Heart and Coronary circulation

Question 1

What forms the base of the heart?

Answer 1

Formed mainly by the left atrium, into which open the 4 pulmonary veins

Question 2

What separates the base of the heart from the descending aorta and oesphagus?

Answer 2

Oblique sinus of pericardium

Question 3

What is the base of the heart inferiorly bounded by?

Answer 3

Posterior part of the coronary sulcus

Question 4

What forms the diaphragmatic surface?

Answer 4

Formed by the 2 ventricles- mainly the left ventricles (2/3)

Question 5

What separates the diaphragmatic surface from the base of the heart?

Answer 5

Part of the coronary sulcus called the post

Question 6

What separates the two ventricles?

Answer 6

Separated by the posterior interventricular groove

Question 7

What is the pericardium?

Answer 7

It is a fibro-serous sac which surrounds the heart and great vessels.

Question 8

What is the pericardium differentiated into?

Answer 8

Outer fibrous layer - fibrous Pericardium and inner serous sac- serous pericardium

Question 9

Where does the pericardium lie

Answer 9

Lies posterior to body of the sternum & 2-6 costal cartilages
Lies anterior to 5-8 thoracic vertebrae

Question 10

What is the role of the fibrous pericardium?

Answer 10

Protects the heart against sudden overfilling

Question 11

What is the fibrous pericardium attached to?

Answer 11

Fused with the central tendon of the diaphragm
Attached to the posterior surface of the sternum b y sternopericardial ligaments
Fused with the tunica adventitia of the great vessles

Question 12

What pierces the central tendon of the diaphragm and pericardium on where?

Answer 12

Inferior vena cava

Question 13

What is serous pericardium?

Answer 13

It is a closed sac which is formed of 1-parietal layer

Question 14

What is the serous pericardium required for?

Answer 14

Lines the inner surface of the pericardium and reflected around the roots of great vessels to become continuous with the visceral layer

Question 15

What two layers make up the serous pericardium?

Answer 15

Visceral layer and parietal layer

Question 16

What does the visceral layer do/

Answer 16

Closely covers heart

Question 17

What does the pericardial cavity contain contain and what is its function?

Answer 17

Contains pericardial fluid and acts as a lubricant

Question 18

What are the main branches of the pericardium and where do they come from?

Answer 18

Pericardiacophrenic and musclophrenic arteries - they are branches of the internal thoracic arteries

Question 19

Where does the pericardium receive pericardial branches from?

Answer 19

Bronchial, oesphageal, and superior phrenic arteries

Question 20

What supplies the epicardium?

Answer 20

Coronary arteries

Question 21

What are the two types of pericardial sinuses?

Answer 21

Transverse sinuses and oblique sinus

Question 22

What is a transverse sinus?

Answer 22

A recess of serous pericardium between aorta & pulmonary T, and upper parts of 2 atria & S.V.C

Question 23

Where does the transverse sinus run?

Answer 23

Runs transversely between the great arteries and great veins

Question 24

What is an oblique sinus?

Answer 24

A recess of serous pericardium behind the base of heart

Question 25

Where does the oblique sinus occur?

Answer 25

On the posterior surface of the heart, surrounded by the large veins (a blind pocket)

Question 26

What is the nerve supply of the fibrous and parietal layer of the serous pericardium?

Answer 26

Phrenic nerve

Question 27

What is the nerve supply of the visceral layer of the serous pericardium?

Answer 27

Branches of the sympathetic trunk and vagus nerves

Question 28

What is functional circulation?

Answer 28

Coronary circulation is the functional blood supply to the heart muscle

Question 29

What is the role of collateral routes?

Answer 29

Ensure blood delivery to heart even if major vessels are occluded

Question 30

What do the branches of the left coronary artery supply?

Answer 30

``` Left atrium Most of left ventricle Most of interventricular septum AV bundles and branches SA node in 40% people ```

Question 31

What do the branches of the right coronary artery supply?

Answer 31

``` Right atrium Most of right ventricle Part of left ventricle SA node in 60% AV node in 80% Part of the left atrium Part of interventricular septum ```

Question 32

How does the blood drain from the heart?

Answer 32

Most of the blood drains into the drain into right atrium through Coronary Sinus

Question 33

What are the tributaries of the coronary sinus?

Answer 33

Small and middle cardiac veins

Question 34

Where is the remainder of the blood returned to?

Answer 34

The right atrium directly by anterior cardiac vein and by small veins open directly into heart chambers

Question 35

What type of innervation does the heart receive?

Answer 35

Heart receives visceral motor innervation

Question 36

What is sympathetic motor innervation?

Answer 36

heart speeds up

Question 37

What is parasympathetic innervation?

Answer 37

Heart slows down

Question 38

How does fetal circulation differ to adults?

Answer 38

the presence of 3 major vascular shunts

Question 39

What are the three major vascular shunts in the fetus?

Answer 39

Ductous venosus Foramen ovale Ductus arteriosus

Question 40

Where is the ductus venosus?

Answer 40

Between the umbilical vein and inferior vena cava

Question 41

Where is the foramen ovale?

Answer 41

Between the right and left atrium

Question 42

Where is the ductus arteriosus?

Answer 42

Between the pulmonary artery and arch of aorta

Question 43

What is the foramen ovale?

Answer 43

A hole between the right and left atria, allowing blood pass from the right side to the left and not ever get pumped to the lungs

Question 44

What is the role of the ductus arteriosus?

Answer 44

Allows blood to skip past the lungs and join up with the partially oxygenated blood that is being pumped out of the left ventricle

Question 45

What is the adult remnant of the foramen ovale?

Answer 45

Fossa ovale

Question 46

What is the adult remnant of the ductus arteriosus?

Answer 46

ligamentum artiosum

Question 47

What is the adult remnant of the umbilival artery (within fetus)

Answer 47

Medial umbilical ligaments

Question 48

What is the adult remnant of the umbilcal vein?

Answer 48

Round ligament of liver

Question 49

What is the adult remnant of the ductus venosus?

Answer 49

Ligamentum venosum

Question 50

What are the two main coronary arteries?

Answer 50

The left coronary artery- which subdivides into the left anterior descending and circumflex branches The right coronary artery

Question 51

What are the two main coronary arteries?

Answer 51

The left coronary artery- which subdivides into the left anterior descending and circumflex branches The right coronary artery

Question 52

What is a myocardial ischaemia?

Answer 52

Occurs when the blood flow demands of the heart exceed the blood supplied by the coronary arteries

Question 53

What is the leading cause of myocardial ischaemia?

Answer 53

Atherosclerosis | Blockage of coronary arteries due to the accumulation of lipid plaques/ thrombus

Question 54

What is meant by ischaemia?

Answer 54

Inadequate blood flow to a tissue or part of the body

Question 55

What is angina pectoris?

Answer 55

It is the major symptom of myocardial ischaemia

Question 56

How does angina pectoris present?

Answer 56

Commonly presented as- pain | pressure or a burning sensation in the area of the sternum

Question 57

What is an myocardial infarction?

Answer 57

Irreversible injury and eventual death of myocardial tissue that results from ischaemia and hypoxia

Question 58

What are most MIs the direct result of?

Answer 58

Occlusion of a coronary blood vessel by lipid deposit