Lecture 6 - Heart Anatomy Flashcards
What splits the mediastinal compartment into superior mediastinal
The bottom of the bottom of the manubrium
What level is the bottom of the manubrium
T5
The transition point between the xiphoid process and body of the sternum is at what spinal level? What is the portion of the mediastinum below this level
T9; inferior
What nerve innervates the pericardium and what motor innervation does it have
Phrenic; diaphragm
During cardiac tamponade what A is leaking
Pericardiophrenic A fills the pericardium
What are the symptoms of cardiac tamponade
Pressure collapses the venous return
- shock
- distension of v
- low arterial BP
- distant heart sounds
What is the treatment for cardiac tamponade
Pericardiosentesis; needle into apex area of pericardium
Where is the transverse sinus
Posterior to aorta and pulmonary artery and anterior to vena cava
Where is the oblique pericardial sinus
Space between the left and right pulmonary v; inferiorly opens into to pericardium
What are the pericardial layers
There is a outermost fibrous later inside that is a serous layer, on the outer surface of the heart is a serous layer
Where is the apex of the heart normally
5th intercostal
Where is the heart normally
It is slightly twisted causing it to primarily be on the left side
What is the atrioventricular groove
A groove that separates the 2 atrium from the 2 ventricles; also called the coronary groove
What separates the two ventricles
Anterior interventrical groove; there is also a posterior interventricular groove
What runs in the anterior interventricular groove
Left coronary A and great cardiac V
What runs in the posterior interventricular groove
Posterior interventricular A and middle cardiac V
What runs in the coronary groove
Coronary sinus, main vein draining heart
Where do the superior vena cava and aorta branch
Around the 1st rib
What is the LAD known as
Left anterior descending A or Anterior interventricular A
What A penetrates the heart
Atrioventricular nodal A
Pathology of the LAD can affect what structure of the heart
Bundle of His
What node is the pacemaker
SA node
What does the sinuatrial nodal A branch off of
Right coronary A
What is the most prominent A of the right coronary A
Right marginal A
What does the right marginal A terminate as
Posterior interventricular A
What does the left coronary A branch into
Circumflex A and LAD
A balanced heart happens in ____% of individuals
30
What is different in left dominant heart
Posterior branch comes off the circumflex A
Abnormal origin of the circumflex branch, where does it come off ofl?
Left circumflex comes off the R coronary A
What do the cardiac veins drain into
Coronary sinus
What veins drain straight into the RA
Anterior cardiac V
What is given for angina pectoralis
Nitroglycerin; this is chest pain
What is a thrombus? What is a embolism?
Blood clot; dislodged thrombus or plaque
What is the adult feature of the foramen ovale? What did it used to do
Fossa ovalis; connect RA to LA
Where is the tricuspid valve
Between RA and RV
What closes the valves of the heart
Papillary muscles pulling on chorda tendinae
What is the septal marginal trabeculae?
Regulatory band; RV structure that keeps the heart from overexpanding and carries bundle branches to the RV
Where is the mitral valve?
Also called bicupid valve; between LA and LV
What kind of CT is the cardiac skeleton
Dense irregular CT
What are the functions of the cardiac skeleton
- insulator between atrial and ventricular contractions
- holds valves in place
- origin and insertions for cardiac muscles
Where do the coronary arteries originate
Outside the left semilunar valve; they fill during diastole
Where is the best site to listen to the aortic semilunar valve
R 2nd intercostal
Where is the best place to listen to the pulmonary semilunar
L 2nd intercostal space
Where is the best place to listen to the mitral valve
L 5th intercostal space, mid-clavicle
Where is the best place to listen to the tricuspid valve
R 5th intercostal space, mid-clavicle
What coronary A block would affect the AV node
R
What is the cause of fibrillation
Ischemia causes extracellular K
Sympathetic preganglion cells are found where
Paravertebral
Cardiac innervation for sympathetic is from where
T1-T4/5
What postganglionic neurons are innervating the heart
Superior cervical ganglia, and middle/inferior ganglia, and thoracic ganglia
What are the parasympathetic fibers for the heart
Preganglionic fibers from vagus; superior/inferior cervical and thoracic and recurrent branches
Where does metabolic pain from the heart get referred to and from what
T1-4
If the sympathetics are cut to the heart, as they are in a CABG, what are some side effects
Heart takes longer to respond
