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USMLE Step 1 > Heart Anatomy > Flashcards

Heart Anatomy Flashcards

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USMLE® Step 1 flashcards
1
Q

Location of the heart

A
  • Anterior: sternum and rib cartilage
  • Posterior:
    • esophagus
    • vertebral column (T5-T8)
    • primary bronchi
  • upper:
    • On 3rd costal cartilage
  • Lower:
    • left side of the sternum between and 4th and 5th ribs
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2
Q

Which blood vessels brings deoxygenated blood to the right atrium?

A
  • Superior vena cava
  • Inferior vena cava
  • Coronary Veins.
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3
Q

What is the right auricle?

A

It is muscular parch that act to increase the capacity to the atrium.

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4
Q

How is related the auricle to the atrium?

A

It is separated by the terminal sulcus and the terminal crest.

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5
Q

Cavotricuspid isthmus, why is it important?

A
  • It is the region of fibrous tissue between opening of the inferior vena cava and tricuspid valve.
  • Common location of the reentry circuit in atrial flutter, common site for development of thrombi.
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6
Q

Most common site of thrombi in patient with atrial fibrillation.

A
  • Cavotricuspid isthmus
  • Left auricle.
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7
Q

Which are the atrial valves?

A
  • Tricuspid valve
  • Mitral valve
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8
Q

Papillary muscles key points.

A
  • Derived from the myocardium
  • Extend from the heart wall and the septum.
  • The apices are attached to the chordae tendianeae
  • It contract during systole, contracting the AV valve, preventing the prolapse or regurgitation
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9
Q

Wich are the semiulnar valves?

A
  • Pulmonary valve
  • Aortic valve
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10
Q

Mention the coronary arteries.

A
  • Left coronary artery.
    • Left IV anterior artery (LAD)
    • Left circumflex artery.
  • Right coronary artery.
    • Sinoauricular nodal artery
    • AV nodal artery
    • Posterior IV artery (PDA)
    • Rigth marginal artery
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11
Q

Anatomical situation of the left anterior descending artery.

A
  • Descends between the left ventricle, and the right ventricle in the interventricular sinus towards the apex, give several diagonal branches.
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12
Q

Territory of the left anterior descending artery

A
  • Anterior aspect of the left ventricle
  • Anterior 2/3 of the IV septum.
  • Anterolateral papillary muscle
  • Apex.
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13
Q

Anatomical situation of the left circumflex artery.

A

Course through the coronary sulcus towards the posterior aspect, ending before the posterior interventricular sulcus.

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14
Q

Territory of the left circumflex artery.

A
  • Posterolateral aspect of the atrium and. ventricle.
  • Anterolateral papillary muscle.
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15
Q

Anatomical situation of left marginal artery.

A

Along the diaphragmatic border of the heart.

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16
Q

Territory of the right marginal artery.

A
  • Lateral ventricle
  • Cardiac Apex
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17
Q

Anatomical situation of the posterior descending artery.

A

Between right and left ventricle through the posterior interventricular sinus to the cardiac Apex.

18
Q

Territory of the posterior descending artery

A
  • posterior third of the interventricular septum
  • posteroinferior aspect of the heart
  • posteromedial papillary muscle
19
Q

Phrenic nerve KeyPoint.

A
  • it is part of somatic nervous system
  • Its function is the sensory inervation of the pericardium.
20
Q

Cardiac plexus KeyPoint

A
  • it is part of the sympathetic nervous system
  • Functions:
    • chromotropy, inotropy, and dromotropy
    • coronary artery dilation
21
Q

Vagal nerve key points

A
  • It is part of the parasympathetic nervous system
  • Functions:
    • negative chromotropy, inotropy, and dromotropy
22
Q

Tell me the layers of the heart

A
  • Epicardium
  • Myocardium
  • endocardium
23
Q

Endocardium structure

A
  • Endothelium: simple squamous epithelium.
  • A sublayer of a loose connective tissue
  • Subendocardium: loose connective tissue containing Purkinje cells, also veins and nerves.
24
Q

Myocardium structure

A

Tick myocardial layer, compose by:
- Cardiomyocyte connected by intercalated discs to form long fibers.
- fibroblast
- Extracellular matrix: collagen, elastin and glycosaminglyons.

25
Q

Pericardial layers structure

A
  • serous pericardium
    • visceral layer of serous pericardium (epicardium)
    *Pericardial cavity: contains serous pericardial fluid.
    • Parietal layer of serous pericardium
  • fibrous pericardium.
26
Q

Endocardial cushions, details and evolution

A
  • came from the neurocranial crest cells.
  • Forms:
    • atrial septum
    • Interventricular septum
    • heart valves
27
Q

Primitive atrium, details, and evolution

A
  • it is a single cavity separated from the ventricular cavity by endocardial cushion
  • Forms:
    • trabeculated portions of the atria
28
Q

Primitive ventriculum: details and evolution

A
  • It’s a single cavity separated from the primitive atrium by endocardial cushion
  • Forms:
    • Trabeculated portions of the ventricles
29
Q

Sinus venous, details and evolution.

A
  • it’s form from a pouch in the dorsal wall of the left primitive atrium.
  • Forms the smooth portion of the left atrium.
30
Q

Bulbus cordis evolution

A
  • It forms the right and left ventricular outflow tracts
  • RV
31
Q

Key events of the atrial septation.

A
  1. Development of the septum primun
    • It forms from the endocardial cushions.
  2. Narrowing of the foramen primun
    • As the septum primun grows
  3. Development of the foramen secundum
    • an opening on the cranial end to ensure the shunt.
  4. Development of the septum secundum
    • grows in the right side of the septum primun.
  5. Development of the foramen orale cordis
    • is the space between the two septum.
    • meanwhile, the superior portion of the septum primun regress, the inferior portion persist and act as one way valve.
  6. Formation of the atrial septum.
    • closure of the foramen ovale occurs when the l left atrial pressure increase and the right atrial pressure decrease due to the lost of placental circulation and increase pulmonary circulation upper lung inflation; respectively.
    • The septum secundum fuse with the remnant of the septum Primun to form the atrial septum during infancy
32
Q

Were come from the heart tube?

A

From the splacnic portion of the lateral mesoderm

33
Q

Effect Off VEGF’S On Evolution Of The Heart tube

A

VEGF’S is secreted by the endoderm and promote the differentiation into angioblast and hemocytoblast

34
Q

Mentioned the sinus venosus veins

A
  • common cardinal veins
  • Vitalines veins
  • umbilical veins
35
Q

Ventricular septation key points

A
  • A caudally located muscular IV septum forms with a foramen between ventricles.
  • Later the cranially developing aorticpulmonary septum rotates and caudally fuses with muscular IV septum, forming the membranous IV septum, closing the IV foramen.
  • Endocardial cushions grows to separate ventricles and the atria.
36
Q

Mention associated conotrunkal abnormalities

A
  • failure to spiral: transposition of great vessels
  • Malaligned aortic pulmonary septum: tetralogy of fallout
  • partial Aortic pulmonary septum development: persistent Truncus arteriosus
37
Q

Wich embryonic structure origin semiulnar valves?

A
  • endocardial cushions of outflow tract.
38
Q

Wich embryonic structure origin, atrioventricular valves?

A

Fuse endocardial cushions of AV canal.

39
Q

Mencione the structures on the Coronary sulcus.

A
  • Coronary Sinus
  • LCX
  • Small cardiac vein
  • Right coronary artery
40
Q

Mencione the structures on the Anterior IV sulcus.

A
  • LAD
  • Great cardiac vein
41
Q

Mencione the structures on the posterior IV sulcus.

A
  • PDA
  • Middle cardiac vein.
42
Q

What’s the most common congenital cardiac anomaly?

A

Ventricular septal defect. (37%)

USMLE Step 1 (6 decks)

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