Lecture 13: Heart

Question 1

Define pericardium

Answer 1

Fibroserous sac that encloses heart and great vessels

Question 2

What are the outer and inner layers of the pericardium

Answer 2

Outer: Fibrous pericardium
Inner: serous

Question 3

Fibrous pericardium is ________ CT

Answer 3

Dense CT

Question 4

What fibrous pericardium is fused to the

Answer 4

Diaphragm

Question 5

What is the function of the fibrous pericardium

Answer 5

Prevents heart from overfilling, restricts heart movement

Question 6

What runs along side (and innervates) the pericardium?

Answer 6

Phrenic nerves

Question 7

The serous pericardium is composed of…

Answer 7

Serous membrane that secretes an oily fluid

Question 8

The serous pericardium parietal layer adheres to…

Answer 8

fibrous pericardium

Question 9

The visceral layer of the serous pericardium…

Answer 9

Adheres to the heart wall (Epicardium)

Question 10

What is the innervation of the fibrous and parietal layer of the serous pericardium?

Answer 10

Phrenic nerves

Question 11

What is the innervation of the visceral layer of the serous pericardium?

Answer 11

ANS (coronary plexus)

Question 12

Where is pain of the fibrous + parietal layer of serous pericardium felt?

Answer 12

Severe and localized

Question 13

Where is pain of the visceral layer of serous pericardium felt?

Answer 13

Reffered pain

Question 14

What is the blood supply to the fibrous and parental layer of serous pericardium?

Answer 14

Pericardiacophrenic vessels

Question 15

What is the blood supply to the visceral layer of serous pericardium?

Answer 15

Coronary arteries.

Question 16

What is cardiac tamponade?

Answer 16

Compression of heart due to excessive fluid in pericardial cavity

Question 17

What are the causes of cardiac tamponade?

Answer 17

Severe pericarditis, rupture of heart wall or aorta, stab wound

Question 18

In cardiac tamponade, the patient will have enlarged head and neck veins. Why?

Answer 18

Not as much blood coming back in the heart, so it gets backed up.

Question 19

What is the objective of a pericardiocentesis?

Answer 19

To remove the fluid that is putting pressure on the heart.

Question 20

What is the flow of blood through the heart

Answer 20

RA –> Tricuspid –> RV –> Pulmonary semilunar –> Lungs –> LA –> Bicuspid –> LV –> Aortic Semilunar –> aorta –> Body

Question 21

Where does Deoxy blood enter the heart

Answer 21

RA from coronary sinus (from IVC, SVC)

Question 22

How many cusps are found in the semilunar valves

Answer 22

3

Question 23

What is the fibrous skeleton of the heart composed of?

Answer 23

Dense Fibrous CT

Question 24

What does the fibrous skeleton of the heart consist of

Answer 24

4 annuli (rings) that surround heart valves

Question 25

What are the 3 functions of the fibrous skeleton of the heart

Answer 25

1. Place of attachment for myocardial fibers
2. Place of attachment for cusps of valves - prevents valves from stretching
3. Partially separate atria from venticles (allows electrical current to slow down)

Question 26

Label the auscultation points.

Answer 26

A. Aortic Semilunar Valve
B. Tricuspid Valve
C. Pulmonary Semilunar Valve
D. Bicuspid Valve

Question 27

List the 3 grooves found on the exterior of the heart

Answer 27

1. Coronary sulcus
2. Anterior interventricular
3. Posterior interventricular

Question 28

What do the coronary arteries do

Answer 28

Take oxygenated blood to heart wall tissues

Question 29

Coronary arteries are functional end arteries. What does this mean?

Answer 29

If one vessel is occulded, the others CANNOT accommodate

Question 30

What are the 3 cardiac veins

Answer 30

1. Great cardiac v
2. Middle cardiac v
3. Small cardiac v

Question 31

Where do you find the great cardiac v

Answer 31

anterior IV sulcus

Question 32

Where do you find the middle cardiac v

Answer 32

posterior IV sulcus

Question 33

Where do you find the small cardiac v

Answer 33

along right inferior margin

Question 34

What is the function of the coronary sinus

Answer 34

Collects blood from all these major veins and delivers to RA

Question 35

What is the innervation of the heart

Answer 35

Via ANS – coronary plexus

Question 36

T/F: The ANS initiates the heartbeat

Answer 36

FALSE - the ANS does NOT initiate the heartbeat, rather it regulates the rate and force of heartbeat

Question 37

What is the sympathetic portion of the coronary plexus?

Answer 37

T1-T4 (T5) segments of spinal cord

Question 38

The sympathetic portion of the coronary plexus _______ HR

Answer 38

Increases

Question 39

What is the parasympathetic portion of the coronary plexus?

Answer 39

Vagus Nerve (CN X)

Question 40

Vagus nerve ________ HR

Answer 40

Decreases

Question 41

Myocardial ischemia is…

Answer 41

Inadequate blood supply to part of the heart

Question 42

Is myocardial ischemia temporary?

Answer 42

Yes

Question 43

What is myocardial ischemia caused by?

Answer 43

Occlusion of coronary arteries

Question 44

When does myocardial ischemia go away?

Answer 44

With a period of rest

Question 45

What is angina pectoris?

Answer 45

Chest pain resulting from cardiac ischemia

Question 46

What is a myocardial infarction?

Answer 46

Heart attack - Death of part of myocardium due to prolonged myocardial ischemia

Question 47

T/F: Pain caused by a myocardial infarction will go away with rest.

Answer 47

FALSE - it will NOT go away

Question 48

Where is myocardial ischemia/infarction pain felt?

Answer 48

T1-T5 dermatomes
(Left upper ext., left chest wall, sometimes R. side of chest/arm)

Question 49

Where can referred pain also be felt?

Answer 49

Jaw (more common in females)

Question 50

What is coronary bypass graft?

Answer 50

Rerouting of blood using artery or vein. Artery typically used: internal thoracic, vein: great saphenous

Question 51

What is coronary angioplasty?

Answer 51

Stent (can have balloon that can be blown up to open up pathway)