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Anatomy ICOM > Heart And Cardiac System > Flashcards

Heart And Cardiac System Flashcards

1
Q

Superficial palpations

A
  1. 3rd costal cartilage
  2. 2nd intercostal space
  3. 5th intercostal space
  4. 6th costal cartilage
  5. Midclavicular line
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2
Q

Arterial system

A

A. High pressure
B. Fast flow
C. Smooth muscle provided patency and shock absorption

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3
Q

Venous system

A
  1. Low pressure

2. Slow flow - like canal and reservoir

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4
Q

Mediastinum

A 
Space between pulmonary cavities
1. Borders:
  A. Lateral: mediastinal pleura
  B. Anterior: sternum
  C. Posterior: bodies of thoracic vertebrae
  D. Superior: superior thoracic aperture
  E. Inferior: diaphragm
2. Subdivisions: sup and inf divided by line thru T4-T5 space and sternal angle
  A. Superior contains:
    1. Superior vena cava
    2. Ascending aorta and arch
    3. Thoracic duct
    4. Trachea
    5. Esophagus
    6. Thymus
    7. Vagus nerve
    8. Left recurrent laryngeal nerve
    9. Phrenic nerves
  B. Inferior contains:
     1. Anterior
        A. Remnants of thymus
        B. Lymph nodes
        C. Fat and CT
     2. Middle
        A. Pericardium
        B. Heart
        C. Roots of great vessels
        D. Arch of azygos vein
        E. Main stem bronchi
     3. Posterior
        A. Esophagus
        B. Thoracic aorta
        C. Azygos and hemiazygos veins
        D. Thoracic duct
        E. Vagus nerve
        F. Sympathetic trunks
        G. Splanchnic nerve
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5
Q

Fibrous pericardium

A

Part of mediastinum

  1. Tough outer layer
  2. Constrains heart
  3. Protects heart from overfilling
  4. Inferior blends w/ central tendon of diaphragm
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6
Q

Cardiac tamponade

A

Fluid build-up in pericardium (fibrous)

  1. Damage
  2. Infection
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7
Q

Pericardial cavity

A

Part of mediastinum
1. Serous pericardium
A. Parietal: covers internal aspect of fibrous pericardium
B. Visceral (epicardium)
C. Serous fluid between parietal and visceral

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8
Q

Mediastinum sinuses

A
  1. Transverse pericardial: passes transversely between where aorta and pulmonary trunk exit and SVC
    A. Can be used to tie off aorta and pulmonary arteries
  2. Oblique pericardial: blind recess posterior heart wraps behind vena cava and pulmonary veins
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9
Q

Mediastinum innervation

A
  1. Fibrous and partietal pericardium: somatic afferent of phrenic nerve (C3-C5)
  2. Visceral pericardium and heart: autonomically
    A. Vagus (parasympathetic)
    B. T1-5 sympathetic trunks
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10
Q

Heart layers

A
  1. Epicardium: visceral fascia
  2. Myocardium: muscle
  3. Endocardium: internal fascia
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11
Q

Atria

A

Collecting chambers
1. Muscle bundles attach to upper surface of fibrous rings that form AV openings
2. Right
A. Sinus venarum: most of RA w/ smooth muscle walls
*remnant of embryonic venous sinus
B. Right auricle: conical muscular pouch
*remnant of primordial atrium
C. Coronary sinus: larger vein/sinus
1. Collects coronary venous drainage from sm, middle, and large coronary veins
D. Fossa ovalis: remnant of foramen ovals, along interatrial septum
E. Crista terminalis: thick muscular crest, separated primordial atrium and sinus venarum
F. Pectinate muscles: rough striated muscular wall of RA

  1. Left
    A. Slightly thicker wall than RA
    B. Left auricle: similar to right auricle
    1. Remnant of primordial atrium
    2. Contains pectinate muscles
      C. Smooth walled portion: remnant of resorted embryological pulm veins
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12
Q

Ventricles

A

Right
1. Tricuspid valve: separates right atrium and ventricle
A. Cordae tendineae attach papillary muscles (anterior, posterior, septal)
2. Moderator band: from interventricular septum thru anterior papillary muscle
A. Shortcut for perkinje conductiion for simultaneous contraction of all 3 papillary muscles
3. Tribiculae Carneae: roughened textured striated muscle forms external wall
4. Conus arteriosus: thinner, smooth walled part - leads to pulmonary valve

Left

  1. Wall 2-3x thicker than RV
  2. Bicuspid (mitral) valve: chordae tendineae arise off 2 cusps
  3. Tribelulae carneae: finer and more numerous than RV
  4. Papillary muscles bigger
  5. Aortic vestibule: smooth non-muscular outflow tract
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13
Q

Outflow valves

A

Aortic and pulmonary (semilunar)
1. Prevent backflow
2. Don’t have external support, thicker at margins
3. 3 cusps
A. Pulmonary: right, left, anterior
B. Aortic: right, left, posterior
4. Openings to right and left coronary arteries during ventricle diastole

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14
Q

Coronary supply and return

A 
Right and left coronaries supply heart tissue
1. Many variants
2. Right: supplies RA, SA node, post interventricular septum, and some left ventricle
  A. Branches
    1. Nodal
    2. Right marginal
    3. Posterior interventricular
3. Left: supplies LA, most LV, anterior interventricular septum, and some RV
  A. Branches
    1. Anterior interventricular (LAD)
    2. Circumflex
    3. Left marginal
    4. Posterior interventricular
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15
Q

Cardiac venous return

A

Thru cardiac veins
1. Left: primary great cardiac vein
A. Begins at end LAD -> circumflex -> coronary sinus -> RA
B. Picks up left marginal and posterior ventricle veins
2. Right: 2 routes
A. Small and middle cardiac veins
B. RA via anterior cardiac veins

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16
Q

Cardiac autonomic control

A

Meet body demand
1. Sympathetic: inc. HR and force of contraction
A. 1st vasoconstriction then dilate
B. From symp chain T1-T5
1. Post-synaptic from paravertebral ganglia -> cardiac plexus -> SA node, AV node, and coronary artery muscle

  1. Parasympathetic: dec. HR and force of contraction
    A. Vasoconstricts
    B. Vagus n.
17
Q

Referred pain

A
  1. visceral afferents carry signal to dorsal root ganglia

A. Brain thinks it came from dermatomes of T1-T5 (usually left shoulder)

18
Q

Synchronization of heart contractions

A
  1. Cardiac muscle allows spontaneous and rhythmic contraction
    A. Direct fiber -> fiber spread
  2. Separation between atria and ventricle releases from synchronization
  3. SA node: starts atrial contraction
  4. AV node: slows signal and bundle rapidly transfers signal
  5. Purkinje fibers: continuation of AV node and bundles into ventricle
19
Q

Pericarditis

A

Inflammation/infection of serous membrane of pericardium

1. Dx: auscultation - “rustle of silk”

20
Q

Pericardial tamonade (effusion)

A

Fluid in pericardial cavity

1. Restricts contraction

21
Q

Thrombi

A

Blood clot in wall of LA (usually)

1. Dislodge and block arteries

22
Q

Valvular heart disease

A

Ossification or plaque build-up of valves -> backflow

1. Aortic stenosis (common) -> LV atrophy

23
Q

Aortic aneurism

A

Aortic wall integrity dec. -> enlargement -> possible hemorrhage (fatal)
1. Change in voice if impinges recurrent laryngeal nerve

24
Q

Coronary heart disease

A

Plaque build-up -> dec. O2 to cardiac tissues +> work harder, less efficient

25
Q

Artheriosclerosis

A

Lipid deposits narrow coronary arteries

26
Q

Myocardial infarction

A

Coronary artery plugged -> necrosis supplied tissue

  1. Anterior IV 40-50%
  2. RCA 30-40%
  3. Circumflex 15-20%
27
Q

Atrial/ventricular fibrillation

A

Rapid, irregular contraction

1. Defibrillation resets

28
Q

Bypass

A

Vessels grafted to supply tissue if coronary arty not working
1. Usually internal thoracic arteries or great saphenous vein in leg used

29
Q

Angioplasty

A

Artery stretched w/ balloon, can place stent

30
Q

Pacemaker/defibrillator

A

Inserted into one or both nodes to help if arrest or arrhythmia occur

Anatomy ICOM (34 decks)

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