Lufti Review Flashcards
Left coronary artery gives off…
Circumflex and left marginal artery
Anterior interventricular artery (aka LAD)
Right coronary artery gives off…
Right atrial branch
Conal branch
Right marginal branch
Posterior interventricular artery (aka PAD)
The right coronary artery supplies…
AV and SA nodes
Posterior/Inferior 1/3 of septum
Right marginal artery, which supplies RV
Posterior interventricular artery, 1/3 RV and 2/3 LV
Left coronary artery supplies…
LAD- LV, RV, and 2/3 of septum
AV bundle
Circumflex artery - LA and LV
Marginal artery - LV
Where do the branches of the left and right coronary arteries anastomoses?
- Nodal anastomoses
- About the conus arteriosus
- Circumflex
- anterior interventricular septum
- posterior interventricular septum
Where is the SA node located?
Superior to the cristae terminalis
At the junction of the anteromedial aspect of the SVC and the right auricle
Subepicardial
What supplies the blood to the SA node?
A branch of the Right coronary artery
Describe the AV node and it’s location.
Smaller smaller collection of nodal tissue located in the interatrial septum, on the ventricular side of the orifice of the coronary sinus.
Submyocardial
What supplies the blood to the AV node?
A Branch of the Right coronary artery
The Atrioventricular bundle of His travels what path and is supplied by what artery?
Travels from AV node into septal wall of RA; to upper membranous part of the ventricular septum where it divides.
Right branch goes to RV by passing through the septomarginal trabecula. Left branch goes to LV.
The bundle of His is supplied by the LAD.
Describe the conducting system of the heart
Consists of specialized cardiac muscle cells and conducting fibers (NOT nervous tissue).
Compartments are specialized for initiating impulses and conducting them rapidly through the heart.
Initiate the normal heart beat and coordinate the contractions of the four chambers- Atria contracting at the same time,as do the ventricles, but atria contract before ventricles.
What contributes to the Falx Inguinalis (conjoint tendon) and where does it insert to?
IOM (interior oblique muscle) and transverse abdominalis m.
Inserts onto the pubic symphysis
What makes up the EOM aponeurosis?
Inguinal ligament (Poupart's ligament) Lacunar ligament (Gubernat's ligament) Pectinal Liament (Cooper's ligament) Superficial Inguinal ring External spermatic fascia
I love pretty sexy Emma.
The upper 2/3 of the rectus sheath (btwn the costal margins and ASIS) is formed by…
- EOM aponeurosis is anterior to the rectus abdominis.
- IOM aponeurosis splits into the anterior layer going above the rectus abdominis and the posterior part going below
- Transversus abdominis is posterior to the posterior part of the IOM
What are the superficial vessels in the superficial fascia of the abdomen and where are they derived from?
Superficial epigastric arteries (from the femoral artery) and veins
The lower 1/3 of the rectus sheath (between the ASIS and the pubic symphysis) is formed by…
The aponeuroses of all three wall muscles form the anterior wall of the rectus sheath
The fascia transversalis forms the posterior wall of the rectus sheath.
What forms the posterior wall on the lower 1/3 of the rectus sheath?
Fascia transversalis
What are the boundaries of the the epiploic foramen?
Anteriorly: portal hepaticus (portal triad)
Posteriorly: IVC and the right crus of the diaphragm
Superiorly: caudate lobe of the liver
Inferiorly: superior part of the duodenum
The portal triad is contained within what?
Hepatoduodenal ligament of the lower ligament
What are the contents of the the portal triad and what are their relative locations?
Portal vein (posterior)
Proper hepatic artery (left)
Common bile duct (right)
What is a hernia?
An abnormal protrusion of tissue for a cavity in which it belongs
Inguinal hernias are more common in males or females?
Males
What are the two types of hernias?
Indirect Inguinal hernias (congenital)
Direct Inguinal hernias (acquired)
Describe indirect Inguinal hernias and the path they take.
Indirect Inguinal hernias take the indirect route through the abdominal wall. They leave the abdominal cavity LATERAL to the inferior epigastric vessels, traverse the deep Inguinal ring, Inguinal canal, and superficial Inguinal ring.
What is the most common type of Herniation? By what percentage?
Indirect Inguinal herniations are more common in 75% of cases
What are direct Inguinal herniations and what route do they take?
Direct Inguinal herniations protrude anteriorly through the posterior wall of the Inguinal canal and leave through the abdominal wall MEDIAL to the inferior epigastric vessels.
Direct herniations pass through the Inguinal triangle (Hesselbach’s triangle).
Where and what are the borders of the Hasselbach’s triangle?
The Hasselbach’s triangle is located posteriorly to the superficial Inguinal ring and is bounded by
Inferior: Inguinal ligament
Lateral: inferior epigastric vessels
Medial: lateral border of rectus abdominis muscle
Where is the gallbladder?
In a fossa on the visceral surface of the liver, in and between the right costal margin and the right linea semilunaris at the transpyloric plane (L1) in the RUQ.
What are the parts of the gallbladder? Which part becomes the cystic duct?
Fundus, body and neck (which becomes the cystic duct)
What is the blood supply of the gall bladder and bile duct?
Cystic artery ( via the right hepatic artery, which is from the common hepatic artery, which is from the celiac trunk )
What is the innervation of the gallbladder and the bile duct?
Vagus (parasympathetic)
Greater splanchnic nerve (sympathetic)
Where is the tricuspid valve? (With ICS space)
On the right, between the RA and the RV, behind the right half of the sternum opposite ICS 4.
Where is the bicuspid or mitral valve?
On the left, between the LA and LV, behind the left 1/2 of the sternum opposite costal cartilage 4
Where is the aortic semilunar valve?
Connects to the ascending aorta, left 1/2 of the sternum opposite ICS 3
Where is the pulmonary semilunar valve?
Connected to the pulmonary trunk, behind the medial end of the 3rd left costal cartilage.
The epiploic foramen connects what two spaces?
Lesser sac (lesser omental bursa) and greater sac
For auscultation, where would you hear the heart sounds of the aortic valve?
over the Right 2nd ICS
For auscultation, where would you hear the heart sounds of the pulmonary valve?
over the Left 2nd ICS
For auscultation where would you hear the secondary pulmonic heart sound?
over the left 3rd ICS.
For auscultation where would you hear sounds of the bicuspid valve?
Over the apex of the heart, 6-7 cm median from the plane, generally in the LEFT 5th ICS
For auscultation, where would you hear heart sounds of the tricuspid valve?
Over the left 1/2 of the lower end of the body of the sternum in the Left 4th ICS.
What does the SMA and its branches supply?
The SMA and its branches supply from the 2nd part of the duodenum to the left colic flexure.
What are the branches of the SMA and to what organs do they supply?
It’s branches are:
Jejunal and ilium branches - Jenjunum and ilum
Ileocolic A - ascending colon, cecum and appendix
Right colic A - right colic flexure
Middle colic A - transverse colon
What does the IMA supply?
From the left colic flexure to the rectum
What are the branches of the IMA and what organs do they supply?
Left colic A - left colic flexure
Descending branch of IMA - Descending colon
Sigmoidal A - Sigmoids
Superior rectal A. (aka. superior hemorrhoidal arter) as the terminal artery of the IMA. - Rectum