G: Heart Flashcards
Superior and inferior mediastinum are separated by ___
sternal angle
Superior mediastinum extends from __ (superior) to __ (inferior)
rib 1 to sternal angle
right around the root of the neck
Inferior mediastinum extends from __ (superior) to __ (inferior)
sternal angle to diaphragm
divided into anterior/posterior/middle
The pericardium is made up of 2 main layers. What ar ethey?
- outer fibrous layer
2. inner thin serous pericardium (parietal and visceral parts)
2/3 of the heart sits __ to midline
Midclavicular line should line up with __
should sit between __ intercostal space and __ intercostal space
left
apex of heart
between 2-5 intercostal spaces
From superficial to deep, name the layers of the heart wall
- epicardium (visceral layer of serous pericardium)
- myocardium (cardiac muscle)
- endocardium (endothelium lining the chamber)
Base of the heart
- where is it
- why is it important
posterior side of heart
this is where great vessels come in/put
Apex of heart
- where is it
- points to what
inferior (around 5th intercostal space)
points to left hit, sits on the diaphragm
Inferior border of the heart faces the ___
Right border of the heart faces the ___
Left border of the heart faces the ___
Superior border of the heart ___
inferior (diaphragmatic border)- diaphragm
right - right lung
left - left lung
superior - where vessels coming in/out
Anterior surface of the heart is against ___
Inferior surface of the heart is against ___
Right pulmonary surface of the heart is against ___
left pulmonary surface of the heart is agains t___
anterior - sternum AKA STERNAL BORDER
inferior - diaphragm
righ tpulmonary - right lung
left pulmonary - left lung
what’s the difference between border and surface of a heart?
border is a sharp edge
surface is a flat side
Where are the 4 chambers relative to the borders/surfaces of the heart?
right atrium - right border
right ventricle - inferior broder and anterior surface
left atrium - superior border and posterior surface
left ventricle - left border and apex
Atrioventricular valves and semilunar valves are important for ___
one directional blood flow
Which is tougher in composition: atrioventricular valves or semilunar valves
semilunar valves
Semilunar valves are between __ and __
ventricles and ejecting vessels
atrioventricular valves are between __ and __
atria and ventricles lol
Interatrial septum is between ___
interventricular septumis between __
right and left atria lol
between right and left ventricles lol
Fossa ovalis is found on ___
interatrial septum
___ has a muscular portion and an intramembronous portion
interventricular septum
Describe the clinical features found in the right atrium
- crista terminalis
- auricle
- pectinate mm
- fossa ovalis
- interatrial septum
The smooth wall portion of the right atrium is the ____.
This is derived from ___
interatrial septum is smooth wall
derived from sinus venosus
The auricle of the right atrium is the ___
roof
The roughened wall part of the right atrium is called ___
pectinate mm
What is the crista terminalis of the right atrium?
vertical ridge that separates the rough part from the smooth part of right atrium
Fossa ovalis is a remnant of ___
Found within the ___
foramen ovale
on the interatrial septum
Fossa ovalis is ___ to the opening for the coronary sinus
superior
20% of the population has a patent foramen ovale
what does this mean
foramen ovale never closed into fossa ovalis
they still have the opening
Right atrium receives ____ blood from what structures?
deoxygenated blood
from:
- superior vena cava
- inferior vena cava
- coronary sinus
The right atrium receives deoxygenated blood from SVC, IVC and coronary sinus.
Where do each of these drain blood from?
- superior vena cava - head/neck
- inferior vena cava - lower extremity
- coronary sinus (from heart itself)
The right atrium receives deoxygenated blood from svc, ivc, ccoronary sinus.
Do the openings from these structures contain valves?
no
these are always “open”
The right atrioventricular valve is also called ___
tricuspid valve
What are the 3 cusps on the tricuspid valve?
anterior cusp
posterior cusp
septal cusp
The 3 cusps on the tricuspid valve are anchored to the ___ in the ventricles
papillary mm
The 3 cusps on the tricuspid valve are anchored to the papillary muscles in the ventricles via ____
chordae tendineae
What are chordae tendinae?
they anchor the tricuspid valve cusps to the papillary muscles in the ventricles
The roughened part of the right ventricle is called ___
trabeculae carneae
What is trabeculae carneae?
the roughed part of the right ventricle
What is the septomarginal trabeculae (moderator band) of the right atrium?
located medially
this structure makes up part of the conduction system
What is the conus arteriosus (infundimbulum) of the right ventricle?
funnel to the pulmonary trunk
most superior part of the ventricle!
The most superior part of the right ventricle is on it’s way out to the pulmonary trunk.
This is called ___
conus arteriosus (infundibulum)
Papillary muscle in right atrium
- how many
- what is it formed form
coming off of floor from trabeculae carneae
3 in right atrium
- anterior, posterior, septal
Off of papillary muscles in the right atrium, ___ connect them to the right AV valve
chorda tendinae
TRA-PAP-CORD-AV
what the f does this mean
trabeculae carnea
- > papillary m -> cordae tendinae
- > av valve
The pulmonary valve is located ___
in the pulmonary trunk
at the apex of the infundimubul
How many cusps does the pulmonary valve have?
3 cusps
left, right, anterior
What clinical features does the left atrium have?
- left auricle
- valve of foramen ovale
- pectinate mm
- pulmonary veins
The left atrioventricular valve is also called __
bicuspid valve
mitral valve
What are the names of the cusps for the bicuspid valve
anterior cusp
posteror cusp
The bicupsid valve cusps are anchored via __ to __
anchored via chordae tendinae to papillary muscles
What is the aortic orifice of the left ventricle?
leads into the ascending aorta
Is there a moderator band in the left ventricle?
no
because the myocardium is 3x thicker than that of the right ventricle
Aortic valve is lcoated in the ___
How many cusps? Names?
located in aorta
3 cusps
left, right, posterior
4 valves of the heart are attached to a ____
fibrous skeleton (composed of dense collagen rings and trigones)
The listen to the heart, you need to place the stethescope ___ of the blood flow
downstream
What is the auscultation point for the tricuspid valve?
left of sternum
near 5th intercostal space
What is the auscultation point for the mitral valve?
over apex of heart in left 5th intercostal space on mid-clavicular line
What is the auscultation point for the pulmonary valve?
over medial end of left second intercostal space
What is the auscultation point for the aortic vavle?
over medial end of right second intercostal space
The coronary arteries arise from either side of the ____
aortic sinuses
What are the 2 main coronary arteries
right coronary artery
left coronary artery
What are the 3 main branches of right coronary artery
- anterior right atrial artery
- right marginal artery
- posterior interventricular artery
The right coronary artery travels in the ____ around the right side of the heart
coronary sulcus
The right coronary artery travels through the coronary sulcus.
It turns inferiorly and becomes ____
posterior interventricular artery
The posterior interventricular artery lies in the ____
posterior interventricular sulcus
Right marginal artery aka ___
Runs towards the __
acute margina artery
Runs towards apex of heart
The superior continuation of the anterior right atrial artery is ____
sinu-atrial nodal artery
The right coronary artery supplies: __
- right atrium
- right ventricle
- sinu-atrial node
- atrioventricular node
- interatrial septum
- portion left atrium
- posterior inferior 1/3 interventricular septu
- portion posterior part of left ventricle
Left coronary artery supplies most of ___
- left atrium
- left ventrcle
- interventricular septum
- atrioventricular bundle and it’s branches
Left coronary artery branches
- anterior interventricular artery (left anterior descending artery - LAD)
- circumflex artery -> left marginal artery
Coronary dominance is established by which (R/L) coronary artery gives off ____
posterior interventricular artery
because that supplies most of the heart
What is the general distribution of coronary dominance?
right = 65%
left = 15%
balanced = 20%
Most veins of the heart are tributaries to the ___
coronary sinus
The coronary sinus is located ___
in posterior portion of coronary sulcus
The coronary sinus opens into the ___ between __ and __
right atrium
between the IVC and AV orifices
What are the main veins in the venous drainage system of the heart?
great cardiac vein
middle cardiac vein
small cardiac vein
anterior cardiac vein
What is the course of the great cardiac vein?
w/ anterior interventricular artery in anterior IV sulcus
turns left- runs in coronary sulcus
travles w/ circumflex artery around left side of heart
empties into coronary sinus
What is the course of the middle cardiac vein?
travels with posterior interventricular artery in posterior IV sculcus
drains into coronary sinus superiorly
What is the course of the small cardiac vein?
travels with right margin artery along lateral right ventricle
turns right to run in coronary sulcus
travels with right coronary artery around side of heart
empties into coronary sinus
What is the course of anterior cardiac veins?
travel with anterior right ventricular aa along right ventricle
ascend toward righat auricle and empty directly int right atrium through orifices
All cardiac veins drain into coronary sinus except for ___
anterior cardiac veins drain directly into right atrium
What is cardiac catherization?
a procedure used to diagnose and treat cardiovascular conditions
Use thin tube called catheter inserted into artery/vein in groin/neck/arm and threaded blood vessel to the heart
Occlusion of major coronary arteries, usually due to atherosclerorsis, leads to ___
inadequate oxygenation of an area of myocardium
eventually cell death
____ may be used for coronary artery bypass grafts
great saphenous veins
alternatively: internal thoracic artery or radial artery
The heart has it’s own conduction system called ___
intrinsict conduction system
Does the autonomic nervous system affect the rate of heartbeat?
yes
How does the ANS affect the rate of heartbeat?
sympathetic innervation from T1-T12
parasympathetic innervation from vagus nerve (CN X)
Both sympathetic and parasympathetics contribute to ____ plexuses of nerves
superficial cardiac plexuses
deep cardiac plexuses
Impulses initiated by the SA node travel to the ___
AV node
propagation allows for atrial contraction
Impulses travel from AV node to ____
AV bundle and IV septum
The AV bundle impulses divide into ___
right and left bundle branches
From bundle branches, impulse is transferred to ____
Purkinje fibers
Purkinje fibers travel to ____ for contraction
ventricles
Damage to intrinsic cardiac conduction results in ___
cardiac arrhythmias
Damage to AV node will cause ___
heart block
uncoordinated contractions
Pacemakers may be inserted to control contractions of cardiac arrythmias occur.
What types of pacemakers are there?
single chamber
dual chamber
biventricular
Placing a pacemaker…
battery pack is inserted subcutaneously below ___
electrode threaded down through ___
Pass through __
Electrode terminal firmly fixed to ___
Placed in contact with ___
battery pack inserted subcutaneously below clavicle
electrode threaded through svc to right atrium
passes through av valve to right ventricle
electrote terminal firmly fixed to trabeculae carnea
placed in contact with endocardium of ventricular wall
Which coronary artery is known as teh “widdow maker” because of it’s association with common vascular problems?
anterior interventricular artery (LAD = left anterior descending artery)
