Heart

Question 1

Pericardial attachments

Answer 1

the fibrous pericardium is attached to the sternum by sternopericardial ligaments and to the diaphragm by pericardiacophrenic ligaments

Question 2

Fibrous pericardium

Answer 2

tough external layer of dense CT

anchors heart to prevent overfilling attached to the parietal pericardium of the serous membrane

Question 3

cardiac tamponade

Answer 3

pericardial space fills with fluid due to trauma inflammation and the heart cannot fill to capacity
can be lethal

sx=Beck’s Triad

1) Distended neck veins
2) hypotension
3) muffled heart sounds

Question 4

pericardiocentesis

Answer 4

remove exs pericardial fluid

needle inserted thur the bare area of heart ( L of sternum @5th/6th ICS)

Question 5

Transverse pericardial sinus

Answer 5

space posterior to the ascending aorta and pulmonary trunk

allows surgeon to place a clamp here to divert blood during surgery

Question 6

Oblique pericardial sinus

Answer 6

pocket-like cal-du-sac posterior to heart

bound by pulmonary veins in IVC

Question 7

innervation to fibrous and parietal pericardium

Answer 7

sensory comes from phrenic n.,
pericarditis–>pain referred to shoulder/neck (C345)

there are not pain fibers to visceral pericardium

Question 8

Apex

Answer 8

inferior and to left
LV only
posterior to 5th ICS (MCL)

Question 9

base

Answer 9

posteriorly

LA only

Question 10

Anterior surface

Answer 10

2/3 RV, 1/3 LV

Question 11

Diaphragmatic surface

Answer 11

2/3 LV 1/3 RV

Question 12

fibrous skeleton

Answer 12

1) supports valve patency
2) prevents distention of heart during contraction
3) provide attachement for muscle anv valve leaflets
4) insulates against impulse conduction from atria to ventricles (tunnel for His)

annulus fibrosis around valves, supported by trigones

form the membranous portions of IV and AV septa

Question 13

Sinus Venarum

Answer 13

smooth and thin walled part of RA
derived from sinus venosus
entrance of IVC, SVC, and coronary veins

Question 14

Auricle

Answer 14

small pouch over root of aorta
derived from embryonic atrium
lined with pectinate muscle
separated from sinus venarum by crista terminalis

Question 15

Fossa ovalis

Answer 15

depression in the IA septa

whats left of foramen ovale

Question 16

Moderator (septomarginal) band

Answer 16

specialized trabecular muscle that runs from IV septum to anterior papillary muscle in the RV

Question 17

Heart valve auscultation

Answer 17

Pulmonary: L 2nd ICS
Aortic: R 2nd ICS
Tricuspid: L 4th ICS
Bicuspid (mitral) L5th ICS

Question 18

RCA

Answer 18

From the aortic sinus w/in right cusp of aortic SL valve
–>SA node branch
R marginal branch
Posterior interventricular artery (PDA)

Question 19

Things supplied by RCA

Answer 19

RA
SA and AV nodes
most of RV
diaphragmatic portion of LV
posterior 1/3 of IV septum

Question 20

LCA

Answer 20

from left aortic sinus (left cusp of valve)
–>anterior interventricular branch (LAD)
Circumflex artery–> L marginal a.

Question 21

things supplied by LCA

Answer 21

LA
Most of LV
some of anterior RV
anterior 2/3 of IV septum

Question 22

sites of coronary occlusion –> MI

Answer 22

1) LAD
2) R coronary
3) Circumflex
4) L coronary= widow maker
5) PDA
6) RCA on posterior

Question 23

Lymph drainage of the heart

Answer 23

RV–>LVA

LV–>RVA

Question 24

Conduction system of heart

Answer 24

SA (at crista terminalis)–> AV -slight pause- —->AV bundle (of His)–> L and R bundle branches–>Purkinje fibers

Question 25

cardiac plexus

Answer 25

Post SNS and Pre PSNS in the muscles and nodes of heart

distribute via coronary a.

Question 26

sympathetic innervation to heart

Answer 26

Pre fibers in T1-4

also receive cardiopulmonary splanchnics

Increase HR, increase contractile force, increase dilation

also carry sensory pain fibers —>T1-T4/5 referred pain to chest and medial arm

Question 27

PSNS to heart

Answer 27

Post cell bodies found in the wall of heart (esp SA and AV)

decrease HR
Vasoconstriction
carry visceral afferents (stretch receptors)