Olinger - Cardiology Flashcards
Superior and Inferior Mediastinum
The separated by sternal angle
The infernal mediastinum is
subdivided into anterior, middle, posterior
Anterior mediastinum is
anterior to heart
Middle mediastinum is
the heart
Posterior mediastinum is
posterior to the heart
Systemic circulation
FROM left atrium –> bicuspid valve –>Left Ventricle–> Aortic Valve –> Aorta –> Arterial System –> capillaries –> venous system –> superior/inferior vena cava –> heart
pulmonary circulation
Superior/Inferior Vena Cava –> Right Atrium –> tricuspid –> Rive Ventricle –> Pulmonary valve –> Pulmonary trunk –> R/L lungs –> Pulmonary veins –> heart
Epicardium
(outermost layer: made up of visceral serous pericardium)
Myocardium
thick muscular layer made up spiraling overlapping layers of cardiac muscle
Myocardial Infarction
lack of blood flow to a specific area of myocardium, usually result of a blockage in coronary artery
Angia Pectoris
literally means “strangling pain of the chest” originates in heart and radiates into chest
usually has something to do with obstructed coronary arteries that produce ischemia of the myocardium
Endocardium
thin internal endothelial and subendothelial layer lining the inside of the chambers of the heart and valves
Fibrous skeleton of the heart
dense collagenous fibers
produces attachment points for the myocardium
produces attachment points for the vales of the cuspid valves
supports and strengthens atrioventricular and smilunar orifices
provides an electrically insulated barrier between atria and ventricles
the heart is self-
initializing: meaning if you cut all the innervation to it, it will still pump
the heart is made up of a serious pericardium: what are the components of the serous pericardium
the Parietal and Epicardium (visceral pericardium)
what serve as attachment sites for the myocardium?
the fibrous rings that surround the openings. also attachment point for the valves, and it’s also an insulator so atrial contraction doesn’t pass waves through musculature
what direction does the apex of the heart point?
leftward
Sternocostal surface
Right Ventricle
Diaphragmatic surface
R/L Ventricles
Pulmonary Surface
Paired: Right atrium and Left Ventricle occupying the cardiac impression on both lungs
Borders of the heart
Right Atrium/ Inferior (Right Ventricle)/ Left Ventricle/ Superior (R/L Atria and the exit point for the aorta and pulmonary trunk)
What border is defined by the R and L atria, and serves as the exit point for the aorta and pulmonary trunk?
Superior border
Ligamentum Arteriosum
embryological remnant of the ductus arteriosus
served as communication between the pulmonary trunk and arch of the aorta
Right Atrioventricular groove
divides right atrium and right ventricle: carries R. Coronary A.
Left Atrioventricular groove
between left atrium and left ventricle, houses the “Coronary sinus”
Anterior interventricular groove
between Right and Left on anterior aspect of heart
transmits Anterior Interventricular A and the Great Cardiac V
Posterior interventricular groove
between Right and Left ventricles on the posterior aspect of the heart, transmits posterior interventricular A and the middle cardiac a
Sulcus terminalis
External vertical groove corresponding to the internal crista terminalis
Ligamentum Ateriosum
travels from the superior aspect of the pulmonary trunk to the inferior concave border of the aortic arch.
adult remnant of the ductus arteriosus
what two muscle “named” groups do you find in the R. Atrium?
Pectinate (rough)
and Sinus Venarum (smooth)
Crista terminalis
the ridge that separates the pectinate from the sinus venarum
sinus venarum
smooth muscle, the septa between the R/L atrium: called the the interatrial septum
where Venae Cavae and Coronary Sinus empty
what is the septa between the r/l atria?
the sinus venarum –> interatrial septum
Fossa Ovalis
oval shaped depression that is an embryological remnant
depression on the interatrial septum
Opening for the coronary sinus
in the right atrium
R/L Auricles
the little flappy things on the atria that clinicians call the “appendages”
Foramen ovalis
the hole in the interatrial septum allowing fetal blood to be shunted from the r. atrium to the l. atrium
becomes fossa ovalis
Atrial Septa defects
typically incomplete closure of the foramen ovale, roughly 15-120% of adults have small patency in their forament ovale which is considered clinically insignificant
What do we find in the R atria?
Opening for R. coronary artery Fossa Ovalis (in adults) Interatrial septum Sinus venarum Pectinate muscle Crista terminalis
R. Atrioventricular Orifice
passage from R. Atrium to R. Ventricle
occluded by tricuspid
Tricuspid valve
covers R. Atrioventricular Orifice
Tricuspid
has 3 cusps, separates R. Atrium from R. Ventricle
Anterior Cusp, Posterior Cusp, Septal Cusp
Chordae Tendonae: attaches free edges of the three cusps
Chordae Tendonae
attaches free edges of the three cusps to the three corresponding papillary muscles
Trabecula Carnae
the rought wall of the R. Ventricle
Conus Arteriosus
smooth wall of R. Ventricle
Septomarginal Trabeculum
carries subendocardial branch (Purkenki fibers), extension of the conus arteriosus
Pulmonary Valve
R/L/A cusp
What do you find in the R. Ventricle?
Trabecula Carnae
Conus Arteriosus
Pulmonary valve
Septomarginal Trabeculum
L. Atrium contains
opening for the 4 pulmonary veins sinus venarum interatrial septum left auricle leads to left atrioventricular orifice
L. Ventricle contains
Bicuspid valve anterior cusp Chordae Tendonae Posterior Cusp Papillary M. Aortic sinuses Aortic Valve Aortic Vestibule Trabecula Carnae
Aortic valve
NOT an active valve, works passively because of the backflow of blood due to recoil of elastic aorta.
What is the connection between the aortic valve and the coronary arteries?
there’s a backflow of blood due to recoil of elastic aorta when the aortic valve is passive shut, this causes the coronary arteries to begin filling when the myocardium is relaxed
what function do the aortic sinuses serve?
they fill with blood because of the backpressure on the aortic valve, and they lead to the coronary arteries
r. aortic sinus –> r. coronary artery
l. coronary sinus –> l. coronary artery
Where does the ascending aorta begin?
at the aortic valve
diastole
initiated by sinoatrial node
sinoatrial node —>
atrioventricular wall —> atrioventrical node
pacemaker of heart
atrioventricular node —>
atrioventricular bunde —> subendocardial branches
“fibrillation”
twitching of the heart
defibrillator
makes the heart STOP, not twitch!
sequence of pericardiums
fibrous, visceral, parietal
Fibrous Pericardium (outside) –> Parietal Serous –> Visceral Serous Pericardium (inside)
Transverse Pericardial Sinus
runs under great
vessels superior vena cava
ascending aorta
pulmonary aorta
Oblique Pericardial Sinus
essentially the layer posterior to the heart where it sits, things collect there
Pericarditis
inflammation of pericardium
Pericardial effusion
fluid inside pericardium but outside the heart
Pericardiocentesis
removal of fluid from pericardium
