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MBBCh 2- ANAT2020A > The Heart > Flashcards

The Heart Flashcards

1
Q

What is the position of the heart? (4)

A
  • Lies in the middle mediastinum
  • Behind the body of the sternum and the 2nd to 6th costal cartilages
  • 1 third lies to the right of the midline and 2 thirds lies to the left
  • Lies opposite to T5-T8 vertebrae in supine position and T6-T9 vertebrae in erect position
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2
Q

What is the apex of the heart?

A

Apex- inferolateral part of the left ventricle

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3
Q

What is the base of the heart? (4)

A

o Mainly formed by left atrium and slightly by right atrium
o Faces posteriorly towards T6-T9
o Extends superiorly to bifurcation of pulmonary trunk and Inferiorly to coronary sinus
o Receives pulmonary veins on right and left sides of left atrium and receives SVC and IVC at superior and inferior ends of right atrium

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4
Q

What is the Sternocostal (anterior) surface?

A

Mainly formed by right ventricle, and slight by right atrium and left ventricle.

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5
Q

What is the Diaphragmatic (inferior)?

A

Formed mainly by the left ventricle and partly by the right ventricle

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6
Q

What are the borders of the heart? (4)

A
  • Superior border- formed by right and left atria and auricles
  • Right border- right atrium, between superior and inferior vena cava
  • Left border- formed by left ventricle and a little by the left auricle
  • Inferior border- formed mainly by the right ventricle and slightly by the left ventricle
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7
Q

What is the surface marking of the superior border of the heart?

A
  • 3rd right costal cartilage to 2nd intercostal space on the left of sternum
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8
Q

What is the surface marking of the inferior border of the heart?

A

Sternal end of 6th right costal cartilage to midclavicular line in 5th left IC space

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9
Q

What is the surface marking of the right border of the heart?

A

Extends from 3rd right costal cartilage to near 6th right costal cartilage

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10
Q

What is the surface marking of the left border of the heart?

A

2nd left IC space to midclavicular line in 5th left IC space

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11
Q

What is the sulci of the heart?

A

Sulci of the heart
* Internal partitions divide the heart into 4 chambers and produce surface grooves- sulci

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12
Q

What are the sulci of the heart? (3)

A

o Atrioventricular (coronary) sulcus- on the right and left sides
o Anterior interventricular sulcus
o Posterior interventricular sulcus

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13
Q

Right auricle- continuous _______ pouch

A

muscular

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14
Q

What are the 3 openings of the heart?

A

o SVC- opens at level of 3rd right costal cartilage
o IVC- opens at level of 5th right costal cartilage
o Coronary sinus- between right atrioventricular orifice and orifice of IVC

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15
Q

What are the internal structures of the right atrium? (7)

A
  1. Smooth, thin-walled posterior part (sinus venarum) where all 3 veins open
  2. Rough, muscular anterior portion composed of pectinate muscles
  3. Right AV orifice where blood leaves the right atrium
  4. Sulcus terminalis- shallow vertical groove that externally separates smooth and rough parts of
    the wall
  5. Crista terminalis- internally separates smooth and rough parts of the wall
  6. Fossa ovalis- thumb-shaped depression on the interatrial septum
    o Remnant of the foramen ovale and its valve in the foetus
    o Border- limbus ovalis
  7. SA node is between the SVC and crista terminalis
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16
Q

What are the features of the left atrium? (2)

A
  • Openings for 4 pulmonary veins in its smooth posterior wall
  • Smaller auricle containing pectinate muscle
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16
Q

What are the features of the left atrium? (2)

A
  • Openings for 4 pulmonary veins in its smooth posterior wall
  • Smaller auricle containing pectinate muscle
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17
Q

What does the right ventricle taper into?

A

Tapers superiorly into the conus arteriosus
which leads to the pulmonary trunk

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18
Q

Interior surface of the right ventricle has irregular muscular elevations- ______ _______.

A

Trabeculae carneae

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19
Q

What is the Supraventricular crest in the right ventricle?

A

Thick muscular ridge separating the ridged muscular wall from the smooth wall of conus arteriosus.

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20
Q

What is the tricuspid valve? (2)

A

Tricuspid valve- guards right AV orifice
o Has posterior, septal and anterior cusps
o Chordae tendineae arise from thempapillary muscles and attach to the valve cusps

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21
Q

What do the papillary muscles do?

A

Papillary muscles- prevent prolapse of
tricuspid valve

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22
Q

What is the anterior papillary muscle?

A

Anterior- largest, arising from anterior wall and attaching to anterior and posterior cusps.

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23
Q

What is the poster papillary muscle?

A

Posterior- consists of several parts, arising from the inferior wall of right ventricle and attaches to posterior and septal cusps

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24
Q

What is the septal papillary muscle?

A

Septal- arise from IV septum and attaches to anterior and septal cusps

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25
Q

What is the Septomarginal trabecula (moderator band)?

A
  • Traverses the right ventricle from the inferior part of
    the IV septum to the base of the anterior papillary muscle
    o Helps with right ventricular contraction by facilitating conduction time
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26
Q

What are the major differences between the left and right ventricles? (4)

A
  • walls are 2-3 times thicker than right ventricle
  • trabeculae carneae are finer and more numerous
  • conical cavity longer than right ventricle
  • 2 papillary muscles- larger than in right ventricle
    o Anterior and posterior
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27
Q

What do the mitral valves guard in the left ventricle?

A
  • Mitral valve guards left AV orifice
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28
Q

What is the Aortic vestibule?

A

Aortic vestibule- smooth supero-anterior outflow region leading to the aortic valve

29
Q

Atrioventricular valve function: (4)

A
  • Blood returns to the heart, fills the atria and puts pressure on against the AV valves, forcing them
    open
  • As ventricles fill, valve flaps hang limply into ventricles
  • Ventricles contract, forcing blood against AV valve cusps and causing them to close
  • Papillary muscles contract and chordae tendineae tighten, preventing cusps from everting into atria
30
Q

Semilunar valve function: (2)

A
  • As ventricles relax and intraventricular pressure falls, blood flows back from the arteries
  • The cusps are filled with blood since they are cup-shaped causing them to close
31
Q

Right coronary artery:
Origin
Course
Distribution
Anastomoses

A

Right aortic sinus

Follows right coronary sulcus

Right atrium, SA and AV nodes, posterior IV septum

Circumflex and anterior IV branches of LCA

32
Q

SA nodal (60%) artery:
Origin
Course
Distribution

A

RCA near origin

Ascends to SA node (short branch)

Pulmonary trunk and SA node

33
Q

Right marginal artery:
Origin
Course
Distribution
Anastomoses

A

RCA

Passes to inferior margin of heart towards apex

Right ventricle and apex

IV branches of LCA

34
Q

Posterior IV (67%) artery:
Origin
Course
Distribution
Anastomoses

A

RCA

Runs in posterior IV groove to apex

Ventricles and posterior third of IV septum

Anterior IV branch of LCA at apex

35
Q

AV nodal artery:
Origin
Course
Distribution

A

Near origin of posterior IV a.

Passes to AV node (short branch)

AV node

36
Q

Left coronary artery:
Origin
Course
Distribution
Anastomoses

A

Left aortic sinus

Branches near origin

Most of left atrium and ventricle, IV septum and AV bundles

RCA

37
Q

SA nodal (40%) artery:
Origin
Course
Distribution

A

Circumflex br.

Ascends on posterior surface of left atrium to
SA node

Left atrium and SA node

38
Q

Anterior IV artery:
Origin
Course
Distribution
Anastomoses

A

LCA near origin

Passes along anterior IV groove to apex

Ventricles and anterior 2 thirds of IV septum

Posterior IV branch of RCA at apex

39
Q

Circumflex artery:
Origin
Course
Distribution
Anastomoses

A

LCA near origin

Passes left in AV sulcus running posteriorly

Left atrium and ventricle

RCA

40
Q

Left marginal artery:
Origin
Course
Distribution
Anastomoses

A

Circumflex br.

Follows left border

Left ventricle

IV branches

41
Q

Posterior IV (33%) artery:
Origin
Course
Distribution
Anastomoses

A

LCA

Runs in posterior IV groove to apex

Ventricles and posterior third of IV septum

Anterior IV branch

42
Q

Venae comitantes
o Small cardiac v. runs with ____ _____ a.
o Middle cardiac v. runs with _______ IV a.
o Anterior IV v. (first part of greater cardiac v.) runs with ______ IV a.

A

right marginal
posterior
anterior

43
Q

Great cardiac vein drains: (3)

A
  • Anterior 2 thirds of IV septum
  • Ventricles
  • Left atrium
44
Q

Middle cardiac vein drains: (2)

A
  • Posterior third of IV septum
  • Ventricles
45
Q

Small cardiac vein drains:

A
  • Right atrium and ventricle
46
Q

Oblique vein of left atrium drains:

A
  • Posterior left atrium
47
Q

Posterior vein of left ventricle drains:

A
  • Posterior left ventricle
48
Q

What are the Anterior cardiac veins? (2)

A

o Several small veins draining blood from anterior aspect of right ventricle
o Open into right atrium

49
Q

What is the function of the Venae cordis minimae? (2)

A

o Drains endocardium and deep myocardium
o Open directly into every chamber

50
Q

How is the heart innervated? (3)

A
  • Sympathetic fibers- superior, middle and inferior cervical ganglia (T1-T4)
  • Parasympathetic fibers- vagus nerve
  • Fibers reach heart via superficial and deep cardiac plexuses
51
Q

Conduction system of the heart
What are the 3 components?

A
  1. Sinoatrial node
  2. Atrioventricular node
  3. AV bundle
52
Q

What is the function of the Sinoatrial node? (3)

A

o Pacemaker
o Initiates impulses and contractions
o Located anterolaterally just deep to epicardium at junction of SVC and right atrium near the
superior end of sulcus terminalis

53
Q

What is the function of the Atrioventricular node? (2)

A

o Located in postero-inferior region of interatrial septum near opening of coronary sinus into the right atrium
o Contraction is delayed

54
Q

What is the function of the AV bundle? (3)

A

o Bridge between atrial and ventricular myocardium, passing through fibrous skeleton of heart along the IV septum
o Divides into left and right bundles which ramify (branch) into Purkinje (subendocardial) fibers
o Purkinje fibers extend into the walls of the ventricles and stimulate the anterior papillary muscles via the moderator band

55
Q

How does the conduction system of the heart work? (4)

A
  1. SA node initiates an impulse that is rapidly conducted to cardiac muscle fibers in atria causing them to contract
  2. Impulse spreads by myogenic conduction which rapidly transmits the impulse from SA node to AV node
  3. Signal is distributed from AV node through AV bundle and its right and left branches to Purkinje fibers
  4. Ventricles contract
56
Q

Aortic valve:
Location
Auscultation site

A

Posterior to sternum at level of 3rd IC space

2nd right IC space at sternal border

57
Q

Pulmonary valve:
Location
Auscultation site

A

3rd costal cartilage at left side of sternum

2nd left IC space at sternal border

58
Q

Tricuspid valve:
Location
Auscultation site

A

Posterior to sternum at right 3rd or 4th IC space

5th left IC space at sternal border

59
Q

Mitral valve:
Location
Auscultation site

A

Posterior to sternum at 4th left costal cartilage

5th left IC space at midclavicular line

60
Q

What is Angina pectoris? (2)

A
  • Chest pain due to myocardial ischemia
  • Often caused by narrowed coronary arteries
61
Q

What is the Cardiac referred pain in terms of an Angina pectoris? (3)

A

o Visceral afferent fibers travel within the sympathetic cardiac nerves to the sympathetic
trunk on their way to the spinal cord, which they enter through T1-T5
o These visceral afferents are thus in the same roots as the somatic afferents returning
from the medial border of the left upper limb and side of chest wall
o Cardiac pain is often referred to areas of the body surface which send sensory impulses
to the same levels of the spinal cord that receive cardiac sensation

62
Q

What is a Myocardial infarction?

A

Necrosis of cardiac tissue due to ischemia to heart’s muscular wall

63
Q

How is a myocardial infarction caused? (3)

A

Caused by occlusion of ‘end’ coronary aa. with an embolus
o Anterior IV branch (of LCA)
o RCA
o Circumflex branch (of LCA)

64
Q

Ascending aorta:
Origin
Course
Branches

A
65
Q

Arch of aorta:
Origin
Course
Branches

A
66
Q

Thoracic (decsending) aorta:
Origin
Course
Branches

A
67
Q

Posterior intercostal:
Origin
Course
Branches

A
68
Q

Bronchial (1- 2 branches)
Origin
Course
Branches

A
69
Q

Esophageal
Origin
Course
Branches

A
70
Q

Superior phrenic (vary in number)
Origin
Course
Branches

A
71
Q

Fill in the missing labels.

A

MBBCh 2- ANAT2020A (60 decks)

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