

A
  1. Anterior cusp

2. Posterior Cusp

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38
Q

How many leaflets does the tricuspid valve have?

A
  1. Anterior cusp
  2. medial cusp
  3. posterior cusp
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39
Q

Layers of the TV and Mitral Valves

A

Atrial side: fibrosa layer
Middle layer: spongiosa
Distal (Ventricular) side: ventricularis

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40
Q

Right and Left Fibrous Trigones

A

Areas next to TV and Mirtal Valves that consists of stronger Fibrous tissue

  • Thickest part of the heart, very thick
  • OR surgeons use to anchor
  • Located below atria, above ventricles
  • LEFT: Ao and MV
  • RIGHT: TV and MV
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41
Q

Commissures

A

Point where leaflets meet when closed (each valve)

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42
Q

Interventricular Septum

A

Divides RV and LV
2 components:
Muscular Septum (thick muscle)
Membranous Septum

Interventricular Septum can be divided into:
Base section, Mid segment, and Apical segment

43
Q

Atrioventricular Valves

A 
Mitral and Tricuspid Valves
Components:
1. Leaflets: composed of elastin, collagen, fibrogin (thin yet strong)
2. Cordae (3 groups)
3. Pap muscles
4. Annulus
44
Q

TV and MV annulus Fibrosus

A

Fibrous skeleton

The structual “skeleton” support around each valve

45
Q

Serous Fluid

A

Clear, protein based fluid inside sacs or cavities for lubrication

46
Q

Parts of the Aorta

A
  1. Ascending Ao (root)
    • After AoV to first head vessel
  2. Transverse Ao (arch)
    • Top of arch - all 3 head vessels
  3. Descending/Thoracic Ao
    • After last head vessel to diaphragm
  4. Abdominal Ao
    • Once it passes diaphragm
47
Q

Thebesiian Veins

A

Very tiny veins that drain venous blood into each chamber

*Responsible for O2 drops in chambers!

48
Q

Rib Cage/Thoracic Cage

A

Made up of:
Contains 12 thoracic vertebrae, sternum, 24 rib, intercostal and muscles
Superficial
Protection and structure for cavities
Pressure -1 to -5 atmospheres
Contains 5 cavities: thoracic, 2 pleural, mediastinal, and pericardial

49
Q

Peritoneal Cavity

A

Separates abdominal and thoracic cavities

Borders inferiorly to thoracic cavity (to lower tip of sternum)

50
Q

Normal Fluid amount in pericardial sac:

A

5-15 mls

51
Q

Pericardial Effusion

A

too much in pericardial cavity

  • Serous
  • Hemorrhagic
  • Air
  • Sanguinous: blood tinged
52
Q

Pericarditis

A

Inflammation of pericardium

*can be due to open heart surgery, flu, lung problems, bronchitis

53
Q

Pericardial Friction Rub

A

Pericardium irritated by rubbing on pericardial sac

sounds like rubbing sand paper

54
Q

Valve of Thebesii

A

Valve over coronary sinus

55
Q

Coronary Sinus

A

Venous return from coronary arteries
Normal SvO2: 8-20%: very low due to high metabolic rate in myocardium

Valve of Thebesii: prevents backflow

Located next to valve of Eustachii (IVC) to move blood towards tricuspid valve.

56
Q

Superior Vena Cava

A

Venous return from upper extremities, brain, and thorax

Located next to ascending aorta

superior and anterior to right atrium

No Valve, continuous flow
Normal pressure: 3-5mmHg
Normal SvO2: 72-74% (brain uses a lot of O2)

57
Q

5 main cardiac circulation Veins:

A
  1. SVC
  2. IVC
  3. Jugulars - internal and external
  4. subclavian - arms
  5. Brachiocephallic
58
Q

Inferior Vena Cava

A

Venous return from lower extremities and abdominal

Sits on the floor of the RA

Valve of Eustachii - prevents backflow

Located behind heart, to the right of the descending aorta

Normal Pressure: 3-5mmHg
Normal SvO2: 76-78%

59
Q

IVC Filters

A

Stops blood clots

Types of patients: sedentary, diabetic, obese, renal failure, smokes, chemotherapy, clotting disorder

60
Q

Left Circumflex

A

Located in left atrioventricular sulcus

Provides circulation to left atrium and LV

Ends at obtuse marginal

61
Q

LAD

A

comes off of left main coronary artery

Lies in anterior interventricular sulcus

62
Q

Septal Perfurators

A

Supplies:

  1. Interventricular Septum
  2. HIS Bundle
  3. R & L Bundle Branches
63
Q

Posterior Interventricular Sulcus

A

Divides LV and RV posteriorly

Contains posterior interventricular artery and middle cardiac Vein

Has Septal perforators that supply HIS bundle,
R & L bundle branches and interventricular septum

64
Q

Left Main Coronary Artery

A

Very short-stemmed: 4mm then biforcates into:

  1. LAD
  2. L Circumflex
    • Typically stops @ L. Margin in right dominant
65
Q

Right Atrioventricular Sulcus

A

Lies between RA & RV

Contains right coronary artery

66
Q

Pulmonic Valve Sinuses

A

Not as prominent as AoV

Sinuses help support PV

67
Q

Sinus of Valsalva

A

Cusps on Aortic Valve (ascending Ao)

Used for coronary reserve

68
Q

When does coronary profusion occur?

A

During diastole

*Cannot profuse when myocardium contracts

69
Q

What are 2 Semilunar Valves?

A

Aortic Valve and Pulmonic Valve

Semilunar: 3 cusps

70
Q

Valve of Eustachii

A

Valve located in RA to prevent backflow into IVC

71
Q

Right Atrial Appendage

A

Small appendage on right atrium

Located anterior to SVC and Aorta

Used for Vascular Access during open heart surgery

Prone to clot formation is patient has A-fib or arrhythmias

72
Q

Right Atrium

A

Systemic Venous Return

Normal Pressure: 3-5mmHg
Normal SvO2: 74-76%

73
Q

Pericardium

A

Fibrous sac that contains the heart

supports the heart during systole and diastole whhen heart rotates

Extends 2cm up great vessels and pulmonary veins

protects heart from infection and isolates it from mediastinum

74
Q

congestive heart failure (CHF)

A

Hearts inability to maintain CO

depressed ejection fraction

leads to multi-system failure

75
Q

Pulmonary Infiltrates

A

Venous Congestion:

Left or right heart failure can cause pulmonary congestion - respiratory problems

Forces fluid into alveoli which decreases gas exchange

76
Q

Hypertrophy

A

Enlarged Muscle

77
Q

Dilated

A

Enlarged chamber or vessel

78
Q

Cardiac Mass (Weight)

A

Males: 280-340 grams
Females: 230-280 grams

79
Q

Point of maximal Impact (PMI)

A

Point where apex of heart hits chest wall thru 4th or 5th intercostal space

By palpating- should be size of quarter

80
Q

Cardiac Apex

A

Primary consists of LV and some RV

Points inferior, anterior and sits 60 degrees to the left

81
Q

Pericardial Attachments

A

Inferior: anchored to diaphragm by tendon
Superior: anchors/supported by head vessels
Lateral: borders R and L pleural sacs
Anterior: sternal ligaments

82
Q

Layers of pericardium

A

Endocardium (inside chambers)
Myocardium (inside muscles)
Epicardium (outside muscle)
Pericardial space

Make up of the pericardium:
Parietal Layer
Fibrous Layer (pericardial sac)

Epicardial fat

83
Q

Mediastinal Cavity

A 
Contains:
Great Vessels
Trachea
Esophagus
Thymus
Pericardial cavity
Vagus nerve
Phrenic Nerve
84
Q

Pericardial Cavity

A

Contains:
Heart
Pericardial sac
Great vessels that enter and leave the heart

85
Q

Pericardial sac

A

Serous membrane sac that heart sits in-
surrounds up to 2cm around the heart

Helps anchor the great vessels to the heart when heart twists during systole

86
Q

What helps to maintain breathing?

A

scalene muscles
diaphragm
intercostal muscles (contract)
negative pressure (-1) to (-5) inside the thoracic cage

87
Q

Diaphragm

A

Separates thoracic and peritoneal cavitites

Sheet of muscle that flattens and contracts

2 layers:
Muscles and Tendons help close Thoracic cavity Inferiorly

Helps maintain breathing

88
Q

Scalene Muscles

A

2 sets:
Elevate first and second ribs

Anterior scalene: 1st rib
Posterior scalene: 2nd rib

89
Q

Intercostal Muscles

A

Located in between ribs

External: towards medial, downward

Internal: towards lateral (outward)

90
Q

Sternum

A

Lies anteriorly in Thoracic cage. Articulates with the clavicles and first 7 ribs

3 parts:

  1. manubrium (top)
  2. body
  3. xyphoid process (bottom)

Sternal angle of louie

91
Q

Sternal Angle of Louie

A

Where the manubrium meets the body of the sternum

*Anatomical landmark for second intercostal space

92
Q

Sulcus Costae

A

Costal groove in each rib that protects the intercostal arteries, veins, and nerves

The innermost intercostal muscle keeps the arteries, veins, and nerves against the groove

93
Q

Transverse and oblique pericardial sinuses

A

Anatomical landmark seen by TEE that are folds in the pericardium filled with serous fluid

Transverse: located inferior to pulmonary trunk
Oblique: located medial to pulmonary veins

94
Q

2 LV Papillary muscles

A

Anterior Lateral
Posterior Medial

Attached at myocardium that contracts and connects cordaes of mitral valve

95
Q

Left Ventricle

A

Systemic output

Normal pressure: 120-130mmHg systolic
0-10 mmHg diastolic
Normal SaO2: 95-97%

Larger than RV, cone shaped, wider @ base, narrow @ apex, not trabeculated as much as RV

96
Q

Bronchiole Veins

A

Venous return from bronchiole branches to azygos vein

97
Q

Normal LV myocardium thickness

A

1cm

98
Q

Left Atrium

A

Receives oxygenated blood from lungs

Normal Pressure: 9-15mmHg
Normal SaO2: 97-99%

Has left atrium appendage (not useful)

Contains only smooth walls

99
Q

Vq

A

More Ventilating, less blood profusion

Example: standing

100
Q

vQ

A

Less Ventilation, more blood profusion in lower lobes

Example: sitting

101
Q

Crista Terminalis

A

Groove located inside right atrium

separates smooth wall and trabeculated wall

102
Q

Valve of Eustachii

A

Valve over IVC

103
Q

Afterload

A

What the ventricle has to pump against

104
Q

Nodulus Arantii

A

Notches that help close the valve

Located in center of each cusp

101 Cardiovascular Physiology 1 Fall 2013 (6 decks)

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