Slide Set 4

Question 1

The mediastinum is located

Answer 1

Between the lungs

Question 2

The mediastinum contains

Answer 2

the heart, trachea, esophagus, and great vessels

Question 3

The heart is located in

Answer 3

the middle inferior mediastinum

Question 4

Which nerves drive the diaphragm

Answer 4

The phrenic nerves

Question 5

The right vagus nerve innervates

Answer 5

the SA node

Question 6

The left vagus nerve innervates

Answer 6

the AV node

Question 7

SA node would fire at ____ with no PNS stimulation

Answer 7

110

Question 8

How many serous layers of the pericardium? What are their names

Answer 8

2; inner or visceral serous pericardium and parietal serous pericardium

Question 9

What is the outermost layer of the pericardium

Answer 9

the fibrous pericardium

Question 10

Where does the heart sit

Answer 10

In the middle of the diaphragm on the central tendon

Question 11

What vessel causes patent ductus arteriosus and what is it’s purpose during fetal development

Answer 11

Ligamentum arteriosum; it helps circulate blood around the body without using the lungs for gas exchange

Question 12

Which valve only has two cusps

Answer 12

Mitral

Question 13

What connects directly to the AV valves

Answer 13

The chordae tendineae

Question 14

The valves are anchored to the heart wall by

Answer 14

the chordae tendineae and papillary muscle

Question 15

NCC is

Answer 15

non coronary cusp; the posterior cusp of the aorta

Question 16

Name the cusps of the mitral valve

Answer 16

Anterior and posterior cusps; attached to the posterior cusp is a the commissural cusp

Question 17

Name the cusps of the tricuspid valve

Answer 17

Anterior, posterior, septal cusps

Question 18

Name the cusps of the pulmonic valve

Answer 18

Right, left, and anterior cusps

Question 19

Name the cusps of the aortic valve

Answer 19

Right, left, and posterior (NCC) cusps

Question 20

What drives coronary perfusion

Answer 20

Aortic pressure

Question 21

What opposes coronary perfusion

Answer 21

Wall pressures

Question 22

Calcified or poor fitting aortic valves cause

Answer 22

decreased coronary perfusion

Question 23

What is the purpose of the cardiac cartilaginous ring

Answer 23

Electric insulation between the atria and ventricles

Question 24

The cardiac cartilage has a tendency to rattle during

Answer 24

Filling/diastole

Question 25

Pedi hearts are more resistant to? How do they compensate?

Answer 25

Increases in volume; compensate through increasing HR

Question 26

Why do we have more mitral valve problems than tricuspid valve issues?

Answer 26

Higher intraventricular pressures on left side

Question 27

The LCA splits into

Answer 27

The left anterior descending artery and circumflex artery

Question 28

The RCA feeds into the

Answer 28

posterior descending artery in 85% of people

Question 29

15% of people have a posterior descending artery that comes off the

Answer 29

LCA

Question 30

Codominance of the coronary arteries occurs when

Answer 30

There is an anastomosis or connection between the RCA and LCA (circumflex)

Question 31

Where do you listen to the aortic valve

Answer 31

2nd ICS on the right side of the sternum

Question 32

Where do you listen to the pulmonic valve

Answer 32

2nd ICS on left side of the sternum

Question 33

Where do you listen to the tricuspid valve

Answer 33

5th ICS on the left side of the sternum

Question 34

Where do you listen to the mitral valve

Answer 34

5th ICS left side of the sternum, midclavicular

Question 35

Longest heart sound? How long is it?

Answer 35

1st heart sound; 0.14s

Question 36

The first heart sound is

Answer 36

the closure of AV valves; low pitched

Question 37

The second heart sound is

Answer 37

the closure of the aortic valve; high pitched

Question 38

What is physiologic splitting of heart sounds

Answer 38

Occurs when the aortic valve shuts first and then the pulmonic valve; may be loudest during inspiration - inspiration causes a drop in afterload and pulmonary arterial pressures, causing the pulmonic valve to close slower

Question 39

Frequency is measure in ___? How can we calculate it?

Answer 39

Hz or kHz; Freq = number of oscillations over 1s

Question 40

What is the normal range of hearing in Hz?

Answer 40

20-20000

Question 41

The third heart sound is

Answer 41

The rattling of cartilage during filling (end of rapid filling typically)

Question 42

If we could hear it, the fourth heart sound may be

Answer 42

atrial kick due to the pushing of extra blood into the ventricle

Question 43

Aortic stenosis would present as what type of murmur? Why?

Answer 43

Systolic; Ejection of blood against a noncompliant valve in the aorta

Question 44

Mitral stenosis would present as what type of murmur? Why?

Answer 44

Diastolic; heard at the end of diastole d/t poor filling of the left ventricle

Question 45

Mitral regurgitation would present as what type of murmur? Why?

Answer 45

Systolic; during ejection, blood is moving backwards d/t high ventricular pressures

Question 46

Aortic regurgitation would present as what type of murmur? Why?

Answer 46

Diastolic; during filling, aortic pressure is higher than ventricular filling and leads to increased filling of LV during diastole

Question 47

What is the loudest murmur?

Answer 47

Aortic stenosis

Question 48

Patent ductus arteriosus has a murmur that lasts the whole cardiac cycle. When is it the loudest? Why?

Answer 48

During systole d/t shunting of blood from aorta to pulmonary artery

Question 49

A high delta P of aortic and ventricular pressures indicates

Answer 49

Higher amount of coronary artery perfusion

Question 50

When does retrograde perfusion of the coronary arteries occur? Why?

Answer 50

During the beginning of systole; intraventricular pressures exceed aortic pressure

Question 51

In aortic stenosis, the body may compensate for decreased SV by raising heart rate. What ways does this hurt the coronary arteries?

Answer 51

Decreased time spend in diastole when we already have increased wall pressures