Lecture 13: Heart Flashcards
Define pericardium
Fibroserous sac that encloses heart and great vessels
What are the outer and inner layers of the pericardium
Outer: Fibrous pericardium
Inner: serous
Fibrous pericardium is ________ CT
Dense CT
What fibrous pericardium is fused to the
Diaphragm
What is the function of the fibrous pericardium
Prevents heart from overfilling, restricts heart movement
What runs along side (and innervates) the pericardium?
Phrenic nerves
The serous pericardium is composed of…
Serous membrane that secretes an oily fluid
The serous pericardium parietal layer adheres to…
fibrous pericardium
The visceral layer of the serous pericardium…
Adheres to the heart wall (Epicardium)
What is the innervation of the fibrous and parietal layer of the serous pericardium?
Phrenic nerves
What is the innervation of the visceral layer of the serous pericardium?
ANS (coronary plexus)
Where is pain of the fibrous + parietal layer of serous pericardium felt?
Severe and localized
Where is pain of the visceral layer of serous pericardium felt?
Reffered pain
What is the blood supply to the fibrous and parental layer of serous pericardium?
Pericardiacophrenic vessels
What is the blood supply to the visceral layer of serous pericardium?
Coronary arteries.
What is cardiac tamponade?
Compression of heart due to excessive fluid in pericardial cavity
What are the causes of cardiac tamponade?
Severe pericarditis, rupture of heart wall or aorta, stab wound
In cardiac tamponade, the patient will have enlarged head and neck veins. Why?
Not as much blood coming back in the heart, so it gets backed up.
What is the objective of a pericardiocentesis?
To remove the fluid that is putting pressure on the heart.
What is the flow of blood through the heart
RA –> Tricuspid –> RV –> Pulmonary semilunar –> Lungs –> LA –> Bicuspid –> LV –> Aortic Semilunar –> aorta –> Body
Where does Deoxy blood enter the heart
RA from coronary sinus (from IVC, SVC)
How many cusps are found in the semilunar valves
3
What is the fibrous skeleton of the heart composed of?
Dense Fibrous CT
What does the fibrous skeleton of the heart consist of
4 annuli (rings) that surround heart valves
What are the 3 functions of the fibrous skeleton of the heart
- Place of attachment for myocardial fibers
- Place of attachment for cusps of valves - prevents valves from stretching
- Partially separate atria from venticles (allows electrical current to slow down)
Label the auscultation points.
A. Aortic Semilunar Valve
B. Tricuspid Valve
C. Pulmonary Semilunar Valve
D. Bicuspid Valve
List the 3 grooves found on the exterior of the heart
- Coronary sulcus
- Anterior interventricular
- Posterior interventricular
What do the coronary arteries do
Take oxygenated blood to heart wall tissues
Coronary arteries are functional end arteries. What does this mean?
If one vessel is occulded, the others CANNOT accommodate
What are the 3 cardiac veins
- Great cardiac v
- Middle cardiac v
- Small cardiac v
Where do you find the great cardiac v
anterior IV sulcus
Where do you find the middle cardiac v
posterior IV sulcus
Where do you find the small cardiac v
along right inferior margin
What is the function of the coronary sinus
Collects blood from all these major veins and delivers to RA
What is the innervation of the heart
Via ANS – coronary plexus
T/F: The ANS initiates the heartbeat
FALSE - the ANS does NOT initiate the heartbeat, rather it regulates the rate and force of heartbeat
What is the sympathetic portion of the coronary plexus?
T1-T4 (T5) segments of spinal cord
The sympathetic portion of the coronary plexus _______ HR
Increases
What is the parasympathetic portion of the coronary plexus?
Vagus Nerve (CN X)
Vagus nerve ________ HR
Decreases
Myocardial ischemia is…
Inadequate blood supply to part of the heart
Is myocardial ischemia temporary?
Yes
What is myocardial ischemia caused by?
Occlusion of coronary arteries
When does myocardial ischemia go away?
With a period of rest
What is angina pectoris?
Chest pain resulting from cardiac ischemia
What is a myocardial infarction?
Heart attack - Death of part of myocardium due to prolonged myocardial ischemia
T/F: Pain caused by a myocardial infarction will go away with rest.
FALSE - it will NOT go away
Where is myocardial ischemia/infarction pain felt?
T1-T5 dermatomes
(Left upper ext., left chest wall, sometimes R. side of chest/arm)
Where can referred pain also be felt?
Jaw (more common in females)
What is coronary bypass graft?
Rerouting of blood using artery or vein. Artery typically used: internal thoracic, vein: great saphenous
What is coronary angioplasty?
Stent (can have balloon that can be blown up to open up pathway)
