Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CV > Heart > Flashcards

Heart Flashcards

1
Q

sites of auscultation

A

Pulmonary 2nd ICS; left of sternum
Aortic 2nd ICS; right of the sternum
Tricuspid 4th ICS left of the sternum
Bicuspid(mitral) 4th or 5th ICS; left MCL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Middle mediastinum boundaries

A
  1. Superior: transverse thoracic plane – disc between TV4 and TV5
  2. Inferior: diaphragm
  3. Lateral: mediastinal pleura
  4. Anterior: anterior surface of pericardium
  5. Posterior: posterior surface of pericardium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

middle mediastinum contents

A
  1. Pericardium
  2. Heart
  3. Origin of great vessels: pulmonary trunk, ascending aorta, pulmonary veins.
  4. Phrenic nerve and pericardiophrenic vessels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

pericardium

A

A closed, fibroserous sac surrounding the heart and origins of great vessels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

fibrous pericardium

A
  1. Tough external layer composed of dense irregular connective tissue.
  2. Anchors heart and prevents overfilling.
  3. The fibrous pericardium is attached:
    a. anteriorly to the sternum via superior and inferior sternopericardial ligaments.
    b. posteriorly to the fascia of the esophagus.
    c. Inferiorly to the central tendon of diaphragm via pericardiacophrenic ligaments.
    d. Superiorly with the adventitia (outer connective tissue layer) of the great vessels.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Serous pericardium

A
  1. Thin serosal membranes (visceral and parietal layers)

2. A closed sac that provides smooth, nearly frictionless surfaces for the heart to move in during contraction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Parietal pericardium

A

a. Composed of simple squamous epithelial cells + thin layer of loose connective tissue
b. Continous with the inner surface of fibrous pericardium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Visceral pericardium

A

a. Composed of simple squamous epithelial cells + thin layer of loose connective tissue
b. Lines heart surfaces; reflects and is continuous with parietal pericardium at great vessels.
c. Forms outer layer of the heart and is called the epicardium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pericardial sac

A
  1. Potential space between parietal and visceral pericardium; contains only a minimal amount of lubricating serous fluid.
  2. CLINICAL CORRELATION – Cardiac tamponade: If the pericardial sac is filled with fluid (due to trauma, inflammation, malignant effusion) the heart cannot fill to capacity due to the surrounding fluid and the inflexibility of the fibrous pericardium. This condition can be lethal as filling of the heart (preload) is reduced. The maximum capacity of pericardial sac is approximately 300 cc.
  3. CLINICAL CORRELATION – Pericardiocentesis is a procedure which removes excess pericardial fluid. Typically, a big needle is inserted through the bare area of the heart (left of sternum; 5th or 6th intercostal space) to avoid pleural cavity.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

pericardial sinuses

A

separate the arterial and venous ends of the embryonic tubular heart.
Transverse (between aorta and SVC)
Oblique (between pulmonary veins and IVC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Transverse pericaridal sinus

A
  1. Anterior border: aorta and pulmonary trunk.
  2. Posterior border: SVC and pulmonary veins.
  3. CLINICAL CORRELATION – Clinically important sinus because it allows surgeons to pass a surgical clamp around the major arteries and veins and insert tubes allowing blood to be diverted to a cardiac bypass pump during coronary artery bypass grafting and other cardiac procedures.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

oblique pericardial sinus

A
  1. Pocket-like, cul-de-sac posterior to the heart.

2. Bounded by the pulmonary veins and IVC.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

vascular supply to pericardial area

A

Pericardiacophrenic arteries from internal thoracic artery

Pericardiacophrenic veins → internal thoracic veins.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

pericardial innervation

A
  1. Phrenic nerve provides sensory innervation to fibrous and parietal pericardium.
  2. Visceral pericardium is supplied by the cardiac plexus (see below).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

pericardial referred pain

A

Pain from the pericardium is typically referred to the shoulder/neck region (dermatomes supplied by the phrenic nerves; C3,4,5).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

pericarditis

A

If the serous pericardial membranes become inflamed (pericarditis), they become rough and no longer slide easily over one another. Pericarditis can be very painful due to the presence of pain fibers in the fibrous and parietal pericardium (There are no pain fibers in visceral pericardium).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

orientation of heart

A
  1. Due to rotation during development, the left portion of the heart lays posterior and the right anterior.
  2. The heart resembles a tipped-over cone. The apex is directed inferiorly and to the left while the base is directed posteriorly.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

flow of blood through the heart

A

C. Flow of blood through the heart

  1. Deoxygenated blood enters the right atrium through the SVC and IVC.
  2. Blood passes through the tricuspid valve to enter right ventricle.
  3. Blood exits right ventricle via pulmonary valve and pulmonary trunk – to lungs. (i.e. pulmonary circulation)
  4. Oxygenated blood enters left atrium through pulmonary veins (two on left, two on right).
  5. Blood passes through the bicuspid (mitral) valve to enter left ventricle.
  6. Blood is pumped from the left ventricle to the systemic circulation through the aorta.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

external sulci

A
  1. Atrioventricular sulcus (coronary sulcus)

2. Interventricular sulci (anterior and posterior)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

surfaces and borders of heart

A
  1. Apex
    a. Directed inferiorly and to the left.
    b. Composed entirely of left ventricle.
    c. Lies posterior to the left fifth intercostal space (MCL).
  2. Base
    a. Formed by left atrium
    b. Directed posteriorly
  3. Surfaces
    a. Anterior (sternocostal); 2/3 right ventricle, 1/3 left ventricle.
    b. Right; right atrium.
    c. Left; left ventricle + auricular appendage
    d. Diaphragmatic (in the anatomical position, the heart rests on its diaphragmatic surface); 2/3 left ventricle, 1/3 right ventricle.
  4. Borders
    a. Right ; right atrium
    b. Inferior ; 2/3 right ventricle, 1/3 left ventricle
    c. Left ; left ventricle + auricular appendage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

function of fibrous skeleton

A

a. Provide structural support for heart valves; maintaining patency and preventing distention during heart contraction.
b. Provide attachment sites for the cardiac muscle and for the valve leaflets.
c. Insulates against impulse conduction from atria to ventricles; prevents aberrant spread of impulses.
d. Provides tunnel for passage of the A/V Bundle (of His)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

fibrous rings of fibrous skeleton

A

a) anulus fibrosis – around each orifice of the 2 atrioventricular valves.
b) fibrous coronets – around the aortic and pulmonary semilunar valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Fibrouse trigones

A
  • connections between the fibrous rings.
    a. Left fibrous trigone forms a link between aortic and mitral valves.
    b. Right fibrous trigone forms a link between aortic, mitral, and tricuspid valves.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

fibrous skeleton components

A

Fibrous rings, fibrous trigones,, membranous portions of interventricular and atrioventricular septa

25
Q

Components of right atrium

A

Sinus venarum, auricle, crista terminalis, interatrial (muscular) and atrioventricular (membranous and muscular) septa, fossa ovalis, right atrioventricular orifice, sinuatrial and atrioventricular nodes

26
Q

Sinus venarum

A

a. Smooth and thin-walled; derived embrologically from the sinus venosus.
b. Forms the entrances of the IVC, SVC, and coronary veins.

27
Q

auricle

A

a. Small, ear-like pouch extending anteriorly over the root of the aorta.
b. Represents the embryonic atrium.
c. Wall is lined with pectinate muscles.

28
Q

crista terminalis

A

a. Dividing line between sinus venarum and embryonic atrium (auricle).
b. The crista terminalis is demarcated externally by the sulcus terminalis.

29
Q

fossa ovalis

A

a. Oval depression in interatrial septa representing the embryonic foramen ovale.
b. Embryologically, the foramen ovale allowed blood returning from the body to be shunted directly to the left atrium thus bypassing the fetal lungs.

30
Q

right atrioventricular orifice

A

a. Opening between right atrium and right ventricle with tricuspid valve.
b. Surrounded by a fibrous ring (anulus fibrosis) to maintain shape and patency.

31
Q

SA and AV nodes: locations

A

a. SA node is located in the sub-epicardium of the right atrium near the junction of the sulcus terminalis and the SVC.
b. AV node is located in the sub-endocardium of the right atrium, near the opening of coronary sinus.

32
Q

Components of right ventricle

A

trebeculae carnae, conus arteriosus, right atrioventricular (tricuspid) valve, membranous interventricular septum, muscular interventricular septum, pulmonary (semilunar) valve

33
Q

Trebeculae carnae

A

a. Muscular ridges of the ventricular wall.
b. Moderator band (septomarginal) – a specialized trabecular muscle passing from the interventricular septum to the anterior papillary muscle.

34
Q

conus arteriosus

A

smooth-walled portion of chamber leading to pulmonary artery.

35
Q

Right atrioventricular (tricuspid) valve

A

a. Located posterior to the sternum at the 4th or 5th intercostal space.
b. 3 cusps (anterior, posterior and septal) attach to fibrous ring.
c. Chordae tendineae connect the valve cusps to the papillary muscles.
d. Papillary muscles attach valve cusps to ventricle wall. When papillary muscle contract they pull the valve leaflets centrally and close the AV orifice. This also prevents the valves from everting into right atrium during ventricular contraction.

36
Q

Membranous interventricular septum

A

very short, thin walled portion of the IV septum

37
Q

Muscular interventricular septum

A

much larger thick, muscular portion of the interventricular septum

38
Q

Pulmonary (semilunar) valve

A

a. Located posterior to the sternum at the level of the 3rd costal cartilage.
b. 3 cusps (anterior, left and right) attach to fibrous ring.
c. Free edge of the cusp is thickened to form the nodule and lunule.
d. Pulmonary trunk surrounding each cusp is dilated, forming pulmonary sinuses.
e. When ventricle relaxes, blood in pulmonary trunk reverses its flow. The sinuses fill with blood and the cusps close.

39
Q

Left atrium

A
  1. During development, the proximal portion of the pulmonary vein becomes incorporated into the adult left atrium, forming the larger, smooth-walled posterior portion of the chamber.
  2. Receives the 2 superior and 2 inferior pulmonary veins.
  3. The auricle represents the embryonic atrium and is lined with pectinate muscles.
  4. Interatrial and atrioventricular septa.
  5. The valve of the foramen ovale is located in interatrial septa opposite fossa ovalis.
  6. Left AV orifice
    a. Opening between left atrium and left ventricle with bicuspid (mitral) valve.
    b. Surrounded by a fibrous ring (anulus fibrosis) .
40
Q

Left ventricle

A
  1. Trabeculae carneae muscles are finer but more abundant than in the right ventricle.
  2. Aortic vestibule: smooth-walled portion of the left ventricle leading to the aorta.
  3. Left atrioventricular (bicuspid, mitral) valve
    a. Located posterior to the sternum at the 4th costal cartilage.
    b. 2 cusps (anterior, posterior) attach to fibrous ring.
    c. Chordae tendineae, papillary muscles (see tricuspid valve for action)
  4. Aortic (semilunar) valve
    a. Located posterior to the sternum at the level of the 3rd intercostal space.
    b. 3 cusps (posterior, left, right) attach to fibrous ring.
    c. Within the left and right cusps are openings for left and right coronary arteries.
41
Q

valve insufficiency (regurgitation)

A
  1. Valve insufficiency (regurgitation) is the failure of any of the heart valves to close completely.Valve stenosis is narrowing of the valvular orifice.
  2. These anomalies can be detected upon auscultation as a heart murmur.
42
Q

Right Coronary Artery origin

A

a. The right coronary artery originates from the right aortic sinus within the right cusp of aortic valve.
b. The vessels of the heart travel within the loose connective tissue of the epicardium.

43
Q

Right coronary artery branches

A

a. Sinuatrial node branch to SA node (60% from RCA; 40% from LCA)
b. Right marginal branch which travels along the inferior border of heart to apex.
c. Posterior interventricular artery (posterior descending artery-PDA) which courses along the posterior interventricular sulcus to the apex of the heart. Gives rise to the atrioventricular node branch (80% from RCA; 20% from LCA).

44
Q

right coronary artery supplies

A

a. Right atrium including the SA and AV nodes.
b. Most of the right ventricle.
c. Some of the diaphragmatic portion of the left ventricle.
d. Posterior 1/3 of the interventricular septum.

45
Q

Left Coronary artery origin

A
  • left aortic sinus; within the left cusp of the aortic valve
46
Q

Left coronary artery branches:

A
  1. Branches
    a. Anterior interventricular branch (left anterior descending artery-LAD) courses within anterior interventricular sulcus.
    b. Circumflex artery courses within coronary sulcus; gives off a left marginal artery.
47
Q

left coronary artery supplies

A

a. The left atrium
b. Most of the left ventricle
c. Some of the anterior portion of the right ventricle
d. The anterior 2/3 of the interventricular septum

48
Q

Variations in coronary arterial supply

A
  1. Dominance is determined by which artery provides posterior interventricular branch (PDA).
    a. Right dominance (67%)
    b. Left dominance (15%)
    c. Codominance (18%)
  2. Some people have only 1 coronary artery; others have accessory artery (4%).
49
Q

Atherosclerosis

A
  1. Coronary artery disease (atherosclerosis) results in reduced blood flow to the heart, which can lead to a myocardial infarction (MI). If blood flow is suddenly occluded (for example, by an embolus), damage or death of the heart muscle occurs. If the occlusion occurs slowly (as in the case of the atherosclerotic process), collateral circulation within the heart may develop and may prevent a MI.
50
Q

Angina

A
  1. Ischemia (reduced blood flow) to the heart which is below the MI threshold produces angina. Angina results in chest pain, tightness of the chest and pain which radiates to the shoulder and inner arm region (mainly the left brachial region).
51
Q

Venus drainage of the heart

A

A. The coronary sinus receives most of the venous drainage of the heart; this vein travels within the posterior left coronary sulcus and opens into the right atrium.

52
Q

tributaries of coronary sinus

A
  1. Great cardiac vein (parallels the anterior interventricular artery (LAD)).
  2. Middle cardiac vein (parallels the posterior interventricular artery (RCA)).
  3. Small cardiac vein (parallels the right marginal artery).
53
Q

small veins that enter the chambers of the heart directly

A
  1. Anterior cardiac veins; drain the anterior surface of the right ventricle.
  2. Venae cordis minimae; small veins originating in the myocardium drain directly into each chamber.
54
Q

lymphatic drainage of the heart

A

A. Most lymph drains to the subepicardial lymphatic plexus.
B. Lymphatic vessels following right coronary artery terminate in anterior mediastinal lymph nodes → left bronchomediastinal trunk.
C. Lymphatic vessels following left coronary artery terminate in inferior tracheobronchial nodes → right bronchomediastinal trunk.

55
Q

conduction system of heart

A

Cardiac muscle fibers are capable of generating intrinsic impulses (i.e. they have an intrinsic rhythmicity), however, certain cardiac cells are specialized for generating impulses and maintaining the cardiac cycle. Note that these tissues are specialized myocardial fibers not neurons..
SA node –> AV node –> Bundle of His –> Purkinje fibers

56
Q

Sinuatrial node

A
  1. Located in right atrium near the SVC orifice (at sulcus terminalis).
  2. Pacemaker – sets the heart rate between 60-100 beats/minute.
  3. From SA node, impulses spread rapidly throughout left and right atrium to AV node.
57
Q

Atrioventricular node

A
  1. Located in inferior portion of atrial septum; near the opening of the coronary sinus.
  2. Once impulses reach AV node, there is a slight pause (on the order of milliseconds) before the impulses spread to the ventricles. This pause, which is maintained by the fibrous skeleton, allows time for atria to fully empty before the ventricles contract.
58
Q

AV conducting bundle (“Bundle of His”)

A
  1. Continuation of the AV node through the membranous interventricular septum.
  2. After passing through the membranous portion of the interventricular septum, the AV bundle splits into left and right bundle branches.
  3. Right bundle branch sends fibers through septomarginal band to anterior papillary muscle.
  4. Contraction of ventricles begins at the apex and spreads superiorly.

CV (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions