Heart Flashcards
Fibrous sac which encloses the heart and great vessels
pericardium
Strong, dense outer part of pericardium. “cardiac seatbelt”
Fibrous pericardium
Connects fibrous pericardium to back of the sternum
sternopericardial ligaments
Inner surface of the fibrous pericardium
Parietal layer of the serous pericardium
Potential space between the parental and the visceral layers of the serous pericardium
Pericardial cavity
Adherent to the outer surface of the heart. AKA “epicardium”
Visceral layer of the serous pericardium
Composed mainly of cardiac muscle fibers arranged in a spiral
myocardium
The smooth endothelium which lines the inside of the heart
endocardium
of chambers in the heart
4
Which clinical note involves rapid leakage of fluid into the pericardial cavity, compressing the heart and impeding venous return.
Cardiac tamponade
Which vessel is particularly vulnerable in cardiac tamponade?
The superior vena cava
Which vessel becomes prominent in cardiac tamponade?
The external jugular vein
A subdivision of the pericardial sac which lies posterior to the aorta and pulmonary trunk
Transverse pericardial sinus
A subdivision of the pericardial sac which lies posterior to the heart
Oblique pericardial sinus
Blood supply to the heart
pericardiacophrenic artery **main
Bronchial artery
Esophageal artery
Coronary arteries
Innervation of the heart
phrenic nerve -sensory
Sympathetic trunk - vasomotor
Vagus
Between which two structures does the phrenic nerve pass
Parietal pleura and fibrous pericardium
T or F: the pericardium is less sensitive to pain than the pleura
true
What divides the hear Tinton left and right halves?
The septal wall
Blood flow through the heart =
R atrium –> R ventricle –> pulmonary trunk –> pulmonary arteries –> lungs –> pulmonary veins –> L atrium –> L ventricle –> systemic circulation
Thickness of chamber walls from thickest to thinnest
L ventricle > R ventricle > L atrium > R atrium
An obstruction of a pulmonary artery by blood is clinically known as what
Pulmonary embolism
What is caused by a pulmonary embolism?
Acute respiratory distress, heart failure, death
This valve is found between the R ventricle and pulmonary trunk and has three cusps
Pulmonary valve
This valve is found between the L ventricle and aorta, has 3 cusps
Aortic valve
Name the two Semilunar valves of the heart
Pulmonary and aortic
This valve is found between the L atrium and L ventricle . It has two cusps
Mitral [Bicuspid]
This valve is between the R atrium and R ventricle. Has 3 cusps
tricuspid
Name the two atrioventricular valves of the heart
Mitral and tricuspid
Name the two atrioventricular valves of the heart
Mitral and tricuspid
What produces the “lub” sound of the heart
Contraction of the ventricles and closure of the atrioventricular valves
What produces the “dub” sound of the heart
Closure of the pulmonary and aortic [ Semilunar ] valves
Where is the Auscultation point of the pulmonary valve
Behind the medial end of the 3rd costal cartilage
**most audible over LEFT 2nd INTERCOSTAL SPACE
Where is the Auscultation point of the aortic valve
Behind the left half of the sternum, medial to the 3rd intercostal space
**most audible over the RIGHT 2nd INTERCOSTAL SPACE
What is the most frequently diseased valve of the heart
Mitral valve
Where is the Auscultation point of the mitral valve
Behind the left half of the sternum, medial to the 4th costal cartilage
**most audible over the LEFT 5th INTERCOSTAL SPACE
Where is the Auscultation point of the tricuspid valve
Behind the right half of the sternum, medial to the 4th intercostal space
** most audible over the LEFT 5th INTERCOSTAL SPACE
What is the orientation of the heart
Forward, downward and to the left
Base formed by
L&R atria
What divides the heart into left and right halves?
The septal wall
Base formed by
L&R atria
What are the surfaces of the heart
Anterior, diaphragmatic, left pulmonary, right pulmonary
Structures of the R atrium =
R auricle, pectinate muscles, Cristal terminals, sinus of vena cavae, fossa ovalis [limbus fossa ovalis]
In 25% of adults, the foramen ovale persists as a small opening in the superior part of the fossa ovalis -name this clinical note
Atrial septal defect
T or F: in most cases, atrial septa defect is not clinically significant.
T
A larger defect of the fossa ovalis which causes dilation of the R atrium and ventricle and pulmonary trunk is called:
Clinical atrial septal defect
Openings in the right atrium
Superior and inferior vena cava, coronary sinus, anterior veins of the right ventricle, right ventricle
Openings in the right atrium
Superior and inferior vena cava, coronary sinus, anterior veins of the right ventricle, right ventricle
Which structures are found in the right ventricle
trabeculae carneae, papillary muscles, chordae tendinae, conus arteriosus, supraventricular crest, moderator band
Openings in the right ventricle
Right atrium, pulmonary trunk
Structures of the left atrium =
Left auricle, pectinate muscles
Openings in the left atrium =
Pulmonary veins, left ventricle
Structures in the left ventricle =
trabeculae carneae, papillary muscles, chordae tendinae, aortic vestibule
Openings in the left ventricle =
Left atrium, aorta
How much thicker are the walls of the left atrium than the walls of the right?
2-3x
Which two valves lack chordae tendinae and papillary muscles?
Pulmonary and aortic
Which two valves lack chordae tendinae and papillary muscles?
Pulmonary and aortic
Which two valves close with ventricular contraction?
Mitral and tricuspid [atrioventricular]
Which two valves open with ventricular contraction?
Pulmonary and aortic [ Semilunar]
Small central thickening on free edge of each cusp
nodules
thin, crescent part of the cusps
lunules
Spaces between the cups and the walls of vessels
Pulmonary and aortic sinuses
Septum between the two atria
Interatrial septum
Small septum above tricuspid valve and below mitral valve
atrioventricular septum
Septum that is thin, smooth and fibrous in structure
membranous interventricular septum
A very thick septum
Muscular interventricular septum
The connective tissue framework of the heart
Fibrous skeleton of the heart
Part of fibrous skeleton that forms the foundation of each of the heart valves
Fibrous ring [anuli]
Part of the fibrous skeleton that connects the rings together. This is the strongest part of the fibrous skeleton
Left and right fibrous trigones
Part of the fibrous skeleton that contains: intertribal septum, atrioventricular septum, membranous interventricular septum.
Membranous part of the septal wall
Functions of the fibrous skeleton
Structural framework for the valves, insulate electrical impulses
Branches of the right coronary artery
sinuatrial nodal artery, right marginal artery, posterior interventricular artery
Which artery is known as “the pace maker of the heart”
sinuatrial nodal artery
Branches of the left coronary artery
Anterior interventricular artery, circumflex artery, left marginal artery
What does coronary artery dominance refer to?
Which coronary artery fives rise to the posterior interventricular artery [Right=70%]
What structures does the right coronary artery supply
Right atrium, most of right ventricle, diaphragmatic surface of left ventricle, posterior 1/3 of interventricular septum, conduction system
What structures does the left coronary artery supply
Left atrium, most of left ventricle, part of right ventricle, anterior 2/3 of interventricular septum
Which coronary artery ALWAYS supplies a greater portion of the hearts tissue?
Left
Which coronary artery ALWAYS supplies a greater portion of the hearts tissue?
Left
The largest vein of the heart. It lies within the coronary sulcus and drains into the right atrium
Coronary sinus
What are the 5 tributaries of the coronary sinus
Great cardiac vein Middle cardiac vein Small cardiac vein Posterior vein of the left ventricle Oblique vein of the left atrium
Smallest veins of the heart. They run within the walls and drain primarily into the right atrium
Venae cordis minimae
The deposition of lipid plaques on the inner walls of arteries is what
atherosclerosis
substernal chest pain upon exertion is called what
Angina pectoris
This occurs when coronary artery branches become completely occluded and a portion of the heart becomes necrotic and is converted into fibrous scar tissue
Myocardial infarction
Most common sites for MI =
Anterior interventricular artery - 40-50%
Right coronary artery - 30-40%
Circumflex artery - 15-20%
What is the lymphatic drainage of the heart
subepicardial lymphatic plexus to tracheobronchial node
T or F: the heart requires a nerve supply to beat rhythmically?
False - has its own mechanism, the conduction system
Name the parts of the conduction system
sinuatrial node, atrioventricular node, atrioventricular bundle, R and L bundle branches
Name the parts of the conduction system
sinuatrial node, atrioventricular node, atrioventricular bundle, R and L bundle branches
Great vessels which exit the heart:
Aorta, pulmonary trunk [R and L pulmonary branches]
Great vessels which enter the heart
Pulmonary veins, superior vena cava, inferior vena cava
This is the remnant of embryonic ductus arteriosus. Connects the arch of the aorta to the left pulmonary artery
Ligamentous arteriosum
This nerve hooks under the arch of the aorta
Left recurrent laryngeal nerve
This nerve hooks under the right subclavian artery
Right recurrent laryngeal nerve
This structure drains the lymph of the entire body except the right upper extremity, right thoracic cavity, and the right side of the head and neck.
Thoracic duct
What structure does the thoracic duct originate
The cisterna chyli
What vertebral level does the thoracic duct cross over to the left?
T5/6