Registry Review - Cardiac anatomy Flashcards
Cardiac Positon
____ of the heart situated to right of middle and ____ of the heart is situated to the left of midline
Cardiac Positon
Base is situated upward toward the head, but more ____ than apex, and includes both atria and all the great vessels
posterior
Cardiac Positon
RV lies ____ to the LV
anterior
Cardiac Positon
___ of the heart refers to junction of the atrial and ventricular septum
The term [Crux Cordis] is Latin and means “the cross of the heart”. It is an anatomical landmark used in angiography. It is formed by the crossing of the atrioventricular sulcus and the conjunction of the posterior interventricular sulcus and the interatrial sulcus.
In the accompanying image the atrioventricular sulcus is colored blue, the posterior interventricular sulcus is red, and the interatrial sulcus is green.
Cardiac Positon
Tall thin patients tend to have a more ___ axis to their heart compared to shorter obese patients who have a more ____ cardiac position
vertical
horizontal
Cardiac Positon
normal position of the heart refers to ____
levocardia
Cardiac Positon
heart is positioned toward the right side of the chest instead of normally pointing to the left
dextrocardia
Cardiac Positon
the heart is very lateral on the left side of the chest; associated with congenital heart disease
extreme levocardia
Cardiac Positon
the heart is located in the middle of the chest with the apex pointing midline
mesocardia
Cardiac Positon
the heart is located in the right side of the chest with the apex pointing to the left; usually occurs due to space lesion abnormality of the left lung (congenital cystic adenomatoid malformation, diaphragmatic hernia)
dextroposition
*levoposition - the heart is located on the left side of the chest; normal position
Cardiac Structure
males: ___ to ___ g
females: ____ to ____ g
280-340
230 - 280
Cardiac Structure
LV is ____ in shape, RV is more ____ in shape
ellipsoid
triangular
Ventricular Structure
papillary muscles attached to each leaflet of AV valves (MV and TV) by the ______, TV has a pap muscle on the _____, and the MV has no _____ pap muscle
chordae tendenae
septum
septal
Ventricular Structure
In the LV, branches of the RCA supply the ____, ____ muscles and LAD and CX supply the ____, _____ muscle
posterior, medial
anterior, lateral
Moderator band: One large muscle bridge connecting the RV ____ wall to the right border of the IVS
anterior
Valvular Anatomy
cardiac valves are made of ______ tissue
fibrous
Valvular Anatomy
valves are covered on both sides by layers of ______
endocardium (epithelial cells)
TV anatomy
3 leaflets: ____, ______, ______
anterior (largest)
posterior (smallest)
septal (medial)
TV Anatomy
It is inserted slightly closer to the cardiac apex than the MV.
T or F ?
T
VT Anatomy
septal leaflet normally has chordal attachment to the ________
ventricular septum (septophilic)
Valvular Anatomy
MV and TV insertion sites are normally ____ mm/m2 apart; this is best evaluated in _____ view
<8
A4C
TV normal valve area is ______
5-8 cm2
TV valve normally opens ___ and closes ___MV
before
after
TV valve best evaluated in the ____ & _____ view
A4C
parasternal (inflow)
MV valve anatomy
2 leaflets: ______ and _______
anterior
posterior
MV valve anatomy
_____ leaflet normally shorter and has a scalloped edge
posterior
MV valve anatomy
leaflets are supported by the valvular apparatus: ______, _______, and _______
mitral annulus
chordae tendinae
pap muscle
MV valve anatomy
normal valve area: _____ cm2
4-6
MV best evaluated in the _____ & _____ views
A4C
PLAX
Which valve is this?
half moon shaped valve leaflets
located between the ventricles and outflow tract
semilunar valves
AoV Anatomy
3 leaflets/cusps: _____, _______, and ______
right coronary
left coronary
non-coronary
AoV Anatomy
*Thin at the edges with a thickened area centrally on each cusp that is called a:
nodule of Arantius
AoV Anatomy
average normal AoV area is _____ cm2
3-4
PV Anatomy
3 leaflets: _____, _______, and ______
right
left
anterior
PV Anatomy
PV lies ____, _____, and ______ to the AoV
anterior, superior, and lateral (left)
PV Anatomy
PV best evaluated in ____ .
Which valve can be seen?
PSAX
most anterior (MPA) *LPA/RPA can be seen depending on the patient
Cardiac Grooves
Coronary Circulation
The majority of antegrade flow in the coronary arteries occurs early in ______
ventricular diastole
Coronary Circulation
Increased LV diastolic pressure will _____ coronary artery flow
decrease
Coronary Circulation
increased HR will reduce the time of ventricular diastole, therefore ______ forward flow in coronaries
reducing
Coronary Circulation
During ventricular systole, the AoV is open covering the _______
coronary ostium (thus no forward blood flow to coronary arteries)
Coronary Circulation
When the AoV _______, blood in aorta easily fills the coronary arteries
closes
____ originated from the Ao Rt at the right cusp of AoV
RAC (right main coronary artery)
In 80% of individuals, the PDA originates from the RCA and is described as __________
right-dominant circulation
In 20% individuals, the PDA originated from the _____ and is described as “left dominant” circulation
LCX
RCA (right main coronary artery ) branches into ___ and runs along the right right atrioventricular groove toward the apex
PDA
*PDA supplies the inferior ventricular septum and inferior wall of LV
____ supplies posterior, medial papillary muscle and ____ & ____ supply the anterior, lateral papillary muscle
RCA
LAD & LCX
Coronary sinus has the ______ O2 saturation of all chambers/vessels
lowest
Coronary sinus crosses behind the LA in the _________ (the junction of the LA and the LV)
posterior atrioventricular groove
If ___ pressure increases, the coronary sinus will dilate
RA
_______ protects the opening of the coronary sinus into the RA
Thebesian valve
What are the three main tributaries of coronary sinus?
- great cardiac vein
- middle cardiac vein
- small cardiac vein
Name each cardiac wall layer:
blue:
green:
purple:
red:
blue: endocardium
green myocardium
purple: epicardium
red: pericardium
Name each coronary artery
- RCA
- LCA
- LCX
- LAD
- Right (acute) marginal artery
- PDA
- Left (obtuse) marginal artery
LV
shape?
Ellipsoid
LV
composed of three sections:
inflow, apex, ooutflow
LV
Anatomical outflow tract extends from ________ to the _________
inner edge of the interventricular septum
leading edge of the anterior mitral leaflet
LV
functional outflow tract refers to the area between the _____ to the ______
&
from the _______ to the _______
septal wall, anterior aortic annulus
&
anterior mitral leaflet, posterior aortic annulus
LV
normal wall thickness in men ?
0.6 - 1.0 cm
LV
normal wall thickness in women?
0.6 - 0.9 cm
LV
normal chamber size end diastole in women?
3.8 - 5.2 cm
LV
normal chamber size end diastole men?
4.2 - 5.8 cm
LV
average normal EF in men & women?
men: 52-72%
women: 54-74%
LV
normal fractional shortening (FS)?
>25%
LV
average LV pressure?
120/10 mmHg
LV
LV diastolic pressure = ???
mean LA pressure
LV
features that differentiate LV from the RV?
- no moderator band
- smooth walls (no trabeculations)
- 2 pap muscles (anterior & posterior *septophobic) instead of 3
- bi-leaflet valves
- apical displacement of the tricuspid valve compared to MV
LA
What are the two distinct cavities of LA?
LA
&
LA appendage
LA
normal AP measurement in PLAX?
<4cm
LA
normal LA area?
<20 cm2
LA
LA volume index is preferred method of assessment and its normal value is?
≤34 mL/m2
LA
pressure range in LA = ?
0-12 mmHg
LA Appendage
shape?
windsock
LA Appendage
locate ____ to the LA
posterior
LA Appendage
Its walls contain ______
pectinate muscle
LA Appendage
best evaluated in ____ view
A2C
LA Appendage
TEE Doppler evaluation using PW Doppler to evaluate the maximum emptying velocity during atrial contraction. Average ___?
>50cm/s
LA Appendage
velocities less than ____ indicate increased risk of thrombus formation in the appendage
20cm/m
RA
- composed of two portions: anterior and posterior
- walls are lined with a thin layer of ______ for structural support
pectinate muscle
RA
_____ RA is connected to the right atrial appendage
anterior
RA
_____ is a muscular ridge that separates the RA into the portions and extends vertically from IVC to SVC
crista terminalis
RA
______ is refers to the external ridge of tissue corresponding to the internal crista terminalis
sulcus terminalis
What is the Smooth area inside the right ventricle that leads to the pulmonary trunk?
Conus Arteriosus (infundibulum)
RA
O2 saturation is ____?
75%
RA
_____ protects the opening of the IVC into the RA *NO hemodynamic function in adults
Eustachian valve