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Anatomy 2 > Nov 4 - Anatomy of the Heart and Great Vessels > Flashcards

Nov 4 - Anatomy of the Heart and Great Vessels Flashcards

1
Q

What is the heart?

A

Muscular, 4-chamber pump that propels blood throughout the systemic and pulmonary circulation

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2
Q

Where is the heart?

A

It is found within a pericardial sac in the middle mediastinum

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3
Q

What controls the heart?

A

It has it’s own pacemaker. Autonomic innervations (sympathetic and parasympathetic) modulate the heart’s actions

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4
Q

Describe how the heart is connected to the lungs?

A

In the hilum of each lung, one pulmonary artery enters the lung and two pulmonary veins leave the lung and enter the heart

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5
Q

Describe the position of the heart?

A

The apex of the heart, formed by the left ventricle, is shifted anteriorly left. All the valves, found at the base of the heart, are shifted obliquely (making it hard to listen)

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6
Q

Where is the base of the heart found?

A

Behind the sternum

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7
Q

Why does the heart move up and down?

A

The pericardium, or pericardial sac, is attached to the central tendon of the diaphragm

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8
Q

Name the layers of the pericardium from superficial to deep

A

The fibrous pericardium, the parietal layer of the serous pericardium, the pericardial cavity, the epicardium (visceral layer of the serous pericardium), the myocardium and the endocardium

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9
Q

Describe the fibrous pericardium

A

The outer layer of the pericardium. It is very tough and non elastic. It attaches to the diaphragm inferiorly

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10
Q

Describe the serous pericardium

A

Two layers: the parietal layer is attached to the fibrous pericardium and the visceral layer or epicardium lines the surface of the heart. The pericardial cavity contains fluid

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11
Q

What is the role of the pericardium?

A

It gives the heart room to move independently and reduces friction

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12
Q

Name the two recesses/sinuses

A

The oblique sinus, behind the heart and the transverse pericardial sinus

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13
Q

Describe the location of the transverse pericardial sinus

A

Posterior to the pulmonary trunk and the the ascending aorta. It separates the outgoing and incoming vessels of the heart (surgeon’s landmark)

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14
Q

What structure is posterior to the heart

A

The esophagus is found posterior to the heart

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15
Q

What attaches the aortic arch and the left pulmonary trunk?

A

The ligamentum arteriosum

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16
Q

What creates the brachiocephalic vein?

A

The junction of the right subclavian and the right internal jugular

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17
Q

Describe the positions of the main bronchi in the left and right hilum of the lung in relation to the pulmonary artery

A

The left main bronchus is inferior to the pulmonary artery and the right main bronchus is posterior to the pulmonary artery

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18
Q

How does the heart sit in the mediastinum

A

More on its posterior inferior surface against the diaphragm (often referred to as the diaphragmatic surface). The apex is to the left (the heart doesn’t stand on its apex)

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19
Q

Why can’t you see the right ventricle in a chest X-ray

A

Because it’s not border forming (anteriorly)

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20
Q

What separates the left and right ventricles?

A

The interventricular septum (IVS)

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21
Q

Which ventricle has a thicker myocardium? Why?

A

The left ventricle because it’s pumping blood into the systemic circulation (whereas the right ventricle pumps blood into the pulmonary circulation)

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22
Q

How is the myocardium arranged?

A

In a spiral way starting from the apex and then pushing the whole volume of blood upward

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23
Q

Name the contents of the ventricles

A

Trabeculae carneae, the papillary muscles, chordae tendinae, atrioventricular valves (AV valves), semilunar valves

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24
Q

What is trabeculae carneae?

A

It’s the rugged surface of the ventricles

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25
Q

What are papillary muscles? How many are in each ventricle?

A

They join with the chordae tendineae to anchor the tips/leaflets of the mitral and tricuspid valves (AV valves) to the ventricular wall. There are two in the left ventricle and three in the right

26
Q

How do papillary muscles function?

A

During atrial contraction of the heart, they are relaxed and the valve is open. During ventricular contraction, the papillary muscles pull the valves closed (active closure to ensure the blood doesn’t escape into the atrium

27
Q

What is found in the right ventricle that is not found in the left? What does it do?

A

The septomarginal trabecula aka moderator band. It carries part of the right AV bundle

28
Q

Describe the flow of blood out from and in to systemic circulation

A

Deoxygenated blood flows into the inferior and superior vena cava, then into the right atrium. The blood flows through the right atrioventricular valve into the right ventricle, which pumps it through the right semilunar valve into the pulmonary trunk. The blood flows through the pulmonary circulation to become oxygenated. Oxygenated blood flows back through the pulmonary veins into the left atrium. The blood flow through the left AV valve into the left ventricle. The left ventricle pumps the blood through the left semilunar valve into the ascending aorta and into the systemic circulation

29
Q

Name the four great vessels

A

The aorta (ascending, arch and descending)
The pulmonary trunk (left and right)
The pulmonary veins (2 left and 2 right)
The superior and inferior vena cava

30
Q

Describe the atria

A

The atria are the receiving chambers of the heart. Each atrium has a protruding auricle. Pectinate muscles are present in the auricles and the rest of the atrial wall is smooth similar to veins

31
Q

Describe the ventricles

A

The ventricles are the discharging chambers of the heart. Papillary muscles and trabeculae carneae muscles mark the walls of the ventricular walls

32
Q

What separates the ventricular volume from the atrial volume?

A

The atrioventricular valves (mitral (left) and tricuspid (right) valves)

33
Q

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

A

The semilunar valves (the aortic and pulmonary valves)

34
Q

What is ventricular diastole?

A

Relaxation of the heart. It’s when the heart refills with blood

35
Q

What is ventricular systole?

A

Contraction of the heart forcing the blood out

36
Q

Describe how the mitral valve opens and closes

A

It opens passively during diastole and closes actively by the contraction of papillary muscles

37
Q

Describe how the aortic valve opens and closes

A

It opens passively during systole and closes passively during diastole

38
Q

What is the role of the holes in the aortic valve?

A

They are the openings of the coronary blood vessels (coronary arteries)

39
Q

What is the role of coronary arteries?

A

They supply the heart muscle with blood so that the heart can get the nutrients during diastole, when the myocardium is relaxed

40
Q

What valves are involved in the high pressure system?

A

The aortic and the mitral valves

41
Q

What valves are involved in the low pressure system?

A

The pulmonary and the tricuspid valves

42
Q

What does auscultation mean?

A

Listening to the internal sounds of the body, using stethoscope

43
Q

Where do you place the stethoscope to listen to the aortic valve?

A

The right second intercostal space

44
Q

Where do you place the stethoscope to listen to the pulmonary valve?

A

The left second intercostal space

45
Q

Where do you place the stethoscope to listen to the mitral valve?

A

The left fifth intercostal space

46
Q

Where do you place the stethoscope to listen to the tricuspid valve?

A

The right fifth intercostal space

47
Q

Name all the arteries that supply the heart with blood (5)

A

The right and left coronary arteries (RCA and LCA)
The marginal artery (MA)
The circumflex artery (CA)
The anterior interventricular artery (AIA) aka left anterior descending artery (LAD)
The posterior interventricular artery (PIA)

48
Q

Name all the veins that supply the heart with blood (3)

A 
The small cardiac vein (SCV)
The anterior cardiac vein (ACV)
The great cardiac vein (GCV)
The posterior cardiac vein (PCV)
The coronary sinus (CS)
The middle cardiac vein (MCV)
49
Q

During what action is the heart perfused? Systole or diastole?

A

Diastole

50
Q

Describe the flow of venous blood in the coronary veins

A

All the coronary veins fuse with the coronary sinus, which empties into the right atrium

51
Q

What does the LCA typically supply?

A

The left atrium, most of the left ventricle, part of the right ventricle, the anterior 2/3 of IVS, AV bundle, and SA node (in 40% of cases)

52
Q

What does the RCA typically supply?

A

The right atrium, most of the right ventricle, diaphragmatic surface of the left ventricle, posterior 1/3 of the IVS, AV bundle, SA node (60% of cases), AV node (80% of cases)

53
Q

Describe the pacemakers of the heart

A

They are under the endocardium. Very small specialized cardiac muscle cells/cardiomyocytes.

54
Q

What is the SA node?

A

The sinoatrial node. Found in the right atrium. It is the node that usually initiates the electrical impulses that trigger cardiac contraction. It naturally discharges at about 60 beats/min

55
Q

What is the AV node

A

The atrioventricular node. Found between the atrium and the ventricle of the heart. Electrical impulse form the SA node activates the AV node. The AV node delays the impulse about 0.12 of a second to ensure the atria have emptied their load before the ventricle contract. The AV node discharges at about 40 beats/min

56
Q

What happens if the SA node fails?

A

The AV node picks up the work

57
Q

What is the His bundle?

A

Same thing as the AV bundle. They conduct electrical impulses from the AV node. They discharge at about 20 beats/min

58
Q

What are purkinje fibres?

A

Specialized cardiomyocytes. They are found in the inner ventricular walls of the heart, just beneath the endocardium. They conduct cardiac action potentials to contract synchronously the walls of the ventricles. They are important for maintaining heart rhythm

59
Q

Describe the autonomic regulation of the heart

A

Parasympathetics from the brain stem travel with the vagus nerve to enter the cardiac plexus. Sympathetics from T2-T4 synapse in the cervical sympathetic ganglia and reach the heart via the cardiac plexus

60
Q

How does sympathetic regulation affect the heart?

A

Sympathetic stimulation acts on the SA and AV nodes, and on the ventricular myocardium. It increases the heart rate (chronotropic), electrical conduction (dromotropic), excitability (bathmotropic) and contractility of the ventricular myocardium (inotropic)

61
Q

How does parasympathetic regulation affect the heart?

A

Parasympathetic stimulation acts on the SA and AV nodes (not on the ventricles). It decreases electrical condcution (dromotropic), heart rate (chronotropic) and excitability (bathmotropic)

62
Q

How are sympathetics stimulated?

A

Via neuronal control and via hormonal control through epinephrin and norepinephrin (beta-1-receptors)

Anatomy 2 (6 decks)

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