Heart

Question 1

the heart….

Answer 1

• 72 beats/min
• located in the cardian m.s
• 2/3 of the heart located left to the midline and 1/3 to the right

Question 2

surfaces of the heart

Answer 2

• sternocoastal> r. atrium + r. and left l. ventricle
• diaphragmatic> 2/5th r. ventricle and 3/5 l. ventricle
• post. Mediastinum> l. atrium between the 4 p. vein openings
• p. right> right atrium
• p. left> left ventricle, contacts the lungs and gives the cardic impression of the lung

Question 3

projections of the heart

Answer 3

-superior left >3rd rib
-superior right >3rd rib 3 cm to the left
-inferior left > 6th SC join 1 cm to the right
inferior right > 5th IC space 9 cm to the left

Question 4

layers of the heart

Answer 4

• parietal pericardium
• inner serous layer
• visceral pericardium (epicardium)
• myocardium
• endocardium

Question 5

in between which two layers does the coronoary a. run in?

Answer 5

the pericardium and epicardium

Question 6

function of the myocardium….

Answer 6

to attach on the fibrous skeleton of the heart by muscular hooks and the cusps

Question 7

the layers of the myocardium…

Answer 7

outer - on the atrioventricular valves to the apex
middle - parallel to the coronary sulcus plane
internal - (longitudinal) forms the papillary m. and trabecula carnea

Question 8

what is the endocardium composed of?

Answer 8

• endothelial cells

- sunendothelial cells

Question 9

what does the pericardial cavity contain

Answer 9

serious fluid which lubricates the serous surface and allows movements of the beating heart with no friction

Question 10

what are the external features of the heart?

Answer 10

• coronary sulcus
• interventricular sulcus
• crux cordis (meeting of cornoary sulcus and interventricular sulcus making a “heart cross”)
• waterstons groove (between r. p. vein and r. atrium)
• aorta
• pulmonary trunk
• superior vena cava
• inferior vena cava
• pulmonary veins
• ligamentum arteriosum
• sulcus terminalis cordis (groove in the r. atrium)

Question 11

features of the RIGHT ATRIUM

Answer 11

-crista terminalis (seperates the r. auricle and r. atrium proper)
-inferior vena cava
-superior vena cava
-orifice of the coronary sinus (has the thebasian valve)
-interatrial septum
koch triangle (area approximating the SA node)
-fossa ovale

Question 12

what are the borders of KOCH’s triangle

Answer 12

sup - tendon of todaro
inf - tricuspid valve
post - thebasian valvue

Question 13

features of the RIGHT VENTRICLE

Answer 13

• conus arteriosus (where p.trunk starts within the heart)
• septomarginal trabecula/moderator band
• tricuspid valve (ant,post,and septal papillary muscles)
• interventricular septum

Question 14

features of the LEFT ATRIUM

Answer 14

-thicker than the r. atrium has a depression that is semilunar and has a valve of the fossa ovalis

Question 15

features of the LEFT VENTRICLE

Answer 15

• forms the left post. surface and most of the diaphragmatic surface also the apex of the heart
• wall is approx. 1-1.5cm
• inlet is the mitral valve
• outlet is the aortic valve
• contains more trabeculae carnea than the r. ventricle
• contains a fibrous ring to which the R. and L. post cusps are attached to

Question 16

what is the fibrous skeleton of the heart, and what are it’s components?

Answer 16

• a network of collagen, which acts as a skeleton
• components are:
• cusps
• membranous part of the IV septum
• R+L trigons

Question 17

what is the function of the fibrous skeleton of the heart?

Answer 17

• attachments of the cusps
• keeps the integrity and structure of the valves
• forms an electrical insulator
• attaches on the myocardium by mycardial hooks and the cusps by cuspal hooks

Question 18

features of the fibrous skeleton

Answer 18

• 2x trigons Right and Left trigon
• the Right trigone carries the atrioventricular bundle
• 3 coronary fillum from the right trigon and 1 coronary fillum from the left trigone

Question 19

where is the left and right trigon located?

Answer 19

• right = between bicuspid, tricuspid and aortic valve

- left = outer edge between mitral and aortic valve

Question 20

the cusps of the valves of the heart

Answer 20

aortic = right, left and posterior cusp
pulmonary = anterior, right and left

Question 21

what is a commissure?

Answer 21

the spaces adjacent to the cusp

Question 22

what does each cusp consist of?

Answer 22

1x nodule and 2x lunules

Question 23

what do the origin of the aorta and p trunks form?

Answer 23

form the aortic sinus and the pulmonary sinus

Question 24

what begins at the right and left aortic sinus

Answer 24

right and left coronary arteries

Question 25

the branches of the right coronary artery in order

Answer 25

• sino-atrial nodal branch
• conus
• atrial branch
• right marginal branch
• atrio-ventricular nodal branch
• posterior inter-ventricular branch

Question 26

the branches of the left coronary artery in order

Answer 26

• cicumflex br.
• atrial br.
• l. marginal br.
• anterior interventricular br.
• conus br.
• diagonal

Question 27

what branches is given by the great cardiac vein

Answer 27

• left marginal
• ant. iv vein
• post. vein of the left ventricle

Question 28

branches of middle cardiac vein

Answer 28

no branches given

Question 29

small cardiac vein

Answer 29

• ant vein of right ventricle

- right marginal vein

Question 30

ant. small cardiac branch

Answer 30

-drains directly to the right atrium found on the surface of r. ventricle

Question 31

marshals vein

Answer 31

under the left auricle (posterior)

Question 32

what is coronary dominance

Answer 32

is dependent on the side which gives the posterior inter-ventricular artery. (70% right dom,20% co-dom,10% left dom.)

Question 33

the coronary sinus….

Answer 33

venous channel on the post. aspect of the heart in the coronary groove that collects great and middle and oblique veins and drains them into the right atrium, has its own thebasian valve guarding its exit

Question 34

the SA node….

Answer 34

subepicardial, loacted on the sup. edge of the crista terminalis

Question 35

the AV node…

Answer 35

subendocardial recieves internodal pathways from ant,mid,post, and bachman internodal branches

Question 36

atrioventricular/ bundle of his

Answer 36

is subendocardial and seperates the bundle into two

Question 37

where does the atrioventricular go?

Answer 37

to the apex > septomarginal trabecular > myocardium > right ventricle by the purkinji fibers

Question 38

where does the left atrioventricular go?

Answer 38

left ventricle and sperates into three once there

-ant mid and posterior branches