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SHB Exam II > Heart > Flashcards

Heart Flashcards

1
Q

Where is the heart located?

A

right behind sternum. Middle mediastinum.

costal surfaces are up against ribs and base of heart

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2
Q

What is significant about the T4/T5 region?

A

arch of aorta, trachea begins to divide

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3
Q

Describe the pericardium layers.

A

heart is surrounded by pericardium cavity
visceral layer- surface of heart. also called epicardium
parietal layer- can dissect/cut this layer.

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4
Q

What purpose do cavities serve? What can I find in the parietal cavity?

A

provide decreased friction of moving parts

there is peritineal fluid in the parietal cavity to decrease friction

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5
Q

Describe the fibrous and serous pericardia.

A

fibrous- outermost layer, continuous with fibrous tissue of vessels surrounding the heart
in heart, parietal layer is thickened further by collagen, fiberblast known as fibrous layer

serous- single cell layer, reduces friction, this is the epicardium (visceral layer)

closed off area… the only thing in the cavity is a bit of serous fluid to reduce friction

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6
Q

Where is the transverse sinus?

A

above pulmonary artery coming in.
behind aorta and pulmonary trunk and anterior to superior vena cava

(clinically surgeons to get to back of heart will have to go around apex to get in the back within oblique sinus)

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7
Q

What kind of blood do the pulmonary arteries/veins in the heart carry?

A

pulmonary artery- carrying unoxygenated blood
pulmonary veins- carrying oxygenated blood
(this is opposite elsewhere in body)

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8
Q

What is the pectinate muscle (opened right atrium: right lateral view) referred to from the opened right ventricle/anterior view?

RIGHT SIDE

A

opened right ventricle: anterior view- trabeculae carneae

opened right atrium: right lateral view- pectinate muscle

(same but named different)

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9
Q

What is different about the left atrium and ventricle? (from the right)

A

no pectinate muscle on left side

2 cusps instead of three (bicuspid valve/mitral valve) on right its the tricuspid valve

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10
Q

Describe the innervation of the heart.

A

all autonomic!

Parasympathetic- vagus n (X) provides parasympathetic fibers which decrease heart rate

Sympathetics- post-ganglionic fibers from T1-T5 reach cardiac plexuses to provide sympathetic supply, which increased heart rate.

intrinsic- Sinu-atrial (SA) node - “pacemaker”
atrioventricular (AV) node- receives impulses from SA node. conveys impulses through the AV bundle (of His) which includes moderator band

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11
Q

Describe the Vagus nerve in regards to the heart.

A

Vagus n has a large plexus/branches given off right around the base of the heart (from Vagus or sympathetic)

cardiopulmonary plexuses also supply the lung

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12
Q

How to sites of auscultation of the valves differ from projections?

A

sites of auscultation- where you listen to valve as it closes (the sound is projected on to the vessel wall so you auscultate at location other than projection)

projection of valve is where on the anterior thoracic surface that you’d find a valve projected

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13
Q 
Describe the middle mediastinum boundaries:
superiorly
inferiorly
laterally on left
laterally on right
A

superiorly- sternal angle (T4/5)
inferiorly- xiphisternum (T9)
laterally on left- 5th intercostal space in midaxillary line
laterally on right- along sternal border

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14
Q

Describe the pericardium.

A

closed sac containing serous fluid for lubrication

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15
Q

What is the visceral layer of the pericardium?

A

epicardium

is a serous epithelium that is closely applied to the heart. It is continuous with the parietal layer where the great vessels enter and leave the heart.

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16
Q

What is the parietal layer of the heart?

A

has 2 layers:

serous epithelium that is continuous with the visceral layer

thick fibrous layer that is continuous with the adventitia of the great vessels entering and leaving the heart

17
Q

What are the two sinuses formed as a reflection of the pericardium where the visceral and parietal layers are continuous with one another at the great vessels?

A 
transverse sinus- above the entry of 4 pulmonary veins
oblique sinus (larger) is below the pericardial reflection between the pulmonary veins

both sinuses are located posterior and can be accessed only from left side because of pericardial reflections between pulmonary veins and superior and inferior vena cava.

18
Q

Describe the circulation of blood through the heart.

A
  1. blood enters right atrium through SVC and IVC
  2. passes tricuspid valve into right ventricle
  3. exits via pulmonary trunk through pulmonary seminlunar valve
  4. returns to left atrium via right and left pulmonary veins.
  5. passes bicuspid (mitral valve) into left ventricle
  6. exits via ascending aorta through aortic semilunar valve
19
Q

Describe the coronary and cardiac circulation of the heart:

Coronary arteries

A

Coronary arteries:
Left coronary artery- anterior descending (interventricular) a, circumflex a, left marginal a

Right coronary artery- right marginal a, posterior descending (interventricular) a

20
Q

Describe the coronary and cardiac circulation of the heart:

Cardiac veins

A

Great cardiac v (anterior interventricular v)
middle cardiac v
cardiac sinus
small cardiac v

21
Q

Where would referred pain from a myocardial infarct radiate?

A

to upper limb (typically left side) along T1 dermatome

sympathetic innervation of the heart

22
Q 
Describe the projection of the heart valves:
Pulmonary semilunar valve
Aortic semilunar valve
bicuspid (mitral) valve
tricuspid valve
A

pulmonary semilunar valve- 2nd costo-sternal junction on the left

aortic semilunar valve- 3rd costo-sternal junction on the left

bicuspid (mitral) valve- 3rd intercostal space to the left of the sternum

tricuspid valve- behind sternum at 4th rib

23
Q 
Describe the auscultation of the heart valves:
pulmonary semilunar valve
aortic semilunar valve
bicuspid (mitral) valve
tricuspid valve
A

pulmonary semilunar valve- 2nd intercostal space to left of sternum

aortic semilunar valve- 2nd intercostal space to the right of sternum

bicuspid (mitral) valve- 5th intercostal space on the left at the mid clavicular line (below the left nipple in males)

tricuspid valve- 5th intercostal space to left of sternum

SHB Exam II (18 decks)

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