Surface Anatomy of the Heart

Question 1

What are the three parts of the pericardial sac?

Answer 1

Fibrous part, parietal layer, and serous layer.

Question 2

What makes up the fibrous part of the pericardial sac?

Answer 2

Ligament to the sternum (sternopericardial ligament), it inferiorly blends with the diaphragm and holds the heart in place.

Question 3

What is the position of the parietal layer of the pericardial sac?

Answer 3

Outer layer.

Question 4

What is the position of the serous layer of the pericardial sac?

Answer 4

Inner layer. It attaches to the heart and great vessels.

Question 5

What does the serous layer of the pericardial sac attach to?

Answer 5

The heart and great vessels.

Question 6

What are the nerve roots of the phrenic nerves?

Answer 6

C3, C4, C5.

Question 7

What do the phrenic nerves give motor and sensory innveration to?

Answer 7

The diaphagm and also just sensory to the pericaridum.

Question 8

What is teh route of the phrenic nerves?

Answer 8

Descends anterior to the lungs. Right phrenic nerve descends over the right atrium, left nerve over left atrium.

Question 9

Where is the heart?

Answer 9

In the chest. It lies deep to the sternum, inferior to the great vessels and superior to the diaphragm. The anterior pericardial surface is attached to the posterior surface of the sternum via the sternopericardiac ligaments. The inferior pericardial surface is fused with the diaphragm.

Question 10

What are the blood vessels of the heart?

Answer 10

Coronary arteries and cardiac veins.

Question 11

Where do the coronary arteries and cardiac veins run?

Answer 11

Across the surfacce of the heart. Just deep to the epicardium, noramlly embedded in fat.

Question 12

Where do the coronary arteries arise from?

Answer 12

First branches of the aorta, arise from the left and right aortic sinuses.

Question 13

Where do the aortic sinuses arise from?

Answer 13

The root of the aorta, just superior to the aortic valve and pass around opposite sides of the pulmonary trunk.

Question 14

What does the right coronary artery supply?

Answer 14

Right atrium, SA, and AV nodes, and posterior part of the interventricular septum.

Question 15

Where does the right coronary artery run on the anterior surface?

Answer 15

RCA travels in the right atrioventricular groove, passing posteriorly between the right atrium and ventricle. It often gives off the sinoatrial node branch, supplying the SA node. It then continues down the atrioventricular groove to give off the right marginal branch, supplies right border of the heart as it runs towards the apex. It then continues in this groove to the posterior aspect of the heart.

Question 16

What is the course of the right coronary artery on the posterior surface?

Answer 16

On posterior surface of the heart at the junction between the four heart chambers, it gives rise to the atrioventricular nodal branch which supplies the AV node. It then gives rise to the posterior interventricular branch, which descends in between the ventricles, supplying adjacent areas of both ventricles and sending perforating interventricular septal branches into the interventricular septum. It then continues for a short distance int eh posteiror AV groove.

Question 17

What does the left coronary artery supply?

Answer 17

Most of the left atrium and ventricle, IVS, and AV bundles, may supply AV node.

Question 18

What is the acourse of the left coronary artery in the anterior surface?

Answer 18

It runs in the left atrioventricular groove, where it splits into two branches. The anterior interventricular artery runs in the anterior interventricular groove of the apex, where it turns around the inferior border of the ehart and commonly anastomases with the posterior interventircular artery. The AIA supplies adjacent parts of both ventircles, and the interventricular branch gives off the diagonal artery, which runs down the anterior surface of the heart. The second branch is the circumflex branch, which follows the atrioventricular groove to teh posterior surface of the heart.