Slide Set 4 Flashcards

1
Q

The mediastinum is located

A

Between the lungs

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2
Q

The mediastinum contains

A

the heart, trachea, esophagus, and great vessels

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3
Q

The heart is located in

A

the middle inferior mediastinum

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4
Q

Which nerves drive the diaphragm

A

The phrenic nerves

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5
Q

The right vagus nerve innervates

A

the SA node

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6
Q

The left vagus nerve innervates

A

the AV node

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7
Q

SA node would fire at ____ with no PNS stimulation

A

110

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8
Q

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

A

2; inner or visceral serous pericardium and parietal serous pericardium

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9
Q

What is the outermost layer of the pericardium

A

the fibrous pericardium

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10
Q

Where does the heart sit

A

In the middle of the diaphragm on the central tendon

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11
Q

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

A

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

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12
Q

Which valve only has two cusps

A

Mitral

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13
Q

What connects directly to the AV valves

A

The chordae tendineae

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14
Q

The valves are anchored to the heart wall by

A

the chordae tendineae and papillary muscle

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15
Q

NCC is

A

non coronary cusp; the posterior cusp of the aorta

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16
Q

Name the cusps of the mitral valve

A

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

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17
Q

Name the cusps of the tricuspid valve

A

Anterior, posterior, septal cusps

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18
Q

Name the cusps of the pulmonic valve

A

Right, left, and anterior cusps

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19
Q

Name the cusps of the aortic valve

A

Right, left, and posterior (NCC) cusps

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20
Q

What drives coronary perfusion

A

Aortic pressure

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21
Q

What opposes coronary perfusion

A

Wall pressures

22
Q

Calcified or poor fitting aortic valves cause

A

decreased coronary perfusion

23
Q

What is the purpose of the cardiac cartilaginous ring

A

Electric insulation between the atria and ventricles

24
Q

The cardiac cartilage has a tendency to rattle during

A

Filling/diastole

25
Q

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

A

Increases in volume; compensate through increasing HR

26
Q

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

A

Higher intraventricular pressures on left side

27
Q

The LCA splits into

A

The left anterior descending artery and circumflex artery

28
Q

The RCA feeds into the

A

posterior descending artery in 85% of people

29
Q

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

A

LCA

30
Q

Codominance of the coronary arteries occurs when

A

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

31
Q

Where do you listen to the aortic valve

A

2nd ICS on the right side of the sternum

32
Q

Where do you listen to the pulmonic valve

A

2nd ICS on left side of the sternum

33
Q

Where do you listen to the tricuspid valve

A

5th ICS on the left side of the sternum

34
Q

Where do you listen to the mitral valve

A

5th ICS left side of the sternum, midclavicular

35
Q

Longest heart sound? How long is it?

A

1st heart sound; 0.14s

36
Q

The first heart sound is

A

the closure of AV valves; low pitched

37
Q

The second heart sound is

A

the closure of the aortic valve; high pitched

38
Q

What is physiologic splitting of heart sounds

A

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

39
Q

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

A

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

40
Q

What is the normal range of hearing in Hz?

A

20-20000

41
Q

The third heart sound is

A

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

42
Q

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

A

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

43
Q

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

A

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

44
Q

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

A

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

45
Q

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

A

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

46
Q

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

A

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

47
Q

What is the loudest murmur?

A

Aortic stenosis

48
Q

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

A

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

49
Q

A high delta P of aortic and ventricular pressures indicates

A

Higher amount of coronary artery perfusion

50
Q

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

A

During the beginning of systole; intraventricular pressures exceed aortic pressure

51
Q

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

A

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