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Anatomy > Heart > Flashcards

Heart Flashcards

1
Q

What is the general location of the heart?

A

Roughly in middle of the inferior mediastinum (but slightly to left)

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2
Q

What is the mediatsinum?

A

Mass of tissue extending between 2 pleural cavities

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3
Q

What are the boundaries of the mediastinum - anterior, posterior, superior & inferior?

A

Ant = from sternum to…
Post = vertebral bodies
Sup = from sup thoracic aperture to…
Inf = inf thoracic aperture (sealed by diaphragm)

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4
Q

What makes up the superior thoracic aperture?

A

From manubrium, 1st rib & round to T1

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5
Q

What can the mediastinum be divided into?

A

-Sup part
-Inf part
–> divided by inf thoracic plane (@ T4/5)

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6
Q

What can be palpated to find the inferior thoracic plane?

A

Sternal angle - T4/5

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7
Q

What is the thoracic plane?

A

Imaginary line between sternal angle & lower portion of vertebrae T4/5
–> divides mediastinum into superior & inferior aspects

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8
Q

What can the inferior part of the mediastinum be further divided up into & what allows this division to be established?

A

-Ant
-Middle
-Post
–> use pericardial sac to divide

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9
Q

Summarise the position of the heart in the mediastinum?

A

In the middle part of the inferior mediastinum

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10
Q

What is the name of what covers the heart?

A

Pericardium

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11
Q

What are the 3 layers of pericardium?

A

*Outer fibrous pericardium/pericardial sac
*2 layers of serous pericardium - visceral & parietal layer
-Visceral layer = surround heart - called the epicardium!!!
-Parietal layer = coats inside of fibrous pericardium

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12
Q

What is fibrous pericardium, what is it made of?

A

-Cone shaped sac
-Surrounds heart
-Made of tough CT

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13
Q

What are at the superior, inferior & posterior boundaries of the fibrous pericardium?

A

-Sup = fuses w/ great vessels
-Inf = blends w/ central tendon of diaphragm
-Sternopericardial ligaments attach it to post surface of sternum

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14
Q

Role of the fibrous pericardium?

A

Attachments help to keep the heart in position within the thoracic cavity

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15
Q

What the important vessels that pass through the fibrous pericardium?

A

Phrenic nerves

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16
Q

What do the phrenic nerves innervate?

A

Diaphragm (key muscle of respiration)

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17
Q

What does serous pericardium consist of?

A

2 layers of serous memb - made of mesothelium & loose CT

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18
Q

What does visceral serous pericardium (aka epicardium) coat?

A

Heart
-Is the outer covering of heart

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19
Q

What is another term for visceral serous pericardium?

A

Epicardium

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20
Q

What does parietal serous pericardium line?

A

Int surface of fibrous pericardial sac

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21
Q

Name of small space between 2 layers of serous pericardium, & what does it contain?

A

Pericardial cavity
- Contains small amount of serous fluid

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22
Q

Role of the serous fluid in the pericardial cavity & the pericardial cavity in general?

A

-Prevents friction as heart beats
-As a pot space - allows heart to move as beats

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23
Q

What are pericardial sinuses?

A

-2 places where serous pericardium layers are fused
-Seals pericardial cavity off - prevents fluid leaving from pericardial cavity = forms pouches

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24
Q

How do the pericardial sinuses form between the 2 layers of serous pericardium?

A

By reflections of serous pericardium:
-Parietal serous pericardium reflects towards visceral & fuses

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25
Q

Where do the 2 pericardial sinuses form?

A

-Sup - surrounds arteries (aorta & pulmonary artery)
-Post - surrounds veins (sup vena cava, inf vena cava, pulmonary veins) = oblique pericardial sinus

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26
Q

What is the name of the pericardial sinus that is posterior?

A

Oblique pericardial sinus

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27
Q

What is transverse pericardial sinus?

A

Passageway - connects ant & post reflections of the serous pericardium

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28
Q

What is pericarditis?

A

Inflamm of pericardium - due to viral infection
-Shown on ECG

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29
Q

Symptoms of pericarditis & how pain is relived?

A

-Chest pain
-High temp
-Leaning forward

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30
Q

What is cardiac tamponade?

A

Compression of heart as is build-up of blood, fluid, pus or gas in the pericardial cavity = pericardial effusion (excess fluid in pericardial cavity)

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31
Q

What does cardiac tamponade cause?

A

–> reduces cardiac output
–> fibrous pericardium is made rigid (fixed - structures can’t expand) - compresses heart = ventricular failure

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32
Q

Causes of fluid accumulation in pericardial cavity?

A

-Haemorrhage
-Infection
-Complication of pericarditis

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33
Q

4 chambers of the heart?

A

-Right atrium
-Right ventricle
-Left atrium
-Left ventricle

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34
Q

Describe the flow of deoxygenated blood into the heart to the lungs & then back to the heart?

A

-Deoxy blood into right atria via vena cava
-Into right ventricle
-Out heart via pulmonary arteries (L&R)
-To lungs = oxygenates
-Oxy blood into left atrium via pulmonary veins (x4)
-Into left ventricle
-Out heart via aorta
-To body

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35
Q

What are great vessels?

A

Large vessels that bring blood to & from the heart

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36
Q

Name the great vessels - in order of deoxy blood into heart & oxy blood out heart?

A

-Sup vena cava
-Inf vena cava
-Pulmonary trunk - divides = L & R pulmonary arteries
-Pulmonary veins (x4 - 2 right & 2 left)
-Aorta

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37
Q

How is the superior vena cava formed?

A

-From the L & R brachiocephalic veins (which come from union of subclavian & internal jugular veins)
-L & R brachiocephalic veins unite = sup vena cava

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38
Q

Which part of the aorta gives off 3 branches?

A

Arch of aorta

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39
Q

What are the branches coming off the aortic arch?

A

A - Arch of aorta
B - Brachiocephalic trunk
C - Common carotid (left)
S - Subclavian (left)
ABCs

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40
Q

Which artery is the only artery to carry deoxygenated blood?

A

Pulmonary artery

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41
Q

What is the direction of great vessels - arteries & veins?

A

-Arteries = Away
-veINs = INto heart

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42
Q

What makes up the most part of the anterior part of heart?

A

Right ventricle (little bits of right atria & left ventricle)

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43
Q

What is ligamentum arteriosum?

A

-Small fibrous remnant of foetal ductus arteriosum
-Foetus allows shunt of blood from pulmonary trunk to aorta, (adults = no function) - may not be - congenital abnormality

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44
Q

What are the 2 surfaces of the posterior part of the heart?

A

-Base = post surface
-Diaphragmatic (inf part of heart sat on diaphragm)

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45
Q

What separates the 2 surfaces of the heart?

A

Coronary sinuses

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46
Q

Base of heart (surface) - shape, what formed from, & where found?

A

-Quadrilateral
-Made of prox ends of great veins (& some L&R atrium)
-Ant to oes (immediately)

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47
Q

What makes up the majority of the inferior part of posterior side of heart?

A

Mainly left ventricle & some right ventricle

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48
Q

What are the internal features of the RIGHT ATRIUM?

A

-Crista terminalis - Ct
-Musculi pectinati (on walls ant to Ct)
-Fossa ovalis
-SVC, IVC, coronary sinuses = how deoxy blood enters right atrium (either of 3)

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49
Q

What is the crista terminalis (RA)?

A

Thick muscular ridge separates 2 structures in embryology
-runs from R side of opening of SVC to IVC
-Pectinate muscles fan out from crista.

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50
Q

What are musculi pectinati (RA)?

A

Pectinate muscles

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51
Q

Describe the walls ant & post to crista terminalis (RA)?

A

-Ant = covered in musculi pectinati (pectinate muscles - come from crista)
-Post = smooth

–> 1/2 wall has muscular ridges, 1/2 is smooth

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52
Q

What is fossa ovalis (RA)?

A

Visible depression - marks location of the embryonic foramen ovale

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53
Q

What is the embryonic foramen ovale (RA)?

A

Embryonic structure - oxygenated blood passed from R atria to L, bypassing lungs (as not developed yet in foetus)
-Should be sealed up once born - if not = congenital abnormality

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54
Q

What separates the R & L atria?

A

Interatrial septum

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55
Q

What does the right atria look like?

A
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56
Q

What are the internal features of the RIGHT VENTRICLE?

A

-Trabeculae carneae
-Tricuspid valve
-Chordae tendinae
-Papillary muscles
-Pulmonary semilunar valve
–> deoxy blood exits via pulmonary trunk to lungs

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57
Q

What is trabeculae carneae (RV)?

A

-Irregular muscular ridges in ventricle wall (ridges form as attach to wall - if not attached or only 1 attachment = forms papillary muscles)

58
Q

What is the tricuspid valve (RV)?

A

-Has 3 cusps (tri)
-Closes AV orifice in ventricular contraction

59
Q

What are chordae tendineae (RV)?

A

-Where free margins of 3 cups (of tricuspid valve) attach
-Chordae tendineae attach to 2 papillary muscles (where ch t arise from)

60
Q

Name the 3 papillary muscles in the RV?

A

-Ant
-Post
-Septal

61
Q

What are pulmonary semilunar valves (RV)?

A

Made of 3 SL cusps

62
Q

Number of septums in heart & what do they each separate?

A

-Interatrial septum - between R & L atria
-Interventricular septum - between R & L ventricles

63
Q

What does the right ventricle look like?

A
64
Q

What are the internal features of the LEFT ATRIUM?

A

-4 pulmonary veins into post 1/2
-Musculi pectinati in ant 1/2 - continuous with…
–> left auricle
-Valve of foramen ovale

65
Q

What is the foramen ovale (LA)?

A

In development = blood moves from RA to LA - may not be fully fused in adults

66
Q

What is the left auricle (LA)?

A

Give more room for blood when heart needs to pump v. fast

67
Q

What are the internal features of the LEFT VENTRICLE?

A

-Mitral/bicuspid valve
-Papillary muscles
-Chordae tendinae
-Trabeculae carneae
-Long thick walls (myocardium)
-Aortic semilunar valves

68
Q

What is the mitral/bicuspid valve (LV)?

A

–> is mightier - closes in ventricular contraction
-Made of 2 cusps (bi)

69
Q

What is the aortic semilunar valve (LV)?

A

Made of 3 SL cups

70
Q

Name the 2 papillary muscles in the LV?

A

-Ant
-Post

71
Q

What does the LV look like?

A
72
Q

Summarise which chambers of the heart make up which parts?

A

-RA = some ant
-RV = forms most of ant surface & 1/3 of diaphragmatic surface & inf post
-LA = forms most of base
-LV = forms 2/3 diaphragmatic surface & most inf post & some ant

73
Q

Summarise common features in R & L atria?

A

-1/2 walls = musculi pectinati - muscular ridges covering walls
-1/2 walls = smooth
–> this difference in wall structure = as each atria are embryonically derived from 2 separate structures
-Fossa ovalis = in RA
-Valve of foramen = in LA

74
Q

Summarise common features in R & L ventricles?

A

-Tri/bi - cuspid valves (3/2 cusps)
-Chordae tendineae = tri/bi cusps free margins attach to
-Papillary muscles = what the chordae tendineae attaches to/arises from
-Trabeculae carnae = irregular muscular ridges in walls
-Pulmonary/aortic SL valves (3 SL cusps)
-Post, ant, septal papillary muscles = RV
-Post, ant papillary muscles only = LV

75
Q

Compare the RV & LV wall differences & why?

A

LV = longer & thicker walls (myocardium) - as pumps blood at higher pressure around body (still only 2 valves not 3)

76
Q

Summarise valves in RV?

A

-Tricuspid valve
-Pulmonary SL valve

77
Q

Summarise valves in LV?

A

-Bicuspid valve
-Aortic SL valve

78
Q

What is mainly found on the right, left, superior & inferior borders of heart?

A

Sup = mainly roots of great vessels

79
Q

What are the 4 surfaces of the heart & what makes up the majority of these?

A

-Sternocostal (anterior) = mainly RV & some atria
-Diaphragmatic (inferior) = 1/3 RV & 2/3 LV
-Base (posterior) = mainly LA
-L & R Pulmonary - in relation to lungs

80
Q

What are the 4 borders of the heart?

A

-Right
-Inferior
-Left
-Superior

81
Q

Where is the apex of the heart?

A
82
Q

Where is the aortic valve?

A

Medial end of R 2nd intercostal space

83
Q

Where is the pulmonary valve?

A

Medial end of L 2nd intercostal space

84
Q

Where is the tricuspid valve?

A

Just left of lower part of sternum near 5th intercostal space

85
Q

Where is the bicuspid/mitral valve?

A

Left 5th intercostal space @ midclavicular line

86
Q

What is the process of electrical conduction in the heart?

A

-Sino-atrial node (cardiac pacemaker) generates excitatory signals
-Excitatory signals spread across atria - causes them to contract
-Wave of excitation stimulates atrioventricular node
-Signal travels down the atrioventricular bundle
-Bundle conducts electrical impulse to all ventricle musculature
-AV bundle divides = R & L (descend to apex) & then divide to = pukinje fibres @ apex/bottom
-Wave of excitation causes ventricles to contact from apex up

87
Q

What is responsible for the contraction of the heart?

A

Cardiac conduction system (= initiates & coordinates contraction)

88
Q

What is the SA node?

A

Collection of cells located at sup end of crista terminalis

89
Q

What is the AV node?

A

Collection of specialised cells near opening of coronary sinus

90
Q

Why is it important that ventricles contact from apex/bottom, up?

A

Forces blood out of ventricles into asc aorta (LV) or pulmonary trunk (RV)

91
Q

What prevents backflow of blood into atria?

A

Tricuspid/bicuspid valves

92
Q

Summarise the direction of contraction of atria & ventricles.

A

-Atria = contract from top - down
-Ventricles = contract from apex/bottom - up

93
Q

How is heart rate increased & decreases (to change inc/dec rate of excitatory signals)?

A

-Parasympathetic nerve = slows down wave of excitatory signals - slows/dec HR
-Sympathetic nerve = speeds up wave of excitatory signals - inc HR

94
Q

What is the fibrous cardiac skeleton?

A

-4 interconnected rings - of dense fibrous CT
-Surrounds:
*2 AV orifices (holes between atria & ventricle)
*Aortic valve
*Pulmonary valve

95
Q

Role of the fibrous cardiac skeleton (x4)?

A

-Maintains integrity of openings it surrounds - so remain open - as valves will be what close these opening
-Give point of attachment for valve cusps
-Give solid structure for heart muscle to contact against
-Separates atria & ventricular musculature - so are electrically isolated (As contract 1st then Vs)

96
Q

Why is it important that the fibrous cardiac skeleton separates the atria & ventricular musculature?

A

So that atria & ventricles DON’T contract at same time - wouldn’t give effective filling of heart

97
Q

What are fibrous trigones in the fibrous cardiac skeleton?

A

-Interconnecting areas
-R & L fibrous trigones:
R = thickened area of CT between aortic ring & right AV ring
L = thickened area of CT between aortic ring & left AV ring

98
Q

What acts as an electrical isolation?

A

Fibrous cardiac skeleton

99
Q

What is meant by electrical isolation?

A

Separation of atrial half of heart from ventricle half of heart

100
Q

What passes through the fibrous cardiac skeleton?

A

AV bundle

101
Q

What is the only connection (in the fibrous cardiac skeleton) between the 2 groups of myocardium i.e., atria/ventricles?

A

AV bundle

102
Q

Where does atrial & ventricular myocardium originate?

A

-Atrial = upper border of rings
-Ventricular = lower border of rings
–> so atria contract 1st & then vs - gives filling time

103
Q

What is the name of the arteries which supply the heart with O2?

A

Coronary arteries

104
Q

Where do coronary arteries come from & how many?

A

Come from aortic valve - x2

105
Q

When do the 2 coronary arteries fill?

A

In diastole

106
Q

Name the 2 coronary arteries?

A

-Right coronary artery = from right aortic sinus
-Left coronary artery = from left aortic sinus

107
Q

What is diastole & what is systole?

A

D = period of relaxation
S = period of contraction

108
Q

Where does the right coronary artery run?

A

Descends into a groove (= coronary sulcus) between right atria & right ventricle

109
Q

What are the 3 branches of the right coronary artery?

A

-Sinoatrial branch
-Right marginal branch
-Posterior interventricular branch

110
Q

Where does the sinoatrial branch of right coronary artery run?

A

Wraps around back of sup vena round to right atria

111
Q

Where does the posterior interventricular branch of right coronary artery run?

A

Between ventricles in post surface of heart

112
Q

What is the CONFUSING thing about the posterior interventricular branch?

A

Can come from right or left coronary arteries (or both - via anastomosis)

113
Q

Where does the left coronary artery run?

A

Between pulmonary trunk & left auricle

114
Q

What are the 4 branches of the left coronary artery?

A

-Circumflex branch
-Anterior interventricular branch (LAD)
-Diagonal branch
-Left marginal branch of circumflex branch

115
Q

What is a branch of the circumflex branch (off of left coronary artery)?

A

Left marginal branch of circumflex branch

116
Q

What is the name of a branch of the LAD (off of left coronary artery)?

A

Diagonal branch

117
Q

What do dissected coronary arteries look like?

A
118
Q

What are the 2 veins that drain the anterior side of heart?

A

-Great cardiac vein
-Small cardiac vein

119
Q

What are the 2 veins that drain the posterior side of heart?

A

-Middle cardiac vein
-Posterior cardiac vein

120
Q

What do the 4 veins from ant & post sides of heart all then drain into?

A

Coronary sinus

121
Q

Where does coronary sinus sit?

A

Between base & diaphragmatic surfaces of heart

122
Q

Which vein enlarges to form the coronary sinus?

A

Great cardiac vein

123
Q

Where does the great cardiac vein run (ant part of heart)?

A

-Starts @ apex & ascends into ant interventricular sulcus
-Ascends into interventricular sulcus where it enlarges = coronary sinus (@ inf base of heart)

124
Q

Where does the small cardiac vein run (ant part of heart)?

A

-Starts @ sulcus between r atrium & r ventricle - continues in this groove (between base & diaphragmatic surface) - then enters into opposite (arterial) end of coronary sinus

125
Q

Where does the middle cardiac vein run (post part of heart)?

A

-Runs in post interventricular sulcus

126
Q

Where does the posterior cardiac vein run (post part of heart)?

A

Lies on post surface of LV - can join great cardiac vein or drain into coronary sinus directly

127
Q

What causes a cardiac arrest & what does it result in?

A

-Often by malfunction in electrical conduction system
-Hearts stops pumping blood = brain starved of O2
-Abrupt loss of breathing & consciousness - unresponsive

128
Q

What are some possible causes of the signal malfunction seen in a cardiac arrest?

A

Ventricular fibrillation, heart attack, inherited heart conditions, congenital heart condition, valve disorders (lack of blood to heart), drug overdose, electrocuted, severe haemorrhage

129
Q

What are coronary artery diseases?

A

Reduced blood flow to myocardium, usually due to build-up of atherosclerotic plaque in coronary arteries
(block/narrow arteries supplying heart itself)

130
Q

Examples of coronary artery diseases?

A

-Stable angina (less severe)
-Unstable angina (more severe)
-Myocardial infarction

131
Q

What is angina?

A

Chest pain caused by reduced blood flow to heart

132
Q

What is a myocardial infarction?

A

Total blockage of blood to all/some of heart section (coronary artery blocked) so that heart muscle dies = have a heart attack aka MI
–> reduced/no blood flow to part of heart = damage (necrosis) to muscular tissue of heart

133
Q

What causes most MIs?

A

Coronary artery disease

134
Q

Which of the coronary arteries are most associated with MIs?

A

-LAD (left anterior descending) - most
-Right coronary artery - middle
-Circumflex branch of left coronary artery - less

135
Q

What can a heart attack/MI lead to?

A

Cardiac arrest

136
Q

What is an angioplasty?

A

Balloon used to stretch artery that is blocked hardened and narrowed - then insert mesh wire stent to keep open & allow for more blood flow

137
Q

What is referred cardiac pain?

A

Pain perceived at a location other than the site of the painful stimulus/origin

138
Q

What is cardiac ischemia?

A

Pain of heart attack felt in the jaw, neck, left shoulder and down the left arm

139
Q

Why does cardiac referred pain occur?

A

-Pain sensation - carried through visceral sensory (afferent) nerves
-Multiple primary sensory neurons converging on 1 asc tract in spinal cord (sensory inn for skin & organs converge on same spinal route then to brin - brain not expect pain from organs - but is on skin)
-Pain perceived in visceral receptors interpreted by brain as more common signals that arise from somatic receptors (skin), not viscera

140
Q

What is the dermatome?

A

Area of skin innervated by a spinal nerve, but nerve distribution is variable, & territories can overlap

Anatomy (21 decks)

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