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CP I > GA 3b cardiology > Flashcards

GA 3b cardiology Flashcards

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Systemic vs. pulmonary circulation

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  • Systemic Circulation (from the Left Atrium past the Bicuspid Valve into the Left Ventricle out of the Heart past the Aortic Valve into the Aorta, through the arterial system, through the capillaries, through the venous system and back into the Heart through the Inferior and Superior Vena Cavae)
  • Pulmonary Circulation (from the Superior and Inferior Vena Cavae into the Right Atrium past the Tricuspid Valve into the Right Ventricle out of the Heart past the Pulmonary Valve into the Pulmonary Trunk, through the Right and Left Lungs Back into the Heart through the Pulmonary Veins)
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Myocardial Infarction

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Myocardial Infarction: lack of blood flow to a specific area of the myocardium, usually the result of a blockage in a Coronary A. Coronary Atherosclerosis, or buildup of lipids on the internal walls of the Coronary arteries decreases the size of lumen of that vessel, increasing the likelihood of an embolus, or plug blocking a vessel off entirely.

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Angina Pectoris

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Angina Pectoris: Pain that originates in the heart and produces a strangling pain of the chest. Angina Pectoris literally means strangling pain of the chest. The main is usually the result of narrow or obstructed coronary arteries that produces ischemia of the myocardium.

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7
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Layers of the heart

and what are they made up of?

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  • Epicardium (outermost layer; made up of Visceral Serous Pericardium)
  • Myocardium (thick muscular layer made up of spiraling, overlapping layers of Cardiac muscle)
  • Endocardium (thin internal endothelial and subendothelial layer lining the inside of the chambers of the Heart and valves)
  • Fibrous skeleton of the heart
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8
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Fibrous skeleton of the heart

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Fibrous Skeleton of the Heart (dense collagenous fibers)

  • Produces attachment points for the Myocardium
  • Produces attachment points for the vales of the cuspid valves
  • Supports and strengthens Atrioventricular and Semilunar orifices
  • Provides an electrically insulated barrier between the atria and ventricles
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(inferolateral part of the Left Ventricle, projects predominantly to the Left)

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(posterior portion, near the Left Atrium)

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(Right Ventricle)

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Diaphragmatic (Right and Left Ventricles)

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Pulmonary(Paired;RightAtriumandLeftVentricle,

occupying the Cardiac Impression on both Lungs)

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Right (RightAtrium)

Inferior (RightVentricle)

Left (Left Ventricle)

Superior (Right and Left Atria and the exit point for the Aorta and Pulmonary Trunk)

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  • Right Atrioventricular Groove (between the Right Atrium and Right Ventricle, transmits the Right Coronary A.)
  • Left Atrioventricular Groove (between the Left Atrium and Left Ventricle, houses the Coronary Sinus)
  • Anterior Interventricular Groove (between Right and LeftVentricles on the anterior aspect of the Heart, transmits the anterior Interventricular A. and Great Cardiac V.)
  • Posterior Interventricular Groove (between Right and Left Ventricles on the posterior aspect of the Heart, transmits the Posterior Interventricular A. and the Middle Cardiac V.)
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16
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external vertical groove corresponding to

the internal Crista Terminalis

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17
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What did this arise from?

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Ligamentum Arteriosum (embryological remnant of the Ductus Arteriosus, communication between the Pulmonary Trunk and the Arch of the Aorta)

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19
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The Ligamentum Arteriosum

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The Ligamentum Arteriosum travels from the superior aspect of the Pulmonary Trunk to the inferior concave border of the Aortic Arch. The Ligamentum Arteriosum is the adult remnant of the embryological Ductus Arteriosus which shunted blood from the Pulmonary Trunk to the Aorta to bypass the nonfunctional lungs. The Left recurrent Laryngeal N. of the Vagus N. (CN X) loops around the Aortic Arch and Ligamentum Arteriosum then ascends to the Larynx.

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  1. Sinus Venarum (posterior, smooth, thin walled region where the Venae Cavae and Coronary Sinus empty)
  2. PectinateMuscle(anterior,rough muscular wall)
    a. Right Auricle
  3. CristaTerminalis(internal ridge separating smooth and rough regions)
  4. interatrial septum(wallbetweenthetwoAtria)
    a. Fossa Ovalis (embryonic remnant of the

Foramen Ovalis)

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Atrial Septal Defects

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Typically involves an incomplete closure of the Foramen Ovale. It is estimated that 15-20% of adults have a small patency of their Foramen Ovale which is considered clinically insignificant. Larger openings in the Interatrial Septum can be clinically significant as they allow mixture of oxygen rich and oxygen depleted blood.

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Right Atrioventricular Orifice (passage from Right Atrium to Right Ventricle, variably occluded by the Tricuspid Valve)

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  1. tricuspid valve (separatesRightAtriumandRight Ventricle)
  • Anterior Cusp
  • Posterior Cusp
  • Septal Cusp
  • Chordae Tendineae (attach free edges of the three cusps to three corresponding Papillary muscles)
  • Anterior Papillary M. (joined to the Anterior Cusp of the Tricuspid valve via Chordae Tendineae)
  • Posterior Papillary M. (joined to the posterior cusp of the Tricuspid valve via Chordae Tendineae)
  • Septal Papillary M. (joined to the Septal Cusp of the Tricuspid valve via Chordae Tendineae)
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  • Trabecula Carnae (rough muscular region)
    • Septomarginal Trabeculum (Moderator Band; from the Interventricular Septum to the Base of the Anterior Papillary M., transmits the right bundle branch of Atrioventricular bundle to the Anterior Papillary M.)
  • ConusArteriosus(Infundibulum)(smooth-walled, leads into the Pulmonary Trunk)
  • Pulmonary Valve (Semilunar valve possessing Right, Left and Anterior Cusps, separates Right Ventricle from the Pulmonary Trunk)
    • Pulmonary Sinuses (space between the wall of the Pulmonary Trunk and the Cusps of the Pulmonary Valve)
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  • Pulmonary Valve (Semilunar valve possessing Right, Left and Anterior Cusps, separates Right Ventricle from the Pulmonary Trunk)
    • Pulmonary Sinuses (space between the wall of the Pulmonary Trunk and the Cusps of the Pulmonary Valve)
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Cardiac Catheterization

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Cardiac Catheterization: Insertion of a catheter into the femoral vein which is then passed up to the Inferior Vena Cava allowing radiographic visualization of the Right Atrium, Right Ventricle, Pulmonary Trunk and Pulmonary arteries.

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Left Atrium (thicker-walled than the Right Atrium)

  1. Left Auricle(containsPectinateM.)
  2. Openings for the 4 Pulmonary V.
  3. interatrial septum
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Left Atrioventricular Orifice (passage from Left Atrium to Left Ventricle, variably occluded by the Bicuspid Valve)

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Bicuspid(Mitral)Valve(separatestheLeftAtriumfrom

the Left Ventricle)

  • Anterior cusp
  • Posterior cusp
  • Chordae Tendineae (attach free edges of the two cusps to ventricular surfaces)
  • Anterior Papillary M. (joined to the Anterior Cusp of the Bicuspid valve via Chordae Tendineae)
  • Posterior Papillary M. (joined to the Posterior Cusp of the Bicuspid valve via Chordae Tendineae)
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  • Trabecula Carnae (rough muscular region)
  • Aortic Vestibule (Smooth-walled, leads into the Ascending Aorta)
  • Interventricular Septum (Myocardial wall separating the two ventricles, houses the Atrioventricular Bundle, Right and Left Bundle Branches and Subendocardial Branches. Described as having a Membranous (Fibrous) part that belongs to the Fibrous Skeleton of the Heart and a much larger Muscular part)
  • aortic valve(Semilunar valve possessing Right,
    Left and Posterior (Non-coronary) Cusps, separates Left Ventricle from the Ascending Aorta, occupies the Aortic Orifice)
    • Aortic Sinuses (space between the Wall of the Ascending Aorta and the Cusps of the Aortic Valve, the Right and Left Aortic Sinuses house the openings for the Right and Left Coronary A.)
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interventricular septum (Myocardial wall separating the two ventricles, houses the Atrioventricular Bundle, Right and Left Bundle Branches and Subendocardial Branches. Described as having a Membranous (Fibrous) part that belongs to the Fibrous Skeleton of the Heart and a much larger Muscular part)

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Ventricular Septal Defects

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Ventricular Septal Defects: Due to the embryologically divergent tissues that make up the Interventricular Septum that structure is particularly susceptible to defects. All defects are clinically relevant as they allow the mixture of oxygen rich and oxygen depleted blood.

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aortic valve (Semilunar valve possessing Right,
Left and Posterior (Non-coronary) Cusps, separates Left Ventricle from the Ascending Aorta, occupies the Aortic Orifice)
a. Aortic Sinuses (space between the Wall of the Ascending Aorta and the Cusps of the Aortic Valve, the Right and Left Aortic Sinuses house the openings for the Right and Left Coronary A.)

35
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cardiac cycle

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  • Beginning of Diastole (Aortic and Pulmonary Valve Close due to a drop in pressure inside the Ventricles)
  • Early Diastole (As the Ventricles relax the Heart lengthens and the Atrioventricular Valves (Tricuspid Valve and Bicuspid Valve) open flooding the ventricles with blood)
  • Diastole (Atrial contraction takes place in the late moments of Diastole and expulsion of blood into the Ventricles)
  • Beginning of Systole (Atrioventricular Valves close due to and increased pressure in the Ventricles)
  • Early Systole (Ventricles begin to contract thereby increasing the pressure, opening the Aortic Valve and the Pulmonary Valve)
  • Systole (full Ventricular contraction and expulsion of blood into the Ascending Aorta and Pulmonary Trunk)
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a. Atrioventricular Node (small bundle of specialized cardiac
muscle fibers located in the Interatrial Septum near the Opening for the Coronary Sinus, responds to the impulse from the Sinuatrial Node that distributed through the wall of the Atrium and distributes that signal through the Ventricles)
1. atrioventricular bundle (crosses the electricall insulated barrier provided by the Fibrous Skeleton of the Heart and distributes the impulse from the Atrioventricular Node into a Right and Left Atrioventricular Bundle which then distributes as Subendocardial Branches)

  1. Subendocardial Branches (distribute the
    Atrioventricular Nodal impulse from the Right and Left Atrioventricular Bundle Branches first to the Interventricular Septum, then to the Papillary muscles, and finally to the rest of the Ventricular Wall; also called Purkinje Fibers)
37
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Artificial Cardiac Pacemaker

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Artificial Cardiac Pacemaker: Produces a regular electrical impulse that is carried to the Ventricles via electrodes which are inserted through a large vein to the Superior Vena Cava, into the Right Atrium past the Tricuspid Valve into the Endocardium of the Trabecula Carnae of the Right Ventricle.

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Atrial Fibrillation

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Atrial Fibrillation: Irregular twitching of the Atrial cardiac muscle fibers to which the ventricles respond at irregular intervals. Circulation usually remains satisfactory.

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Ventricular Fibrillation

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Ventricular Fibrillation: Rapid irregular twitching of the ventricles rendering the Heart unable to pump blood. An electric shock administered by electrodes can cease all cardiac movement (defibrillation), in the hopes that the Heart may begin beating regularly after a period of time

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Cardiac Referred Pain

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Cardiac Referred Pain: Ischemia stimulates visceral pain sensory fibers in the heart of the Autonomic Nervous system. These visceral sensory fibers often share a spinal ganglion with the somatic sensory fibers of areas such as the upper limb and superior lateral chest wall. Anginal pain is typically referred to the area innervated by the Left Medial Brachial Cutaneous nerve, the left substernal area, left pectoral area and medial aspect of the left upper limb are often involved in this variety of referred pain.

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Oblique Pericardial Sinus (wide recess posterior to the base of the Heart)

Transverse Pericardial Sinus (transverse passage traversing the origins of the great vessels)

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Significance of the Transverse Pericardial Sinus

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Surgical Significance of the Transverse Pericardial Sinus: this space allows cardiac surgeons to access the area posterior to the aorta and pulmonary trunk to clamp or insert the tubes of a bypass machine into these large vessels.

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Pericarditis

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Pericarditis: Inflammation of the pericardium, which can make the pericardium rough and produce friction. This friction called a pericardial friction rub can be observed with a stethoscope. If left untreated the pericardium can calcify.

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Pericardial Effusion

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Pericardial Effusion: Inflammation of the pericardium can result in the accumulation of fluid or pus in the pericardial sac which can compress the heart. Heart compression is known as Cardiac Tamponade.

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Pericardiocentesis

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Pericardiocentesis: Drainage of blood, fluid or pus from the pericardial sac. This is usually done to relieve cardiac tamponade.

CP I (21 decks)

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