Great Vessels and the Heart Flashcards
what makes up the anterior surface of the heart
the right ventricle mostly, some contribution of right atrium and left ventricle
what makes up the left pulmonary surface of the heart?
left ventricle and portion of left atrium
what makes up right pulmonary surface of the heart
right atrium
what makes up the diaphragmatic surface of the heart?
left ventricle and some of right ventricle
what makes up the apex of the heart
the left ventricle, faces downward, to the left and slightly anteriorly
what separates the superior and inferior mediastinum?
sternal angle
what is the location of the mediastinum in proportion to midline?
it is shifted 2/3 left of midline
what divides the inferior mediastinum?
the pericardial sac divides it into anterior, middle and posterior mediastinum
what is the pericardium?
fibroserous sac (has continuous layers of fibrous and serous pericardium), surrounds heart and proximal great vessels
clinical application of fibrous pericardium?
non-distensible, so rapid accumulation of fluid within pericardial sac will compress the heart and result in biventricular failure (cardiac tamponade)
describe the serous pericardium
parietal and visceral layers are continuous with each other, around roots of great vesicles
what are the sinuses in the pericardium
transverse pericardial sinus and oblique pericardial sinus
where is the transverse pericardial sinus
superiorly, the pericardium surrounds aorta and pulmonary trunk, but when the pericardium is reflected, there is a space where a finger can slide behind the aorta and pulmonary trunks, and in front of the superior vena cava
where is the oblique pericardial sinus
posteriorly, when the heart is taken out of the body, the pericardium surrounds pulmonary veins and venae cavae
what causes semilunar valves to close?
when the ventricles contract, the aortic and pulmonary sinuses fill with blood and forces the cusps to close
what distinguishes the pulmonary semilunar valves from the aortic semilunar valves?
the aortic semilunar valves have openings for the coronary arteries in the cusps
what is the nodule of a semilunar valve and role?
thickened, middle portion of each cusp, helps to add weight to the cusp to help them close
what differentiates semilunar valves from the tricuspid and bicuspid valves?
they don’t have papillary muscles or chordae tendinae
what allows the right and left coronary arteries to fill?
during diastole, when the aortic sinuses begin to fill, blood is forced into the right and left coronary arteries that are “behind” the closed semilunar valves
muscle in the wall of atria?
pectinate
muscle in wall of ventricles?
trabeculae carnae
describe the valves of the tricuspid valve?
has anterior, septal and posterior cusps
describe the valves of the bicuspid valve?
anterior and posterior cusps
what muscles assist in opening the bicuspid and tricuspid valves?
papillary muscles that are attached to chordae tendineae
which is the largest papillary muscle in the right ventricle?
the anterior papillary muscle
which are the pulmonary semilunar valves?
anterior, right, and left semilunar cusps
what are the aortic semilunar valves?
posterior, right and left semilunar cusps
what is the crista terminalis?
the division of pectinate muscle and smooth interior of right atrium, correlates with the sulcus terminales outside
where is the fossa ovalis?
between right and left atria, is a smooth depression
what is the fossa ovalis?
where the foramen ovale was in the fetus
what was the role of the foramen ovale?
allowed oxygenated blood from the inferior vena cava that enters the right atrium to directly enter the left atrium and bypass the fetal lungs
what is the ductus arteriosus?
connected the pulmonary trunk to the arch of the aorta, which allowed bypass of the lungs, became ligamentum arteriosum
in the fetal heart, where does the superior vena cava empty?
directly into the right atrioventricular orifice into the right ventricle, through the pulmonary trunk shunted to the ductus arteriosus
in the fetal heart, where does the inferior vena cava empty?
into the right atrium, which is shunted through the foramen ovale to the left atrium to go to left ventricle and aorta
what is the coronary sulcus?
separates the atria from the ventricles, and contains the right coronary artery
what is the anterior interventricular groove?
separates the ventricles, and contains the anterior interventricular artery (left anterior descending artery from the left coronary artery)
what supplies the SA node?
right coronary artery
where is the opening of the coronary sinus?
next to the valve of the inferior vena cava, coronary sinus has a valve too
site of the AV node?
in interatrial septum near coronary sinus opening
pathway of signal conduction of the heart
SA node, AV node, bundle of His (AV bundle), right and left bundle branches, Purkinje fibers
where is the bundle of His
in membranous part of intraventricular septum
where are the purkinje fibers?
in the muscle of ventricles (walls)
where are the right and left bundle branches?
in the muscular portion of the IV septum
what is the septomarginal trabecula?
the moderator band, connects the anterior papillary muscle in the right ventricle to the muscular part of IV septum
site of SA node
near opening of SVC in right atrium
what regulates rate, force of contraction and CO?
autonomic system
what is the effect of the parasympathetic stimulation of the heart?
decreased HR, reduced force of contraction, constriction of coronary arteries
what is the effect of the sympathetic stimulation of the heart?
increases HR and force of contraction
what is the treatment for CAD?
drugs, bypass graft, angioplasty, stent
what is CAD?
heart muscle is not receiving sufficient blood supply, due to narrowing of vessels due to atherosclerosis, artery spasm or clot
what is MI?
death of area of heart muscle that is replaced by scar tissue from a lack of O2
what are the prognostic factors for MI?
location of occlusion, size of occlusion, how long occluded
what is angina pectoris?
chest pain from ischemia of cardiac muscle
what is CABG?
coronary artery bypass grafting, where a vein is used from elsewhere in the body (internal thoracic or saphenous) and flipped upside down (so valves don’t stop blood flow) to supply an ischemic heart
what is a coronary angioplasty?
balloon catheter is threaded through obstruction, inflated, squashing the plaque and stretching the arterial wall
what vein runs with the right marginal artery?
small cardiac vein
what vein runs with the LAD?
the great cardiac vein (LAD becomes GLAD)
what vein runs with the posterior interventricular artery (posterior descending artery, PDA)
middle cardiac vein (middle schoolers love PDA)
where to listen to heart sounds?
pulmonary, aortic, mitral, tricuspid
where to listen to pulmonary heart sounds?
left upper sternal border, medial end of the left second intercostal space
where to listen to aortic heart sounds?
right upper sternal border, medial end of the right second intercostal space
where to listen to mitral heart sounds?
5th left intercostal space over the apex of the heart along midclavicular line
where to listen to tricuspid sounds?
4th left intercostal space, to the left of the sternum near the 5th intercostal space
what branches off the RCA?
atrial branch, right marginal branch, PDA (posterior interventricular branch)
what branches off the LCA?
LAD (anterior interventricular branch), circumflex branch, which gives rise to left marginal branch
what supplies the AV node?
the end of RCA posteriorly
what supplies the SA node?
the atrial branch of the RCA
what is right dominant coronary artery?
where the PDA rises from the RCA (most are right dominant)
what is left dominant coronary artery?
where the PDA arises from the circumflex branch of the LDA
