Heart Flashcards
Pericardial attachments
the fibrous pericardium is attached to the sternum by sternopericardial ligaments and to the diaphragm by pericardiacophrenic ligaments
Fibrous pericardium
tough external layer of dense CT
anchors heart to prevent overfilling attached to the parietal pericardium of the serous membrane
cardiac tamponade
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
pericardiocentesis
remove exs pericardial fluid
needle inserted thur the bare area of heart ( L of sternum @5th/6th ICS)
Transverse pericardial sinus
space posterior to the ascending aorta and pulmonary trunk
allows surgeon to place a clamp here to divert blood during surgery
Oblique pericardial sinus
pocket-like cal-du-sac posterior to heart
bound by pulmonary veins in IVC
innervation to fibrous and parietal pericardium
sensory comes from phrenic n.,
pericarditis–>pain referred to shoulder/neck (C345)
there are not pain fibers to visceral pericardium
Apex
inferior and to left
LV only
posterior to 5th ICS (MCL)
base
posteriorly
LA only
Anterior surface
2/3 RV, 1/3 LV
Diaphragmatic surface
2/3 LV 1/3 RV
fibrous skeleton
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
Sinus Venarum
smooth and thin walled part of RA
derived from sinus venosus
entrance of IVC, SVC, and coronary veins
Auricle
small pouch over root of aorta
derived from embryonic atrium
lined with pectinate muscle
separated from sinus venarum by crista terminalis
Fossa ovalis
depression in the IA septa
whats left of foramen ovale
Moderator (septomarginal) band
specialized trabecular muscle that runs from IV septum to anterior papillary muscle in the RV
Heart valve auscultation
Pulmonary: L 2nd ICS
Aortic: R 2nd ICS
Tricuspid: L 4th ICS
Bicuspid (mitral) L5th ICS
RCA
From the aortic sinus w/in right cusp of aortic SL valve
–>SA node branch
R marginal branch
Posterior interventricular artery (PDA)
Things supplied by RCA
RA SA and AV nodes most of RV diaphragmatic portion of LV posterior 1/3 of IV septum
LCA
from left aortic sinus (left cusp of valve)
–>anterior interventricular branch (LAD)
Circumflex artery–> L marginal a.
things supplied by LCA
LA
Most of LV
some of anterior RV
anterior 2/3 of IV septum
sites of coronary occlusion –> MI
1) LAD
2) R coronary
3) Circumflex
4) L coronary= widow maker
5) PDA
6) RCA on posterior
Lymph drainage of the heart
RV–>LVA
LV–>RVA
Conduction system of heart
SA (at crista terminalis)–> AV -slight pause- —->AV bundle (of His)–> L and R bundle branches–>Purkinje fibers
cardiac plexus
Post SNS and Pre PSNS in the muscles and nodes of heart
distribute via coronary a.
sympathetic innervation to heart
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
PSNS to heart
Post cell bodies found in the wall of heart (esp SA and AV)
decrease HR
Vasoconstriction
carry visceral afferents (stretch receptors)
