Heart ( Handout ) Flashcards

0
Q

The pericardium extends just superior to the ___________ to the ____________

A

Sternal angle

Xiphisternal joint

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1
Q

Fibroserous membrane that covers the heart and beginning of great essels

A

Pericardium

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2
Q

2 layers of pericardium

A

Fibrous and serous

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3
Q

What are the layers of the serous pericardium

A

Visceral and Parietal

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4
Q

Tough external layer that stabilizes the heart and prevents the heart from overdilating

A. Fibrous pericardium
B. Serous pericardium

A

A. Fibrous

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5
Q

The fibrous pericardium fuses SUPERIORLY with _________ of the great vessels

A

Tunica adventitia

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6
Q

Attaches the pericardium to the posterior part of the sternum

A

Sternopericardial ligament

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7
Q

The fibrous pericardium blends with the central tendon of the diaphragm to form what ligament?

A

Pericardiacophrenic ligament

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8
Q

Composed mainly of mesothelium that lines the internal surface of the fibrous pericardium and external surface of the heart

A

Serous pericardium

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9
Q

Serous layer that lines the internal surface of the fibrous pericardium
A. Parietal
B. Visceral

A

A. Parietal

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10
Q

Closely applied to the heart and makes up the epicardium
A. Parietal
B. Visceral

A

B. Visceral

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11
Q

Where is the visceral continuous with the parietal layer?

A
  1. Where aorta and pulmonary trunk leave the heart

2. Where SVC, IVC, and pulmonary veins enter the heart

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12
Q

Potential space between the parietal and visceral layer

A

Pericardial cavity

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13
Q

How much fluid is contained in the pericardial sac?

A

30-50ml

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14
Q

A space that lies posterior to the aorta and pulmonary trunk and anterior to the SVC
A. Transversus sinus
B. Oblique sinus

A

A. Transverse Sinus

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15
Q
Boundary of the Transversus Sinus: 
Serous pericardium covering the posterior aspect of the pulmonary trunk and ascending aorta
A. Anterior
B. Posterior
C. Inferior
D. Lateral
A

A. Anterior

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16
Q
Boundary of the Transversus Sinus: 
Pericardium covering the SVC
A. Anterior
B. Posterior
C. Inferior
D. Lateral
A

B. Posterior

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17
Q
Boundary of the Transversus Sinus: 
Visceral pericardium covering the atria of the heart
A. Anterior
B. Posterior
C. Inferior
D. Lateral
A

C. Inferior

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18
Q

Pocket-like recess in the pericardial cavity posterior to the base of the heart
A. Transversus sinus
B. Oblique sinus

A

B. Oblique sinus

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19
Q
Boundary of the Oblique Sinus:
Pericardial reflections surrounding the pulmonary veins and IVC
A. Anterior
B. Posterior
C. Inferior
D. Lateral
A

D. Lateral

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20
Q

MAIN blood supply of the pericardium

A

Pericardiacophrenic a

Internal thoracic a

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21
Q

Small contributions of arterial blood to the pericardium comes from?

A
CBEMS
Coronary (visceral only)
Bronchial
Esophageal
Musculophrenic
Superior phrenic
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22
Q

Venous drainage of the pericardium

A

Pericardiacophrenic v to brachiocephalic v

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23
Q

The phrenic nerve supplies what part of the pericardium?

A

Fibrous pericardium

PARIETAL layer of the serous pericardium

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24
Q

The sympathetic trunks and vagus nerve supplies what part of the pericardium?

A

VISCERAL layer of the serous pericardium

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25
Q

Condition: compromises expansion of the heart that limits the amount of blood the heart can receiving thereby decreasing the cardiac output

A

Cardiac tamponade

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26
Q

Drainage of fluid from pericardial cavity that is done for cardiac tamponade relief

A

Pericardiocentesis

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27
Q

In performing pericardiocentesis, a wide bore is inserted where?

A

5th-6th ICS near sternum

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28
Q

What is the normal weight of the heart?

A

250-300g in female

300-350g in males

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29
Q

A complex of dense collagen that provides attachment for the leaflets, cusps, and myocardium

A

Fibrous skeleton

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30
Q

What are the structures formed by the fibrous skeleton?

A

4 fibrous rings
R & L fibrous trigone
Membranous parts of the interatrial and interventricular septum

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31
Q

Keeps the orifices of the AV and semilunar valves patent and forms an electric insulator

A

Fibrous skeleton

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32
Q

Formed by the inferolateral part of the left ventricle

A

Apex of the heart

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33
Q

The apex of the heart lies where?

A

Posterior to the L 5th ICS, 9cm from the median plane

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34
Q

Where the sounds of mitral valve closure are maximal

A

Apex

- apex beat

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35
Q

Opposite the apex and forma the posterior aspect of the heart

A

Base

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36
Q

Formed mainly by the L atrium and partially by the R atrium

A

Base

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37
Q

Extends superiorly to the bifurcation of pulmonary trunk and inferiorly to the coronary groove

A

Base

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38
Q

The base of the heart receives what vessels?

A

Pulmonary veins
SVC
IVC

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39
Q

What are the surfaces of the heart?

A

Sternocostal
Diaphragmatic
R pulmonary
L pulmonary

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40
Q

Surface of the heart:
Formed mainly by the R ventricle

A. Sternocostal
B. Diaphragmatic
C. R pulmonary
D. L pulmonary

A

A. Sternocostal

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41
Q

Surface of the heart:
Forms the anterior surface of the heart

A. Sternocostal
B. Diaphragmatic
C. R pulmonary
D. L pulmonary

A

A. Sternocostal

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42
Q

Surface of the heart:
Formed mainly by the L ventricle and partly by the R ventricle

A. Sternocostal
B. Diaphragmatic
C. R pulmonary
D. L pulmonary

A

B. Diaphragmatic

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43
Q

Surface of the heart:
Related to the central tendon of the diaphragm

A. Sternocostal
B. Diaphragmatic
C. R pulmonary
D. L pulmonary

A

B. Diaphragmatic

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44
Q

Surface of the heart:
Forms the inferior surface of the heart

A. Sternocostal
B. Diaphragmatic
C. R pulmonary
D. L pulmonary

A

B. Diaphragmatic

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45
Q

Surface of the heart:
Formed mainly by the R atrium

A. Sternocostal
B. Diaphragmatic
C. R pulmonary
D. L pulmonary

A

C. R pulmonary

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46
Q

Surface of the heart:
Formed mainly by the L ventricle

A. Sternocostal
B. Diaphragmatic
C. R pulmonary
D. L pulmonary

A

D. L pulmonary

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47
Q

Surface of the heart:
Forms the cardiac impression of the L lung

A. Sternocostal
B. Diaphragmatic
C. R pulmonary
D. L pulmonary

A

D. L pulmonary

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48
Q

What are the four borders of the heart?

A

R border
Inferior border
L border
Superior border

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49
Q

Border of the heart:
Formed by the R atrium extending between the SVC & IVC

A. R border
B. Inferior border
C. L border
D. Superior border

A

A. R border

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50
Q

Border of the heart:
Formed by the R ventricle & slightly by the L ventricle

A. R border
B. Inferior border
C. L border
D. Superior border

A

B. Inferior

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51
Q

Border of the heart:
Formed by the L ventricle & slightly by the L auricle

A. R border
B. Inferior border
C. L border
D. Superior border

A

C. Left

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52
Q

Border of the heart:
Formed by the R and l atria and auricles

A. R border
B. Inferior border
C. L border
D. Superior border

A

D. Superior

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53
Q

Border of the heart:
Forms the inferior boundary of transverse pericardial sinus

A. R border
B. Inferior border
C. L border
D. Superior border

A

D. Superior

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54
Q

What emerges from the superior border of the heart?

A

Ascending aorta
Pulmonary trunk
SVC enters its R side

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55
Q

What are the three layers of the heart?

A

Endocardium
Myocardium
Epicardium

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56
Q

Layer of the heart:
Thin internal layer

A. Endocardium
B. Myocardium
C. Epicardium

A

A. Endocardium

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57
Q

Layer of the heart:
Serves as the lining membrane of the heart and its valves

A. Endocardium
B. Myocardium
C. Epicardium

A

A. Endocardium

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58
Q

Layer of the heart:
Thick middle layer composed of cardiac muscle

A. Endocardium
B. Myocardium
C. Epicardium

A

B. Myocardium

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59
Q

Layer of the heart:
Thick external layer

A. Endocardium
B. Myocardium
C. Epicardium

A

C. Epicardium

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60
Q

Layer of the heart:
Formed by the visceral layer of the serous pericardium

A. Endocardium
B. Myocardium
C. Epicardium

A

C. Epicardium

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61
Q

What are the four chambers of the heart?

A

R & L atrium

R & L ventricle

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62
Q

Chamber of the heart:
Forms the R border of the heart

A. R atrium
B. L atrium
C. R ventricle
D. L ventricle

A

A. R border

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63
Q

The R atrium receives venous blood from what vessels?

A

SVC
IVC
Coronary sinus

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64
Q

The SVC opens to the superior part of the R atrium at what level?

A

R 3rd costal cartilage

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65
Q

The IVC opens to the superior part of the R atrium at what level?

A

5th Costal Cartilage

66
Q

The R atrium has a rudimentary valve called?

A

Eustachian valve

67
Q

Where is the opening of the coronary sinus located?

A

Between the atrioventricular orifice and the IVC orifice

68
Q

Receives most of the cardiac veins

A

Opening of the coronary sinus

69
Q

The coronary sinus has a valve called?

A

Thebesian valve

70
Q

Ear-like conical muscular pouch that increases the capacity of the atrium (serves as an add-on room)

A

Auricle

71
Q

A muscle resembling the teeth of a comb that forms the rough muscular anterior wall of the R atrium

A

Pectinate muscle

72
Q

Smooth, thin-walled, posterior part of the R atrium where the SVC, IVC, and coronary sinus open up

A

Sinus venarum

73
Q

A vertical ridge separating the smooth and rough parts of the atrium

A

Crista terminalis

74
Q

Also known as the terminal groove

A

Sulcus terminalis

75
Q

Separates the right from the left atria

A

Interatrial septum

76
Q

Remnant of the foramen ovale

A

Fossa ovalis

77
Q

Contains the fossa ovalis

A

Interatrial septum

78
Q

Contains the remnant of foramen ovale

A

Interatrial septum

79
Q

Condition: incomplete closure of the foramen ovale

A

Atrial septal defect

80
Q

Incomplete closure of the foramen ovale will cause
A. R to L shunt
B. L to R shunt

A

B. L to R shunt

81
Q

Causes enlargement of the R atrium and ventricle and dilatation of the pulmonary trunk
A. R to L shunt
B. L to R shunt

A

B. L to R shunt

82
Q

Opening where poorly oxygenated blood from the R atrium is discharged into the R ventricle

A

R atrioventricular orifice

83
Q
Guards the R AV orifice
A. Bicuspid valve
B. Tricuspid valve
C. Thebesian valve
D. Eustachian valve
A

B. Tricuspid valve

84
Q

The tricuspid valve has three cusps. What are those?

A

Anterior
Posterior
Septal

85
Q

Attached to the free edges of the cusp of the tricuspid valve

A

Tendinous cords

86
Q

Tricuspid valve is located

A. R atrium
B. L atrium
C. R ventricle
D. L ventricle

A

C. R ventricle

87
Q

Irregular muscular elevations that gives the ventricular wall a sponge-like appearance

A

Trabecular carnae

88
Q

What are the three types of trabeculae carnae

A

Papillary muscles
Moderator band
Prominent ridges

89
Q

Conical muscular projections attached to the ventricular wall

A

Papillary muscles

90
Q

The papillary muscles are connected to the cusps of the tricuspid valve via?

A

Chordae tendinae

91
Q

How many papillary muscles are present in the R ventricle?

A

3

  • anterior
  • posterior
  • septal
92
Q

Right Ventricle: Papillary muscles
Arise from the anterior wall of the R ventricle

A. Anterior
B. Posterior
C. Septal

A

A. Anterior

93
Q

Right Ventricle: Papillary muscles
Arise from the inferior wall of the R ventricle

A. Anterior
B. Posterior
C. Septal

A

B. Posterior

94
Q

Right Ventricle: Papillary muscles
Arise from the interventricular septum

A. Anterior
B. Posterior
C. Septal

A

C. Septal

95
Q

Also known as septomarginal trabecula

A

Moderator band

96
Q

Muscular bundle from the inferior part of the IVS yo the base of the anterior papillary muscle

A

Moderator band

97
Q

Carries part of the R branch of the AV bundle to the anterior papillary muscle

A

Moderator band

98
Q

Partition of between the R and L ventricle

A

Interventricular septum

99
Q

The IVS has two parts. What are those?

A

Muscular

Membranous

100
Q

Condition: incomplete closure of the ventricular septum

A

Ventricular septal defect

101
Q

Where is the most common site of the ventricular septal defect?
A. Muscular
B. Membranous

A

B. Membranous part

102
Q

Condition: incomplete closure of the ventricular septum
A. R to L shunt
B. L to R shunt

A

B. L to R shunt

103
Q

Condition: incomplete closure of the ventricular septum

Size of defect?

A

1-25mm

104
Q

A shunt that may lead to pulmonary hypertension resulting to cardiac failure
A. Atrial septal defect
B. Ventricular septal defect

A

B. Ventricular septal defect

105
Q

A shunt that may lead to pulmonary hypertension resulting to cardiac failure
A. R to L shunt
B. L to R shunt

A

B. L to R shunt

106
Q

Arterial cone which leads into the pulmonary trunk

A

Conus arteriosus

107
Q

Another name for conus arteriosus

A

Infundibulum

108
Q

Separates the ridged muscular wall of the inflow part from the smooth wall of the outflow part

A

Supraventricular crest

109
Q

Inflow
A. Ridged muscular wall
B. Smooth wall

A

A. Ridged muscular wall

110
Q

Outflow
A. Ridged muscular wall
B. Smooth wall

A

B. Smooth wall

111
Q

Deflects the incoming flow into the main cavity

A

Supraventricular crest

112
Q

Deflects the outgoing flow into the conus arteriosus

A

Supraventricular crest

113
Q

The supraventricular crest deflects the incoming flow into the ____________

A

Main cavity

114
Q

The supraventricular crest deflects the outgoing flow into the ____________

A

Conus arteriosus

115
Q

The supraventricular crest deflects the ________ flow into the main cavity

A

Incoming

116
Q

The supraventricular crest deflects the ________ flow into the conus arteriosus

A

Outgoing

117
Q

What valve guards the pulmonary orifice?

A

Pulmonary valve

118
Q

Where is the pulmonary valve located?

A

Level of 3rd costal cartilage

119
Q

A valve that has no tendinous cords and is located at the level of 3rd costal cartilage

A

Pulmonary valve

120
Q

How many semilunar cusps are present in the pulmonary valve?

A

3

  • anterior
  • right
  • left
121
Q

Approx 5 cm long and 3 cm wide and conducts poorly oxygenated blood to the lungs for oxygenation

A

Pulmonary trunk

122
Q

What are the divisions of the pulmonary trunk?

A

R an L pulmonary arteries

123
Q
Forms most of the base or posterior surface of the heart
A. R atrium
B. L atrium
C. R ventricle
D. L ventricle
A

B. L atrium

124
Q

Thicker wall
A. R atrium
B. L atrium

A

B. L atrium

125
Q

What veins enter the L atrium?

A

R and L pulmonary veins

- 2 superior and 2 inferior pulmonary veins

126
Q
The R and L pulmonary veins enter the 
A. R atrium
B. L atrium
C. R ventricle
D. L ventricle
A

B. L atrium

127
Q

Forms the superior part of the L border of the heart. Also functions as an add-on room.

A

L auricle

128
Q

True or False:

The L atrium contains pectinate muscles

A

True

129
Q

Condition: benign neoplasm or tumor that is 90% located in the atrium and can present as a hard globular mass or may have a soft gelatinous appearance
(+) fever and malaise
* surgical removal is curative

A

Myxoma

130
Q

Forms the apex of the heart, nearly all its L surface and border and most of its diaphragmatic surface

A. R atrium
B. L atrium
C. R ventricle
D. L ventricle

A

D. L ventricle

131
Q

Walls are 2 to 3 times thick
A. R ventricle
B. L ventricle

A

B. L ventricle

132
Q

Performs more work
A. R ventricle
B. L ventricle

A

B. L ventricle

- arterial pressure is higher in the systemic than in pulmonary circulation

133
Q

Has a longer and narrower conical cavity
A. R ventricle
B. L ventricle

A

B. L ventricle

134
Q

Opening through which the L atrium discharges oxygenated blood into the L ventricle

A

L atrioventricular orifice

135
Q
The L AV orifice is surrounded by what valve?
A. Bicuspid valve
B. Tricuspid valve
C. Mitral valve
D. Thebesian valve
A

C. Mitral valve

136
Q
Located posterior to the sternum at the level of 4th costal cartilage
A. Bicuspid valve
B. Tricuspid valve
C. Mitral valve
D. Thebesian valve
A

C. Mitral valve

137
Q
Resembles a bishop's miter
A. Bicuspid valve
B. Tricuspid valve
C. Mitral valve
D. Thebesian valve
A

C. Mitral valve

138
Q

True or False:

Tendinous cords are attached in the mitral valve

A

True

139
Q

The mitral valve has how many cusps?

A

2

  • anterior
  • posterior
140
Q

Condition: ballooning of mitral valve leaflets. Leaflets are enlarged, thick, and rubbery.

A

Mitral valve prolapse

141
Q

Trabeculae carnae is finer and more numerous
A. R ventricle
B. L ventricle

A

B. L ventricle

142
Q

Anterior and posterior papillary muscles are larger
A. R ventricle
B. L ventricle

A

B. L ventricle

143
Q

Presence of moderator band
A. R ventricle
B. L ventricle

A

B. R ventricle

144
Q

True or False:

The L ventricle has a moderator band

A

False

145
Q

Smooth-walled superoanterior outflow part of the L ventricle that leads to the aortic valve an aortic orifice

A

Aortic vestibule

146
Q

Located at the upper right and posterior part in which the blood leaves the L ventricle
A. Aortic valve
B. Aortic vestibule
C. Aortic orifice

A

C. Aortic orifice

147
Q
Located posterior to the L side of the sternum at the level of the 3rd ICS
A. Pulmonary valve
B. Aortic valve
C. Mitral valve
D. Eustachian valve
A

B. Aortic valve

148
Q

True or False:

The aortic valve has tendinous cords attached to it.

A

False

149
Q

How many semilunar cusps are present in the aortic valve?

A

3

  • right
  • left
  • posterior
150
Q
(+) lunule and nodule and has no tendinous cords
A. Pulmonary valve
B. Aortic valve
C. Mitral valve
D. Eustachian valve
A

B. Aortic valve

151
Q

The R coronary artery arises from what sinus?

A

R aortic sinus

152
Q

The L coronary artery arises from what sinus?

A

L aortic sinus

153
Q

Condition: Most frequent valve abnormality that results to L ventricular hypertrophy

A

Aortic valve stenosis

154
Q

The aorta is divided into how many parts?

A

4

  • ascending
  • arch
  • descending
  • abdominal
155
Q
Arise from the base of the L ventricle
A. Ascending
B. Arch
C. Descending
A. Abdominal
A

A. Ascending

156
Q

What are the branches of the ascending aorta?

A

R and L coronary artery

157
Q
Continuation of the ascending aorta
A. Ascending
B. Arch
C. Descending
A. Abdominal
A

B. Arch

158
Q

What are the branches of the arch of the aorta?

A

Brachiocephalic
L common carotid
L subclavian

159
Q
Brachiocephalic A is a branch of?
A. Ascending
B. Arch
C. Descending
A. Abdominal
A

B. Arch

160
Q
L coronary A is a branch of?
A. Ascending
B. Arch
C. Descending
A. Abdominal
A

A. Ascending

161
Q
L common carotid A is a branch of?
A. Ascending
B. Arch
C. Descending
A. Abdominal
A

B. Arch

162
Q
L subclavian A is a branch of?
A. Ascending
B. Arch
C. Descending
A. Abdominal
A

B. Arch

163
Q
R coronary A is a branch of?
A. Ascending
B. Arch
C. Descending
A. Abdominal
A

A. Ascending