The Heart Flashcards
Smooth walled Sinus Venarum
From embryonic Rt Sinus Venosus
Fossa Ovalis
From embryonic Foramen Ovale
Shunt from Rt Atrium to Lt Atrium to bypass Lungs
Opening to the coronary sinus
Venous drainage of blood from Heart Wall
Valve directs blood right into the ventricle
Location of SA Node
Superior aspect of Crista Terminalis
Conduction System “Pace Maker”
Crista Terminalis
Separates Original Rt Atrium from smooth walled part
Why does an occlusion of the right side of the heart cause significant issues for the heart?
Both the SA and AV nodes are on the right side
Pectinate muscles
Tricuspid valve
Anterior Cusp of Tricuspid Valve
Posterior and Septal Cusps
Membranous part of IV Septum
IV Septal Defects here are bad
Lack of Neural Crest Cell migration
Heart Defects are most common abnormalities (1 in 100 births)
Defect in muscular portion typically fixes itself as the fetus grows
Chordae tendinae (superior) attached to the anterior papillary muscle
Moderator Band
Part of Conduction System
View of the left atrium and ventricle (sectioned with mitral valve cut away)
Fossa avoalis pictured in left atrium
Where do you listen to heart sounds?
Valves of the heart during systole
Valves of the heart during diastole
Right Coronary Artery From behind Right Cusp of Aortic Valve
Originates from aorta at flap of valsalva (does not full occlude when aortic valve is closed)
The SA nodal branch of the right atrial branch
Supplies the SA node (branch from right coronary artery also aupplies AV node)
Acute Marginal Branch
Small Cardiac Vein parallels it
Acute because of the angle of the artery
Right coronary artery
The posterior interventricular (descending) artery (portion of the right coronary artery)
Paralelled by middle cardiac vein
What is the viewing angle?
From the sternocostal surface
Left coronary artery
From behind Left Cusp of Aortic Valve
Circumflex branch
The circumflex branch typically gives of three obtuse marginal branches
Anterior interventricular artery (LAD)
Really important, supplies 2/3 of the interventricular septum
Great cardiac vein parallels the LAD
Leads into the coronary sinus - coronary sinus leads to right atrium
In dextrocardia, where does the posterior descending interventricular artery arise?
Off of the circumflex artery
Not good, the LAD does 2/3 of the interventricular septum as well as the anterior wall
What is indicated when the apex of the heart points more downward?
Hypertropy of the left ventricle (also with increased left heart border)
Where is the thinnest wall of the heart located?
The apex of the heart
Loss of blood supply causes necrosis and rupture
The red crescent indicates presence of heart tissue
What would this deviation from normal radiograph indicate?
Defective tricuspid valve, causing hypertrophy of the right ventricle
Also the apex of the heart points more superiorly in pulmonary stenosis (outflow tract of the right ventricle)
Right heart border increases
What artery accompanies the phrenic nerve?
One or two pericardicophrenic arteris ( a branch of the internal thoracic - attached to chest wall)
The internal thoracic artery branches off of _____ ?
The proximal subclavian artery
Trauma to the sternum can damage what portion of the heart?
The right ventricle (most anterior)
Where is the left atrium located?
Posteriorly
Mitral valve
Bicuspid (left atrioventricular valve)
Coronary sulcus
Between the right atrium and ventricle (houses the right coronary artery)
Ligamentum areteriosum
Left atrium
Transverse pericardial recess
Moderator band
Coronary sinus
What areas of the heart does the LAD supply?
2/3 of the anterior interventricular septum
Anterior wall
You notice your patient’s heart rate on the monitor increases when you enter the room – what fibers, immediately exiting the cardiac plexus, are responsible for signaling this increase?
Post-ganglionic sympathetic fibers from upper thoracic levels
SA Node
S1
The first heart sound, closure of the mitral and tricuspid valves.
S2
Aortic valve closure, as well as the closure of the pulmonic valves, produces the second heart sound, S2
Which closes first, aortic or pulmonic valve?
The aortic valve closes first during a normal heart beat.
During inspiration, the right heart filling time is increased, which increases right
ventricular stroke volume and the duration of right ventricular ejection compared with the neighboring LV. This delays the closure of the pulmonic valve, P2, splitting S2 into its two audible components. During expiration, the right ventricular ejection period is faster, and A2 and P2 fuse into a single sound, S2.
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Note that because the walls of veins contain less smooth muscle, the venous system has more capacitance than the arterial system and lower systemic pressure. Distensibility and impedance in the pulmonary vascular bed contribute to the “hangout time” that delays P2
Precordial areas of cardiac auscultation
Right second intercostal space or cardiac apex - Aortic valve
Left second and third intercostal spaces close to the sternum, but also at higher or lower levels - Pulmonic valve
At or near the lower left sternal border - Tricuspid valve
At and around the cardiac apex - Mitral valve
