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Anatomy > Heart > Flashcards

Heart Flashcards

1
Q

Position of heart

A

. Middle mediastinum post. And slightly left of sternum, ant. To esophagus
. Apex: med. to midclavicular line
. Base: faces post., directly ant. To esophagus at T6-9 vertebral levels

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2
Q

Pericardium

A

. 3 layered membranous sac surrounding heart

. Pericardiacophrenic a. And pericardiacophrenic vv.

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3
Q

Fibrous pericardium

A

. Thought, outer layer

. Attaches to central tendon of diaphragm

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4
Q

Serous pericardium

A

. Thin membranous lining prevents friction during heart movement
. Parietal layer: lines internal wall of fibrous pericardium
. Visceral layer: directly adheres to surface of heart, contains coronary vessels

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5
Q

Transverse and oblique pericardial sinuses

A

. Where visceral and parietal layers becomes continuous where great vessels enter/exit the heart

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6
Q

Pericardial cavity

A

. Btw visceral and parietal serous pericardia
. Contains small amt serous fluid
. Heart is NOT in cavity

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7
Q

Pericardiacophrenic a.

A

. Branch of internal thoracic a.

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8
Q

Pericardium innervation

A

. Pericardial branches of phrenic nn. (C3-5) contain sensory fibers
. Vagus nerve
. Branches from sympathetic trunk (vasomotor)

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9
Q

Where is pericardial pain referred to?

A

Ipsilateral shoulder region (C3-5 dermatome)

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10
Q

Acute pericardial effusion

A

. Rapid accumulation fo excess fluid in pericardial cavity

. Heart becomes compressed and circulation fails (tamponade)

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11
Q

Pericarditis

A

. Inflammation of pericardium
. Causes chest pain
. Rough surfaces of smooth serous pericardium produce rub sound
. Can lead to cardiac tamponade

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12
Q

Epicardium

A

. Outermost layer, visceral layer of serous pericardium plus subepicardial fat

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13
Q

Myocardium

A

Middle layer, consists of cardiac muscle

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14
Q

Endocardium

A

. Inner layer, endothelial lining and subendothelial CT of heart chambers

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15
Q

Fibrous skeleton of heart

A

. 4 fibrous rings surrounding orifices of cardiac valves
. Provides attachment and suppler for myocardium and leaflets/cusps of valves
. Electrical insulator allowing independent contractions of the atria and ventricles

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16
Q

Apex of heart

A

. Formed by tip of L ventricle

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17
Q

Surfaces of heart

A

. Anterior (sternocostal): mainly R ventricle
. Diaphragmatic: mainly L ventricle w/ some R ventricle
. Left pulmonary: faces L lung, primarily L ventricle
. Right pulmonary: faces R lung, primarily R atrium
. Base: formed by L atrium, small contribution from R atrium

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18
Q

Borders of the heart in radiographic examination

A

. Right border: mostly R atrium
. Inf. Border: mostly R ventricle, some L ventricle
. Left border: mostly L ventricle
. Sup. Border: R and L atria and auricle, sup. Vena cava, ascending aorta, and pulmonary trunk

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19
Q

External sulci (grooves) of the heart

A

. Coronary (AV) sulcus: surface groove encircling heart, delineates the separation of atria from ventricles
. Ant. And post. Interventricular sulci: surface grooves delineating interventricular septum

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20
Q

Pulmonary trunk

A

. Pulmonary trunk: exits R ventricle carrying deoxygenated blood to lungs and divides into R and L pulmonary aa.

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21
Q

Pulmonary veins

A

. Carry oxygenated blood from lungs to L atrium
. Sup. And inf right pulmonary veins
. Sup. And inf. Left pulmonary veins

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22
Q

Ascending aorta

A

Exits L ventricle carrying oxygenated blood from heart to the rest of the body

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23
Q

Interatrial septum

A

Separates 2 atria

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24
Q

Interventricular septum

A

. Separates ventricles
. Thin membranous part, continuous w/ skeleton of heart
. Thick muscular part

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25
Q

right atrium

A

. Forms right border of heart
. R auricle overlaps the ascending aorta
. Receives blood from the SVC, IVC, and coronary sinus

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26
Q

Coronary sinus

A

Opens btw IVS and tricuspid valve orifices

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27
Q

Right atrium. Interior walls

A

. Rough ant. Wall contains bundles of cardiac muscle fibers (pectinate mm.)
. Pectinate mm. Merge together forming crista terminalis that extends btw openings of SVC and IVC
. Sulcus terminalis: groove on surface that marks location for crista terminalis
. Post. Atrial wall smooth where orifices of SVC, IVC, and coronet sinus located

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28
Q

Interatrial septum

A

. Has fossa oval is (oval-shaped depression) that is remnant of foraman ovale

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29
Q

Right atrioventricular (tricuspid) valve

A

. Deoxygenated blood flows from R atrium into R ventricle through this

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30
Q

Right ventricle

A

. Forms largest part of sternocostal and small part of diaphragmatic aspects of heart
. Defines almost entire inf. Border of heart
. Middle myocardial layer thinner than L ventricle
. Interior lined by trabeculae carneae (muscle bundles)
. Papillary muscles (ant., post., septal) project from wall and connect to R AV valve via chordae tendineae

31
Q

Septomarginal trabecula (moderator band)

A

. Muscular band that connects interventricular septum to base of ant. Papillary muscle

32
Q

Tricuspid valve

A

. 3 leaflets attached to atrioventricular orifice
. During ventricular contraction the papillary muscles contact to prevent version of valve leaflets and blood reflux into R atrium

33
Q

Pulmonary (pulmonic) valve

A

Brings deoxygenated blood exits R ventricle to pulmonary trunk

34
Q

Left atrium

A

. Forms most of base of heart
. Left auricle forms sup. Part of left border of heart and overlaps pulmonary trunk
. Interior walls smooth, rough surface only found in auricle from pectinate muscles there
. Pulmonary vv. Open into L atrium carrying oxygenated blood from lungs
. Fossa ovalis visible on interatrial septum
. Blood flows to L ventricle via mitral valve

35
Q

Left ventricle

A

. Forms left margin, apex, and most of diaphragmatic surface of the heart
. Middle myocardial layer thicker than R ventricle as L ventricle must pump blood into systemic circulation
. Interior lined by trabeculae carneae
. 2 (ant. And post.) papillary muscles connect mitral valve leaflets via chordae tendineae
. Aortic orifice marks beginning of aorta from L ventricle (aortic valve here)
. La dn R coronary aa. Branch from aorta just sup. To aortic valve

36
Q

Left atrial appendages closure

A

. Surgery to reduce risk of stroke in patients w/ atrial fibrillation
. Erratic heat eat causes blood collection and clot formation in left auricle so it is closed to reduce risk

37
Q

AV valves

A

. Separate atria and ventricles
. Valves consist of cusps that are attached to fibrous cardiac skeleton
. Chordae tendineae in each ventricle attach papillary muscles to free edges of leaflets
. Closure of valves prevents regurgitation

38
Q

Semilunar valves

A

. Prevents blackflow of expelled blood into ventricles
. 3 pocket-like cusps
. Pulmonary and aortic valve

39
Q

Cardiac cycle

A

. Ventricular diastole, atria fill, AV valves open, blood flows into ventricles, semilunar valves closed
. SA node initiates contraction of aria completing passage of blood to ventricle
. Inc. bp causes AV valves close
. AV node stimulation starts ventricular contraction (systole)
. Semilunar valves open and blood flows from R ventricle to pulmonary trunk and from L ventricle into aorta
. Relaxation of ventricles causes backflow of blood in pulmonary trunk and aorta closing semilunar valves

40
Q

When is coronary aa. Blood flow greatest?

A

Diastole because they are compressed during systole

41
Q

Auscultation sites of cardiac valves

A

. Aortic valve: right 2nd intercostal space at sternal margin
. Pulmonary valve: left 2nd intercostal space at sternal margin
. Tricuspid valve: near left sternal border
. Bicuspid: left 5th intercostal space at midclavicular line, cardiac apex

42
Q

HEart valve disease

A

. Narrowing of orifice (stenosis) from failure of valve to open properly
. Valvular incompetence caused by failure of the valve to close completely
. Defective valves surgically replaced

43
Q

Coronary aa. And cardiac vv.

A

. Supply tissue of heart

. On outer surface of heart w/in epicardium and fatty CT

44
Q

Right coronary a.

A

. Gives of SA nodal branch to SA node
. Courses to right w/in coronary sulcus
. Right marginal a. Branches off and courses along inf. Border of heart
. R coronary continues post. Along post. Portion of coronary sulcus
. Gives off AV nodal branch to AV node and post. Interventricular a. That goes in post. Interventricular sulcus

45
Q

Regions supplied by R coronary a.

A 
. R atrium 
. SA node (in 60% cases)
. AV node (80% cases)
. Most R ventricle
. Diaphragmatic surface of L ventricle
. Post. Third of interventricular septum
46
Q

L coronary a.

A

. Divides into ant. Interventricular a. That goes in ant. Interventricular sulcus and circumflex a. That goes to the left in coronary sulcus

47
Q

Circumflex a.

A

Gives off L marginal branch and sometimes a diagonal branch

. Courses post. In coronary sulcus where it terminates

48
Q

Acute MI

A

. Sudden bloackage of blood flow in coronary circulation that causes ischemia and necrosis of cardiac muscle
. Most common area of occlusion is ant. Interventricular a. Followed by R coronary a. Then circumflex a.

49
Q

Coronary atherosclerosis

A

. Most common cause of ischemic heart disease
. Causes angina pectoris
. Coronary angioplasty and/or bypass surgery performed to inc. blood supply to myocardial tissue

50
Q

Leading cause of death worldwide

A

Ischemic heart disease

51
Q

Regions supplied by L coronary a.

A 
. L atrium 
. Most of L ventricle
. Part of R ventricle
. Most of interventricular septum including AV bundles 
. SA node (40% cases)
52
Q

Right dominant pattern of arterial branches

A

. R coronary a. Has prominent transverse branch that extends across base of heart in coronary groove at expense of circumflex a.

53
Q

Co-dominant pattern of coronary branches

A

. Both R and L coronary aa. Give off branches that course in post. Interventricular sulcus

54
Q

Left dominant pattern of coronary branches

A

. L coronary a. Has large circumflex branch that gives off post. Interventricular a.
. R coronary a. Will not have transverse branch

55
Q

Cardiac vv.

A

. Empty into coronary sinus on post. Part of coronary sulcus
. Coronary sulcus drains into R. Atrium adjacent to IVC

56
Q

Great cardiac v.

A

. Drains areas supplied by L coronary a.
. Main tributary of coronary sinus
. Beings in ant. Interventricular sulcus and courses sup. To coronary sulcus

57
Q

Middle cardiac v.

A

. Accompanies post. Interventricular a.

. Drains areas supplied by R coronary a.

58
Q

Small cardiac v.

A

. Parallels R marginal a. And joins coronary sinus as it enters R atrium
. Drains areas supplied by R coronary a.

59
Q

Ant. Cardiac vv.

A

Drains into R atrium

60
Q

Venae cordis minimae

A

Smallest veins, open directly into each heart chamber

61
Q

Lymphatic drainage of heart

A

. Cardiac lymph vessels follow coronary aa. And drain into tracheobronchial lymph nodes

62
Q

T/F autonomic innervates regulates HR and force fo contractions but DOES NOT generate HR

A

T

63
Q

Sup. And deep cardiac plexuses

A

. Carry Autonomic fibers and visceral afferent fibers

64
Q

Preganglionic cardiac sympathetic fibers

A

. T1-5/6 levels of sympathetic trunks

. Synapse in cervical and sup. Thoracic sympathetic trunk ganglia

65
Q

Postganglionic cardiac sympathetic fibers

A

. Known as cardiopulmonary splanchnic nn.
. Pass to heart to terminal in SA and AV nodes and along coronary aa.
. Innervation inc. HR and inc. contraction strength

66
Q

Preganglionic cardiac parasympathetic fibers

A

. From cervical and upper thoracic branches of vagus nn.
. Synapse w/ intrinsic ganglia located near SA and AV nodes an along coronary aa.
. Dec. HE and contraction force

67
Q

Afferent visceral pain fibers in heart

A

. Accompany sympathetic fibers retrogradely and enter spinal cord at T1-4
. Pain from heart perceived as pain originated from superficial body regions w/ T1-4 sensory input
. Referred pain in upper chest, upper back, and ant. Surfaces of upper limb

68
Q

sinoatrial node

A

. Initiates and coordinate heartbeat (pacemaker)

. Located just deep to epicardium at junction of SVC and R atrium

69
Q

Atrioventricular node

A

. Receives electrical signal from SA node

. Carries signals to AV bundle for distribution to ventricles

70
Q

AV bundle of His

A

. Conducts electrical signals btw atrial and ventricular myocardial
. Passes from AV node through membranous part of interventricular septum
. Divides into R and L bundle branches at junction of membranous and muscular parts of interventricular septum
. R bundle branches to moderator band and other branches that extend to IV septum and wall of R ventricle
. L bundle branches extend to IV septum, ant. And post. Papillary muscles, and wall of L ventricle

71
Q

Purkinje fibers

A

. Arise as bundles continue on each side of septum deep to endocardium
. Extend to walls of ventricles

72
Q

Septomarginal trabecula (moderator band)

A

. Allow branches of right AV bundle to reach ant. Papillary muscle

73
Q

Atrial fibrillation

A

. Common arrhythmia
. Cardiac electrical signals in SA node are overwhelmed by signals starting in other parts of the heart, usually roots of pulmonary veins
. Leads to disorganized, irregular impulses propagating through heart
. Causes poor blood flow in body

Anatomy (49 decks)

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