Heart & Great Vessels

Question 1

pericardium

Answer 1

a fibrous sac surrounding the heart and roots of the great vessels

Question 2

fibrous pericardium

Answer 2

inelastic; very tough
fuses superiorly with the tunica adventitia of SVC, ascending aorta, and pulmonary arteries
fuses inferiorly with the central tendon of the diaphragm

Question 3

what reinforces the pericardium?

Answer 3

2 sternopericardial ligaments (w/in the anterior mediastinum) anteriorly and posteriorly by loose CT attaches the pericardium to the tracheal bifurcation and main bronchi

Question 4

attachments of the pericardium function to…

Answer 4

keep the heart in position & limit cardiac distension

Question 5

what overlaps the pericardium?

Answer 5

two pleural sacs and lungs

Question 6

what lies posteriorly to the pericardium?

Answer 6

the esophagus, descending thoracic aorta, and main bronchi

Question 7

pericardium outer layer

Answer 7

dense CT called the fibrous pericardium

Question 8

pericardium inner serous part contains:

Answer 8

-parietal layer
-visceral layer

Question 9

pericardial cavity

Answer 9

-potential space b/w the parietal and visceral layers
-contains a thin film of fluid that enables the heart to move and beat in a relatively frictionless environment

Question 10

fibrous pericardium function

Answer 10

retain the heart in position and limit its distension-prevents sudden overfilling

Question 11

parietal layer of serous pericardium

Answer 11

closely adherent to the fibrous pericardium

Question 12

visceral layer of serous pericardium

Answer 12

more loosely bound to the heart and is also called the epicardium

Question 13

what part of the heart is not covered by the epicardium?

Answer 13

posterior, irregular area between the venae cavae and pulmonary vv. where myocardium contacts fibrous cardium

Question 14

development of the heart and the pericardial sinuses

Answer 14

due to folding of embryonic heart tube
as heart tube folds, venous end moves posterior and up, so venous end then is up by arterial end, separated by transverse sinus
as veins of heart grow and expand, oblique sinus is formed, a recess, a blind sac behind posterior side of the heart

Question 15

pericardial sinuses

Answer 15

reflections of pericardium (where 2 layers of pericardium meet each other)
-transverse sinus
-oblique sinus

Question 16

transverse sinus

Answer 16

at arterial end where pulmonary trunk & aorta leave heart

Question 17

transverse sinus clinical implication

Answer 17

can stop circulation to the aorta or pulmonary artery by making a stitch through the sinus

Question 18

oblique sinus

Answer 18

at venous end where SVC, IVC pulmonary veins enter the heart

Question 19

oblique sinus function

Answer 19

assists with frictionless movement of the heart in the pericardial cavity

Question 20

blood supply to fibrous & parietal layers of pericadium

Answer 20

majority from pericardiacophrenic arteries
also from musculophrenic arteries, branches of the thoracic aorta and coronary arteries

Question 21

bloody supply to epicardium

Answer 21

via the coronary arteries

Question 22

venous drainage of pericardium

Answer 22

pericardiacophrenic vv, internal thoracic vv, and tributaries of the azygos system

Question 23

somatic sensory innervation to the fibrous & parietal layers via

Answer 23

the phrenic nerves

Question 24

visceral sensory innervation to the epicardium via

Answer 24

the cardiac plexuses

Question 25

epicardium is insensitive to ____

Answer 25

pain

Question 26

vasomotor innervation of pericardium

Answer 26

from sympathetic trunks

Question 27

pericarditis

Answer 27

inflammation, usually causes chest pain sharp chest pain associated with pericarditis occurs when the irritated layers of the pericardium rub against eachother

Question 28

pericarditis can lead to ____

Answer 28

pericardial effusion

Question 29

pericardial effusion

Answer 29

the presence of an abnormal amount of fluid and/or an abnormal character to fluid in the pericardial space can be caused by a variety of local and systemic disorders or idiopathic

Question 30

cardiac tamponade

Answer 30

build-up of blood or other fluid in the pericardial sac puts pressure on the heart, which may prevent it from pumping effectively

Question 31

periocardiocentesis

Answer 31

drains fluid from pericardial sac xiphoid approach: needle inserted b/w the xiphoid process and L costal margin

Question 32

what artery runs in the anterior interventricular groove?

Answer 32

anterior interventricular artery

Question 33

two parts of the right atrium

Answer 33

-sinus venarum -pectinate muscles

Question 34

sinus venarum of right atrium

Answer 34

the smooth thin-walled posterior part that recieves the venae cavae and coronary sinus derived from the embryonic sinus venosus

Question 35

what divides the pectinate muscles from the sinus venarum in right atrium?

Answer 35

crista terminalis

Question 36

what divides the right and left atrium?

Answer 36

interatrial septum

Question 37

fossa ovalis

Answer 37

remnant of the fetal foramen ovale and valve

Question 38

what percentage of individuals have an atrial septum defect?

Answer 38

25%

Question 39

what happens if foramen ovale is too large?

Answer 39

allows O2 blood to be shunted to the right atrium resulting in an overloading of the pulmonary system subsequently, R atrium, R ventricle and pulmonary trunk will become enlarged

Question 40

where does right ventricle receive blood from?

Answer 40

the right atrium via the right atrioventricular orifice *guarded by the tricuspid valve

Question 41

trabeculae carneae

Answer 41

the irregular muscular elevations on the internal surface of the right & left ventricles *prevent prolapse

Question 42

two parts of the interventricular septum

Answer 42

-muscular part -membranous part that is superior and posterior

Question 43

conus arteriosus

Answer 43

cone-shaped pouch that leads into the pulmonary trunk

Question 44

pulmonary valve

Answer 44

semilunar valve guarding the pulmonary trunk

Question 45

how many cusps does the right atrioventricular valve have?

Answer 45

3 *tricuspid

Question 46

cusps of right atrioventricular valve

Answer 46

-anterior cusp -posterior cusp -septal cusp

Question 47

tricuspid valve contains:

Answer 47

-papillary muscles (3) -chordae tendinae

Question 48

function of atrioventricular valves

Answer 48

prevent backflow into the atria during ventricular contraction

Question 49

what do the papillary muscles and chordae tendinae do in the atrioventricular valves?

Answer 49

prevent the cusps from prolapsing into the atria

Question 50

ventricular diastole=

Answer 50

atria contract

Question 51

ventricular systole=

Answer 51

ventricles contract

Question 52

where does the left atrium receive blood from?

Answer 52

receives oxygenated blood from the lungs via four pulmonary veins

Question 53

structure of left atrium

Answer 53

smooth interior except for pectinate muscles in the left auricle

Question 54

where does the left ventricle receive blood from?

Answer 54

the left atrium via the left atrioventricular orifice *guarded by the mitral valve

Question 55

does the R or L ventricle have a thicker wall?

Answer 55

left ventricle wall is 2x thicker

Question 56

aortic vestibule

Answer 56

part that leads into the aorta from L ventrical; smooth walled

Question 57

aortic valve

Answer 57

semilunar valve guarding the ascending aorta

Question 58

ventricular septal defects

Answer 58

-25% of all congenital heart defects -opening b/w L & R ventricles, associated w/ shunting of blood -4 types based on position and severity -most occur in muscular portion (can spontaneously connect) -membranous defects are more commonly surgically corrected

Question 59

how many cusps does the mitral valve have?

Answer 59

two *biscupid valve

Question 60

bicuspid valve contains:

Answer 60

-papillary muscles (2) -cordae tendinae

Question 61

what valve of the heart is the most commonly diseased?

Answer 61

mitral (bicuspid) valve

Question 62

mitral valve prolapse can cause

Answer 62

enlargement of the L atrium

Question 63

the pulmonary & aortic valves are...

Answer 63

tricuspid semilunar valves

Question 64

tricuspid semilunar valves

Answer 64

-have 3 cup-like cusps that prevent backflow into the ventricles during ventricular relaxation -NOT associated w/ chordae tendinae & papillary muscles

Question 65

each cusp of a semilunar valve contains:

Answer 65

- a fibrous nodule at the midpoint of its free edge -a thin CT area on either side of the nodule called the lunule *when valves close the nodules & lunules meet in the center

Question 66

coronary arteries arise from

Answer 66

aortic sinuses

Question 67

coronary arteries fill as the aortic sinuses fill following what?

Answer 67

ventricular contraction