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BLOCK C - CIRCULATION > Internal Anatomy of the Heart > Flashcards

Internal Anatomy of the Heart Flashcards

1
Q

The right pump moves blood from the heart to…

The left heart moves blood from the heart to…

A

The right pump moves blood from the heart to the lungs for gas exchange (pulmonary circulation).

The left pump moves blood from the heart to all tissues of the body (systemic circulation).

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2
Q

Through what structures does deoxygenated blood enter the right atrium?

A
  • Superior or inferior vena cavae
  • Coronary sinus
  • Directly (anterior cardiac veins)
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3
Q

Of the following, which has/have a valve to prevent backflow?

a) inferior vena cava
b) superior vena cava
c) coronary sinus

A

a) Inferior vena cava
b) Coronary sinus

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4
Q

Describe the differences between the posterior and anterior/lateral walls of the right atrium.

A

The posterior atrial wall, where the blood vessels enter, is smooth.

The anterior/lateral atrial wall contains parallel folds of pectinate muscles that extend into the right auricle.

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5
Q

What is the function of pectinate muscle in the right atrium?

A

Pectinate muscle helps expand atrial volume while minimizing atrial wall stress.

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6
Q

What is the crista terminalis (CT)?

A

It is a muscular ridge in the right atrium of the heart that marks the boundary between the smooth wall and pectinate muscle of the atrium.

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7
Q

What is the name of the valve through which blood passes when moving from the right atrium and to the right ventricle?

A

Right atrioventricular valve (aka tricuspid valve)

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8
Q

What is the fossa ovalis and where is it located?

A

It a depression located in the right atrium on the smooth wall between the two atria.

It is a developmental remnant of the foramen ovale, an opening in the wall between the two atria of a fetal heart. Shortly after birth, the foramen ovale seals, leaving an impression in the atrial - the fossa ovalis.

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9
Q

In some cases, the foramen ovale fails to seal completely after birth. How frequently does this happen and what is this condition called?

A

The foramen ovale will fail to seal completely in ~25% of people.
Instead, it forms a patent foramen ovale.

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10
Q

Why is there a fossa ovale between the atria in a developing fetus?

A

In utero, fetal lungs and pulmonary circulation are “offline”. Instead, gas exchange occurs through the yolk sac and placenta.
Prenatal circulation includes shunts that allow it to bypass the pulmonary circulation.
The foramen ovale allows oxygenated blood from the inferior vena cava to bypass the right ventricle and go into the left atrium instead.

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11
Q

The right atrioventricular (tricuspid) valve has 3 cusps, linked by … to 3 sets of …

A

The right atrioventricular (tricuspid) valve has 3 cusps, linked by CHORDAE TENDINEAE to 3 sets of PAPILLARY MUSCLES.

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12
Q

Name the 3 papillary muscles in the right ventricle.

A

Anterior, posterior, septal

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13
Q

What is the function of the chordae tendinae and papillary muscles in the right ventricle?

A

They “hold on” to the cusps of the atrioventricular valve to prevent them from prolapsing into the right atrium during ventricular contraction (systole).

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14
Q

When the deoxygenated blood leaves the right ventricle to enter the pulmonary trunk, it passes through…

A

the pulmonary valve, aka right semilunar valve

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15
Q

What are trabeculae carnae?

A

They are muscular ridges on the inner walls of the right ventricle, that help the ventricle walls to pump deoxygenated blood into the pulmonary trunk.

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16
Q

How many pulmonary veins enter the left atrium?

A

4

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17
Q

What is the key difference between the auricles of the right and left atria?

A

The auricle of the left atrium has less pectinate muscle than the right auricle.

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18
Q

What is the key difference between the right and the left atrioventricular valves?

A

The left atrioventricular valve (i.e. bicuspid, mitral) only has 2 sets of cusps/chordae/papillary muscles (rather than 3).

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19
Q

What is the key difference between the right and left ventricular wall?

A

The left ventricular wall is much thicker than the right.

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20
Q

When oxygenated blood exits the left ventricle and enters the aorta, it passes through…

A

the aortic valve (left semilunar)

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21
Q

What is the ligamentum arteriosum and where is it located?

A

It is a bridge of ligamentous tissue between the aorta and pulmonary trunk located at the level of the sternal angle.

22
Q

Explain why we have a ligamentum arteriosum. What is the name of the structure it originates from?

A

It is a remnant of another shunt system in fetal development that also helps bypass pulmonary circulation (like the foramen ovale).

In the fetal heart, it forms a tunnel (ductus arteriosus) that connects the pulmonary trunk to the aorta (allows blood from right ventricle to bypass the pulmonary arteries).

23
Q

Name the anatomical remnants that the following pre-natal structures give rise to after birth:
* foramen ovale
* ductus arteriosus

A

Foramen ovale: Fossa ovalis

Ductus arteriosus: Ligamentum arteriosum

24
Q

Define the following:
a) Systole
b) Diastole

A

a) Systole: Left and right ventricles contract and pump blood out into the aorta and pulmonary trunk, respectively.

b) Diastole: Left and right ventricles relax and fill with blood entering from the atria.

25
Q

Which of the following phases is shorter?
a) systole
b) diastole

A

a) Systole is a shorter phase than diastole.

26
Q

Which valves are open and which valves are closed during systole?

A

During systole, the semilunar valves are open:
* aortic
* pulmonary

During systole, the atrioventricular valves are closed:
* bicuspid/mitral
* tricuspid

27
Q

Which valves are open and which are closed during diastole?

A

During diastole, atrioventricular valves are open:
* tricuspid
* bicuspid/mitral

During diastole, the semilunar valves are closed:
* aortic
* pulmonary

28
Q

During auscultation, what makes the audible sound that can be heard through the stethoscope?

A

When the valves snap shut, they make an audible sound that can be heard through the stethoscope during auscultation.

29
Q

What is the LUB-DUB sound?

A

First sound: LUB (S1)
* Caused by closure of atrioventricular valves
* Marks the start of systole

Second sound: DUB (S2)
* Caused by closure of semilunar valves
* Marks the end of systole and beginning of diastole

30
Q

Which is louder?
a) LUB
b) DUB

A

a) LUB (louder, longer, low-pitched)

31
Q

Where should you place your stethoscope to hear the left semilunar (aortic) valve? Which type of sound will you hear?

A

Right parasternal line
second intercostal space
DUB

32
Q

Where should you place your stethoscope to hear the right semilunar (pulmonary) valve? Which type of sound will you hear?

A

Left parasternal line
second intercostal space
DUB

33
Q

Where should you place your stethoscope to hear the right atrioventricular (tricuspid) valve?

A

Left parasternal line
Fifth intercostal space
LUB

34
Q

Where should you place your stethoscope to hear the left atrioventricular (bicuspid/mitral) valve?

A

Left midclavicular line
Fifth intercostal space
LUB

35
Q

Sympathetic control of the heart arises from…

A

sympathetic cardiac nerves arising from the cervical ganglia and sympathetic chain (T1-T4).

36
Q

Parasympathetic control of the heart arises from…

A

cardiac branches of the vagus nerve (cranial nerve X).

37
Q

How do parasympathetic and sympathetic efferent signals affect the heart?

A

Parasympathetic stimulation leads to decreased heart rate.

Sympathetic stimulation leads to increased heart rate.

38
Q

Sympathetic fibres in the heart arise from spinal cord levels T1-T4 and from cervical ganglia and form…

A

sympathetic cardiac nerves

39
Q

Parasympathetic fibres in the heart arise from the vagus nerve and form…

A

cardiac branches

40
Q

SNS and PSNS fibres in the heart mesh to form a…

A

cardiac plexus

41
Q

The cardiac plexus innervates… (3)

A
  • conduction system of the heart
  • coronary vasculature
  • myocardium (heart muscle walls)
42
Q

What is the location of the sinoatrial (SA) node?

A

Right behind the superior vena cava.

43
Q

What is the location of the atrioventricular (AV node)?

A

In the septum between the two atria, next to coronary sinus opening.

44
Q

What is the specific name of specialized fibres responsible for stimulating cardiac muscle?

A

Purkinje fibres

45
Q

What is the septomarginal (moderator) band in the heart?

A

It is a “bridge” across the inferior right ventricle that improves conduction of electrical impulses to the right anterior papillary muscle.

46
Q

What is the ‘natural’ pacemaker of the heart?

A

Sinoatrial (SA) node

47
Q

True or false: The ANS is both afferent and efferent.

A

False! The ANS is only efferent.

48
Q

How does sensory input from the heart travel back to the brain?

A

Via general visceral afferent fibres (GVA) that run alongside the ANS fibres.

49
Q

What can happen due to the fact that the general visceral afferent fibres of the heart and somatic afferent fibres share the same circuitry in the spinal cord?

A

Referred pain: Somatic and visceral signals get misinterpreted by the brain such that visceral pain is perceived as somatic pain from the same spinal dermatomes (T1-T4).

50
Q

At the onset of a myocardial infarct, what sort of pain might a person perceive?

A

Vague pain in the chest and left arm (due to the referred pain phenomenon).

BLOCK C - CIRCULATION (10 decks)

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