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Anatomy: Thorax and Neck > The Heart > Flashcards

The Heart Flashcards

1
Q

where does the right atria receive blood from?

A

superior and inferior vena cava

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2
Q

The surface of the right atrium can be divided into two parts, smooth and rough these two parts are separated by a muscular ridge called what?

A

crista termanalis, this extends between the superior and inferior vena cava

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3
Q

what separates the right and left atria?

A

interatrial septum

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4
Q

what is the small oval-shaped depression in the septal wall of the right atrium called and what is it a remnant of?

A

fossa ovalis: it is a remnant of the foramen ovale which allows blood to flow from the right to left atrium bypassing the lungs in the foetus. After birth it closes.

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5
Q

does the left atrium receive oxygenated or deoxygenated blood? where does it receive this blood from?

A

the left atrium receives oxygenated blood from the four pulmonary veins (coming from the lungs)

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6
Q

does the right atrium receive oxygenated or deoxygenated blood? where does it receive this blood from?

A

the right atrium receives deoxygenated blood from the superior and inferior vena cava. This comes from the rest of the body.

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7
Q

Where does the right ventricle pump blood through?

A

the pulmonary artery which goes to the lungs.

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8
Q

Where does the left ventricle pump blood through?

A

the aorta which goes to the rest of the body

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9
Q

What are chordae tendinae?

A

connect papillary muscles to the tricuspid valve cusps. These prevent the valve cusps becoming everted into the atrium during ventricular systole.

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10
Q

What separates the two ventricles?

A

interventricular septum

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11
Q

which valve separates the right atrium from the right ventricle?

A

tricuspid valve

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12
Q

which valve separates the left atrium from the left ventricle?

A

mitral valve

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13
Q

name the four valves in the heart

A

tricuspid valve: separates the right atrium and ventricle
mitral valve: separates the left atrium and ventricle
aortic valve: separates left ventricle from the aorta (semilunar)
pulmonary valve: separates the right ventricle from the pulmonary trunk (semilunar)

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14
Q

what are the muscular ridges inside the ventricles called?

A

trabeculae carneae

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15
Q

why are the walls of the left ventricle 3x thicker than the right?

A

because of increased pressure required to push blood to systemic circulation

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16
Q

where is the apex of the heart?

A

formed by the left ventricle, mid-clavicular line 5th intercostal space

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17
Q

what blood vessels come off the arch of the aorta?

A

brachiocephalic artery, left common carotid artery and left subclavian artery

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18
Q

what is the aorta divided into?

A

ascending aorta, arch of the aorta and descending aorta

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19
Q

where does the arch of the aorta commence and end? (surface landmark)

A

commences at the sternal angle and ends at the lower border of T4.

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20
Q

What is the small vein which lies across the arch of the aorta called?

A

left superior intercostal vein: this drains the 2nd and third intercostal spaces and in turn drains into the left brachiocephalic vein

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21
Q

what does the pulmonary trunk branch into?

A

the right and left pulmonary arteries at T5-T6. which supply the respective lung on each side.

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22
Q

How many pulmonary veins are there?

A

4 pulmonary veins, 1 superior and 1 inferior for each lung. Superior return blood from the upper lobes and inferior the lower lobes.

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23
Q

what veins is the superior vena cava formed from?

A

merging of brachiocephalic veins

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24
Q

Where does the inferior vena cava receive blood from?

A

lower body, all structures inferior to the diaphragm. It is initially formed in the pelvis by the common iliac veins joining together.

25
Q

where does the inferior vena cava enter the pericardium?

A

T8

26
Q

Where does the superior vena cava receive blood from?

A

upper body from the merging of the brachiocephalic veins

27
Q

What is the heart muscle supplied by?

A

right and left coronary arteries.

28
Q

Where do the right and left coronary arteries arise from?

A

left and right aortic sinuses, small openings behind the flaps of the aortic valve. When the heart is relaxed the backflow of blood allows pooling of blood in these valve pockets meaning blood can flow to the coronary arteries.

29
Q

What does the left coronary artery initially branch into?

A

the left anterior descending artery (widow maker- most commonly occluded)

30
Q

What branches off the left anterior descending artery?

A

left marginal artery and left circumflex artery

31
Q

What does the right coronary artery branch into?

A

right marginal artery, in 80-85% of individuals it also branches into the posterior interventricular artery

32
Q

What does the first heart sound mean in terms of action of the heart?

A

atrioventricular valves closing

33
Q

what does the second heart sound mean in terms of action of the heart?

A

semilunar valves closing (aortic and pulmonary valve).

34
Q

What are the main components of the conducting system of the heart?

A

Sinoatrial node, Atrioventricular node, Bundle of His and Purkinje fibres

35
Q

Where is the excitation signal created to begin a heart muscle contraction?

A

Sinoatrial node, top of the right atrium

36
Q

Where is the atrioventricular node located?

A

on the interatrial septum close to the tricuspid valve

37
Q

Describe the sequence of electrical events leading to a full contraction of the heart muscle

A

A excitation signal is created by the sinoatrial node
this wave of excitation spreads across the atria causing them to contract
Upon reaching the AV node the signal is delayed
It is then conducted into the bundle of his down the interventricular septum
The bundle of his and purkinje fibres spread the wave impulses along the ventricles causing them to contract.

38
Q

What is the parasympathetic nerve supply to the heart?

A

Vagus nerve CX

39
Q

What is the sympathetic nerve supply to the heart?

A

cervical and upper thoracic sympathetic ganglia

40
Q

What are branches of the left common carotid artery?

A

internal common carotid (brain) and external common carotid (face)

41
Q

describe the blood flow from the left subclavian artery to the wrist?

A

axillary artery (upper limb) then brachial artery (arm, brachial pulse), radial artery (wrist, radial pulse), ulnar artery (wrist)

42
Q

What could a heaving apex beat which is forecful and sustained indicate?

A

hypertension or aortic stenosis (pressure overload)

43
Q

what could a thrusting beat which is forceful but not sustained indicate?

A

mitral of aoritc regurgitation (volume overload)

44
Q

What could a tapping apex beat (sudden but brief) indicate?

A

mitral stenosis

45
Q

When could the apex beat be missing?

A

obesity, pleural or pericardial effusion, emphysema

46
Q

what are the cardiac veins tributaries of?

A

coronary sinus: sizeable vein on the posterior surface or the atrioventricular groove , it opens into the right atrium.

47
Q

what artery does the great cardiac vein accompany?

A

posterior interventricular artery/ posterior descending artery

48
Q

what artery does the small cardiac vein accompany?

A

marginal artery

49
Q

where do the anterior cardiac veins drain into?

A

right atrium

50
Q

If a coronary artery or its branch is occluded what is the most likely pathology?

A

myocardial infarction: cell death due to inadequate blood supply

51
Q

If there is partial occlusion of a coronary artery or its branch what is the likely symptom?

A

Angina: deep pain in sternal area radiating to the left arm and left side of neck

52
Q

which artery is named the ‘widow maker’ due it being the most often occluded in fatal heart attacks?

A

left anterior descending artery. This is due to it supplying blood to the most vital and largest areas of the heart muscle

53
Q

What technique would you use to diagnose partial or full occlusion of a coronary artery and what could the treatment be?

A

coronary angiogram: inject radio-opaque dye

Angioplasty

54
Q

What is Pericardiocentesis?

A

when there is accumulation of blood or fluid in the pericardial cavity (due tot trauma or disease) pericardiocentesis is the procedure used to drain this fluid. A needle is placed at a 45 degree angle towards the left shoulder between the xiphoid process and left 7th costal carticalge .

55
Q

What would occur if the chordae tendinae or papillary muscles failed?

A

tricuspid incompetence and regurgitation of blood back into the atrium during ventricular systole. Blood from the atrium can then pool back into the liver and neck veins (via the SVC and IVC as they don;t have valves). Therefore you would get enlarged neck veins and a palpable liver.

56
Q

what symptoms could occur with an aortic arch aneurysm?

A

occlude the left bronchus, left lung collapse. compression fot he left recurrent laryngeal nerve, cause a change in voice

57
Q

What lung symptom could you get with left heart failure?

A

fluid in the lungs and crackling

58
Q

what symptoms could be present with right heart failure?

A

oedema in the legs

Anatomy: Thorax and Neck (6 decks)

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