Heart Anatomy

Question 1

Location of the heart

Answer 1

• 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

Question 2

Which blood vessels brings deoxygenated blood to the right atrium?

Answer 2

• Superior vena cava
• Inferior vena cava
• Coronary Veins.

Question 3

What is the right auricle?

Answer 3

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

Question 4

How is related the auricle to the atrium?

Answer 4

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

Question 5

Cavotricuspid isthmus, why is it important?

Answer 5

• 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.

Question 6

Most common site of thrombi in patient with atrial fibrillation.

Answer 6

• Cavotricuspid isthmus
• Left auricle.

Question 7

Which are the atrial valves?

Answer 7

• Tricuspid valve
• Mitral valve

Question 8

Papillary muscles key points.

Answer 8

• 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

Question 9

Wich are the semiulnar valves?

Answer 9

• Pulmonary valve
• Aortic valve

Question 10

Mention the coronary arteries.

Answer 10

• 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

Question 11

Anatomical situation of the left anterior descending artery.

Answer 11

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

Question 12

Territory of the left anterior descending artery

Answer 12

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

Question 13

Anatomical situation of the left circumflex artery.

Answer 13

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

Question 14

Territory of the left circumflex artery.

Answer 14

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

Question 15

Anatomical situation of left marginal artery.

Answer 15

Along the diaphragmatic border of the heart.

Question 16

Territory of the right marginal artery.

Answer 16

• Lateral ventricle
• Cardiac Apex

Question 17

Anatomical situation of the posterior descending artery.

Answer 17

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

Question 18

Territory of the posterior descending artery

Answer 18

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

Question 19

Phrenic nerve KeyPoint.

Answer 19

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

Question 20

Cardiac plexus KeyPoint

Answer 20

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

Question 21

Vagal nerve key points

Answer 21

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

Question 22

Tell me the layers of the heart

Answer 22

• Epicardium
• Myocardium
• endocardium

Question 23

Endocardium structure

Answer 23

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

Question 24

Myocardium structure

Answer 24

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

Question 25

Pericardial layers structure

Answer 25

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

Question 26

Endocardial cushions, details and evolution

Answer 26

- came from the neurocranial crest cells. - Forms: • atrial septum • Interventricular septum • heart valves

Question 27

Primitive atrium, details, and evolution

Answer 27

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

Question 28

Primitive ventriculum: details and evolution

Answer 28

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

Question 29

Sinus venous, details and evolution.

Answer 29

- it’s form from a pouch in the dorsal wall of the left primitive atrium. - Forms the smooth portion of the left atrium.

Question 30

Bulbus cordis evolution

Answer 30

- It forms the right and left ventricular outflow tracts - RV

Question 31

Key events of the atrial septation.

Answer 31

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

Question 32

Were come from the heart tube?

Answer 32

From the *splacnic portion* of the *lateral mesoderm*

Question 33

Effect Off VEGF'S On Evolution Of The Heart tube

Answer 33

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

Question 34

Mentioned the sinus venosus veins

Answer 34

- common cardinal veins - Vitalines veins - umbilical veins

Question 35

Ventricular septation key points

Answer 35

- 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.

Question 36

Mention associated conotrunkal abnormalities

Answer 36

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

Question 37

Wich embryonic structure origin semiulnar valves?

Answer 37

- endocardial cushions of outflow tract.

Question 38

Wich embryonic structure origin, atrioventricular valves?

Answer 38

Fuse endocardial cushions of AV canal.

Question 39

Mencione the structures on the Coronary sulcus.

Answer 39

- Coronary Sinus - LCX - Small cardiac vein - Right coronary artery

Question 40

Mencione the structures on the Anterior IV sulcus.

Answer 40

- LAD - Great cardiac vein

Question 41

Mencione the structures on the posterior IV sulcus.

Answer 41

- PDA - Middle cardiac vein.

Question 42

What’s the most common congenital cardiac anomaly?

Answer 42

Ventricular septal defect. (37%)