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DPT 701: Clincal Anatomy > Heart > Flashcards

Heart Flashcards

1
Q

What are the divisions of the inferior mediastinum

A

Anterior, middle, posterior

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2
Q

What are the contents of the superior mediastinum

A 
Thymus
R/L brachiocephalic vein
Superior vena cava
Trachea
Esophagus
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3
Q

What are the contents of the inferior anterior mediastinum

A

Thymus
Internal thoracic a/v
Fat
Lymph nodes

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4
Q

What are the contents of the inferior middle mediastinum

A 
Superior vena cava
Ascending aorta
Pulmonary a/v
Pulmonary trunk
Heart
Pericardium
Phrenic n
Inferior vena cava
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5
Q

What are the contents for the inferior posterior mediastinum

A 
Descending aorta 
Azygos veins
Thoracic duct
Esophagus
Nerve plexus
Sympathetic
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6
Q

What branches are given off the aorta

A

Brachiocephalic trunk
L common carotid
L subclavian

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7
Q

What branches are given off the brachiocephalic trunk

A

R common carotid

R subclavian

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8
Q

What are the layers of the protective coverings of the heart out to in

A

Fibrous pericardium
Partial pericardium
Visceral pericardium (epicardium)

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9
Q

What are the layers of the heart out to in

A

Epicardium
Myocardium
Endocardium

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10
Q

What are the functions of the parietal sac

A

Protect heart
Lubricate heart
Prevent cardiac distension

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11
Q

What is the parietal cavity

A

Narrow space between partial and visceral pericardium
Allows uninhibited movement of heart
Small amount of fluid

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12
Q

Attachments for pericardium

A

Central tendon
Posterior sternum
Posterior mediastinum

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13
Q

What nerve innervates pericardium

A

Phrenic n

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14
Q

What is pericardial effusion

A

A rapid accumulation of excess fluid within the parietal sac

Sac compress heart (cardiac tamponade) resulting in heart failure

Because fibrous pericardium does not distend

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15
Q

Outer layer of heart
Composed of visceral pericardium and serous pericardium
Fat and coronary vessels are deep to epicardium

A

Epicardium

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16
Q

Middle of heart

Cardiac muscle responsible for contraction

A

Myocardium

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17
Q

Internal layer of heart
Endothelial cells
Lines the lumen of four chambers
Lines cusps of valves

A

Endocardium

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18
Q

Where is the apex

A

Inferiolateral left ventricle
Midclavicular 5th intercostal space
Remains motionless throughout contraction
Sound of mitral valve

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19
Q

What is the base of heart and location

A

Posterior aspect of heart
Mostly left atrium
Lesser contributions than right atrium
Contacts with esophagus

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20
Q

Superior and inferior vena cava to

A

Right atrium

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21
Q

Right atrium to right ventricle you go through

A

Tricuspid valve

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22
Q

Leaving right ventricle blood travels through

A

Pulmonary valve to pulmonary trunk to pulmonary arteries and to lungs

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23
Q

When blood first leaves the lungs it goes through

A

Pulmonary veins with oxygenated blood

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24
Q

From pulmonary veins to

A

Left atrium

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25
Q

After leaving left atrium blood flows through

A

Bicuspid/mitral valve

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26
Q

After passing bicuspid valve, blood goes through

A

Left ventricle

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27
Q

Left ventricle blood then flows through what valve

A

Aortic semilunar valve to aorta

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28
Q

From aorta, blood goes

A

To the body then back to the superior and inferior vena cava

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29
Q

The left pump of the heart does what

A

Receives oxygenated blood from the lungs and sends it back to the body via the systemic (systole) and coronary (diastole) circulation

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30
Q

What is the function of superior vena cava

A

Returns deoxygenated blood from tissues ABOVE diaphragm to right atrium

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31
Q

What is the function of inferior vena cava

A

Return deoxygenated blood from tissues BELOW diaphragm to the right atrium

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32
Q

What is the function of the coronary sinus

A

Returns deoxygenated blood from the myocardium by coronary circulation to right atrium

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33
Q

What is diastole

A

Ventricles relax

Ventricles fill with blood

AV valves are open

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34
Q

What is systole

A

Ventricles contract
Blood is forced from ventricles into aorta or pulmonary arteries
Aortic and pulmonary valves are open

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35
Q

What is the right atrial appendage auricle

A

Add on room
Muscular pouch
Projects from right atrium
Increases capacity of atrium as it overlaps the ascending aorta

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36
Q

Rough myocardium on internal surface of the auricle

In both R/L atrium

A

Pectinate muscles

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37
Q

Internal vertical ridge separating the smooth and rough parts of R atrium
Extends to SVC and IVC
SA node is located in the superior part

A

Crista terminalis

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38
Q

Between R/L atrium

Remanent of foramen ovale in fetus

A

Fossa ovalis

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39
Q

Opening in the right to left atrium in fetus

Allows blood to flow from r to l atrium and bypass the lungs

Bypass occurs because placenta provides the gas exchange

A

Foramen ovale

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40
Q

Fibrous cords connect free edges of AV valves to papillary muscles on floor of ventricles

A

Chordae tendinae

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41
Q

Elevations of ventricular myocardium

Attach to AV valve leaflets via chordae tendinae

A

Papillary muscles

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42
Q

What is the combined function of chordae tendinae and papillary muscles

A

Keep AV valves from prolapsing backward into the atriums when closing during systolic contraction of ventricles

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43
Q

Projection ridges of myocardium

Papillary muscles are specialized

A

Trabeculae carnae

44
Q

A single specialized trabeculum that Carrie’s part of the conduction system to the anterior wall of right ventricle

A

Moderator band

45
Q

Where is the pulmonary valve

A

Between the right ventricle and pulmonary trunk

3 semilunar cusps

Forms a pocket like sinus

46
Q

Do atria or ventricles have thicker walls

A

Ventricles, they have to pump blood to rest of the body

Left ventricle has more myocardium to send blood through the aorta

47
Q

Right side blood flow

A 
SVC, IVC, Coronary sinus
Right atrium 
Tricuspid valve
Right ventricle
Pulmonary valve
Pulmonary trunk 
Pulmonary arteries
Lungs
48
Q

Left side blood flow

A 
Lungs
Pulmonary veins
Left atrium 
Bicuspid valve
Left ventricle
Aortic valve
Aorta 
Systemic circulation
49
Q

Pulmonary circuit characteristics

A

Short with low pressure circulation

50
Q

Systemic circulation characteristics

A

Long, high friction

More pressure

51
Q

What is coronary circulation

A

Blood supply to heart itself
Shortest circulation
Delivered during relaxation
Left ventricle receives most blood supply

52
Q

Where do coronary arteries stem from

A

Base of Aorta

53
Q

What is the coronary sulcus

A

Left and right coronary arteries encircle the heart

54
Q

How much of the body’s blood is used for the heart itself

A

1/20 th

55
Q

What merging veins form the coronary sinus

A

Greater cardiac- anterior inter ventricular sulcus
Middle cardiac - posterior inter ventricular sulcus
Small cardiac- inferior margin

56
Q

Coordinated heart beat is a function of what

A

Gap junctions

Intrinsic cardiac conduction system

57
Q

What is the sinoatrial node

A

Pacemaker of the heart in right atrial wall

58
Q

What part of the heart depolarizes the fastest

A

SA node

59
Q

What is sinus rhythm

A

75 x/minute

60
Q

How does impulse spread across the atria of the of the heart?

A

Via gap junctions to AV node

61
Q

Where is the atrioventricular node

A

Lower right atrium in interventricular septum

62
Q

What is the delay of the AV node
Because?
What does this allow?

A

.1 second delay

Because fibers are smaller in diameter and have fewer gap junctions

Allows atrial contraction before ventricular contraction

63
Q

Rate of AV node without SA node

A

50 bpm

64
Q

What is the atrioventricular bundle

A

Bundle of his

In superior interventricular septum

Only electrical connection between atria and ventricles

65
Q

What are the R/L bundle branches

A

Two pathways in the interventricular septum that carry impulse towards the apex of the heart

66
Q

What is the subendocardial conduction network

A

Purkinje fibers

Complete pathway through the interventricular septum into the apex and ventricular walls

67
Q

The purkinje fibers are more elaborate on what side

A

L side

68
Q

AV bundle and purkinje fibers depolarize at what rate without AV node

A

30 bpm

Ventricular contraction immediately follows depolarization from apex towards atria

69
Q

Contraction process takes approximately how long

A

.22 seconds from initiation at SA node to complete contraction

70
Q

What system both increase the rate and force of the heartbeat

A

Sympathetic nervous system

71
Q

Where in the brain is the cardioacceleratory and cardioinhibitory

A

Medulla oblongata

72
Q

Where do sympathetic nerve fibers project

A

SA node, AV node, bulk of myocardium

Releases norepinephrine

73
Q

Cardioacceleratory center is the source of what

A

Sympathetic output of the heart

74
Q

Cardioinhibitory center is the source of what

A

Parasympathetic output of the heart

75
Q

Where do parasympathetic fibers project

A

Vagus nerve to the SA node and AV node

Release acetylcholine

76
Q

What is an electrocardiograph

A

Graphic recording of electric activity

Composite of all action potentials at a given time

Measure voltage differences- 12 leads

77
Q

What does the P wave represent

A

Depolarization of SA node and atria

78
Q

What does QRS complex represent

A

Ventricular depolarization and atrial depolarization

79
Q

What does T wave represent

A

Ventricular repolarization

80
Q

What does P-R interval represent

A

Beginning of atrial and ventricular excitation

81
Q

What does S-T segment represent

A

Entire ventricular myocardium depolarized

82
Q

What does Q-T interval represent

A

Beginning of ventricular depolarization to end of repolarization

83
Q

What does the first pub-dip sound represent

A

The closing of AV valves at the beginning of ventricular systole

84
Q

What does the second lub-dup sound represent

A

Closing of semilunar valves at the beginning of diastole

85
Q

What is the pause between sounds

A

Heart relaxation

86
Q

What is the order of valves closing

A

Mitral before tricuspid

Aortic before pulmonary

87
Q

Where do you listen to aortic valve

A

R 2nd intercostal space

88
Q

Where are the pulmonary valve sounds heard

A

L 2nd intercostal space

89
Q

Where is the mitral valve heard

A

Over the heart apex, 5th intercostal space in line with middle clavicle

90
Q

Where is the tricuspid valve heard

A

R 5th intercostal space

91
Q

Air reaching the bronchi is

A

Warm and cleansed of impurities

Saturated with water vapor

92
Q

Air passage undergoes how many orders

A

23

93
Q

What vessels attach to the left atrium and where are they coming from

A

L/R superior/inferior pulmonary veins

Coming from lungs to the L atrium

94
Q

When are the AV valves closed and open

A

Open during diastole

Closed during systole

95
Q

When are semilunar valves closed and open

A

Closed during diastole

Open during systole

96
Q

What arises from R aortic sinus

A

Right coronary artery

97
Q

What arises from L aortic sinus

A

Left coronary sinus

98
Q

What are the branches of the R coronary artery

A

SA node branch

Acute marginal

AV nodal branch

99
Q

What are the branches of the L coronary artery

A

Left anterior descending artery

Circumflex

Obtuse marginal

100
Q

Where does the great cardiac vein run

A

Runs with left anterior descending and circumflex branch of the left coronary artery

Continues path in coronary sulcus and enlarges to form coronary sinus entering R atrium

101
Q

Where does the middle cardiac vein run

A

With posterior descending artery

102
Q

What is the blood supply to the SA node

A

Sinoatrial artery that is supplied by the R coronary artery in 60% of people and L coronary artery in 40%

103
Q

Normal alignment of pulmonic valve

A

Anterior
Left
Right

104
Q

Normal alignment of aortic valve

A

Posterior
Left
Right

105
Q

Normal alignment of tricuspid valve

A

Septal
Anterior
Posterior

106
Q

Normal alignment of mitral valve

A

Posterior

Anterior

DPT 701: Clincal Anatomy (12 decks)

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