Heart Flashcards
What’s the superior border of the middle mediastinum?
Sternal angle (T4-T5)
What’s the inferior border of the middle mediastinum?
Xiphisternum (T9)
What’s the left lateral border of the middle mediastinum?
5th intercostal space in midaxillary line
What’s the right lateral border of the middle mediastinum?
Along sternal border
What’s another name for the visceral pericardium?
What type of epithelium is it?
- Epicardium
- Serous epithelium
What are the layers of the parietal pericardium and what are they continuous with?
- Serous epithelium that’s continuous with the visceral layer
- Fibrous layer continuous w/adventita of great vessels entering/leaving heart
What are the 2 sinuses formed as a result of the reflections of pericardium where the visceral and parietal layers are continuous with one another at the great vessels?
Where are they?
- Transverse sinus (post to ascending aorta and pulmonary trunk, ant to inf vena cava)
- Oblique sinus (below the pericardial reflection b/w the pulmonary vv)
- Both located posteriorly, can be accessed only from left due to reflections
Explain the flow of blood thru the heart, starting at the right atrium (include valves).
- Blood enters the right atrium through the superior and inferior vena cavae.
- Passes the tricuspid valve into the right ventricle.
- Exits via the pulmonary trunk through the pulmonary semilunar valve.
- Returns to the left atrirum via the right and left pulmonary veins.
- Passes the bicuspid (mitral) valve into the left ventricle
- Exits via the ascending aorta through the aortic semilunar valve.
What are the unique features of the right atrium?
- fossa ovalis
- musculi pectinati
- opening of coronary sinus
- crista terminalis
- valve of inferior vena cava
- openings of superior and inferior vena cavae
What are the unique features of the right ventricle?
- tricuspid valves (anterior, posterior, septal)
- chorda tendinae
- papillary muscles (anterior, posterior, septal)
- trabeculae carnae
- moderator band (septomarginal trabeculae)
What are the unique features of the left atrium?
- valve of foramen ovale
- openings of pulmonary veins
What are the unique features of the left ventricle?
- bicuspid valves (anterior, posterior)
- chorda tendinae
- papillary muscles (anterior, posterior)
- trabeculae carnae
Which chambers are musculi pectinati found in?
Atria
Where is the coronary sinus?
Where does it drain into?
- Posterior, b/w L atrium and L ventricle.
- R atrium
Define chordae tendinae.
Connect valves to m.
Define crista terminales.
Where is it found?
Smooth muscular ridge in superior portion of right atrium that divides musculi pectinati and the right atrial appendage (auricle) from smooth surface of right atrium
Which chambers are trabeculae carnae found in?
- Ventricles
What aa. branch from the right coronary artery?
Right marginal and posterior interventricular aa.
What aa. branch from the left coronary artery?
Anterior interventricular a. (LAD), circumflex a.,
What vv does the coronary sinus receive blood from?
What does it drain into?
- Great, middle, and small cardiac vv.
- Right atrium
What artery and vein run together on the anterior heart surface?
- Anterior interventricular a. and great cardiac v.
What artery and vein run together on the posterior heart surface?
- Posterior interventricular a. and middle cardiac v.
What separates the atria?
Interatrial septum
When the foramen ovale closes as an adult, what is it now called?
Fossa ovales
What is the name of the smooth part of the right atrium?
sinus venarum
Where are the papillary mm. found?
Ventricles
What is the moderator band and where’s it located?
- Connects interventricular septum to the base of the anterior papillary mm.
- Right ventricle
What’s the moderator band’s function?
What’s another name for it?
- Prevents over-distension of the ventricle
- Septomarginal trabecula
What n. provides parasympathetic input to the heart? What does it function to do?
Vagus n. (decreases HR)
Where do the postganglionic sympathetic fibers arise from? What do they synapse at?
T1-T5
- Cardiac plexuses
Why does pain radiate sometimes during an MI?
Referred pain radiates upper limb (typically left side) along T1 dermatome
Where do nn. synapse on the heart?
SA and AV nodes.
Where is the projection of the pulmonary semilunar valve?
Left 2nd costosternal junction
Where is the projection of the aortic semilunar valve?
Left 3rd costosternal junction
Where is the projection of the bicuspid (mitral) valve?
3rd intercostal space, to left of sternum
Where is the projection of the tricuspid valve?
Behind sternum at 4th rib
Where do you auscultate the pulmonary semilunar valve?
2nd intercostal space, to left of sternum
Where do you auscultate the aortic semilunar valve?
2nd intercostal space, to right of sternum
Where do you auscultate the mitral valve?
5th intercostal space on the left at the mid-clavicular line
below left nipple in males
Where do you auscultate the tricuspid valve?
5th intercostal space to the left of sternum
56 y/o man develops chest pressure and pain radiating to L arm. 50 pack/year smoker and BMI of 33. Calls 911 and rushed to hospital where he gets cardiac cath, revealing LAD artery is occluded. Which area of heart affect by this?
A. Post portion of L ventricle
B. Anterior interventricular septum and anterior ventricles
C. Left atrium
D. Right atrium
E. Both SA and AV nodes
B. Anterior interventricular septum and anterior ventricles
Explain the directional venous drainage in the heart.
What vein runs across the anterior side of the heart, near the aorta and pulmonary trunk?
- Middle cardiac vv. (posterior side) goes superiorly to coronary sinus.
- Great coronary v. (anterior side) goes around left side of heart, back to coronary sinus
- Small coronary v. (on right side) goes posteriorly
- There is none.
