Heart anatomy Flashcards

1
Q

What is the heart

A

4 chambered fibromuscular pump

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2
Q

What is the size of the heart

A

Size of an adult fist

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3
Q

Where is the heart located

A

Mediastinum

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4
Q

How many and what are the external features/surfaces of the heart

A
  1. Diaphragmatic surface
  2. Posterior (Base) surface
  3. Sternocostal (Anterior) surface
  4. Right pulmonary surface
  5. Left pulmonary surface
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5
Q

What are the cusps of the valves in the right ventricle

A

Pulmonary valve which has 3 cusps - Anterior semilunar, Right semilunar, Left semilunar

Tricuspid valve which has 3 cusps - Septal, Anterior, Posterior

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6
Q

Where are the atrioventricular and semilunar cardiac valves located

A

Atrioventricular and aorto-pulmonary pathway of blood flow

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7
Q

What is the problem that could arise from valve incompetency

A

Blood backflow which leads to heart failure over time

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8
Q

What happens in a cardiac failure

A

Hypertrophied heart
- Diastolic heart failure due to filling problem
- Left ventricle unable to relax normally resulting in fluid backing up into lungs
- Diastolic failure leads to problems with heart relaxation and filling with blood

Dilated heart
- Systolic heart failure due to pumping problem
- inability of heart to contract enough to provide blood flow forward
- problems with contraction and blood ejection

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9
Q

What is the other name of bicuspid valve

A

Mitral valve

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10
Q

What does each cusp contain

A

Core of connective tissue and endothelial covering

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11
Q

What are the 3 apex of the heart

A

Clinical apex, true anatomical apex, radiological apex`

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12
Q

Which pericardium is pain sensitive

A

Fibrous and Parietal Serous pericardium. Both are innervated by Phrenic nerve

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13
Q

What are the supporting ligaments of the heart

A

Vertebropericardial ligaments, Superior sternopericardial ligament, Sternopericardial ligament, Phrenicopericardial ligament

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14
Q

What is the difference between pulmonary and systemic circulation

A

Pulmonary circulation is from heart to lungs

Systemic circulation is from heart to body

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15
Q

Explain the process of blood flow

A
  1. O2 rich blood from left atria moves into left ventricles and then to aorta
  2. O2 rich blood flows from aorta to the systemic capillaries and gas exchanges occurs
  3. O2 poor blood flows back into heart via inferior and superior vena cava to right atria and then to right ventricle
  4. Blood flows from right ventricle to pulmonary trunk and then to pulmonary arteries to lungs
  5. Gas exchange occurs at pulmonary capillaries
  6. O2 rich blood flows through pulmonary veins to left atrium
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16
Q

what makes the posterior surface (base)

A

Left atrium + Right atrium + Proximal part of great veins

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17
Q

What makes the sternocostal (anterior) surface

A

Right atrium, Right ventricle, Left ventricle

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18
Q

What makes the diaphragmatic surface

A

Left and Right ventricle

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19
Q

What is the significance of transverse pericardial sinus

A

Allows surgeon to isolate the pulmonary trunk and ascending aorta and apply a temporary ligature or clamp. This allows surgeons to stop or divert the circulation of blood in these arteries while performing cardiac surgery, such as coronary artery bypass grafting.

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20
Q

What is the significance of pericardium with relation to pericardiocentesis

A

Pericardiocentesis is a procedure done to remove fluid that has built up in the sac around the heart (pericardium). It’s done using a needle and small catheter to drain excess fluid. If not, heart is unable to pump blood enough and effectively

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21
Q

Why should atrioventricular and semilunar valves remain competent always

A

Leads to blood backflow and heart failure

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22
Q

Where are atrioventricular cardiac valves located

A

Located at opening of atria into ventricles

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23
Q

Where are the semilunar cardiac valves located

A

Located at opening of ventricles into aorta and pulmonary trunk

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24
Q

What is the difference between atrioventricular and semilunar cardiac valves

A

Closure of valves is active in atrioventricular valves whereas semilunar cardiac valves are passive

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25
What is the function of papillary muscles
Works with chordae tendineae to prevent inversion or prolapse of valves on systole
26
What is the function of chordae tendineae
Works with papillary muscles to prevent inversion or prolapse of valves on systole
27
What is the purpose of trabeculae carneae
Prevents high pressure blood flowing in from forming bubbles and suction could occur which impairs heart's ability to pump efficiently
28
What are the components of left ventricle
Mitral/bicuspid valve - anterior and posterior cusp Papillary muscles - anterior and posterior Chordae tendineae Coronary sinus
29
What are the components of left atrium
Pulmonary veins Valves of foramen ovale Mitral/Bicuspid valve
30
What are the components of right ventricle
Tricuspid valve - Anterior, Septal, Posterior Chordae Tendineae Papillary muscles - Anterior, septal Posterior Trabeculae carneae Conus arteriosus septomarginal trabecula Pulmonary valve - Anterior, Right, Left semilunar Pulmonary trunk Arch of aorta
31
What is the function of conus arteriosus
Transports deoxygenated blood from right ventricle to pulmonary trunk and onto lungs
32
What is the function of septomarginal trabecula
AKA Moderator band Does not attach to the tricuspid valve, but acts as part of the electrical conduction pathway of the heart
33
Significance of foramen ovale
Significant in fetal circulation
34
What are the components of Right Atrium
Superior and Inferior vena cava Valve of inferior vena cava Oval fossa Limbus of oval fossa fossa ovalis Valve and opening of coronary sinus Crista terminalis Musculi pectinati
35
What is the function of crista terminalis
discrete bundle of atrial myocardium that conducts impulses generated by the SA node to the atrioventricular (AV) junction
36
What is the function of musculi pectinati
Acts as a Right atrium volume reserve during adverse loading conditions
37
Explain the covering layers of the heart
Outside to inside 1. Fibrous pericardium 2. Parietal layer of serous pericardium 3. Pericardial cavity 4. Visceral layer of serous pericardium 5. Myocardium 6. Endocardium
38
What is the pericardial cavity filled with and how many mL
Pericardial fluid 15 - 50 mL
39
What is the treatment methods for Ischemic Heart Disease
Coronary artery bypass grafting Balloon angioplasty and stents
40
What makes the posterior (base) orientation of the heart
Left atrium, proximal parts of great veins, and right atrium
41
What makes the diaphragmatic orientation of the heart
Right and left ventricle
42
What makes the sternocostal (anterior) orientation of the heart
Left ventricle, right ventricle and right atrium
43
What is the significance of Transverse pericardial sinus
Allows surgeon to isolate pulmonary trunk and ascending aorta Use these to stop/divert blood circulation in arteries while performing cardiac surgery
44
Coronary arteries of heart
Right coronary artery Right marginal branch of right coronary artery Left coronary artery Sino-atrial nodal branch of left coronary artery Posterior interventricular branch of circumflex branch of left coronary artery Left circumflex artery (Circumflex branch of left coronary artery) Left anterior interventricular artery (Anterior interventricular branch of left coronary artery) Diagonal branch of anterior interventricular branch
45
Coronary veins
Great cardiac vein Anterior interventricular vein Posterior cardiac vein coronary sinus Middle cardiac vein Small cardiac vein Right marginal veins Anterior veins of right ventricle
46
What are capillaries lacking compared to veins and arteries
No elastic tissue, smooth muscle, fibrous tissue
47
What are blood arteries and the disadvantages of them
They are end arteries which means if compromised, the muscles supplied by that vein/artery is affected
48
Describe cardiac cells
Cross striations and connected by intercalated discs and connects one myocyte with another
49
Difference between ventilation and respiration
Ventilation is gas movement whereas respiration is the exchange of gases
50
What is the role of upper respiratory tract and lower respiratory tract
Upper respiratory tract - Ventilation Lower respiratory tract - Ventilation & Respiration
51
What separates the nose from mouth (nasopharynx from oropharynx)
Soft palate
52
Oropharynx is in between what pathways
Air and food pathways
53
What is the significance of the pharynx
Separates food and air pathways
54
How do you see the opening of larynx
Laryngoscopy
55
What is the significance of larynx
Prevent asphyxiation (choking; primary function) and voice production (secondary function)
56
What is the function of goblet cells
Produce mucus
57
What is the function of ciliated cells
Move mucus to esophagus via pharynx
58
What is the function of mucus
Traps dust and moisture incoming air to become more humid
59
Why is warming the incoming air necessary for breathing
Cold air will cause the muscles to contact which makes it difficult to breathe. Bringing the temperature to body temperature reduces the muscle contraction and minimize air resistance
60
What happens to prevent food particles from entering the nasopharynx from the oropharynx during the act of swallowing?
Elevation of soft palate
61
Where does the lower respiratory tract starts to trachea
C6 (Cricoid cartilage) to T4 (Sternal angle)
62
What is the smooth muscle found in trachea
Trachealis
63
Where does the tracheal bifurcation occur
Sternal angle in between IV and V vertebrae
64
Which bronchus would food go into when someone starts choking
Right bronchus
65
Why is the right bronchi wider than left bronchi
Right bronchi is already forming other bronchi generations Arch of aorta and heart push the left lung to the side
66
Why is cancer at bronchi dangerous
It can spread to spine which results in back pain and possible malignancy
67
When is a bronchus considered a bronchiole
Lack of cartilage
68
What are the different generations of the bronchus to alveoli
1st - 11th Generation is Bronchi 12th - 14th generation is bronchiole 15th - 23rd generation is respiratory bronchiole to alveoli
69
What are the differences between bronchus and bronchiole
Cartilage - Bronchus has hyaline cartilage plates, bronchioles do not Cell epithelium - Bronchus has respiratory epithelium, bronchioles have low columnar ciliated epithelium Cells - Bronchus has goblet cells and submucous glands, Bronchioles has sparse goblet cells and submucous glands Both have smooth muscle deep to epithelium
70
Which lung is longer
Left lung
71
Which lung is larger and why
Right lung because left lung space taken up by heart
72
Which structure does not cast any impression on mediastinal surface of lungs
Pulmonary trunk
73
What is necessary for alveoli to conduct gas diffusion
Moist air/Water
74
Where is the xiphoid process
Tip of the sternum
75
What is the sternal angle also called
Manubriosternal joint
76
When diaphragm contracts, what does it do?
Descend
77
What is the purpose of the diaphragm
To create negative pressure for air to come in
78
Which ribs are floating ribs
Ribs 11 and 12
79
Which ribs do not connect to the sternum directly but are connected to another rib by cartilage
Ribs 8 - 10 connect to Rib 7 by cartilage
80
What does each lung contain
1x Principal bronchus 1x Pulmonary artery 2x pulmonary veins Bunch of bronchial vessels, nerves and lymphatics
81
Where does the acinus/acini begin
15th - 23rd generation
82
Why is lingula called as such
Because it looks like a tongue
83
Where is the lowest point of pleural fluid
Costodiaphragmatic recess
84
What is the distribution of the surface area of Type I and II cells in alveoli
90% of surface area is Type I and 10% of surface area is Type II
85
What helps to give bronchus its rigid structure
Cartilage
86
What is the difference between trachea and bronchus in terms of their cartilage plates
Trachea has C-shaped cartilage plates whereas bronchus has broken cartilage plates
87
What is the purpose of elastic tissue in the context of lungs
It is stretched to keep bronchiole airway open even where there is no hyaline cartilage
88
Why is the pleural cavity important
With the help of pleural fluid, it reduces friction which could lead to alveoli collapse and ensure a negative intrapleural pressure
89
Which part of the sternum is the most fragile
Sternal angle
90
What are the 2 joints between the ribs and vertebrae
Costovertebral joint and Costotransverse joint
91
What does each rib connect to at the vertebrae
Demifacet
92
What makes the innermost layer of intercostal muscles
Transversus thoracis, Innermost intercostal, Subcostalis
93
Which muscles are the most active in forced expiration
Transversus thoracis, innermost intercostal and subcostalis
94
Which ribs are considered atypical
Ribs 1, 11 and 12
95
Where does Rib 2 articulate with sternum
Articular demifacets of sternal angle (manubriosternal joint)
96
What are lobar bronchi
First Bronchi branching out from left and right bronchi
97
What are the 3 dimensions for respiration
Increased Anterior - Posterior diameter Increased Transverse diameter Increased vertical diameter
98
Why is the lung having bronchopulmonary segments is advantageous
If one love needs to be removed, it can be without compromising the entire lung. However, the amount of air that can be taken in is reduced but still remains functional