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Anatomy Summer 2023 > Heart > Flashcards

Heart Flashcards

1
Q

What is the Mediastinum?

A

Middle portion of the thorax that incases the heart

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2
Q

Contents of the Superior Mediastinum

A

Thymus
Great vessels
Nerves: Vagus, phrenic, cardiac plexus
Veins: Brachiocephalic, SVC
Arteries: Aortic arch Brachiocephalic trunk, Left common carotid, left subclavian
Cervical Viscera: Trachea, esophagus

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3
Q

Contents of the Posterior Mediastinum

A

Thoracic aorta
Thoracic duct
lymphatic trunks
Lymph nodes
Azygos & Hemi-Azygos veins
Esophagus

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4
Q

Contents of Middle Mediastium

A

Pericardium
Heart
Roots of great vessels: Ascending aorta, pulmonary trunk, SVC

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5
Q

List the contents of the Superior Mediastinum in order from anterior to posterior

A

Thymus
Veins: Brachiocephalic, SVC
Arteries: Aortic arch, Brachiocephalic trunk, left common carotid, left subclavian
Trachea
Alimentary tract: esophagus
Lymphatics: Lymphatic trunks & Thoracic duct

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6
Q

Branches (in-order) from the Aorta

A

Ascending->Arch->Descending (thoracic)

Ascending-> coronary arteries

Arch -> Brachiocephalic trunk (splits into RIght common carotid & Right subclavian arteries) -> Left common carotid artery -> Left subclavian

Descending (supplies in 3 separate planes) -> Anterior, midline plane -> Lateral plane -> Posterolateral plane

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7
Q

What do the right and left Brachiocephalic merge to become?

A

Superior Vena Cava

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8
Q

What does the Vagus nerve innervate?

A

R/L pulmonary plexuses
Esophageal plexuses
cardiac plexuses

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9
Q

What do the Recurrent Laryngeal Nerves innervate?

A

R/L intrinsic muscles of the larynx

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10
Q

What do the phrenic nerves innervate?

A

Most of the diaphragm
Mediastinal parietal pleura
pericardium

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11
Q

What are the 2 major lymph structures in the mediastinum?

A

Thoracic duct (drains from rest of the body) & right lymphatic duct (drains from upper right quadrant of the body)

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12
Q

What is the Pericardium?

A

fibrous membrane that covers the heart and the beginning of its great vessels

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13
Q

What are the parts of the pericardium?

A

Tough external layer (fibrous pericardium)
Serous pericardium (parietal & visceral)

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14
Q

Different between Parietal and visceral pericardium

A

Parietal: internal surface touching the fibrous pericardium
Visceral: layer touching the heart and its great vessels

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15
Q

Function of the pericaridum

A

protects the heart from overfilling because it is unyielding & allows for reduced friction between heart and surrounding structures

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16
Q

List the sequence of blood flow through the heart

A

Right atrium -> tricuspid valve -> right ventricle -> semilunar valve (pulmonary valve) -> pulmonary arteries -> lungs -> pulmonary veins -> left atrium -> mitral valve -> left ventricle -> semilunar valve (aortic valve) -> aorta -> Rest of the body

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17
Q

Diastole

A

ventricular filling (relaxation)

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18
Q

Systole

A

ventricular emptying (contraction)

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19
Q

What makes the “lub” sound?

A

The blood slamming on the shut atrioventricular valves (tricuspid & mitral)

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20
Q

What makes the “dub” sound?

A

The blood slamming on the semilunar valves (aortic & pulmonary)

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21
Q

Describe the endocardium

A

Thin internal layer

Lining membrane that covers valves

Epithelium & subendothelial connective tissue

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22
Q

Describe the Myocardium

A

Thick middle layer

Cardiac muscle

Wringing motion w/ contraction because of helical orientation of fibers

23
Q

Describe the Epicardium

A

Thin external layer

Visceral pericardium

24
Q

What makes the pulmonary veins & arteries different from normal veins and arteries?

A

Pulmonary arteries carry de-oxygenated blood to the lungs
Pulmonary veins carry oxygenated blood to the left atria

Normally arteries take oxygenated blood to the rest of the body and veins take de-oxygenated blood back to the heart

25
Q

Characteristics of Right Atrium

A

Receives low oxygen blood from SVC, IVC, & Coronary sinus

Oval Fossa is remnant of oval foramen in fetus

Contracts using Pectinate muscles

Right AV orifice where blood dumps into right ventricle

26
Q

Characteristics of Right Ventricle

A

Receives low oxygen blood from right atrium

Tricuspid valve present with Chordae Tendinae and Papillary muscles that all help to prevent the back flow of blood

Pushes blood to pulmonary valve & artery

*Interventricular septum separates R & L Ventricles

27
Q

Characteristics of Left Atrium

A

Receives oxygenated blood from pulmonary veins

Thicker than right atrium

Left AV orifice that leads oxygenated blood to left ventricle

Smaller pectinate muscles

28
Q

Characteristics of Left Ventricle

A

Receives oxygenated blood from left atrium

Thicker than right ventricle

Mitral valve (2 cusps) with chordae Tendinae (more numerous) and papillary muscles (larger) to prevent back flow

Aortic semilunar valve

Longer cavity

29
Q

List the sequence of conduction throughout the heart

A

Sino-atrial node initiates impulse -> conducted to cardiac muscle fibers in atria causing them to contract -> myogenic conduction of impulse from SA node to atrioventricular node -> AV node distributes signal to ventricles through AV bundle & right and left bundle branches -> Impulses pass to subendocardial branches (purkinje fibers) to supply papillary muscles & walls of ventricles

30
Q

Branches of the Coronary arteries

A

Coronary artery off of the ascending aorta -> 1) Right coronary artery & 2) left coronary artery ->

1) Sinu-atrial nodal branch, Right marginal branch, Atrioventricular nodal branch, posterior interventricular branch

2) Anterior IV Branch -> Lateral branch of anterior IV branch
Circumflex branch -> (40% have SA nodal branch coming from here), Left marginal branch

31
Q

What do the Right Coronary arteries supply?

A

Right atrium
Most of Right ventricle
Part of left ventricle
part of IV septum (posterior aspect)
SA node
AV node

32
Q

What do the left coronary arteries supply?

A

Left atrium
Most of left ventricle
Part of right ventricle
Most of IV Septum (AV Bundle)
(40% SA node)

33
Q

Explain Sympathetic innervation of the heart

A

Increases HR, force of contraction, and blood flow through coronary vessels

34
Q

Explain Parasympathetic innervation of the heart

A

Decreases HR, force of contraction, and constricts coronary arteries

35
Q

Explain Pericarditis

A

Inflammation of pericardium

Symptoms: chest pain, makes pericardium rough so it sounds like rustling silk

36
Q

Explain Pericardial Effusion

A

The passage of fluid from pericardial capillaries into pericardial cavity or the accumulation of pus

Results in: heart compressed and can’t expand fully and fill completely; ineffective pump

37
Q

Explain Congestive Heart Failure (CHF)

A

Blood returns to heart at rate that exceeds cardiac output

Results in: cardiac hypertension which is elevated pressure on right side of the heart; often occurs in non-inflammatory pericardial effusions

38
Q

What are the consequences of an Atrial Septal Defect (ASD)?

A

Congenital anomaly (happens at birth)

incomplete closure of oval foramen

Left-to-right shunt of blood overloads pulmonary vascular system

39
Q

What are the consequences of a Ventricular Septal Defect (VSD)?

A

25% of congenital heart disease

holes between walls of the ventricles

left-to-right shunt of blood causes pulmonary disease and CARDIAC FAILURE

40
Q

What happens when the mitral valve prolapses?

A

Usually results in a heart murmur (1 in 20 people)

allows blood to flow back into the previous chamber

1 or both leaflets are enlarged of floppy

usually has chest pain & fatigue

41
Q

Why is a mitral valve prolapse an issue?

A

this increases the workload on the heart

42
Q

How does coronary artery disease (CAD) develop?

A

An embolus breaks off & occludes a coronary artery leading to an infarction

43
Q

Which are the most common arterial sites for Coronary Artery disease?

A

Anterior IV Branch (LAD - 40%) - widow maker
Right coronary artery (RCA - 30-40%)
Circumflex branch (15-20%)

44
Q

What is a myocardial infarction and what are the potential consequences?

A

Localized tissue death in the muscles of the heart

This causes death

45
Q

How does atherosclerosis develop?

A

Lipids build up in the arteries and form plaque which eventually occludes arteries

This results in stenosis - hardening of the vessels

46
Q

What is Angina Pectoris?

A

Pain that occurs in the heart

Usually results from narrowing of arteries & ischemia of the myocardium

Necrosis DOES NOT occur

47
Q

How can you tell Angina Pectoris from a Myocardial Infarction?

A

pain usually worsens with exercise (especially after a heavy meal) but gets better after 1-2 minutes of rest

A MI does NOT get better with rest

*Sublingual nitroglycerin could help by dilating the blood vessels

48
Q

Explain the procedure for a Coronary Artery Bypass Graft (CABG)

A

Take either the Great saphenous vein or Radial artery and connect it to the ascending aorta and to the other side of the occluded artery to bypass the occlusion

49
Q

Describe a pacemaker

A

Subcutaneous

Acts as an SA node for the heart

It is an electrode that is fixed to trabeculae carneae in ventricular wall

50
Q

Describe cardio pulmonary resuscitation (CPR)

A

Force’s blood out of the hear when compressing the sternum

Heart fills back up with blood after the sternum is decompressed

Used when heart stops beating

51
Q

Describe Atrial Fibrillation (A-Fib)

A

ventricles respond at irregular intervals compared to the atrium

circulation is okay

52
Q

Describe Ventricular Fibrillation

A

Can NOT pump blood sufficiently

NO cardiac output

Fatal if allowed to continue

53
Q

Describe Defibrillation

A

Electrical shock given to the heart to essentially reset the heart

stops the heart beat and hopes that normal heart rhythm continues once it begins beating again

54
Q

How can the heart refer pain to other parts of the body?

A

Usually the spinal nerves that supply the coronary arteries are shared by the visceral afferent terminations for the referred parts of the body

The afferent fibers receive signals at the same posterior roots of these dermatomes

Anatomy Summer 2023 (8 decks)

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