Pericardium and Heart Flashcards
Lateral Cutaneous Nerve 3-6 or 7
Innervates Breast
Anterior Cutaneous nerve 2-6 or 7
Innervates Breast
12 Thoracic Nerves
innervate intercostal muscles, 11 intercostal, 1 subcostal derived from thoracic vertebrae
Supraclavicular nerve
innervates breast; derived from cervical plexus
Right coronary artery
gives off right marginal artery and posterior inter ventricular artery, SA node artery and AV node artery
Left coronary artery
gives off LAD, circumflex, diagonal and left marginal artery
Cardiac veins
coronary sinus, great cardiac vein, middle cardiac vein, small cardiac vein, anterior cardiac vein
Nerves to heart
T1-T4 branches from sympathetic trunk, right and left vagus nerve are parasympathetic. Heart also receives input from cardiac plexus.
Epicardium
Serous visceral layer of pericardium, covers epicardial fat and myocardium
Myocardium
Thick middle layer between the epicardium and the endocardium consisting of cardiac muscle
Endocardium
Thin endothelial membrane that lines heart chambers including valves. Susceptible to ischemia and endocarditis. It has few collateral connections and is perfused by vessels that have to pass through contracting myocardium layers
Where to hear aortic valve sound
2nd RIGHT intercostal space
Where to hear pulmonary valve sound
2nd LEFT intercostal space
Where to hear tricuspid valve sound
Body of sternum
Where to hear mitral valve sound
Apex of heart (5th left intercostal space)
SA node
Found in sulcus terminalis which is intersection of right atrium and superior vena cava, pacemaker of heart
AV node
Found in wall of right atrium, provides left and right bundle branches that travel down IV septum. Right branch is thicker and bigger and passes through moderator band
Pericardiophrenic Ligament
Attaches fibrous pericardium to the diaphragm, allowing it to move heart up and down with movements of diaphragm during respiration.
Pericardiocentesis
Removes fluid from oblique and transverse sinuses! Parasternal or subxiphoid approach
Right dominance variation of coronary arteries
The right coronary artery may be very large and produce part of the LAD
Left dominance variation of coronary arteries
The left coronary artery may be very large and produce part of the posterior interventricular artery
Anterior cardiac veins
The only coronary veins that go directly to the right atrium and bypass the coronary sinus. These are bringing in blood from the right ventricle.
Tricuspid cusps
Anterior, posterior, septal
Bicuspid (Mitral) cusps
anterior and posterior
Pulmonary valve cusps
right, left, and anterior
Aortic valve cusps
Right, left, posterior.
Trigones
Fibrous support for valves. These are thickened areas between the rings of different valves that support and insulate the atria.
Superior border of heart
Between 2nd Left costal cartilage and 3rd Right costal cartilage
Right border of heart
Between 3rd right costal cartilage and 6th right costal cartilage
Inferior border of heart
Between 6th right costal cartilage and 5th left intercostal space at midclavicular line
Left border of heart
Line between 2nd left costal cartilage and 5th left intercostal space
Aortic Valve area for auscultation
2nd intercostal space to the right of the sternal border
Pulmonary Valve area for auscultation
2nd intercostal space to the left of the sternal border
Tricuspid Valve area for auscultation
Left Sternal Border in 5th or 6th intercostal space
Mitral Valve
Apex of heart in 5th intercostal space in midclavicular line
