Heart and pericardium Flashcards
What are the two parts of the pericardium (outside to in)
Fibrous pericardium (outer)
Parietal layer of serous pericardium
Serous layer of serous pericardium
Where is the transverse pericardial sinus found
Posterior to aorta and pulmonary trunk and anterior to SVC
Where is the oblique pericardial sinus found
Serous pericardium which covers SVC, IVC and pulmonary veins
What is the endocardium made of
Endothelium and sub endothelial connective tissue
What is the fibrous pericardium attached to the diaphragm by
Pericardiophrenic ligaments
What is the fibrous pericardium blended into
Adventitia of great vessels
What is the arterial supply of fibrous pericardium
Pericardiophrenic artery
What is the venous drainage of the fibrous pericardium
Pericardiophrenic veins and azygos venous system
What are the surfaces of the heart
Anterior
Inferior
Left pulmonary surface
Right pulmonary surface
What is the anterior surface of the heart formed mainly by
right ventricle
What is the inferior surface of the heart formed mainly by
Mostly L (with a bit of R) ventricle
What is the left pulmonary surface of the heart formed mainly by
Left ventricle (forms cardiac notch)
What is the right pulmonary surface formed mainly by
Right atrium
Numbers for the borders of the heart
2,3,5,6
Borders of the heart
Superior: left cc2–> right cc3
Right: right cc3–> right cc6
Inferior: right cc6–> left ics5
Left: left ics5–> left cc2
What are the valve positions on a heart
PAMT 3344
Pulmonary valve; medial to L cc3
Aortic valve; medial to L Ics 3
Mitral (bicuspid); medial to L cc4
Tricuspid; medial to R ics 4
Which side of the heart are the bicuspid and tricuspid valves found
Tricuspid- RHS
Bicuspid- LHS
Where are the valve auscultation sites
Pulmonary - L ics2 near sternal angle
Aortic- R ics2 near sternal angle
Mitral/bic- L ics5 at apex (midclavicular line)
Tricuspid- 4th/5th Rics
Which vessels pass through the pericardium
Inferior and superior vena cava
Left pulmonary veins
Left pulmonary artery
What is pericarditis
Swelling of the pericardium
Which branches of the coronary arteries are most likely to become occluded
LAD artery
What are the four surfaces of the heart
Sternocostal (anterior) Posterior (base) Inferior (diaphragmatic) Right pulmonary Left pulmonary
What is the anterior surface of the heart made of (anterior)
Right ventricle
What is the posterior (base) surface of the heart made of
Left atrium
What is the diaphragmatic (inferior) surface of the heart made of
Left and right ventricles
What is the right pulmonary surface of the heart made of
Right atrium
What is the left pulmonary surface of the heart made of
Left ventricle
What are the different borders of the heart and what do they contain
Right border- Right atrium
Inferior border-left ventricle and right ventricle
Left border-left ventricle and some of left atrium
Superior border- right and left atrium and the great vessels
what’re the parts of the heart wall
epicardium
Myocardium
Endocardium
What is the fossa ovalis the remnant of
Foramen ovale
When does the fossa ovalis close
When the newborn takes its first breath
What is the purpose of the right and left atrial auricles
Muscular pouches that act to increase the capacity of the atrium and sit on top of the atria
What was the purpose of the foramen ovale in a foetus
Opening which allowed blood from the right atrium to pass directly into the left atrium by bypassing the lungs as blood didn’t require a lot of oxygenation in the foetus as the foetus was obtaining it from the mother
Where are the pectinate muscles found and what do they converge to form
IN the heart- converge to form crista terminalis
What are trabeculae carnae
Irregular ridges on the internal surface of the ventricles
Where are papillary muscles found
IN ventricles
What are papillary muscles attached to
Chordae tendinae which itself are attached to the atrioventricular valves
What are chordae tendinae attached to
atrioventricular valves and papillary muscles
What are chordae tendinae
Fibrous cords attaching to atrioventricular valves
What are chordae tendinae for
Prevent the inversion of the valves allowing unidirectional flow
At which rib level does the superior vena cava enter the atrium
3rd rib
At which vertebral level does the inferior vena cava enter the pericardium
T8
What are the two layers of the serous pericardium
Outer parietal layer
Internal visceral layer/epicardium
What are both layers of the serous pericardium separated by
Pericardial cavity
Innervation of the pericardium and root value
Phrenic nerve (C3-5)
Where is the transverse pericardial sinus
- Posterior to ascending aorta and pulmonary trunk
- Anterior to SVC
- superior to left atrium
What is the clinical significance of the transverse pericardial sinus
Used to identify and ligate the arteries of the heart during coronary artery bypass grafting
What is the origin of the right coronary artery
Right coronary sinus
What are the branches of the right coronary artery
- Right marginal artery
- Posterior interventricular artery
What is the origin of the left coronary artery
Left coronary sinus
What are the branches of the left coronary artery
- Left anterior descending artery
- Left marginal artery
- Left circumflex artery
What does the left circumflex artery contribute to
Posterior interventricular artery
Which two branches anastomose (of the coronary arteries)
Anterior and posterior interventricular branches
What is the coronary sinus
The main vein of the heart
What do some of the veins of the heart drain into
Coronary sinus
What veins drain into the coronary sinus
Great cardiac vein Small cardiac vein Middle cardiac vein Left marginal vein Left posterior ventricular vein
What muscles are found in the atria of the heart
- Auricules
- Pectinate muscles (converge to form crista terminalis)
- Smooth muscle
- Fossa ovalis
What muscles are found in the ventricles of the heart
- Trabeculae carne
- Papillary muscles with chordae tendinae
- Moderator band, contains bundle of his fibres
