Internal anatomy of the heart Nov1 M3

Question 1

how muscle changes when heart contracts

Answer 1

twists a little

Question 2

lumen size of LV

Answer 2

very small

Question 3

heart on ultrasound what we can see

Answer 3

4 chambers of the heart + sometimes 5 if right orientation to get the aorta

Question 4

where RA receives blood from (3)

Answer 4

SVC, IVC, coronary sinus

Question 5

valves present upstream of RA

Answer 5

valve of IVC (IN EMBRYO. prevents back flow in IVC)

valve of coronary sinus

Question 6

name of muscles in RA + function

Answer 6

pectinate muscle. help eject blood towards ventricle

Question 7

muscle other than pectinate in the RA + its function

Answer 7

right auricle or appendage (push blood in RV too and stop it from pooling in the dead end where this muscle is located)

Question 8

embryologic remnant found in RA: 2 names

Answer 8

fossa ovalis (after birth)
foramen ovale (before birth)

Question 9

fossa ovalis composition and function of foramen ovale

Answer 9

is a membrane. previously RA to LA shunt

Question 10

cusps orientation in the tricuspid valve

Answer 10

one A, one P, one towards septum

Question 11

name of muscle in RV + special characteristic

Answer 11

trabeculae carnae. pushes blood with a torsion

Question 12

pulmonary valve cusps orientation

Answer 12

one A, one left, one right

Question 13

papillary muscles projection and attached to what

Answer 13

project to the lumen of the ventricle and attach to the cusps of the AV valves

Question 14

papillary muscles function

Answer 14

when ventricle contracts, contract too to keep AV valve from collapsing in atrium bc of the pressure

Question 15

how many papillary muscles in the LV and how they attach to mitral valve

Answer 15

2 but both attach to each cusp

Question 16

name of structure between papillary muscles and attachment to the cusp

Answer 16

chorda tendinae

Question 17

mitral valve cusps orientation

Answer 17

one A, one P

Question 18

aortic valve number + cusps orientation

Answer 18

3 valves. one cusp right, one left, one posterior

Question 19

only place where can listen to blood coming towards stethoscope

Answer 19

apex of the heart. at midclavic line at 5th intercostal space (hear blood through mitral valve)

Question 20

how to hear blood from tricuspid valve

Answer 20

5th intercostal space, just on the left of the sternum

Question 21

how to hear blood going in aortic valve

Answer 21

steth on 2nd intercost space just on right of the sternum

Question 22

how to hear blood going in pulmonary valve

Answer 22

steth on 2nd intercos space just to the left of the sternum

Question 23

something particular about aortic and pulm valves positionning

Answer 23

pulm valve is more to the left and to the top than the aortic valve

Question 24

where coronary arteries exit from aorta is located

Answer 24

just above aortic valve

Question 25

what aortic valve does at systole and why

Answer 25

open and lie against the opening of coronary arteries holes. prevents their damage bc of the high pressure and their small diameter (4 mm vs 3-4 cm in aorta)

Question 26

how aortic valve closes at diastole

Answer 26

backflow of blood from aorta to LV fills out each cusp and valve closes

Question 27

where nervous tissue is in the heart

Answer 27

imbedded inside the heart

Question 28

SA node location

Answer 28

at junction of SVC, IVC and rest of RA

Question 29

AV node location

Answer 29

on septal wall of right atrium, where it is close to the ventricle

Question 30

name of nervous fibers transmitting AP from SA to AV nodes

Answer 30

internodal bundles

Question 31

name of fiber right after AV node and location

Answer 31

Bundle of His. In ventricular septum

Question 32

only nervous tissue visible in the heart, location and origin

Answer 32

moderator (or septo-marginal) band. comes from bundle of His

Question 33

destination of moderator or septo-marginal band

Answer 33

reaches anterior papillary muscle of RIGHT ventricle

Question 34

why called moderator band

Answer 34

bc ensures specific pattern of contraction of papil muscle so it contracts at same time as ventricle

Question 35

SS input to the heart originates where

Answer 35

T2 to T4 spinal cord levels

Question 36

T2 to T4 input on what 3 ganglia before signal reaches the heart

Answer 36

• superior cervical sympathetic ganglion
• middle cervical ganglion
• inferior cervical ganglion

Question 37

Name of superior, middle and inferior ganglia projection to heart

Answer 37

cardiac nerves

Question 38

name of region where cardiac nerves project + location

Answer 38

cardiac plexus. at level of RA (near SA node)

Question 39

how does SS and PSS change HR specifically

Answer 39

increase or decrease frequency of depolarization at SA node

Question 40

PSS innervation to the heart: origin

Answer 40

medulla (or medulla oblongata)

Question 41

location wise, what’s the importance of the medulla oblongata

Answer 41

junction between the brain and the spinal cord

Question 42

nerve originating from medulla and going to the heart

Answer 42

vagus nerve

Question 43

what can bypass the effect of the SS and PSS

Answer 43

pacemaker, defibrilator

Question 44

pacemaker location and mechanism

Answer 44

under subclavian vein. penetrates there, travels in SVC, stimulates specific parts of the conducting system in the heart (SA, bundle of His, etc.)

Question 45

edema, high jugular pressure, leg swelling, ultrasound echo shows valve problem: which valve

Answer 45

tricuspid valve