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Anatomy (MPAS) > Lecture 15: Anatomy of the Great Vessels > Flashcards

Lecture 15: Anatomy of the Great Vessels Flashcards

1
Q

Parts of the mediastinum

A

Superior

Inferior (middle, posterior, anterior)

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2
Q

Borders of the mediastinum

A

Top: Neck, arm

Left: left lung

Right: right lung

Bottom: Abdomen

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3
Q

Heart orientation and surfaces

A

Ressembles a pyramid that has fallen over

Base (posterior)

Anterior surface

Left pulmonary surface

Diaphragmatic surface (inferior)

Right pulmonary surface

See figure

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4
Q

What is most visible on the anterior side of the heart? Posterior?

A

Anterior: right ventricle

Posterior base: left atrium, part of right atrium

Inferior: left ventricle and part of right ventricle

See figure

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5
Q

What are the great vessels?

A

Aorta: aortic arch, ascending aorta, descending aorta

Pulmonary trunk: right pulmonary artery, left pulmonary artery

Pulmonary veins: two veins from each lung

Vena cavae: Superior vena cava (SVC) and inferior vena cava (IVC)

See figures

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6
Q

What is the ligamentum arteriosum?

A

Shunts blood from pulmonary artery to aortic arch

See figure

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7
Q

Where does the heart connect to the lungs?

A

At the hilum of each lung

1 pulmonary artery enters each lung

2 pulmonary veins leave the lung

See figure

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8
Q

Layers of the pericardium

A

Superficial fibrous pericardium

Two layer serous pericardium

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9
Q

Two layers of the serous pericardium

A

Parietal layer: attached to fibrous pericardium

Visceral layer (epicardium): lines the surface of the heart

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10
Q

What do the serous pericardium layers form? What fluid do they contain?

A

the pericardial cavity

Contains a thin fluid film (serous fluid)

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11
Q

Role of serous fluid

A

Allows heart to move inside pericardium without friction

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12
Q

What is the pericardial sac attached to inferiorly?

A

The diaphragm

Moves with respiration

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13
Q

How are the pericardial sinuses formed?

A

Lines of reflection between the visceral and parietal pericardium

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14
Q

Where is the transverse pericardial sinus?

A

Lies anterior to the superior vena cava and posterior to the ascending aorta and pulmonary trunk

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15
Q

Where is the oblique pericardial sinus?

A

Lies posterior to the heart in the pericardial sac

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16
Q

What are the four chambers of the heart?

A

Right atrium

Right ventricle

Left atrium

Left ventricle

See figures

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17
Q

What is the sinus venarum?

A

In the right atrium of the heart

The smooth, thin-walled posterior part of the atrium on which the SVC, the IVC and the coronary sinus open

Allows blood flow

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18
Q

What are the pectinate muscles?

A

A rough muscular wall of the right atrium

Present in the auricles and part of the atrial wall

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19
Q

What is the role of the right auricle?

A

Small muscular pouch that projects from the right atrium

Increases capacity of right atrium

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20
Q

What is the interatrial septum? What does it contain?

A

Separates the two atria

Has an oval depression called the oval fossa, which is a remnant of the oval foramen and its valve in the fetus

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21
Q

What is the conus arteriosus?

A

The superior tapered portion of the right ventricle

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22
Q

What are the trabeculae carnae?

A

Right ventricle

Irregular muscle elevations

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23
Q

What is the supra ventricular crest?

A

A thick muscular ridge

Separates the ridged muscular wall of the inflow part of the chamber from the smooth wall of the conus arteriosus (outflow part)

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24
Q

What are the different parts of the papillary muscles in the right atrium?

A

Anterior

Posterior

Septal

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25
Q

Where do the chordae tendinae attach?

A

Papillary muscles

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26
Q

What is the role of the papillary muscles and the chordae tendinae?

A

The papillary muscles begin to contract before the contraction of the ventricles, which tightens the cords and draws the cusps together

This prevents the cusps from collapsing as blood is pumped into the semilunar valves

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27
Q

What is the septomarginal trabeculae? Function?

A

Aka Moderator band

Right ventricle

Curved muscular band that runs from the inferior IV septum to the base of the anterior papillary muscle

Carries part of the right bundle branches of the AV bundle of the conducting system to the anterior papillary muscle

Facilitates conduction time and allows coordinated contraction

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28
Q

What valves are in the right ventricle?

A

Tricuspid valve

Pulmonary valve

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29
Q

How many cusps does the tricuspid valve have?

A

Three.

Anterior, posterior and septal

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30
Q

How many cusps does the pulmonary valve have?

A

Three

Anterior, right and left

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31
Q

Where is the bicuspid valve? How many cusps?

A

aka mitral

Between the left atrium and the left ventricle

2 cusps

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32
Q

How many pulmonary veins enter the left atrium?

A

Four

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33
Q

Thickness of left ventricle vs right ventricle

A

Left ventricle is much thicker

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34
Q

How many papillary muscles are in the left ventricle?

A

Two: anterior and posterior

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35
Q

Trabeculae carnae of the left ventricle vs right ventricle

A

The left side are finer and more numerous than those in the right ventricle

36
Q

General function of the atria

A

Receiving chambers of the heart

37
Q

Where does blood enter the right atrium?

A

Deoxygenated blood enters from the superior and inferior vena cava and the coronary sinus

38
Q

Where does blood enter the left atrium?

A

Oxygenated blood enters the left atrium from the pulmonary veins

39
Q

General function of the ventricles

A

Discharge chambers

40
Q

What marks the ventricular walls?

A

Papillary muscles and trabeculae carnae

41
Q

What blood is pumped by the ventricles? Where is it pumped?

A

Right ventricle pumps deoxygenated blood into the pulmonary trunk

Left ventricle pumps oxygenated blood into the aorta

42
Q

What separates the ventricular volume from the atrial volume?

A

Atrioventricular valves (mitral and tricuspid)

43
Q

What separates ventricular volume from the great vessels of the outflow tract?

A

Semilunar valves (aortic and pulmonary)

44
Q

What do the valves of the heart ensure?

A

That blood flow in one direction

45
Q

What are valves of the heart composed of?

A

Connective tissue and endocardium (inner layer of heart)

46
Q

Where are the atrioventricular valves? What are their names?

A

Tricuspid and bicuspid (mitral)

Located between the atria and ventricles

Very tight when closed, don’t let blood through

47
Q

Where are the semilunar valves? What are their names?

A

Semilunar valves are between the ventricles and their corresponding artery

Regulate blood flow leaving the heart

Allow some regurgitation during ventricular contraction

48
Q

What supports the AV valves?

A

The chordae tendinae (fibrous cords)

Chordae tendinae are attached to papillary muscles (inferior surface of ventricles)

Prevents prolapse of the valve leaflets into the atria

See figure

49
Q

Parts of the semilunar valves

A

Sinus: formed by the attachment of the sides of each valve leaflet to the wall of the outflow vessel

Lunule: Thickening of the free superior edge of each leaflet

Nodule: thickest part of valve leaflet

See figure

50
Q

Blood flow in the heart

A

Blood with low oxygen enters the right atrium from the superior and inferior vena cava

It then flows into the right ventricle, where it is pumped through the pulmonary trunk to the lungs.

Blood becomes oxygenated in the lungs and then flows into the left atrium.

It then flows into the left ventricles and is pumped into the aorta

51
Q

What is the cardiac cycle?

A

Period of time that begins with contraction of atria and ends with ventricular relaxation

52
Q

What is systole? What is diastole

A

Period of contraction of the heart

Period of relaxation when chambers fill with heart

53
Q

Which parts of the heart undergo diastole and systole?

A

Both atria and ventricles

54
Q

5 phases of cardiac cycle

A

See table and figure

55
Q

Where does the heart get its own blood supply from?

A

The coronary arteries and veins

*there is a substantial variation in the branching and the distribution of the coronary arteries

See figures

56
Q

What is the first branch of the ascending aorta?

A

Coronary arteries

57
Q

Anterior coronary arteries

A

Right and left coronary arteries (RCA and LCA; in atrioventricular groove)

Marginal artery (MA)

Circumflex artery (CA)

Anterior inter ventricular (AIA; left anterior descending/LAD)

58
Q

Anterior coronary veins

A

Small cardiac (SCV)

Anterior cardiac (ACV)

Great cardiac (GCV)

59
Q

Posterior coronary arteries

A

Right coronary artery (RCA)

Posterior inter ventricular artery (PIA; found in inter ventricular groove)

60
Q

Posterior coronary veins

A

Great cardiac vein (GVC)

Posterior cardiac vein (PCV)

Coronary sinus (CS)

Middle cardiac vein (MCV)

61
Q

What collects the majority of the venous blood?

A

Coronary sinus

Opens into the right atrium

62
Q

What do the coronary arteries connect to?

A

They are terminated, so they do not connect to other arteries, only connected to one another

63
Q

What does the right coronary artery supply?

A

Right atrium

Most of right ventricle

Diaphragmatic surface of left ventricle

Posterior 1/3 of IVS

AV bundle

SA node (in 60% of cases)

AV node (in 80% of cases)

64
Q

What does the left coronary artery supply?

A

Left atrium

Most of the left ventricle

Part of the right ventricle

Anterior 2/3 of IVS

AV bundle

SA node (in 40% of cases)

65
Q

What are the pacemakers of the heart?

A

SA node (60 bpm)

AV node (40 bpm)

His bundle (20 bpm)

66
Q

Where is the His bundle located?

A

IV septum

67
Q

Components of the conduction system of the heart

A

SA node

Intraatrial bundles

AV node

AV bundle (bundle of His)

Right and left bundle branches

Septomarginal trabecular (moderator band)

Purkinje fibers

68
Q

What are the purkinje fibres?

A

Special conduction system to carry impulses to heart muscle

Synchronize contractions

69
Q

What are the components of the autonomic regulation of the heart?

A

Parasympathetics

Sympathetics

70
Q

Where do the parasympathetic innervations of the heart derive from? What do they travel with? Where of they enter?

A

Derive from brain stem

Travel with vagus nerve

Enter cardiac plexus

71
Q

Where do the sympathetic innervations of the heart derive from? Where do they synapse? How do they reach the heart?

A

Originate from T2-T4 of spinal cord

Synapse in cervical sympathetic ganglia

Reach heart via cardiac plexus

72
Q

What parts of the heart does sympathetic stimulation act on?

A

SA node

AV node

Ventricular myocardium

73
Q

Effect of SNS on heart?

A

Increase HR

Increase electrical conduction

Increase excitability and contractility of ventricular myocardium

74
Q

How do sympathetics act on the heart?

A

Neuronal control

Hormonal: epinephrin and norepinephrine

75
Q

What part of heart does PSNS act on?

A

SA node

AV node

No influence on ventricles

76
Q

Effect of PSNS on heart?

A

Decreases HR

Decreases electrical conduction and excitability

77
Q

How to count the ribs?

A

Find the jugular notch

Move down the sternum until ridge is felt (sternal angle between manubrium and body of sternum)

Costal cartilage of rib II articulates here

Identify rib II

Continue counting the ribs, moving in a downward and lateral direction

See figure

78
Q

Where does the upper limit of the heart reach?

A

As high as the third costal cartilage on the right side of the sternum

Second intercostal space on the left side of the sternum

79
Q

Location of left margin of heart

A

Descends laterally from the second intercostal space to the apex located hear the midclavicular line in the 5th ICS

80
Q

Location of the lower margin of the heart

A

Extends from the sternal end of the right 6th cartilage to the apex in the 5th ICS near the MCL

81
Q

Where is the aortic valve area?

A

2nd right ICS, right sternal border

See figure

82
Q

Where is the mitral valve area?

A

5th ICS, left MCL

83
Q

Where is the pulmonic valve area?

A

2nd left ICS, left sternal border

84
Q

Where is the tricuspid valve area?

A

4th left ICS, left MCL

85
Q

Where is the mitral valve area?

A

Apex of heart, 5th ICS, left MCL

86
Q

Which valves are involved in high pressure systems? Low pressure?

A

High pressure: aortic, mitral

Low pressure: pulmonary, tricuspid

Anatomy (MPAS) (22 decks)

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