Heart Structures Flashcards
pericardium is made up of two parts:
fibrous and serous pericardium
serous pericardium has two anatomical regions:
visceral serous pericardium on the heart itself and parietal serous pericardium which forms the inner surface of the wall of the pericardial sac.
fibrous pericardium is tough, indistensible outer portion of the pericardium that fuses with the .. of the great arteries and veins …. cm above the heart
adventitia, 2-4
serous pericardium is a … sac that covers the heart as the visceral layer or the … and on the inner surface of the fibrous pericardium as the … layer.
closed, epicardium, parietal
outer surface of the fibrous pericardium …with the fibrous portions of the diaphragm inferiorly. With each contraction of the diaphragm, the heart is pulled ….
fuses, inferiorly
pericardial cavity is a space normally filled with … ml of lubricating fluid.
15-50 or ~20
pericardial fluid is though to be produced by the … and is essentially an ultrafiltrate of plasma.
visceral pericardium
transverse pericardial sinus is a …. between the right and left sides of the ….cavity.
passageway, pericardial
oblique pericardial sinus is a blind …. dorsal to the ….atrium formed by pericardial reflections surrounding the pulmonary veins and superior and inferior vena cava
pocket, left
oblique pericardial sinus is the most ….portion of the pericardial sac laying supine.
dependent (lowest)
cardiac tamponade
compression of the heart due to rapid accumulation of fluid in the pericardial sac.
Indications of cardiac tamponade
jugular venous distention, distant heart sounds, hypotension with dyspnea
The internal jugular and brachiocephalic veins have …. but the external jugular does not.
valves
pain often worsens in pericarditis when …
laying down
pericardial friction rub
highly specific for acute pericarditis
most of the blood to and from the pericardium comes through the …
pericardiophrenic artery and vein
innervation of the pericardium is via the
phrenic nerve (C3,4,5)
male hearts pump …gm and women …. gm
325, 275
S2 dub sound is produced by …
closing of aortic and pulmonary valves
S1 lub sound is produced by…
closing of the AV valave
base of the heart is ….
posterior aspect formed by left atrium along with a narrow portion of right atrium
apex of the heart is…
blunt descending projection formed by left ventricle
diaphragmatic surface of the heart is..
formed largely by left ventricle along with narrow portion of right ventricle
sternocostal surface of the heart..
composed largely of right atrium and right ventricles along with narrow portion of left ventricle
obtuse margin or left margin of the heart
formed by left ventricle and a little bit of left auricle
acute margin of the heart or inferior border
narrowed inferior boreder where sternocostal and diaphragmatic surfaces meet and is formed largely by right ventricle
right margin formed by…
superior vena cava and right atrium
coronary sulcus separates
atria from ventricles
fibrous skeleton of the heart…
surrounds heart valves
fibrous skeleton has clinical significance only if it becomes …meaning…
stretched; heart valves failed
right atrium volume
75-80 ml
walls are …in right atrium than left
thicker
sinus venarum is in … and is a smooth region derived from incorporation of …of sinus venosus.
right atrium; right horn
auricle more common name; corresponds to primitive…of embryonic heart and contains… muscles
R. atrial appendage; atrium; pectinate
pectinate muscles
ridges of myocardium; only in atria
crista terminalis is the junction of …vs…of the sinus venarum; superior end marks the location of…
pectinate muscles vs smooth interior; SA node
fossa ovalis marks the site of the embryonic …through which blood passes from right atrium to left after birth.
foramen ovale
opening of coronary sinus
site of venous blood return that has passed through the cardiac muscle
valve of inferior vena cava: in embryonic heart, it directs blood from …through … into ….
inferior vena cava through foramen ovale and into left atrium
superior vena cava is a large superior opening in the … that brings …oxygenated blood from the head and upper limbs
sinus venarum that brings poorly oxygenated blood from the head and upper limbs
inferior vena cava is a large inferior opening in the … that brings …oxygenated blood from the …and …
sinus venarum that brings poorly oxygenated blood from the abdomen and lower limb
right AV orifice is the site of blood flow out of the …atrium and into the …ventricle
right, right
right ventricle has a wall that is … think and holds …ml
4-8mm; 120ml
cusps of the tricuspid valve
anterior, posterior and septal cusps of the AV valve
trabeculae carneae are …muscular elevations on the …
irregular; inner wall of the ventricle
papillary muscles are … ,…and … in right ventricle
anterior (largest), posterior (smaller) and septal (smallest)
chordae tendineae
fibrous strands connecting papillary muscles to cusps of AV valves
septomarginal trabecula aka…
moderator band
conus arteriosus aka…is a smooth-walled …tract to the pulmonary trunk and is separated from ventricle by …
infundibulum; outflow; supraventricular crest
pulmonary valve allows blood to exit…
right ventricle and into pulmonary trucnk past the 3 semilunar cusps
left atrium holds … ml and is the …chamber…..to esophagus
55-65; posterior; anterior
pulmonary veins have …right and …left… and they carry ….blood to left atrium.
2,2,oxygenated
smooth-walled part is derived from incorporation of ….veins
pulmonary
fossa ovale
a slight depression in the interatrial wall
rough-walled part
derived from embryonic atrium and contains pectinate muscles
left atrial appendage or auricle is often …in patients with A-fib due to clots
closed
AV orifice is where
blood exits into the left ventricle through the mitral valve
left ventricle holds …. ml
125
wall of left ventricle is …to…times thicker than right
2-3
mitral valve cusps have … and … cusps of the AV valve
anterior and posterior
trabeculae carneae are
irregular muscular elevations on the inner wall of the ventricle
papillary muscles
only anterior and posterior
chordae tendineae
fibrous strands connecting papillary muscles to each cusp of the mitral valve
aortic valve allows blood to exit …ventricle past the …semilunar cusps of the aortic valve leading to the ….
left; 3; ascending aorta
function of papillary muscles and chordae tendineae attached to the AV valve cusps is to …
contract during ventricular systole and prevent blood from regurgitating back into the atrial chambers.
papillary muscles may occasionally…which is due to…
rupture; heart attack complication
if one of the papillary muscles in the left ventricle ruptures, then the …. becomes incompetent and cardiac output is diminished thus fluid accumulates in the lung necessitating sleeping on … due to pulmonary edema.
mitral valve; multiple pillows
What causes left ventricular hypertrophy?
chronic hypertension and aortic valve stenosis
….can cause blood regurgitation
aortic valve insufficiency
tricuspid valve contains…
anterior, posterior and septal cusps
tricuspid valve allows…
blood to flow from right atrium to right ventricle during diastole
tricuspid valve closes at the…
beginning of systole which is the S1 sound
mitral valve contains…
anterior and posterior cusps
mitral valve prolapse is when the valve …into the left atrium when left ventricle contracts.
everts
pulmonary valve has …,…and,,, cusps and sinuses. part of …sound
right, left, anterior semilunar; S2
aortic valve has…, … and …semilunar cusps and sinuses
right, left and posterior
right and left coronary arteries open into ….and ….aortic sinuses
right and left
aorta ends up slightly ….and has a …cusp
posterior
pulmonary trunk ends up …and has an …cusp
anterior
Both aortic and pulmonic valves have …and … cusps
left and right
First sounds (…) coincides with the closure of the…. valve at the start of systole.
S1 (lub); AV
second sound (…) is produced by the closure of the … and …. valves at the end of systole.
S2 (dub); aortic and pulmonary
blood flow into the coronary arteries is greatest during…
diastole
the blood flow into coronary arteries optimizes blood flow when cardiac tissue is…
most capable of receiving blood
aortic sinus is the ….space above each valve cusp.
blood filled
most common congenital heart anomaly
bicuspid aortic valve
bicuspid valve is more likely to cause ….than a normal tricuspid aortic valve.
aortic valve stenosis
stenosis of the aortic valve often causes …which long term can cause …..
excessive turbulence; ascending aortic aneurysmal
right coronary artery’s origin
right aortic sinus
blood distribution from right coronary artery?
right atrium, SA and AV node, posterior portion of IV septum
artery to sinoatrial node’s origin
right coronary artery
distribution of blood from artery to sinoatrial node?
SA node and pulmonary trunk
right marginal (acute marginal artery) origin
right coronary artery
right marginal or acute marginal artery’s distribution of blood?
right ventricle and apex
posterior intervetnricular or posterior descending artery origin
right coronary artery
poster interventricular artery’s distribution of blood?
right and left ventricles and IV septum
AV node origin
right coronary artery 80% of the time
AV node distribution of blood
AV node
left coronary artery origin
left aortic sinus
left coronary artery distribution of blood
left atrium and ventricle, IV septum, AV bundle and AV node (20% of the time)
artery to SA node (40% of pop) origin
left coronary artery
Artery to SA node’s distribution of blood?
SA node and left atrium
anterior interventricular artery origin
left coronary artery
anterior interventricular artery distribution of blood
right and left ventricles and IV septum
LAD or lateral diagonal branch origin
off LAD
LAD distribution of blood
left ventricle on the anterior surface
circumflex artery origin
left coronary artery
circumflex distribution of blood?
left atrium and ventricle
left marginal or obtuse marginal origin
left circumflex
left marginal distribution of blood
left border of left ventricle
right coronary artery supplies
right atrium, most of right ventricle, diaphragmatic surface of left ventricle, posterior 1/3 of AV septum, SA node in 60% of people and AV node in 80% of people.
left coronary artery supplies
left atrium, most of left ventricle, anterior 2/3 of AV septum, SA node in 40% of people and AV node in 20% of people.
variations in arterial supply is all about which coronary artery supplies blood to the ….
posterior interventricular artery
right dominant distribution is…
70% of people and most common. It is posterior interventricular artery arising from the right coronary artery
left dominant distribution is…
10% of people and is present when circumflex branch of left coronary gives off the posterior interventricular artery
balanced distribution is…
20% of people and occurs when both right and left coronary arteries supply the posterior interventricular artery.
most common sites of blockage in coronary arteries
left anterior descending, base of right coronary, left circumflex branch
in coronary artery bypass surgery the distal end of the … artery is attached to the existing coronary artery …to the blockage.
internal thoracic or mammary; distal (down stream)
often the initial artery used is not long enough so they take …artery from the arm and the …. vein from the leg.
radial, great saphenous
most of the blood passed through the coronary arteries and then the myocardium returns to the venous circulatory system at the right atrium through either the …. or by a pair of small …..
coronary sinus (most blood); anterior cardiac veins
most of the blood from coronary circulation returns to … through either the …. or by a small pair of anterior cardiac veins.
right atrium; coronary sinus
coronary sinus is a direction continuation of the ….vein. It lies in … part of coronary sulcus and opens into ….; it receives all cardiac veins except the ..and ….
great cardiac vein; posterior; right atrium; anterior cardiac veins; smallest cardiac veins
great cardiac vein lies beside ….artery.
anterior interventricular
middle cardiac vein lies alongside ….artery.
posterior interventricular
SA node lies in the …. at the superior end of the … near the superior vena cava.
right atrial wall; sulcus terminalis
SA node possesses inherent rhythmicity, but rate of contraction increases when directly stimulated by … nerves and decreases when stimulated by … nerves.
sympathetic cardiac nerves; parasympathetic cardiac nerves
pacemakers can be a substitute of …
SA, AV or atrioventricular bundle
when putting in a cardiac pacemaker, typically the … vein is catheterized which leads to the ….vein which drains into the …vein which drains into the superior vena cava and thus into the …
cephalic, subclavian, brachiocephalic, right atrium
sympathetic innervation are the sensory input of …
pain from ischemic heart conditions
which nerve innervates the heart
vagus
sympathetic nerves that innervate the heart have their cell bodies in sympathetic chain ganglia from … to …
C4-T5
afferent innervation to the heart returns to the CNS with sympathetic nerves accounts for referred pain from heart to upper thoracic wall and medial side of ….; pain may also be referred to … or …. because of hearts early development in cardiogenic and neck regions.
left upper extremity; neck or right upper extremity
first sign of heart attack in males and females
chest
second sign in females which is different in males
nausea, light headedness and unusually tired
visceral afferent run with … nerves not the vagus (parasympathetic) nerves
sympathetic
