L2: CVS imaging and Anatomy

Question 1

Describe the structure of the heart?

Answer 1

Right atrium and ventricle
Left atrium and ventricle
Superior and Inferior vena cava (de-O2 blood)
Pulmonary trunk/ artery (deO2 blood)
Pulmonary veins (O2 blood)
Aorta (O2 blood)

Question 2

How does the aorta branch?

Answer 2

Ascending--> out LV
Arch of aorta --> brachiocephalic (Right subclavian and common cortoid)
--> Left common carotid (middle)
--> Left Subclavian 
Descending aorta

Question 3

What type of imaging of the heart can be done?

Answer 3

X-rays 
CT
MRI (CMR)
Ultrasound
Nuclear medicine

Question 4

What does contrast enhanced angiography allow?

Answer 4

Vasculature to be more easily visible

Question 5

What is the structure of veins?

Answer 5

Tunica externa (connective tissue)
Smooth muscle and elastic fibres (tunica media) –> thin
Endothelium (tunica intima)
Valves –> unidirection flow, low pressure
Muscular pummping –> blood return to heart

Question 6

What is the structure of arteries?

Answer 6

Tunica externa/adventitia (connective tissue)
Smooth muscle and elastic fibres (tunica media) –> thick
–> elastic– expansion and recoil
Endothelium (tunica intima)

Question 7

What is cardiac output? What is normal?

Answer 7

Amount of blood ejected from the heart per minute
CO= SV X HR
Normally= 5L/ min

Question 8

What is the average HR?

Answer 8

60-90 beat per minute

Question 9

What is stroke volume? What is normal?

Answer 9

Amount of blood ejected from the heart each beat.

55-83ml/beat

Question 10

How does HR, SV and CO change during exercise?

Answer 10

CO= 20-35 L/min
HR= 150-200bmp
SV up to 200ml/beat

Question 11

Describe the layers of heart wall?

Answer 11

Paritel pericardium–>outer serous layer
Pericardial cavity–> filled with pericardial fluid, excess compresses on the heart
Epicardium–> Serous membrane outer surface (visceral pericardium -inner serous layer)
Epicardial fat
Myocardium–> muscle layer
Endocardium–> Smooth inner surface
Pectinate muscle –> ridges in auricles and right atrial wall
Trabecular carnae –> muscle ridge and columns–> ventricles

Question 12

What is the sac surrounding the heart called?

Answer 12

Pericardium

Question 13

What can imaging be used for?

Answer 13

Structure of heart and vasculature
Detect disease
Abnormalities

Question 14

What are the names of the valves in the heart?

Answer 14

Aortic –>3 cusps–> LV and aorta
Pulmonary–> 3 cusps–> RV and Pulmonary trunk
Tricuspid –> 3 cusps –> RA and RV
Mitral (bicuspid) –> 2 cusps –> LA and LV

Question 15

What is a tranoesophogeal echocardiography?

Answer 15

Ultrasound
View heart and vasculature
Invasive- camera down oesophagus
Image heart from inside the body

Question 16

What are the coronary arteries?

Answer 16

Supply the heart
Directly off aorta
Left --> Circumflex and Left anterior descending 
Right--> marginal artery 
Posterior interventricular artery 
--> 85% right dominant --> RCA branch 
--> 8% left dominant --> LCA branch 
--> Remainder co-dominant

Question 17

Where do the veins drain into?

Answer 17

Coronary sinus–> RA

Question 18

What is the difference between large, medium and small sized arteries?

Answer 18

Large arteries–> elastic–> allowing them to expand–> aorta and branches
Medium sized–> distributing arteries, muscular
Small arteries–> arterioles, resistance vessels, control blood pressure

Question 19

What does the endothelial layer do?

Answer 19

Secretes hormones

Stops RBC sticking