the heart Flashcards
Spaces of Middle mediastinum
Superior(above t4-5) Inferior (below t4-5) -anterior (infront of heart) -middle (the heart) -posterior (behind the heart)
build up of fluid under the fibrous pericardium leads to
A lot of pain
where is most of the herat
2/3 to the left
where is the apex of the heart
At the midclavicular line
where does the heart sit height
Intercostal space 2-5
layers of the heart wall superficial to deep
- epicardium (visceral layer of the pericardium)
- myocardium
- endocardium
where is myocardium is thickest
In the ventricles
where is the base of the heart
Posteriorly oposite of the apex
where do the great vessels come out of the heart
At the base of the heart
where is the apex of heart
the most inferior part at the tip pointing left
borders of the heart
Inferior (diaphragmatic)
Right
Left
Superior (where vessels come out)
surface of the heart
Anterior- font
Inferior- on diaphram
R pulmonary
L pulmonary
differnce between border and surface
Surface is flat side
Border is the sharp edge
do the r and l parts of the heart work separately
No they work together
how to know what side of the heart is the front
The aorta and pulmonary trunk(more anterior) are on the front
how to know what side of the heart is the back
coronary sinus in the AV sulcus
Pulmonary veins
location of L and R atrium
L: on the left anterior side
R: on the R posterior side
What separates the atria and ventricles
Atrioventricular valves
what is between the ventricles and the ejecting vessels
Semilunar valves
what separates the R and L septum
Interatrial septum
what separates the R and L ventricles
Interventricular Septum
what drains into the right atrium
superior vena cava-near the roof
Inferior vena cava- from the floor
coronary sinus- also the floor but much smaller
what happens to walls of the atrium as you go from septum to walls
Become more roughened
Roughed walls of the Right atrium
Pectinate mm
the line that dinotes the separation between smooth wall and roughened wall of the right atrium
crista terminalis
where is the fossa ovalis
In the right atrium, in the interatrial septum, superior to the coronary sinus
what is fossa ovalis a remnant of
Foramen ovale
The RIght AV valve
Tricuspid
cusps of the RIght AV valve
Anterior
Septal
Posterior
how is the AV valve anchored
Chordae tendineae to papillary mm in the ventricles
what is the texture of the Right ventricles
Roughened
Roughened wall of the ventricle
Trabeculae carnea
Muscles that extend from trabeculae carnea of the atrium to the chordae tendineae
Papillary mm
what is a band of tissue that extends from the Atrial septum to the base of the anterior papillary muscle in the right ventricle
Moderator band (septomarginal trabecula)
The superior part of the Right ventricle to the pulmonary trunk
Conus Arteriosus
where is the pulmonary valve
In the pulmonary trunk at the apex of the infundibulum
Cusps of the Pulmonary trunk
Left
Right
Anterior
presence of corea tendineae and papillary muscle in the pulmonary valves
none present
what drains into the left atrium
4 pulmonary veins
what part of the left atrium is rough
just the left auricle (most of it is smooth) with pectinate muscle
the little lip on the atrial septum of the left atrium
Valve of foramen ovale
The Left AV vAlve
Bicuspid (mitral Valve)
Cusps of the Left av valve
Anterior
Posterior
thickness of r and l ventricle
L is 3x as thick myocardium
where is the aortic valve
In the aorta
cusps of the aortic valve
Left
Right
Posterior
How to listen to AV valves
in the 5th intercostal space
(tricuspid, just left of sternum)
(Bicuspid, far left of sternum)
where to listen to Valves
Down stream
where to listen to semilunar valve
2nd intercostal space
(pulmonary is just L of sternum)
(Aortic is just R of sternum)
main artiers of the heart
Left and Right coronary arteries
where do the R and L coronary arteries branch from
The ascending aorta
main venous drainage of heart
Coronary sinus
length of right and left coronary arteries
Left is super short
what does the Right Coronary Artery supply
R atrium R ventricle Sinu atrial node AV node Interatrial septum Portion of LEft atrium Posteroinferior 1/3 IV septum Portion posterior part of left ventricle
where does The right coronary artery run
Right under the Right auricle of the right atrium
Important branches of the Right coronary artery
Anterior R atrial A
- Sinu-atrial nodal artery
Right Marginal
Posterior interventricular A
travel of the Anterior Right Atrial A
TRavels supperiorly over the top of the heart to make the Sinu-atrial nodal a to the SA node
travel of the Right marginal artery
Right along the R border of the heart
where is the posterior interventricular a
between the two ventricles on the septum on the back of the heart
what does the Left coronary artery supply
Left atrium
Left Ventricle
Interventricular Septum
-Atrioventricular bundle and its branches
where does the Left coronary artery travel
Behind the pulmonary trunk, under the left auricle
branches of the Left Coronary Artery
Anterior Interventricular A (LEft anterior descenind A)
Circumflex A
- left marginal A
where does the Anterior Interventricular A run
Along the interventricular septum on the more left side of the anterior heart over the apex
what does the Anterior Interventricular A anastomose with
Posterior inteventricular
where is the Circumflex A
Goes around the heart on the left side to the back
where does the LEft marginal artery run
Along the left border of the heart
difference between R and L dominant heart
where does the posterior interventricular artery come off
Clinical Significance of R and L dominance
Decides which coronary artery supplies bulk of heart and is a big risk if blocked (possible of Co-dominance)
what dominance is more common
R dominance (60%)
where do veins travel
with arteries
Where is the great cardiac vein
Anteriorly draining directly into the Coronary Sinus
Runs with L anterior descending artery to the posterior
loaction of the midle cardiac vein
Posterior, to run with posterior interventricular artery
location the Small cardiac vein
On the right border of the heart, twists around to drain into the coronary sinus
Runs with the right marginal A
what do the anterior cardiac veins drain into
Directly into the Right atrium deep to auricle
HOw to see the veins of the heart
Put a catheder up the inguinal region all the way to arota where they shoot in dye to see all the arteries
what to do if somehting is blocked in the heart
Coronary artery bypass grafts
what causes the heart to beat
Has its own conducting system
Sympa innervation to heart
T1-T5
Parasympathetic innervation to heart
Vagus N (CN X)
ANS and heart
Affects rate
what do the Sympathetic and parasympathetics contribute to with heart
Both superficial and deep cardiac plexuses
where is the superficial plexus of the heart
right on top of the aorta
where is the deep caridac plexus of the heart
at the trachea bifurcation
conduction systm of the heart
SA node AV node AV bundle (bundle of His) Bundle branches Purkinje fibers
How to deal with Damage to Conduction system of heart
Pacemakers placed subcutaneously throu the Superior Vena cava into the heart
