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Cardiovascular I > Pericardium and Heart > Flashcards

Pericardium and Heart Flashcards

1
Q

What is the general function of the fibrous part of the pericardium?

A

Restricts excessive movement of the whole heart

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2
Q

What is the general function of the serous part of the pericardium?

A

Lubricated container in which the different parts of the heart can contract

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3
Q

What is the relation of the pericardium to the thoracic cage?

A

Posterior to sternum and 2-6 costal cartilages
Anterior to bodies of the T5-T8

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4
Q

What would be compressed if a clamp was placed in the transverse sinus?

A

Ascending aorta
Pulmonary trunk
SVC
Pulmonary veins

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5
Q

What arteries supply the pericardium?

A

Pericardiacophrenic A
Musculophrenic A
Bronchial A
Esophageal A
Superior phrenic A
Coronary arteries

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6
Q

What branches of the internal thoracic A supply the pericardium?

A

Pericardiacophrenic A
Musculophrenic A

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7
Q

What branches of the thoracic aorta supply the pericardium?

A

Bronchial A
Esophageal A
Superior phrenic A

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8
Q

What part of the pericardium is supplied by the coronary arteries?

A

Visceral layer only

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9
Q

What veins drain the pericardium?

A

Pericardicophrenic V
Tributaries of brachiocephalic V
Tributaries to azygos venous system

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10
Q

What is the innervation of the fibrous and parietal layers of pericardium?

A

Phrenic N

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11
Q

What nerve roots/dermatome are associated with the phrenic N?

A

C3-C5

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12
Q

Where does pericardial pain refer?

A

Ipsilateral supraclavicular region - C3-C5 dermatomes

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13
Q

What is the innervation of the epicardium?

A

Vagus N and sympathetic trunks

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14
Q

What is the description and location of the sounds of a pericardial friction rub?

A

Rustle of silk over the left sternal border and upper ribs

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15
Q

Explain cardiac tamponade

A

Excess fluid in pericardial cavity causing heart compression. Caused by bleeding from aneurysm rupture, puncture, or MI

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16
Q

What is pericardiocentesis and what does it treat?

A

Drainage of fluid from cardiac cavity
Cardiac tamponade

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17
Q

Where would you insert a needle for pericardiocentesis?

A

Through the L subcostal/substernal angle
Through the left 5th or 6th intercostal space near the sternum

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18
Q

What are the three layers of the heart wall?

A

Endocardium
Myocardium
Epicardium

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19
Q

What structures make up the base of the heart?

A

L atrium
Small portion of R atrium
Pulmonary Vs
Proximal SVC and IVC

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20
Q

What structure makes up the apex of the heart?

A

Inferior angle of L ventricle

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21
Q

Where is the apex of the heart located?

A

L 5th intercostal space at the midclavicular line

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22
Q

What is the apex beat?

A

Sounds of mitral valve closure

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23
Q

What structure forms the anterior surface of the heart?

A

R ventricle

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24
Q

What structures forms the inferior/diaphragmatic surface of the heart?

A

L ventricle mostly, and some R ventricle

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25
Q

What structure make up the right border/pulmonary surface of the heart?

A

Mainly R atrium

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26
Q

What structure makes up the L pulmonary surface of the heart?

A

Mainly L ventricle
Partly left auricle/atrium

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27
Q

What structures form the inferior border of the heart?

A

R ventricle mostly, and some L ventricle

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28
Q

What structures form the superior border of the heart?

A

R and L atria

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29
Q

What is the extent of the heart on the R chest wall in relation to the rib cage?

A

From 3rd costal cartilage to the 6th

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30
Q

What is the extent of the heart on the L chest wall in relation to the rib cage?

A

From 2nd costal cartilage to the 5th intercostal space

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31
Q

What would be damaged by a penetrating wound to the right parasternal border above the 3rd rib?

A

SVC

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32
Q

What would be damaged by a penetrating wound in the R parasternal 3rd, 4th, or 5th intercostal spaces?

A

R atrium

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33
Q

What would be damaged by a penetrating wound on L parasternal 3rd, or 4th intercostal spaces?

A

R ventricle

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34
Q

What would be damaged by a penetrating wound on 2nd L parasternal intercostal space?

A

L atrium

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35
Q

What is indicated by the sulcus terminalis/terminal groove?

A

External marker of separation of smooth and rough parts of R atrium

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36
Q

What is indicated by the crista terminalis?

A

Internal marker of separation of smooth and rough parts of R atrium

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37
Q

What is the conus arteriosus?

A

Smooth outflowing part of the R ventricle

38
Q

What is the infundibulum?

A

Smooth outflowing part of the R ventricle

39
Q

What are the three papillary muscles in the R ventricle?

A

Anterior
Posterior
Septal

40
Q

What are chordae tendinae?

A

Fibrous cords connecting papillary muscles to valve leaflets

41
Q

What is another name for the moderator band?

A

Septomarginal trabeculae

42
Q

What is the moderator band?

A

Muscular band that conveys AV bundle from septum to base of ventricle

43
Q

What are the two papillary muscles in the L ventricle?

A

Anterior
Posterior

44
Q

What can cause L atrial hypertrophy?

A

Mitral valve prolapse

45
Q

What structure can be compressed by L atrial hypertrophy and its related symptom?

A

Esophagus
Dysphagia

46
Q

What causes S1 heart sounds?

A

Closure of mitral and tricuspid valves

47
Q

What causes S2 heart sounds?

A

Closure of aortic and pulmonary valves

48
Q

What valves are the most frequently involved in valvular heart disease?

A

Mitral
Aortic

49
Q

What are major types of valvular heart disease?

A

Aortic stenosis
Mitral regurgitation
Pulmonary valve stenosis

50
Q

Where is the aorta auscultated on the chest wall?

A

Upper R sternal border at the 2nd intercostal space

51
Q

Where is the pulmonic trunk auscultated on the chest wall?

A

Upper left sternal border at 2nd intercostal space

52
Q

Where is the tricuspid valve auscultated?

A

L 5th intercostal space at the sternal border

53
Q

Where is the mitral valve auscultated?

A

Left 5th intercostal space, near the midclavicular line

54
Q

Where is cardiac percussion performed?

A

At 3rd, 4th, and 5th intercostal spaces, from the L anterior axillary line to the R anterior axillary line

55
Q

Where is the change from resonance to dullness normally seen when percussing the heart?

A

6 cm lateral to the L border of the sternum

56
Q

What branches from the R aortic sinus?

57
Q

What branches from the L aortic sinus?

58
Q

What structures are typically supplied by the RCA and its branches?

A

R atrium
Most of R ventricle
Diaphragmatic surface of L ventricle
Posterior 1/3 of IV septum
SA node (60%)
AV node

59
Q

What is typically supplied by the LCA?

A

Most of L ventricle
Part of R ventricle
Anterior 2/3 of IV septum
AV bundle
SA node (40%)

60
Q

How can you differentiate between the RCA and LCA on an angiogram?

A

LCA branches almost immediately into 2 arteries of similar width

61
Q

What are main branches of the RCA?

A

SA nodal
R marginal
Posterior IV (67%)
AV nodal

62
Q

What are main branches of the LCA?

A

LAD/anterior IV
Circumflex
L marginal
Posterior IV (33%)

63
Q

What arteries anastomose with the RCA?

A

Circumflex and LAD from LCA

64
Q

What anastomosis with the posterior IV?

A

Anterior IV/LAD

65
Q

What is another name for posterior IV A?

A

Posterior descending A (PDA)

66
Q

What is coronary angiography used for?

A

Localizing sites of blockage in coronary arteries

67
Q

Where is the catheter usually inserted in coronary angiography?

A

Femoral A to aorta

68
Q

When does necrosis begin to occur in MI?

A

20-30 minutes after occlusion

69
Q

What is the most commonly affected artery for MI?

70
Q

What coronary artery is known as the widow-maker?

71
Q

What is the second most affected artery for MI?

72
Q

What is the third most commonly affected artery for MI?

A

L circumflex

73
Q

What does PTCA stand for?

A

Percutaneous transluminal coronary angioplasty

74
Q

What is a PTCA procedure?

A

Inserting a balloon catheter into the coronary artery that is blocked, then inflating the balloon to mechanically dilate the A. Usually a stent is also placed.

75
Q

What does CABG stand for?

A

Coronary artery bypass graft

76
Q

What vessels are commonly used in CABG procedures?

A

Great saphenous V
Internal thoracic/mammary A

77
Q

Where does the coronary sinus drain?

78
Q

What are the tributaries of the coronary sinus?

A

Great cardiac V
Middle cardiac V
Small cardiac V
L posterior ventricular V
L marginal V

79
Q

What vein accompanies the LAD?

A

Great cardiac V

80
Q

What vein accompanies the PDA?

A

Middle cardiac V

81
Q

What veins drain directly into the R atrium, bypassing the coronary sinus?

A

Anterior cardiac veins

82
Q

What veins drain directly into the different heart chambers?

A

Venae cordis minimae/Thebesian veins

83
Q

What is the innervation of the conducting system of the heart?

A

Vagus N
Sympathetic trunks from T1 to T5

84
Q

Where is the SA node located?

A

In upper part of the crista terminalis

85
Q

Where is the AV node located?

A

Between opening of coronary sinus and septal cusp of tricuspid valve

86
Q

Where do bundle branch fibers terminate?

A

Purkinje fibers/subendocardial plexus

87
Q

What is the independent rate of ventricles when AV node or bundle is damaged?

A

25-30 times per minute

88
Q

What ANS plexuses innervate the heart?

A

Superficial cardiac plexus
Deep cardiac plexus

89
Q

What is the sympathetic preganglionic fibers that innervate the heart?

A

From T1-T4 or T5

90
Q

What is the parasympathetic innervation to the heart?

91
Q

What is the location of the superficial cardiac plexus?

A

Below the aortic arch, in front of the R pulmonary A

92
Q

What is the location of the deep cardiac plexus?

A

Anterior to bifurcation of the trachea

Cardiovascular I (20 decks)

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