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Human Structure - Block 2 > HS2-16 Heart > Flashcards

HS2-16 Heart Flashcards

1
Q

What are the four chambers of the heart?

A

right atrium

left atrium

right ventricle

left ventricle

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2
Q

What are the vessels travelling to the heart? (2)

A

superior/inferior venae cavae

pulmonary veins

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3
Q

What are the vessels travelling from the heart? (2)

A

aorta

pulmonary trunk (main pulmonary artery)

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4
Q

How does the main pulmonary artery branch?

A

branches into left and right pulmonary arteries

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5
Q

What are the four valves of the heart? Where are they located?

A

tricuspid valve = between right atrium and right ventricle

bicuspid valve = between left atrium and left ventricle

pulmonary valve = between right ventricle and pulmonary trunk

aortic valve = between left ventricle and aorta

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6
Q

Describe the pathway of circulation to the heart (the deoxygenated/venous system). (6)

A

inferior/superior venae cavae + coronary sinus → right atrium → right ventricle → pulmonary trunk → pulmonary arteries → lungs

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7
Q

Describe the pathway of oxygenated blood (the arterial system). (6)

A

lungs → pulmonary veins → left atrium → left ventricle → aorta → body

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8
Q

Draw a trapezoidal schematic of the heart, and identify each of the borders.

A
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9
Q

What is the apex of the heart?

A

junction of left and right ventricles

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10
Q

What is another name for the atrioventricular groove?

A

coronay sulcus

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11
Q

What is the function of the auricles of the heart?

A

increase capacity of atria

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12
Q

What heart structures are visible on a PA CXR? (5)

A

right atrium

aortic arch

main pulmonary artery

left auricle

left ventricle

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13
Q

What heart structures are visible on a lateral CXR?

A

right ventricle

left atrium

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14
Q

How can heart size be estimated on CXR? (@)

A

cardiothoracic ratio = transverse heart size/transverse thoracic diameter

normal cardiothoracic ratio is less than or equal to 0.5

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15
Q

Which type of CXR is not appropriate for calculating the cardiothoracic ratio?

A

AP view, since the heart is magnified in the AP view

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16
Q

What are the three layers of the pericardium?

A

fibrous

parietal serous

visceral serous

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17
Q

The fibrous layer of the pericardium is continuous with

A

the central tendon of the diaphragm

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18
Q

Order the three layers of the pericardium.

A

fibrous

parietal serous

visceral serous (adhered to heart)

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19
Q

Where is the pericardial cavity?

A

between the two serous layers (parietal serous and visceral serous)

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20
Q

The pericardial cavity contains

A

pericardial fluid

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21
Q

What are the two passages of the pericardial cavity?

A

transverse pericardial sinus

oblique pericardial sinus

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22
Q

Where is the transverse pericardial sinus located? (2)

A

anteriorly = between aorta and pulmonary trunk

posteriorly = between superior vena cava and pulmonary vein

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23
Q

Where is the oblique pericardial sinus located?

A

posterior to left atrium, bound by pulmonary veins

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24
Q

What is the blood supply to the pericardium?

A

pericardiacophrenic arteries

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25
Q

What is the innervation to the pericardium?

A

phrenic nerve

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26
Q

What is pericardial effusion?

A

fluid accumulating in the pericardial space

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27
Q

What are the appropriate radiographic imaging methods to visualize pericardial effusion? (3)

A

echocardiography

CT

MRI

[not CXR, because of heart enlargement]

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28
Q

What is the function of the fibrous skeleton of the heart?

A

functions as insulator between atria and ventricles

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29
Q

The fibrous skeleton of the heart provides attachment for (2)

A

myocardial fibers

structures of the valves

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30
Q

The fibrous skeleton of the heart forms what structures? (2)

A

forms 2 trigones to connect the rings around the orifices of the valves

forms membranous portion of interatrial and interventricular septa

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31
Q

What are the two regions of the right atrium?

A

rough region = true atrium

smooth region = sinus venarum

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32
Q

What are the contents of the rough region of the right atrium? (3)

A

pectinate muscles

crista terminalis

opening to right auricle

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33
Q

What are the contents of the smooth region of the right atrium? (3)

A

openings for superior/inferior venae cavae

opening for coronary sinus

fossa ovalis

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34
Q

What is the fossa ovalis?

A

remnant of fetal foramen ovale in the heart

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35
Q

Which valves are found in the right ventricle?

A

tricuspid valve, which controls opening b/w right atrium and right ventricle

pulmonary valve, which controls opening b/w right ventricle and pulmonary trunk

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36
Q

What is the function of the chordae tendinae?

A

connect papillary muscles to valve cusps

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37
Q

What is the septomarginal trabecula?

A

structure involved in impulse conduction that runs from interventricular wall to base of anterior papillary muscle

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38
Q

What is another name for the infundibulum?

A

conus arteriosus

39
Q

What are the contents of the left atrium? (3)

A

openings for 4 pulmonary veins (mostly smooth)

opening to left auricle (rough)

fossa ovalis

40
Q

What muscle is found in the left auricle of the heart?

A

pectinate muscles

41
Q

What valves are found in the left ventricle?

A

bicuspid valve (a.k.a. mitral valve), which controls opening b/w left atrium and ventricle

aortic valve, which controls opening b/w left ventricle and aorta

42
Q

What are the semilunar valves? (2)

A

pulmonary valve

aortic valve

43
Q

What are the contents of the right ventricle?

A

papillary muscles (anterior/posterior/septal)

moderator band a.k.a. septomarginal trabecula

conus arteriosus a.k.a. infundibulum

trabeculae carnae

44
Q

What is the function of the heart’s moderator band (the septomarginal trabecula)?

A

carries impulse to the anterior papillary muscle

45
Q

What is the ventricular analog of the pectinate muscles found in the heart atria?

A

trabeculae carnae

46
Q

What is the relationship between the moderator band and the papillary muscles?

A

moderator band allows simultaneous contraction of papillary muscles

47
Q

(T/F) The papillary muscles shut the heart valves.

A

False. They don’t shut the valves, but they do keep them shut.

48
Q

What are the contents of the left ventricle? (2)

A

papillary muscles (anterior, posterior) to keep mitral valve shut

trabeculae carnae

49
Q

Draw a diagram of the auscultation points. What is the associated mnemonic?

A

All Physicians Take Money

Aortic = 2nd intercostal space, right of sternum

Pulmonary = 2nd intercostal space, left of sternum

Tricuspid = 5th intercostal space, left of sternum

Mitral = 5th intercostal space, left mid-clavicular line

50
Q

Describe the attachment of the bicuspid and tricuspid valve cusps. (2)

A

bases of valve cusps attached to fibrous skeleton

free ends of valve cusps attached to papillary muscles, via chordae tendinae

51
Q

Describe the role of the papillary muscles in relation to the bicuspid and tricuspid valves.

A

papillary muscles contract at beginning of systole, drawing cusps together and preventing them from prolapsing into atrium

52
Q

Describe the shape of the semilunar valves.

A

concave

53
Q

Describe the shape and function of the semilunar valves during systole and diastole.

A

systole = cusps pressed against arterial wall

diastole = blood flows back in direction of ventricle but collect in concave cusps, so edges of cusps are pressed against each other

54
Q

What are the coronary arteries?

A

branches of ascending aorta that supply the myocardium

55
Q

Where does the right coronary artery run?

A

runs in coronary sulcus = atrioventricular groove

56
Q

What are the branches of the right coronary artery? (4)

A

posterior interventricular branch = posterior descending artery [clinical term]

marginal branch

branch to SA node

branch to AV node

57
Q

Where does the posterior descending artery run?

A

runs in posterior interventricular groove

58
Q

What are the branches of the left coronary artery? (2)

A

circumflex branch

anterior interventricular branch = left anterior descending artery (LAD) [clinical term]

59
Q

Where does the circumflex branch of the left coronary artery run?

A

atrioventricular groove

60
Q

Where does the anterior interventricular branch of the left coronary artery run?

A

anterior interventricular groove

61
Q

How can you distinguish between the left and right coronary arteries?

A

left coronary artery bifurcates into 2 branches near origin

62
Q

List the structures supplied by the right coronary artery. (5)

A

right atrium (via atriach branch)

most of right ventricle (via right marginal artery)

part of left ventricle

posterior part of interventricular septum (via posterior descending artery)

SA/AV nodes

63
Q

List the structures supplied by the left coronary artery. (4)

A

left atrium

most of left ventricle (circumflex branch)

part of right ventricle

anterior portion of IV septum (left anterior descending artery)

64
Q

The cardiac veins arise from

A

the myocardium

65
Q

The posterior interventricular artery anastomoses with

A

the left anterior descending artery

66
Q

At what point does the right coronary artery become the posterior interventricular artery?

A

in the posterior interventricular groove

67
Q

In what structure does the left circumflex artery run?

A

AV groove

68
Q

The left circumflex artery anastomoses with

A

the right coronary artery

69
Q

Where do the cardiac veins drain?

A

drain into coronary sinus, then right atrium

70
Q

The great cardiac vein runs with what vessel in what structure?

A

runs with left anterior descending artery in anterior interventricular groove

71
Q

The middle cardiac vein runs with what vessel in what structure?

A

posterior descending artery in posterior interventricular groove

72
Q

The small cardiac vein runs with what vessel in what structure?

A

runs with marginal branches from right anterior margin to atrioventricular groove

73
Q

The coronary sinus opens into

A

the right atrium

74
Q

The coronary sinus runs in what structure?

A

atrioventricular groove

75
Q

What are the four primary venous structures associated with the heart?

A

great cardiac vein

middle cardiac vein

small cardiac vein

coronary sinus

76
Q

What is the exception to the rule that all venous structures of the heart drain into the coronary sinus?

A

the anterior cardiac vein, which drains the right ventricle, crosses the right coronary artery to drain directly into the right atrium

77
Q

What is the mnemonic to remember how the cardiac veins run?

A

a great LAD was caught in the middle of PDA but escaped by a small margin

78
Q

Where is the SA node located?

A

wall of right atrium at superior end of crista terminalis

79
Q

What is the function of the SA node?

A

pacemaker that initiates impulse that spreads through atria and causes them to contract

80
Q

Where is the AV node located?

A

postero-inferior region of interatrial septum, superior to the opening of the coronary sinus

81
Q

What is the function of the AV node?

A

receives impulses from cardiac fibers of atria and distributes impulses to AV bundle

82
Q

What is another name for the AV bundle?

A

bundle of His

83
Q

Draw a diagram of the intrinsic innervation pathway of the heart.

A
84
Q

Sympathetic innervation of the heart comes from

A

the sympathetic trunks

85
Q

What is the function of sympathetic innervation to the heart? (3)

A

increases heart rate

increases force of contraction

dilates coronary arteries

86
Q

What is the function of parasympathetic innervation to the heart? (3)

A

decreases heart rate

decreases force of contraction

constricts coronary arteries

87
Q

Parasympathetic innervation of the heart comes from

A

the vagus nerve

88
Q

Describe how the visceral sensory fibers of the myocardium are related to the phenomenon of referred pain. (4)

A

visceral sensory fibers of myocardium activated by ischemia

fibers run with sympathetic fibers of cardiac plexus to spinal cord

fibers enter spinal cord at T1-T4/T5 and synapse at C3-T5

referred pain felt in dermatomes of C3-T5, most often on left side

89
Q

What is diastole?

A

relaxation and filling of ventricles with blood

90
Q

What is systole?

A

ventricular contraction and emptying of ventricular blood into aorta + pulmonary trunk

91
Q

List the events during diastole. (3)

A

pulmonary and aortic valves close

walls of ventricles relax

tricuspid and bicuspid valves open so blood flows into ventricles

92
Q

List the events during systole. (3)

A

walls of ventricles contract

tricuspid and bicuspid valves close

pulmonary and aortic valves open

93
Q

The contraction of the atria and ventricles is regulated by

A

the intrinsic impulse conduction system of the heart

Human Structure - Block 2 (22 decks)

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