Heart 1: Anatomy of Heart (not development)! Flashcards
Pericardium
Double walled fibrous sac eclousing the hear and roots of the great vessels. Attached to the sternum via sternopericardial ligaments
Sternopericardial ligaments
Attachments of the pericardium to the sternum
Fibrous pericardium
Derived from body wall. Fused to central tendom of diaphragm. Inelastic and protects against overfilling.
Serous pericardium
Shiny and oily. Comprised of parietal and visceral pericardium.
Parietal Pericardium
Fused to internal surface of the fibrous pericardium. Reflects onto great vessels of heart on the superior aspect of heart
Visceral pericardium
AKA epicardium. Portion associated with the organ
Pericardial Cavity
Region between two serous membranes. If fluid (blood) is trapped in this region, heart has no space to beat. Fluid needs to be drained (via a needle)
Oblique pericardial sinus
Cul-du-sac lying posterior to the heart in the pericardial sac. Bounded by the reflection of the serous pericardium onto the inverior vena cava and right pulmonary veins on the right and the reflection of the serous pericardium onto the left pulmonary veins on the left.
Transverse Pericardial sinus
anterior to the superior vena cava and posterior to the ascending aorta and pulmonary trunk. Important for surgery is it separates inflow and outflow so that inflow can be ligated
Apex
Left ventricle at left 5th intercostal space.
Base
Left atrium. Sits in back of heart toward vertebral column. Esophagus is between vertebral column and left atrium.
Surfaces of the heart
Planar. Sternocostal (anterior), diaphragmatic (inferior), and pulmonary (left).
Sternocostal surface
Anterior surface. Comprised of right ventricle.
Diaphragmatic surface
Inferior surface. Both ventricles, but primary left.
Pulmonary surface
Left surface. Occupies cardiac notch
Borders of heart
Left, superior, right, inferior
Right border of heart
Comprised entirely of right atrium. Right 3rd costal cartilage to right 6th costal cartilage.
Inferior border of heart
Comprised primarily of right ventricle, some apex of left ventricle. Right 6th costal cartilage to left 5th intercostal space.
Left border of heart
Comprised of Left ventricle and left auricle
Superior border of heart
Comprised of left and right auricles and conus arteriosus. Left 2nd costal cartilage to right 3rd costal cartilage
Cardiac grooves
Coronary (atrioventricular) sulcus, anterior interventricular groove, posterior interventricular groove
Coronory sulcus
Aka atrioventriculur sulcus. Separates right atrium from right ventricle. Continues around back before running under left auricle.
Anterior interventricular groove
Groove between right and left ventricles on anterior aspect of heart. Denotes the deeper intervetricular septum between the two
Posterior interventricular groove
On back of heart. Separates right and left ventricles on posterior aspect of heart.
Chambers of heart
Right atrium, right ventricle, left atrium, left ventricle
Right atrium
Receives deoxygenated blood from superior and inferior vena cava, coronary sinus, and anterior cardiac veins. Pumps this blood into right ventricle via tricuspid valve.
Superior vena cava
Vein carrying deoxygenated blood from everything above diaphragm into right atrium
Inferior vena cava
Vein carrying deoxygenated blood from everything below diaphragm into right atrium
Sinus venarum
Known as sinus venosus in embroynic heart. The SMOOTH part of the right atrium. Receives the bloodflow from superior and inferior vena cavas. Its smooth nature is due to being derived from a blood vessel.
Crista terminalis
Prominent ridge in right atrium. Point of origin of pectinate muscles. Transition edge from smooth posterior of sinus venarum to rough anterior or pectinate muscles. “Welding part”
Pectinate muscles
Present in anterior wall of right atrium along with in left and right auricles, contributing to their rough appearance. Designate “baby heart” derivation: kept during development.
Interatrial septum of right atrium
Location of fossa ovalis (foramen ovalis in development). Thick, except at fossa ovalis
Fossa ovalis
“Thumb-print”-shaped remnant of the closure of an opening that was present within the interatrial septum of the fetal heart (Foramen ovale) in right atrium
Opening to coronary sinus
Coronary sinus drains out of right atrium. Main drain vein of the heart.
Tricuspid valve
Between right atrium and right ventricle. Prevents backflow between ventricle and atrium during systole. Anchored via chordae tendineae.
Chordae tendinae
Present in both right and left ventricles. Attached to atrioventricular valves (mitral and tricuspid valves) and provide a connection to the papillary muscles.
Papillary muscle
Attach to AV valves via chordae tendinae and contract in order to prevent inversion or prolapse of the valves. Contract before systole and maintain tension throughout in order to prevent backflow.
Trabeculae Carnea
“Rough meat” (so metal). Found in ventricular wall. Papillary muscles come off of here.
Interventricular septum
Divides right and left ventricles.
Conus Arteriorus
Found in anterior aspect of heart, from right ventricle. Gives rise to pulmonary trunk. Outflow of heart. Develops from bulbus cordis.
Pulmonary Semilunar valve
Guard flow out of pulmonary artery. Opens during systole.
Moderator band
In right ventricle. Conducts impulses from right bundle branch to the right ventricular wall
Pulmonary veins
Bring oxygenated blood back from lungs. Drain into left atrium
Left atrium
Smooth, derived from pulmonary vein during embryo. Found in the back. Receives oxygenated blood from lungs via pulmonary veins.
Left auricle
Rough, contains pectinate
Left ventricle
Much thicker than right ventricle due to its “harder” job. Responsible for systemic circulation.
Bicuspid valve
AKA Mitral valve. Prevents backflow between left atrium and ventricle by closing during systole. Opens during diastole.
Aortic Semilunar valves
Guard outfloow of blood from left ventricle out of aorta. Open during systole, closed during diastole
Diastole and systole
Diastole: AV valves open, semilunar valves closed. Systole: AV valves closed, semilunar valves open
Cardiac skeleton
Fibrocatilagenous tissue. Divides atria from ventricles for conductive system and provides attachment for heart valves and myocardium. Includes tendon of conus arteriosus, left fibrous trigone, right fibrous trigone, and membranous portions of the interventricular and interarterial septa
Tendon of conus arteriosus
Component of cardiac skeleton. Attaches aortic semilunar valves to pulmonary semilunar valves
Left fibrous trigone
Component of cardiac skeleton. Attaches mitral valve to aortic semilunar valves.
Right fibrous trigone
Component of cardiac skeleton. Attaches atrioventricular valves to aortic semilunar valves
Right coronary artery
Sits in the coronary groove, between right ventricle and atrium. Gives off nodal, marginal, and posterior interventricular (usually) branches before anastomosing with circumflex artery from left coronary artery. Provides majority (60%) of supply to SA node (via nodal), and supplies AV node
Right marginal artery
Branch of right coronary artery. Runs along inferior border of heart. As right coronary is running to the back, it gives off the right marginal artery which runs down the inferior border towards the apex
Nodal Artery
Branch of right coronary artery. Runs anteriorly and superiorly under the right auricle to the superior vena cava. Supplies the SA node (60% of total supply).
Posterior interventricular artery
Artery in the back of the heart that runs between left and right ventricles. Its supply varies on dominance of the heart. Right dominant heart supplied by right coronary artery, left dominant heart supplied by circumflex artery
Left coronary artery
Very short (.25 inches) Gives off circumflex and anterior interventricular branches (LAD). 40% of supply to SA node
Circumflex artery
Runs in coronary sulcus Anastomoses with right coronary artery. In left dominanry hearts, supplies posterior interventricular artery
Anterior interventricular artery
Widowmaker! Branch of left coronary artery. AKA Left anterior descending artery
Coronary sinus
Main drain vein. Lies in coronary sulcus between left atrium and ventricle
Great cardiac vein
Found in the front of the heart. Runs along with LAD.
Middle cardiac vein
Found in the back of heart, along with posterior interventricular artery
Small cardiac vein
Found on side of the heart. Runs along right marginal artery
Conducting system of heart
Cardiac muscle cells and conducting fibers specialized for iniating and conducting impulses.
Sinuatrial node (SA Node)
Between SVC and RA. Initiates impulse for contraction 70-80/minute. Supplied 60% by right cardiac artery (nodal), 40% left cardiac artery
Atrioventricular node
If required to iniate impulses, can do so at 40-60BPM. Located in posteroinferior region of interatrial septum near coronary sinus. Collects impulses from atria and distributes to ventricles.
Atrioventricular bundle (Bundle of His)
If required, can iniate impulse 20-40 BPM. Located within interventricular septum to ventricular myocardium. Divides into right and left bundle branches
Sympathetic innervation of heart
Sympathetic trunk contributes to cardiac plexus. Leads to increased heart rate (fight of flight)
Parasympathetic innervation of heart
Vagus (cardiac branches of vagus and recurrent laryngeal) off of cardiac plexus
Heart Sounds
Caused by turbulence of blood flow as a result of closures of heart valves. Lub and dub!
“Lub” heart sound
Blood flow hitting the closed valve generated by closure of the AV valves (Tricuspid and Bicuspid [mitral] valves)
“Dub” sound
Blood flow hitting the closed valve generated by closure of the semilunar valves (pulmonary and aortic semilunar valves)
Listen to Aortic semilunar valve at?
Right 2nd intercostal space
Listen to pulmonary semilunar valve at?
Left 2nd intercostal space
Listen to tricuspid valve at?
Lower left body of sternum
Listen to bicuspid (mitral) valve at?
Left 5th intercostal space
