Brainscape's Knowledge GenomeTM

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


See full index

Gross Anatomy > Heart > Flashcards

Heart Flashcards

1
Q

What is the thoracic cage made from…

A

12 vertebrae /IVD
12 pairs of ribs/costal cartilages
Sternum

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

What comprises the sternum?

A

Manubrium
Body
Xiphoid Process (T9)

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

What is the sternal angle of Louis?

A 
Manubriosternal junction
T4/T5 IVD level 
- articulates at rib 2
- bifurcation of the trachea
- arch of aorta
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How are intercostal spaces arranged?

A

Numbered according to the superior rib

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

What is the superior thoracic aperture?

A

Superior opening of the thoracic cage

  • esophagus
  • trachea
  • neurovasculature

Thoracic Outlet Syndrome = structures affected by the obstruction of superior thoracic artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the inferior thoracic aperture?

A

Bordered by..

  • T12
  • ribs 11-12
  • costal cartilages 7-10
  • xiphoid process at T9

Covered by diaphragm

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

Where is the caval opening of the inferior thoracic aperture?

A

IVC

T8

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

What is the esophageal hiatus?

A

vagus nerve CN 10
Esophagus
T10

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

What is the aortic hiatus?

A

Aorta
Azygous
Thoracic duct
T12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the mediastinum?

A

Houses the thoracic structures, excepts for the lungs/pleura

  • fatty/loose connective tissue = facilitates movement
  • becomes less flexible with age and repair
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does widening of the mediastinum indicate?

A

Indicative of the laceration of the great vessels, lymphoma, cardiac hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What connects the superior mediastinum and inferior mediastinum?

A

Transverse thoracic plane

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

What’s the pericardium?

A

Middle mediastinum

Outer fibrous
Inner serous

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

What is the outer fibrous pericardium?

A

Thick, inelastic

Attached to central tendon/sternum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the inner serous pericardium?

A

Mesothelioma with connective tissue

Contains the:

  • parietal pericardium
  • visceral pericardium: epicardium/covers the heart
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the pericardial cavity?

A

In between the parietal and visceral pericardium
Contains serous fluid

Pericarditis=inflammation of the pericardium

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

What is the duodenalojejunum junction?

A

Where the duodenum emerges from behind the peritoneum

On the right side of the abdominal cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does the superior mesenteric artery branch to?

A

Right colic artery -> ascending colon
Jejunal arteries
Ileal arteries - - > make up the vasa recta, which in turn make up the intestinal wall
Ileocolic Artery - supplies the ileocolic junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What does the middle colic artery supply?

A

The transverse colon

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

What is the first portion of the colon/ascending colon

A

Cecum

Attaches to ileum and the veriform appendix (found just posterior)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the second portion of the colon?

A 
Ascending colon
Right colic/hepatic flexure
Transverse Colon
Left colic/splenic flexure
Descending colon
Sigmoid Colon
Sigmoid Mesecolon - mesenteric that connects portions of the sigmoid colon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where do the preganglionic sympathetic neurons come for heart?

A

IMLCC T1-T4

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

Where do the postganglionic neurons for heart innervation come from?

A

They exit the sympathetic chain to mix into the cardiac plexus before entering the heart tissue.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What does sympathetic innervation to the heart cause?

A

Increases rate/force of contraction by…

  • increasing the activity of SA/AV nodes
  • vasodilating the coronary vessels (RCA, LCA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Where does pregaglionic neurons in PARASYMPATHETIC to heart come from?

A

Vargas nuclei in the brain stem, these are parasympathetic branches of the vagus nerve

  • they synapse in the cardiac plexus or the heart tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What does PARASYMPATHETIC innervation to heart cause?

A

Decreases the rate/force of contraction by…

  • decreasing the activity of SA and AV nodes
  • vasoconstriction get the coronary vessels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is preganglionic sympathetic innervation to the lungs?

A

IMLCC T1-T4/T5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is postganglionic sympathetic innervation to lungs?

A

Will exit the sympathetic chain medically as cervical/thoracic sympathetic nerves

Will mix with pulmonary plexus before following the bronchi into lung tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What does sympathetic innervation to the lungs cause?

A

Bronchodilation
Vasoconstriction
Inhibition of glandular secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What does parasympathetic innervation to lungs cause?

A

Bronchoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What else does parasympathetic innervation to lungs cause?

A

Vasodilation of blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Where do preganglionic neurons in parasympathetic division to lungs come from?

A

Vagal nuclei in the brainstem

  • enter pulmonary plexus
  • synapse on bronchi
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is myenteric plexus responsible for?

A

Motility in ENS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the submucosal plexus for?

A

Blood flow and secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Where does sympathetic innervation to abdomen come from?

A

IMLCC T5-L2

- exit the sympathetic chain on splanchnic nerves, which then synapse on collateral ganglia to innervate the abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What do the greater splanchnic sympathetic nerves innervate?

A

T5-T9
Foregut/liver/gallbladder/pancreas

Greater splanchnic nerve projects to the celiac ganglion -> synapses on post-ganglionic neurons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What nerve fibers parasympathetically innervate the foregut/liver/pancreas/gallbladder?

A

Anterior and Posterior Vagal Trunk

Post-ganglionic neurons lie at the viscera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What sympathetic nerves innervate the hindgut?

A

L1-L2
- exit as lumbar splanchnic nerves
> inferior mesenteric ganglion
> postganglionic follows the blood supply of the IMA to the viscera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What parasympathetic nerves innervate the hindgut?

A

Preganglionic S2-S4
- pelvic splanchnic nerves -> inferior hypogastric -> rectal plexus ->viscera

Causes:

  • vasodilation
  • secretormotor to the GI mucosa
  • motor to the GI musculature
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the sympathetic innervations to the kidney?

A

T12
Least Splanchnic Nerve
> aorticorenal plexus
> post-ganglionic synapse and follows blood supply to kidney

Sympathetic:

  • vasoconstriction
  • decreases urine production
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are the sympathetic innervation to the midgut?

A

T10-T11
Lesser Splanchnic Nerve
> Superior Mesenteric Ganglion
> postganglionic fibers follow the blood supply

Vasoconstriction
Inhibits GI musculature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What provides sympathetic innervation to the adrenal gland?

A

Greater splanchnic nerve (T5-T8) -> celiac ganglion

Pre-ganglionic = medulla cells (chromaffin) - synapse on cells and release NE/Epi
Post-ganglionic = blood vessels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the parasympathetic innervation to the midgut?

A

Vagal nuclei in the brainstem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the sympathetic preganglionic cell bodies?

A

T1-L2/L3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What are the preganglionic parasympathetic cell bodies?

A

CN X = thorax/abdomen

Abdomen/Pelvis = S2-S4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the white rami?

A

Preganglionic sympathetic axons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the grey rami?

A

Postganglionic sympathetic axons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What does vagal nerve of parasympathetic nervous system innervate?

A

Thorax and abdomen
Enters..
- esophageal plexus, forms an anterior/posterior vagal trunk before entering the abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is parasympathetic innveration?

A

Vagus Nerve (CN X)

Pelvic Splanchnic (IMLCC S2-S4)
- projects to inferior hypogastric plexus to supply parasympathetic innervation to the gut
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is referred pain?

A

Inability to distinguish between visceral and somatic sensory distribution
- referred pain from heart will result in pain of T1-T4 dermatologist of the chest wall and medial arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Endocardium

A

Lines the blood filled chambers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Myocardium

A

Thick, middle layer

Myocytes for contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Epicardium

A

Thin, external layer

Connective tissue, coronary arteries, mesothelioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Hemopericardium

A

Blood into the pericardial cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Cardiac Tamponade

A

Compression on heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

In cardiac tamponade, what is presentation?

A

Face and neck swell due to impeded venous return to the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Where does pericardiocentesis occur?

A

In cardiac notch

- needle inserted superoposteriorly at infrasternal angle, at 5/6 LICS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What are the sequence of layers penetrated in pericardiocentesis?

A

AFPP

A- anterior body wall
F-fibrous pericardium
P-parietal layer of serous pericardium
P-pericardial cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What are the two pericardial sinuses?

A

Transverse sinus: horizontal gap, anterior to SVC, posterior to aorta-pulm trunk

Oblique sinus: under the apex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is the base of the heart?

A

Posterior heart
Left atrium
Includes…
- proximal parts of the 4 pulmonary veins that empty into LA

(The RA and SVC/IVC form a small part of the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Where does the esophagus lie?

A

Posterior to the base of the heart

Vertebral bodies lie posterior to the esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Where is the heart located?

A

T5-T8 = supine position

T6-T9 = standing position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What does the apex consist of?

A

Left ventricle
Left tip of the LV
- projects anteriorly and left
5th LICS at the MCL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is the apex beat?

A

5th LICS at MCL

During auscultation, listen for sounds of the mitral valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What blood flows into the RA?

A

Coronary sinus
SVC
IVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Where is the sternocostal/anterior border of heart?

A

5 LICS parasternally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

When does the heart contract?

A

Day 21

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What forms the cardiac veins?

A

Migration of neural crest cells in embryonic development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is echocardiogram?

A

Cardiac ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is an electrocardiogram?

A

Measures impulses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

How can heart be catherization?

A

Femoral artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What is the transposition of great arteries?

A

Aorta continues from the RV
Pulmonary trunk continues from LV

Congenital birth defect

  • the NCC-derived aortiopulmonary septum that divides the common artery did not form
  • “arterial switch” procedure carried out
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is dextrocardia?

A

Position of the heart is reversed
Apex is on the right, not the left

If dextrocardia occurs with general transposition of organs (situs I versus) = heart functions normally

Isolated dextrocardia = severe defects!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Where is blood oxygenated at placenta per tally?

A

Umbilical vein => IVC => right atrium

RA -foramen ovale -> LA -> LV -> Aorta (bypasses the. Lungs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is the foramen ovale called postnatally?

A

Fossa ovalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is the ductus arteriosus?

A

Shunts blood from the left pulmonary artery into the arch of aorta

Postnatally = called the ligamentum arteriosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What muscles does the right atrium have?

A

Pectinate muscles

- begins at the 3rd costal cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What separates the RV/LV?

A

IVS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What is the LA?

A

Forms much of the base off the heart

  • 4 pulmonary veins enter
  • left auricle is made up of pectinate muscles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What is the LV?

A

Apex of the heart
Covers the diaphragmatic surface

Carries:

  • traberculae carnae
  • papillary muscles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Hoarse voice:

A

Stretching of the left recurrent laryngeal nerve
- loops under the arch of the aorta next to the ligaamentum arteriosum

LRLN - supplies muscles of the larynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Where do the following structures exit the diaphragm?

A 
Inferior vena cava = T8
Esophagus = T10
Aorta = T12
- aorta bifurcation L4
- inferior vena cava L5
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Celiac Trunk Branching

A

T12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Superior Mesenteric Artery

A

L1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Inferior Mesenteric Artery

A

L3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

How does the superior part of common hepatic artery branch?

A 
Right gastric
Proper hepatic
- left hepatic
- right hepatic
- - cystic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Where does the inferior part of common hepatic Branagh to?

A

Gastroduodenal artery

  • anterior/posterior superior pancreatoduodenal branch
  • anastomoses with anterior/posterior inferior pancreatoduodenal
  • gastroomenal (gastroploic artery)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Where does the trachea bifurcate?

A 
T4/T5
Manubristernal junction (sternal angle of Louis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Where is the superior opening of thorax?

A

T1
1st pair of ribs
Superior border of manubrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Where is the inferior thoracic apeture?

A

Bordered by T12
Xiphoid process of T9
Covered by diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What is the caval opening?

A

T8 level
Allows the IVC to empty into the RA

During inspiration, the diaphragm contracts and widens the caval opening to allow increased blood flow through the IVS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What is the order of covering of heart?

A

Pericardium (multilayered sac that covers the heart vessels)
Fibrous Pericardium
- thick connective tissue
- protects against overfilling
- keeps heart in position — attaches to the central tendon
- phrenic nerve
Inner Serous Pericardium (mesothelium of 2 layers)
- parietal
- visceral (epicardium, covers heart, continuous with parietal pericardium)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

What is VSD?

A

Causes left -> right shunting

  • leads to pulmonary hypertension
  • might cause cardiac failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Muscular VSDs

A

Often spontaneously close during birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Membranous VSDs

A

Occurs as a result of complex formation -> affects the AV bundle of cardiac conduction system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

What are ASDs?

A

Atrial septal defects
- incomplete closure of the foramen ovale
- clinically significant bc:
Allows shunting of blood from LA -> RA
Leads to overload of the pulmonary vascular system
Leads to Right Ventricular Hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What is the ductus arteriosus?

A

Prenatal structure
- shunts blood from the left pulmonary artery to the arch of the aorta (left side of the heart)

at birth:
Increase in O2, bradykinin, decrease in prostaglandins = smooth muscle contracts and forms the ligamentum arteriosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What is the sinus venarum?

A

Openings into the RA
SVC (3rd rib)
IVC
Coronary Sinus (with it cardiac vein supply)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

What is the fossa ovalis?

A

Separates the RA and LA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

What is the coronary sinus?

A

Situated between the IVC opening and the RV opening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

What muscles are in the Rough RA?

A

Pectinate muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

What smooth muscles are in the RA?

A

Sinus venarum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

What forms the largest part of the anterior surface of the heart?

A

RV

  • muscular traberculae carnae = internal RV
  • papillary muscles = finger-like projections internal RV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

What is systole?

A

ventricular contraction
AV valve stops regurgitation = blocks backflow into atrium
- blood outflows via conus arteriosus/infundibulum into pulmonary trunk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

What is the conus arteriosus/infundibulum?

A

Outflow of blood from RV to pulmonary trunk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

The pulmonary trunk bifurcated where?

A

Below the arch of aorta into left and right pulmonary arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

What does the left pulmonary artery contain?

A

Ligamentum arteriosum, connects to the arch of the aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Where does the right pulmonary artery pass?

A

Posterior to the ascending aorta

109
Q

Left Atrium

A

Has pectinate muscles
Has 4 pulmonary veins
Forms much of the base of the heart

110
Q

Left Ventricle

A

Forms the apex. Of the heart

Traberculae carnae and papillar muscles = coral tendinae

111
Q

What supplies muscles to the larynx for phonation?

A

Recurrent laryngeal branch
Loops under arch of aorta
Adjacent to ligamentum arteriosum

112
Q

What causes hoarse voice?

A

Aneurysm (widening) of the arch of aorta = might stretch laryngeal nerve

113
Q

What does the AV have?

A

Chorale tender and papillary muscles

114
Q

What are the SL values?

A

Between the ventricles and pulmonary trunk/aorta

115
Q

When the aortic valve is closed..

A

Blood in the right and left aortic sinuses flow into the right and left coronary arteries
Occurs during diastole

116
Q

What is systole?

A

AV valves closed
Prevents back flow
Blood proceeds through the open SL valves into pulmonary trunk or aorta

117
Q

What is Diastole?

A

SL valves close shut during ventricular filling

Blood flows from the atria into the ventricles

118
Q

What is the LUB sound?

A

Closure of the AV valves for systole

119
Q

What is the DUB sound?

A

Closing of the SL valves for diastole

120
Q

What is a stenotic murmur?

A

Narrowing of the vavle

Slows blood flow

121
Q

What is insufficiency?

A

Prolapse insufficiency

  • failure of valve to close completely
  • results in the backflow of blood into the chamber it was just ejected from
122
Q

What is mitral valve insufficiency?

A

Occurs 1 in 20

Chest pain and fatigue

123
Q

What is aortic valve insufficiency?

A

Collapsing pulse

Blood flow back into the left ventricle

124
Q

What is semilunar valve stenosis?

A

Might lead to ventricular hypertrophy

125
Q

What is aortic valve?

A

Occurs at the 2nd RICS parasternally

Closed during DIASTOLE = if defect, there is an insufficient murmur
Open during SYSTOLE = if defect, there is a stenoic murmur

126
Q

What is the pulmonary valve?

A

2nd LICS parasternally line

Closed during diastole = if defect, there is an insufficient murmur
Open during systole = if defect, there is a stenoic murmur

127
Q

What is the tricuspid valve?

A

5th LICS parasternal

Closed during Systole = if defect, there is an insufficient murmur
Open during Diastole = if defect, there is a stenoic murmur

128
Q

What is the Mitral Valve?

A

5th LICS mid clavicle are line

Closed during systole = if defect, insufficient murmur
Open during diastole = if defect, stenoic murmur

129
Q

What is cardiac referred pain?

A

Sympathetic to the heart, courses with sensory dorsal roots of upper thoracic segments

Pain from fibers in upper dermatology course with the pain fibers from the heart and the brain cannot distinguish between the two

130
Q

Patent ductus arteriosus (PDA)

A

Detected as a machine like continuous heart murmur throughout systole/diastole
Treated with prostaglandin inhibitor
- otherwise, RV will become hypertrophic over time

131
Q

What is tertraology of fallot?

A

Cyanosis
Malposition of aorticopulmonary septum:
- aorta widens
- pulmonary trunk narrows = PULMONARY STENOSIS

Due to:

  • pulmonary stenosis
  • overriding aorta
  • VSD
  • Right Ventricular Hypertrophy

blood from RV passes into overriding aorta
Murmur heard due to pulmonary stenosis

132
Q

Coronary Arrteries

A

Located in the visceral pericardium

  • supply the epicardium/myocardium
  • Epicardium: receives nutrients from the blood in chambers
133
Q

What lies in the coronary sulcus?

A

RCA
LCA - Circumflex Artery
Coronary Sinus (carries great cardiac vein)

134
Q

What is the right coronary artery?

A

Arises from the ascending aorta, passing through the coronary sulcus
Splits into:
- marginal artery
- PIV (posterior interventricular)

Supplies:

  • RA, RV
  • SA/AV node
  • part of the LV
  • posterior IVS 1/3
135
Q

What is the left coronary artery?

A

Arises from the ascending aorta
- passes between left auricle and pulmonary trunk
Branches into:
- circumflex: coronary sulcus around the left border to posterior side to supply the LA
- Left anterior descending:
- - anterior 2/3 of the IVS with the AV bundle
- - supplies part of the LV

136
Q

What is the coronary sinus?

A

Main vein of the heart

Runs left to right int he posterior part of the coronary sulcus

137
Q

Great cardiac vein:

A

Runs along the LAD artery (anterior side), back to the circumflex artery (anterior side) and empties into the coronary sinus

138
Q

Angina

A

Transient pain that results from myocardial ischemia (inadequate blood to the heart)
Pain is product of anaerobic metabolism (lactic acid) - stimulates pain receptors

139
Q

Angina treated with..

A

Sublingual nitroglycerin to dilate coronary arteries

Disappears with rest

140
Q

Coronary Artery Bypass Grafting

A

Surgery where the blood is rerouted to reach the myocardium
- uses portions of an alter artery and vein

Most common:
Internal thoracic arteries
Great saplenous vein

141
Q

CAD

A

Myocardial ischemia that eventually leads to necrosis

142
Q

What is myocardial infarction?

A

Ischemic necrosis of the myocardium

143
Q

Coronary Atherosclerosis

A

Lipid deposition in the coronary artery causing ischemic heart disease

144
Q

Angioplasty

A

Catheter with small balloon
- inflates and flattens plaque against the vessel wall

Femoral artery = access to the left heart
Femoral vein = access to the right heart

145
Q

What are angiograms and arteriograms for?

A

Catheter into the femoral artery by wall of the inguinal region, passes into the ascending aorta

Uses a radiopaaque dye contrast
- injected into vein to allow visualization of lumen of vessel; allows for visualization of stenosis/occlusion

146
Q

Where are the most common occlusion sites?

A

LAD (40-50%)
RCA (30-40%)
LCA circumflex (15-20%

147
Q

Tracheal bifurcation

A

T4

148
Q

What courses with the esophagus?

A

Vagus nerve

149
Q

What drains structures above the diaphragm?

A

SVC at the 1st costal cartilage

150
Q

Azygous Vein

A

Courses along the posterior thoracic wall

Arch of the azygous vein empties into the SVC

151
Q

Esophagus

A

Found to the right of the aorta

Shifts left as it descends to eventually meet the stomach (exits diagphram as esophageal hiatus with the vagus nerve at T10)

152
Q

Thoracic Duct

A

Arises below the diaphragm

Ascends vertically through the diaphragm, just right to the midline

Drains into the:

  • left subclavian vein
  • left internal jugular vein
153
Q

Sympathetic trunk

A

Lies posterior to the mediastinum
Made up of paravertebral postsynaptic sympathetic ganglia

Greater, lesser, lesser splanchnic nerves = arise from the lower thoracic levels

154
Q

Sympathetic nerve fibers

A 
Increases:
- contractility
- rate of impulses in nodal tissues
- force of contraction
- coronary artery vasodilation
Relaxation of vascular smooth. Muscle with B2 adrenergic receptors
155
Q

Parasympathetic fibers

A

Decrease heart rate via innervation of the vagus nerve (CN 10)
Vasoconstriction the arteries (decreases rate of impulses in nodal tissue via the Ach-muscarinic receptor interactions)

156
Q

Pain sensations of heart due to ischemic myocardium

A

Course afferently along

Cardiac sympathetic nerve fibers

157
Q

Cardiac Pain

A

Skin in upper left arm bc spinal cord segments of cutaneous sensory nerves share common terminations for afferent visceral pain sensations

158
Q

Fibrillation

A

Rapid twitches of cardiac muscle that occur in atria/ventricle

Ventricular fibrillation = poor pumping activity (defibrillator elective shock might reset ventricular contraction)

159
Q

SA node

A

SVC-RA junction
Heart pacemaker
~70 impulses per minute
SA -> atrium -> AV node

160
Q

AV node

A

Interarterial septum
Ventricular contraction after atrial contraction

AV node delays the SA node impulse before signaling to the AV bundle

161
Q

AV Bundle of His

A

Membranous IVS
Right bundle branches - muscular
Left Bundle Branches (muscular IVS)
Purkinje Fibers in ventricular Walls

If damaged: no conduction signal from atria->ventricles (results in heart block)

162
Q

Septomarginal Trabercula

A

Cardiac muscle band is shortcut with purkinje fibers that transit:

Right bundle branch in muscular IVS -> across RV -> anterior papillary muscle to coordinate conduction for contraction timing

163
Q

Heart Block

A

Not enough blood is getting to the heart

Occlusion in the LAD (most of AV bundle, anterior 2/3 of IVS)
OR
Occlusion in the RCA (supplies the SA/AV nodes)

164
Q

Bundle Branch Block

A

Ventricular contractions are impaired

Late and asynchronous ventricular contraction
Subcutaneous and artificial pacemaker might be implanted
- produces electrical impulses that initiate ventricular contractions

Occurs if damage to the bundle branches (located in the ventricles)

165
Q

Nodal Tissues…

A

Provide action potentials to the cardiac myocytes (signal is propagated myogenically via gap junctions)
Into chamber wall, all contract in a coordinated effort

166
Q

Connections of intercostal artery

A

Origin: posterior from thoracic aorta
Distributes: intercostal spaces

167
Q

Connections of Superior Epigastric Artery

A

Origin: internal thoracic artery
Distribution: abdominal muscle, anastomoses with inferior epigastric

168
Q

Connections of inferior epigastric

A

Origin: external iliac artery
Distribution: courses deep to the rectus; anastomoses with superior epigastric artery

169
Q

Lumbar artery

A

Origin: abdominal aorta
Distribution: posterior abdominal wall

170
Q

Umbilicus Nerve Supply

A

T10 dermatologist

171
Q

Where are the nerves in the anterolateral abdominal wall located?

A

Between the transversus abdominus and internal oblique muscles

172
Q

Anterolateral abdominal wall nerves

A

Ventral rami of six intercostal nerves
Subcostal nerves (T12)
Iliohypogastric (L1)
Ilioinguinal (L1) - emerges from the inguinal canal

173
Q

Iliolingual Nerve

A

Emerges from the inguinal canal, lateral to the spermatic cord or the round ligament of the uterus

174
Q

Inguinal canal

A

4cm in length

  • passage way for the testes to descend from the kidneys and into the scrotum
  • transmits the spermatic cord in male and round ligament of uterus in females
175
Q

Superficial / External Ring

A

Gap in aponeurosis in external abdominal oblique

Opens up into the subcutaneous layer

176
Q

What does formation of the inguinal canal begin with?

A

Process vaginalis

  • formed by invagination of the peritoneum, which then Eva giants the other layers of the abdominal wall
  • except the transversus abdominus
177
Q

Gubernaculum

A

Connective tissue
Connects the caudal end of the testes with the scrotum

  • When it shortens, it pulls the testes into the canal
  • In females, the gubernaculum becomes the round ligament of uterus
178
Q

Anterolateral Abdominal Wall - 4 quadrants

A

Median plane

Trans umbilical plane (L3/L4)

179
Q

Anterolateral Abdominal Wall’s. 9 Regions

A 
HEH:
Hypochondriac - Epigastric - Hypochondriac
LUL:
Lumbar - Umbilical - Lumbar
IHI:
Inguinal - hypogastric - Inguinal

Cut by:
2 midclavicular vertical planes
Subcostal Plane (L2 - inferior to the 10th rib)
Transtubercular (L5)

180
Q

Iliac Crest

A

Attachment site for muscles (L4)

181
Q

Iliac Tubercle

A

Corresponds to L5

182
Q

ASIS: anterior/superior iliac spine

A

Attachment for muscles and the inguinal ligament

Pubic Tubercle - attachment site for the inguinal ligament

183
Q

Layers of the abdominal wall

A 
SEITTEP
Subcutaneous Tissue
External Abdominal Oblique
Internal Abdominal Oblique
Transversus Abdominal Muscle
Transversalis Fascia
Extraperitoneal Fat
Parietal Peritoneum
184
Q

What are flat muscles of abdomen for?

A

Primarily responsible for compression of the broken/modulating intra-abdominal pressure

185
Q

What is the rectus abdominus?

A

T7-T12
Flexes the trunk
- originates at the pubic symphysis and inserts onto the xiphoid process

186
Q

Linea Alba

A

Midline of the rectus abdominus (aponeurosis of rectus abdominus)

187
Q

Acurate Line

A

All 3 muscles pass anteriorly

188
Q

Posterior Lamina of the Rectus Sheath

A

Aponeurosis of the transverses abdominus

189
Q

Anterior Lamina of the Rectus Sheath

A

Formed from the

  • aponeurosis of the external oblique
  • 1/2 of internal oblique
190
Q

Contents of the Inguinal Canal for Males

A

Ductus deferens
Testicular Vessels
Autonomic Nerve
Lymphatics

191
Q

What are the coverings of the inguinal canal?

A

Internal Spermatic Fascia (transversalis fascia)
Chemasteric Fascia (Internal Abdominal Oblique)
External Spermatic Fascia (External Oblique Fascia)

192
Q

Inguinal Hernias

A

Portions of fat/bowel might protrude when intra-abdominal pressure is increased (laughing fit or urination)

Reducible - contents can be returned
Irreducible - contents can’t be returned
Strangulated Hernia - contents of sac become ischemic as a result of arrested circulation

193
Q

Direct Inguinal Hernia

A

Inferior to the epigastric blood vessel (artery that arises from the external iliac artery)

  • extends through Hesselbach triangle
  • acquired over time as transversalis becomes stretched
194
Q

Indirect Inguinal Hernia

A

Process vaginalis typically obliterates
- occurs lateral to the inferior epigastric blood vessels
- most commonly congenital
- occurs into the deep inguinal ring
Tunica vaginalis remains anterior to the testes

195
Q

What supplies the midgut?

A

SMA
2nd part of duodenum -> left 1/2 transverse colon

Anastomoses with IMA via the marginal artery

196
Q

What branches off the SMA?

A

Anterior and posterior inferior pancreatic duodenal artery
Intestinal Arteries (jejunum/ileum branches)
Ileocolic Artery
Right Colic Artery

Underneath the intestines = middle colic artery - anastomoses into marginal artery

197
Q

Inferior Mesenteric Artery

A

L3 (SMA is at L1)
Supplies the hindgut
Left transverse 1/3 colon -> Superior Rectum

  • Left Colic Artery
  • Sigmoidal Artery
  • Superior Rectal
198
Q

What branches do the abdominal aorta give off?

A 
Inferior phrenic - Parietal
Lumbar artery - Parietal
Middle suprarenal - Visceral
Renal - Visceral
Gonadal testicular artery - Visceral 
ILMRG
199
Q

What are the terminal branches of the abdominal aorta?

A

Common iliac -> Internal Iliac and External Iliac

Median sacral

200
Q

I 8
10 E
A 12

A

Inferior Vena Cava = T8
T10 = esophagus
Aorta = T12

201
Q

What are abdominal branches off the aorta?

A

Celiac Trunk (T12)
SMA (T1)
IMA (T3)

202
Q

What does the celiac trunk supply?

A 
T12
Foregut
- lower esophagus
- duodenum 1st half
- liver
- gall bladder
- pancreas/spleen

anastomoses wit the SMA via the pancreaticduodenal arteries

203
Q

Celiac Trunk branches off into..

A

Left Gastric
Splenic (coiled)
Common Hepatic

204
Q

Superior branches of the common hepatic

A

Right gastric (over the lesser curvature)
Proper Hepatic
- Left Hepatic
- Right Hepatic (-> Cystic)

205
Q

Gastroesophageal Anastomoses

A

Left Gastric -> Esophageal vein -> Azygous Vein

206
Q

Anorectal Anastomoses

A

Superior rectal vein -> Middle and Inferior Rectal Vein -> Internal Iliac Vein

207
Q

Paraumbilical Anastomoses

A

Paraumbilical vein -> superficial epigastric vein -> axillary or femoral vein

208
Q

Retroperitoneal Anastomoses

A

Colic Vein -> Retroperitoneal Vein -> IVC

209
Q

Abdominal Aorta Aneurysm

A

Dilation of the aorta 1.5x the normal size

  • occurs when a wall becomes weakened/expands
  • 75% of patients are asymptomatic, males more likely to have, confirmed by ultrasound
210
Q

Terminal branches of the IVC

A

median sacral
Common iliac, external and internal iliac vein
Lumbar veins

211
Q

What drains into the left renal vein?

A

Left suprarenal vein

Left testicular/ovarian vein

212
Q

Hepatic Portal Venous System

A

Splenic Vein/Superior Mesenteric Vein/Inferior Mesenteric Vein

Blood with nutrients from the GI course into the Liver
Liver -> Hepatic Vein (processing/detoxification) -> IVC

213
Q

What is enclosed in the hepatoduodenal ligament?

A

Portal Triad

  • hepatic portal vein (to the liver!)
  • common bile duct
  • proper hepatic artery
214
Q

Liver Lobectomy

A

Removal of the lobe = possible if a tumor is isolated to a certain region

Due to: organized blood supply of hepatic arteries/venous branches

215
Q

Hepatic Proper Artery

A

Provides 30% of total blood to the liver
Whereas…
Hepatic Portal Vein = 70% of the blood to the liver

Then both travel through hepatic veins -> IVC

216
Q

Portal Hypertension

A

Increased resistance forces blood into alternative pathways and back to systemic circulation.

Might cause varies (dilation of veins) at the site of anastomoses.
Occurs secondary to liver pathology (cirrhosis, tumor, thrombosis of portal vein)
Common in chronic alcoholism

217
Q

What are the vessels to the diaphragm?

A

Phrenic nerves
Inferior phrenic arteries
Azygous Vein

218
Q

What are the muscles in the posterior abdominal wall?

A 
Diaphragm
Quadratus Lumborum
Psoas Major
Psoas Minor
Iliacus

Most laterally:

  • external oblique
  • internal oblique
  • transversalis
219
Q

What are the nerves of the abdomen?

A

Celiac ganglion
Superior mesenteric ganglion
Aorticorenal ganglion = supplies ureters
Inferior mesenteric ganglion
Sympathetic Trunk - lumbar splanchnic nerves
Superior Hypogastric Plexus - at the bifurcation of aorta

220
Q

Where do the ureters naturally constrict at?

A
  1. Renal pelvis
  2. Crossing the pelvic brim
  3. Entering the bladder
221
Q

Where do the adrenal veins drain into?

A

The renal veins

222
Q

Where does the left gonadal vein drain into?

A

The renal vein

The arterial connection on th aorta reminds us of the origin of the testes on the posterior abdominal wall

223
Q

What is the SMA in a position to do?

A

Compress the left renal vein

224
Q

Major Calyx

A

Where multiple minor calyces join

Multiple major calyx join into the renal pelvis

225
Q

What is the papilla?

A

The tip of the renal pyramid

226
Q

Ureter

A

Retroperitoneal space

- muscular duct that conveys urine from renal pelvis into the urinary bladder

227
Q

What is the pain of kidney stones being lodged at…

A
  1. Renal pelvis
  2. Pelvic brim
  3. Entrance to bladder

Experience flank pain: loin to groin pan (T11-L2)

228
Q

Where are kidneys usually transplanted to?

A

Iliac fossa
Make the ureter as short as possible, yet must have a good supply=therefore you take the 1st third of ureter with it.

The renal artery and vein is anastomosed to the external/internal iliac artery/vein.

229
Q

What holds the valve closed in the bladder?

A

Pressure

Urine enters the bladder via peristalsis in the ureter

230
Q

What innervates the ureter?

A

Aoritcorenal plexus

Blood supply: renal artery/gonadal artery

231
Q

What artery lies just inferior to the renal arteries?

A

Gonadal arteries

232
Q

Where does the testicular artery go into?

A

Deep inguinal ring

233
Q

Where do the ovarian arteries go into?

A

Pelvic Brim

234
Q

Where do the suprarenal arteries drain into?

A

Drain into the renal veins

235
Q

Where does the left gonadal vein drain into?

A

Renal vein

236
Q

Where can the gonadal veins be traced from?

A

From the pelvis (women) or from the deep inguinal ring (male)

237
Q

Lumbar Plexus = SIIGLFO

A 
Subcostal
Iliohypogastricc
Ilioinguinal
Genitofemoral (emerges from psoas major)
Lateral Femoral Cutaneous Nerve (passing along the ilacus muscle)
Femoral 
Obturator (medial to the psoas major)
238
Q

For renal innervation…

A

Preganglionic sympathetic: directly onto the cells of the adrenal medulla
Postganglionic sympathetic: blood vessels

239
Q

Iliohypogastric nerve

A

Found along the Iliac crest

240
Q

Ilioinguinal nerve

A

Found exiting the superficial inguinal nerve

241
Q

Femoral nerve

A

Found lateral to the distal end of the psoas major

242
Q

IMV courses into the…

A

Hepatic portal vein

243
Q

What lies more left in the abdomen?

A

Aorta

244
Q

What lies more right in the abdomen?

A

IVC

245
Q

Aortic bifurcation occurs at…

A

T4

246
Q

Where does IVC bifurcate?

A

L5

247
Q

What are the branches off the splenic artery?

A

Pancreatic artery

Left gastroomentum / gastroeploic = anastomoses with the right gastroomentum

248
Q

What is the branch off the left gastric?

A

Anastomoses with right gastric artery on the lesser curvature

249
Q

What are the branches off the common hepatic?

A

Gastroduodenal
Right Gastric
Proper Hepatic

250
Q

What are the branches off the gastroduodenal?

A

Posterior and anterior superior pancreatic duodenal

Right Gastroomenal

251
Q

When does abdominal aortic anuerysm occur?

A

1.5x more dilation of aorta (occurs when the segment becomes weakened and expands)

252
Q

What branches off the IMA?

A

To the hindgut at L3

  • left colic (descending colon)
  • sigmoid artery (3-4, sigmoid colon)
  • superior rectal artery

Left 1/3 transverse -> superior rectal

253
Q

SMA

A

Supplies the midgut
2nd half of duodenum to the left 1/3 transverse colon

Compression on SMA leads to obstruction of renal vein
Anastomoses with IMA via marginal artery

254
Q

What are the left side contributors of the SMA?

A

Jejeunal intestinal arteries
Ileum intestinal arteries
Arterial arcades/vasa recta

255
Q

What are the right side contributors from SMA?

A 
Ileocolic (ileum-colon junction)
Right Colic (ascending colon)
Middle Colic (transverse colon)
256
Q

What part of duodenum does the common bile duct exit into?

A

Mid way down (retroperitoneal)

257
Q

Spleen

A

Filters blood and not lymph
Recycles Hb to the liver to make bile salts
Aids in immune function

258
Q

Ligamentum Venosum

A

Obliterated ductus venosus

259
Q

Cantile’s Line

A

Divides the left and right lobes

260
Q

Epiploic Foramen of Winslow

A

Opening into lesser sac (omental bursa)

261
Q

Parietal peritoneum

A

Lines the walls of the abdominal cavity

262
Q

Visceral peritoneum

A

Covers organs

263
Q

Mesentery of GI

A

Double layer of peritoneum that connects organ to the body wall

264
Q

Ligament of GI

A

Double layer of peritoneum that connects one organ to another

265
Q

Falciform ligament -

A

Ligamentum teres hepatis in the liver

266
Q

Intraperionenal organs

A

Organs surrounded by peritoneum

Suspended from abdominal wall by mesentery

267
Q

Tanea Coli

A

Longitiudinal muscle layers in the intestines

268
Q

Umbilicus

A

L4

269
Q

9 regions in the abdominal planes

A 
Midclavicular lines
Subcostal line (L2 - Rib 10)
Transtubercular line (L5)

HEH - right hyogastric, epigastric, left hypogastric
LUL - right lumbar, umbilical (L3/L4), left lumbar
IHI - right inguinal, hypogastric, left inguinal

Gross Anatomy (6 decks)

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