The Heart Flashcards

1
Q

pulmonary circulation

A

right heart pumps deoxygenated blood to the lungs at a low pressure of 12-16 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

systematic circulation

A

left heart pumps oxygenated blood throughout the body at a high pressure of 70-120 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what makes up the sternocostal surface

A
  • Right ventricle
  • right atrium ( a little)
  • left ventricle (a tiny bit)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

diaphragmatic surface

A
  • Left ventricle
  • a little right ventricle

Separated from the base of heart by the coronary sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Apex of the heart

A

✓ Left 5th intercostal space and 8-10 cm left of midline

✓ More superior and lateral in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Base of the heart

A

✓ Composed primarily of left atrium and pulmonary veins, small portion of right atrium.

✓ Fixed posteriorly to the pericardium, at the level of T6(5)-T9(8) vertebrae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Right margin:

A

– Right atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Left margin:

A

– Left ventricle and left auricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Inferior margin

A

– Right ventricle + left ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

✓ Coronary sulcus

A

− Separates atria from ventricles
− Right coronary artery
− Left circumflex artery
− Coronary sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

✓ Anterior interventricular sulcus

A

– Anterior interventricular artery
– Great cardiac vein [Anterior interventricular vein]
– Right of the apex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

✓ Posterior interventricular sulcus

A

– Posterior interventricular artery

– Middle cardiac vein [Posterior interventricular vein]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

SEPTA & CHAMBERS

A
✓ Interatrial (IA) septum
✓ Interventricular (IV) septum
✓ Atrioventricular (AV) septum
✓ Right (RA) and left (LA) atria
✓ Right (RV) and left
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

RIGHT ATRIUM (RA)

A

✓ Temporary reservoir for deoxygenated blood
✓ Receives blood from Superior v. cava (SVC), inferior v. cava (IVC), coronary sinus and smallest cardiac veins
✓ Internally, crista terminalis is a muscular ridge that separates right atrium from right auricle
✓ Sulcus terminalis externally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

✓ Fossa ovalis

A

− On the right side of IA septum
− Site of foramen ovale in foetus
− Margin is limbus fossae ovalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

✓ Opening of SVC

A

− Deep to the joint between right
3rd costal cartilage and sternum
− No valve
− Intervenous tubercle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

✓ Opening of coronary

A

− Valve of coronary sinus

prevent regurgitation of blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

RIGHT AURICLE

A

Rough surface, formed by pectinate muscles

− Provide some power of contraction without significantly thickening the cardiac wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

RIGHT VENTRICLE (RV)

A

✓ Deoxygenated blood from the RA enters through right AV orifice into the RV
✓ Sits on central tendon of diaphragm
✓ Wall thickness 3-4 mm.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

✓ Outflow tract right ventricle

A

Infundibulum [conus arteriosus] where the pulmonary trunk arises
− Blood flows upwards, backwards and to the left
− Surface of Infundibulum is smooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Walls of RV have numerous irregular muscular ridges called

A

Trabeculae carnea

22
Q

✓Morphologically there are 3 types of muscles on right ventricle wall

A
  1. Trabeculacarnea
  2. Septomarginal trabecula
    − Bridge between IV septum and anterior papillary muscle
    − Only in RV
    − Carries right bundle branch of AV bundle of cardiac conduction system
23
Q

Papillary muscles

A

− Fibrous chords called Chorda tendinea run between their apex and free edges of tricuspid valve cusps
− Contract before ventricular

24
Q

Chorda tendinea

A

prevent evertion of cusps→regurgitation of blood into the atria during ventricular systole
✓Chorda tendinea from one papillary muscle attach to more than one cusp

25
Q

TRICUSPID VALVE

A

✓ Closes right AV orifice
✓ Consists of 3 cusps (anterior,
posterior and septal)
✓ Base of each cusp attached to right fibrous ring (anulus fibrosus)
✓ Blood flows forwards and medially through this valve

26
Q

PULMONARY VALVE

A

✓ Consists of 3 semilunar cusps: anterior, right and left
✓ On their free edge, there is nodule of the semilunar cusp
✓ Each cusp forms a pulmonary sinus, which helps closure of pulmonary valves after systole

27
Q

LEFT ATRIUM (LA)

A

✓ Forms most of the base of heart
✓ Four pulmonary veins carry
oxygenated blood from the lungs
− Pulmonary veins do not have valves

✓ Consists of Left auricle and left atrium
✓ Depressed area on the IA septum (falx septi) is caused by the fusion of valve of foramen ovale
− Not at the same level as foramen ovale

28
Q

LEFT VENTRICLE (LV

A

✓ Blood flows anteriorly, towards the apex
✓ Thickest wall: 8-12 mm
✓ LV pressure: 70-120 mmHg
✓ Apex belongs to left ventricle
✓ Muscular ridges: Trabecula carnea
✓ Anterior and posterior papillary muscles

29
Q

MITRAL (BICUSPID) VALVE

A

✓ Consists of 2 cusps: anterior and posterior
✓ Bases of the cusps are attached to left fibrous ring (anulus fibrosus)
✓ Chorda tendinea extend between their free margins and papillary muscles

30
Q

AORTIC VALVE

A

✓ Aortic vestibule is the outflow tract of LV
✓ Blood in the LV is ejected into the aorta
✓ Blood flows upwards, backwards and to the right side through this valve
✓ Aortic orifice is closed by aortic valve ✓ Consists of 3 semilunar cusps: Right,
left, posterior

31
Q

Between the superior surface of the cusps and aortic wall are pocket-like aortic sinuses called

A

sinus Valsalvae

32
Q

AORTIC VALVE

A

3 semi-lunar cusps at the apex of the aortic vestibule (right and left→coronary, posterior → non-coronary sinus)

33
Q

FIBROUS SKELETON of HEART

A

Provides a great amount of structural and functional support
✓ 4 fibrous rings (anulus fibrosus) around AV, aortic and pulmonary valves
✓ Between the four rings are two trigones (right and left) and the membranous portions of the IA, IV, and AV septa

34
Q

FIBROUS SKELETON of HEART functions

A

Points of attachment for the cusps
✓ Maintains the patency and integrity of AV
and semilunar orifices
✓ Serves as origin/insertion for atrial and ventricular muscles
✓ Insulates the atria from the ventricles
− Allows independent atrial and
ventricular contraction
− Atrioventricular bundle of His should be the only conduction between them (arrhythmias)

35
Q

✓ Endocardium:

A

Thin layer of endothelium that lines the inner surface of the walls as well as the valves. Receives oxygen and nutrients directly from the chambers of the heart

36
Q

✓ Myocardium

A

− Atrialmusculature
− Ventricular musculature
− Muscles are arranged in spiral and circular bundles − Originate and insert on fibrous skeleton

37
Q

✓ Epicardium

A

Visceral layer of the serous pericardium

38
Q

1st corner of the heart

A

Right 3rd costal cartilage – 2 cm right of the midline

39
Q

2nd corner of the heart

A

Right 6th costal cartilage – 2 cm right of the midline

40
Q

3rd corner of the heart

A

Left 5th costal cartilage – 7-9 cm left of the midline (apex cordis)

41
Q

4th corner of the heart

A

Left 2nd costal cartilage – 3 cm left of the midline

42
Q

✓ Tricuspid valve

A

Behind the right half of the sternum, at the level of the 4th intercostal space

43
Q

✓ Mitral valve:

A

Posterior to the articulation between left 4th costal cartilage and the sternum

44
Q

✓ Pulmonary valve:

A

Posterior to the articulation between left 3rd costal cartilage and the sternum

45
Q

✓ Aortic valve:

A

Posterior to the sternum, at the level of the 3rd intercostal space

46
Q

heart sounds

A

✓ Closure of AV valves causes 1st heart sound
✓ Closure of semilunar valves causes 2nd heart sound
✓ Rapid filling of the ventricle causes 3rd heart sound
✓ Sitting or recumbent position, inspiration, expiration, valsalva manoeuvre, exercise can cause changes in heart sounds

47
Q

✓ Tricuspid valve (HS1)

A

Best heard just to the left of the lower part of the sternum near the 5th intercostal space

48
Q

✓ Mitral valve (HS1):

A

Best heard over the apex of the heart in the left 5th intercostal space at the midclavicular line (apex cordis)

49
Q

Aortic valve (HS2):

A

Best heard over the medial end of the right 2nd intercostal space

50
Q

✓ Pulmonary valve (HS2)

A

Best heard over the medial end of the left 2nd intercostal space