Heart anatomy Flashcards
1
Q
anatomical location of heart
A
thoracic region
inferior mediastinum
medially between the lungs
above the diaphragm
2
Q
what surface is right ventricle
A
antieror/ sternoncostal
3
Q
what surface is left atrium
A
posterior/base
4
Q
what surface is left and right ventricles
A
inferior/diaphragmatic
5
Q
what surface is the right atrium
A
right pulmonary
6
Q
what surface is the left ventricle
A
left pulmonary
7
Q
2 layers that surround the hear
A
fibrous pericardium (outer)
serous pericardium (inner)
8
Q
fibrous pericardium (outer) role
A
thick connective tissue
protects heart and maintains its position
9
Q
serous pericardium (inner) role
A
helps to lubricate heart
10
Q
layers of 2 layers serous pericardium (inner)
A
parietal = fused to fibrous pericardium
visceral (epicardium) = fused to heart
11
Q
pericardial cavity
A
lies between the parietal and visceral layers of the serous pericardium
serous fluid
reduced friction when heart contracts
12
Q
where is serous fluid released
A
mesothelium
12
Q
where is serous fluid released
A
mesothelium
13
Q
where is fat around heart
A
associated with epicardium
14
Q
auricles
A
thin walled
increase collecting capacity of the atria
15
Q
sulci (sulcus)
A
contain major coronary blood vessels
coronary sulcus, Anterior interventriclar sulcus, posterior inter ventricular sulcus
16
Q
coronary sulcus
A
between atria and ventricles
17
Q
anterior inter ventricular sulcus
A
between 2 ventricles on anterior heart surface
18
Q
posterior inter ventricular sulcus
A
between 2 ventricles on posterior heart surface
19
Q
wall of the heart layers
A
epicardium (superficial)
myocardium (middle) - left thicker than right
endocardium (deepest)
20
Q
interatrial septum
A
between 2 atria
oval shaped depression (fossa ovals) remnant of foramen ovale
21
Q
atrioventricular septum
A
between atria and ventricles
4 openings = valves are present at openings
22
Q
cardiac skeleton
A
dense connective tissue surrounding the openings and point of attatchment for heart valves
23
Q
interventricular septum
A
between 2 ventricles
thicker than intertribal septum
24
atria
left and right
receives blood from connecting vessels
25
valves between atria and ventricles
right - tricuspid
left - bicuspid
26
pectinate muscle in atria
right = pectinate muscle on anterior surface and auricle
left = pectinate in auricle only
27
where does atria receive blood from
right = inferior and superior vena cave
left - pulmonary veins
28
walls of ventricles are lined with
trabecular carneae
29
valve between ventricle and vessel
right = pulmonary valve between right ventricle and pulmonary trunk
left = aortic valve between left ventricle and aorta
30
features of right and left ventricle
right = trabecular carneae
3 papillary muscles
left = trabecular carneae
2 papillary muscle
myocardium thicker than right ventricle
31
features of the valves in the heart
4 valves
2 AV
2 SL
composed of flaps/cusps = made of fibrous connective tissue
situated in openings of heart
unidirectional flow of blood
closing of valves generates heart sounds
32
AV valves
between atria and ventricles
close at start of ventricular contraction
produce first heart sound
33
tricuspid valve
between right atrium and ventricle
3 cusps/leaflets
34
bicuspid/mitral valve
between left atrium and ventricle
2 cusps/leaflets
35
chord tendinea
thin, strong inelastic fibrous cords
extend from free edges of valve cup to papillary muscles
36
papillary muscles
5 in total
on interior surface of ventricle
attach to valve cusps via chord tendinea
3 = tricuspid valave
2 = mitral vavle
37
purpose of chordae/papillary muscle complex
support for AV valves
prevents prolapsing of valve into atrium when ventricle contracts
38
SL valves
between ventricles and arteries
close at beginning of ventricular relaxation
second heart sound
no papillary muscle or chord tendineae associated with these valves
39
pulmonary valve
between right ventricle and pulmonary trunk
3 flaps
40
aortic valve
between left ventricle and aorta
3 flaps (some have 2)
41
2 main coronary arteries
left and right coronary artery
42
left coronary artery
80% of blood to heart tissue
supplies left atrium, most of left ventricle and Interventricular septum
left anterior descending and left circumflex branches
43
right coronary artery
along coronary sulcus
supplies right t ventricle, right atrium , SA, AV node , inter ventricular septum and inferior part of the left ventricle
posterior inter ventricular artery
44
coronary veins
drains deoxygenated blood from myocardium to right atrium
e.g vena cave, great cardiac vein, small cardiac vein, coronary sinus, middle cardiac vein, anterior cardiac vein, great cardiac vein
45
coronary sinus
most of veins come together into coronary sinus -> right atrium
anterior cardiac and small veins directly drain into cardiac chambers
46
nerve supply to heart
sympathetic and parasympathetic stimulation
through cardiac plexus located at the base of the heart
47
Vagus nerve
parasympathetic
decreases HR
48
Sympathetic cardiac nerve
increase HR and force of contraction
49
conduction system of the heart
1. SA node
2. AV node
3. bundle of his
4. purkinje fibres
50
sinoatrial node
- junction of superior vena cave and right atrium
- specialised myocardial conducting cells
- main pacemaker of heart
51
atrioventricular node
inferior portion of right atrium within AV septum
myocardial conducting cells
slowing of impulse to allow full atrial contraction
52
purkinjie fibres
conducts impulses to ventricular contractile fibres
53
small pause before AV node transmits the impulse to AV bundle
his allows the atrial cadiomyoctes to complete contraction and pump blood into ventricles before the inpluse is transmitted to the ventircular cells
54
heart conduction steps
- SA node depolarises
- impulse spreads through the atria to AV node via internal pathways
- AV node provides a slowing of impulse to allow full atrial contraction
- impulse proceeds down atrio-ventriclar bundle and its right and left bundle branches to apex of heart
- purkinjie fibres conduct impulse to ventricular contractile fibres
- ventricles contract
55
ventricular diastole steps
- ventricles and atria relax
- all valves closed
- blood enters right and left atrium
- blood pools in atria
- pressure in atrium exceeds pressure in ventricles mitral and tricuspid valves open
- SL valves still closed
- blood flows into relaxed ventricle
- SA node fires causing atrial contraction
- ejects residual blood into ventricles
- ventricular filling finishes
- impulse travels through AV node -> atrioventricular bundle -> purkinje fibres
56
ventricular systole steps
-ventricular contraction begins
-pressure in ventricles exceeds corresponding atrial pressure
-closure of AV valves
-when ventricular pressure exceeds pressure in ----connecting arteries
-SL valves open
-blood ejected into corresponding arteries
(right - pulmonary trunk, left - aorta)
-pressure changes result in closure of SL valves at --end of systole
57
4 valves we can hear when examining
aortic
pulmonary
tricuspid
mitral
58
heart sound 1
Lub
signals the start of systole
corresponds with closure of AV (mitral and tricuspid) valves
59
heart sound 2
dub
signals Strat of diastole
correspond with closure of semolina (aortic and pulmonary) valves
60
ECG
records electrical signalling of heart
involved placement of electrodes over chest and on each limb
61
P wave on ECG
electrical signal from SA node desolate atria
atrial contraction starts just after start of P wave
62
PR interval
start of P wave to attract of QRS complex
electrical signal passes from atria to ventricles
63
QRS complex
electrical signal depolarises ventricles
ventricular contraction starts near peak of R wave
64
T wave
ventricles repolarise
following depolarisation - ventricles relax
65
QT interval
beginning of QRS complex to end of T wave
time taken for ventricles to depolarise and depolarise (ventricles contract and relax)
66
blood pressure
pressure against the walls of arteries
67
what measure does blood pressure record
systolic = peak in arterial pressure during systole
diastolic = represents minimum arterial pressure during diastole
68
healthy BP
120/80 mmHg
69
hypertension BP
140/90 mmHg
many levels of hypertension - heart attack, stroke, renal disease
70
hypotension BP
90/60 mmHg
many levels of hypertension - heart attack, stroke, renal disease
71
chest x ray provides info about the
shape of the heart
size of the heart
cardiothoracic ratio
presence of abnormalities (calcification)
72
normal cardiothoracic ratio
0.42-0.5
73
enlarged cardiothoracic ratio
>0.5
74
tetralogy of fallot
congenital heart condition
infant born with it
structural cardiac abnormalities = calcified lesion
75
upturned apex
right ventricular hypertrophy or enlargement
boot shaped heart
76
echocardiogram
ultrasound scan
size and structure of heart
movement of heart valves, septum, walls of heart chambers
doppler ECHO = speed and direction of blood flow
77
dextrocardia
heart on wrong side of the body
78
coronary disease
narrow of coronary arteries due to atherosclerosis
myocardium supplied by affected artery becomes ischemia
79
what can coronary disease cause
angina (narrowing of artery / arteries results in symptoms upon exertion )
actor coronary syndrome (heart attack)
80
treatment of coronary disease
severity and patients clinical condition
some interventions involve the coronary arteries themselves
81
angioplasty
occlusion in artery = mechanicaly widened with a balloon
stent (wire mesh) inserted at site of occlusion to maintain patency
82
coronary artery bypass graft
when there is widespread CAD (triple vessel disease)
blockages = coronary arteries are bypassed with harvested venous or arterial vessels from patients body
83
common vessels used as grafts
left internal mammary artery and saphenous vein
84
atrioventricular block/ heart block
- delay/ disturbance of transmission of electrical impulse from atria to ventricles
impairment in heart conduction system at the level of the AV node or below
85
first degree heart block
prolonged PR interval
delayed conduction of impulse from atrium to ventricle
no symptoms
86
second degree heart block
not all p waves are followed by QRS complex
regular patter (2:1, 3:1)
intermittent conduction of atrial signal to ventricles
can range from asymptomatic to haemodynamic instability
87
third degree heart block
p waves are never related to the QRS complex
absence of AV node conduction
atria and ventricles conduct independent of each other
range from fatigue / chest pain / syncope to haemodynamic instability
88
treatment of heart block
sometimes don’t require treatment = sometimes have serves damage to their conduction system - more severe arrhythmias = may require a pacemaker
89
valvular heart disorders
dysfunction of heart valves
benign to fatal
various cause (cognenital, infection, trauma)
any valve affected
some more common than others (mitral , aortic)
patients have heart murmur - dependent on type of valvular disease
90
2 main categories of valvular heart disorders
valvular stenosis
valvular insufficiency/regurgitation
91
valvular stenosis
heart valve does not fully open
stiff or fused leaflets = valves not fully opening
limits blood flow out of the atria or ventricle
heart has to pump with increased force to push blood through stenotic valve
weekend heart resulting in heart failure
92
aortic vavle stenosis cause
age related calcification
associated with ejection systolic murmur
93
ventricular insufficiency (regurgitation)
valve does not close tightly
some blood leaks backwards across the valve
less blood exits heart if severe insufficiency
heart has to work harder to compensate for blood regurgitating back
Leaky valve = does not close tightly = backward leaking = heart has to work harder to make up for it = mitral regurgitation
can lead to heart failure
94
mitral regurgitation causes
various causes
mitral vale prolapse, rheumatic fever, coronary heart disease
pan systolic murmur
95
patent foramen ovale
in the foetus - foramen ovale directs blood flow directly from the right to the left atrium
bypassing the pulmonary circulation
following birth of foramen ovale closes (fossa ovals)
failure of closure = patent foramen ovale - small intertribal shunt
often asymptomatic = may have faint systolic murmur
96
ventricular septal defect
incomplete development of interventriculr septum
various types depending on part of septum affected
results in a shunt between right and left ventricles
97
what does size and location determine
- amount and direction of blood shunted
- symptoms of affected individual = often have pansystolic murmur
98
what 4 structural abnormalities are in tetralogy of fallot
congenital heart disease
1. ventricular septal defect
2. pulmonary stenosis (narrowing)
3. misplaced aorta
4. ventricular hypertrophy (thicker)
99
symptoms of tetralogy of fallot
hyper cyanotic episodes when crying or feeding
loud systolic ejection murmur
