Thoracic cardiology Flashcards
what does the right side of the heart do?
receivess blood from SVC and IVC
pumps it to lung for oxygenation
what does the left side of the heart do?
recieves blood from lungs
pumps it to body
describe the flow of systemic circulation
left atrium past bicuspid to left ventricle
out of heart past aortic valve into aorta
through arteries, then capillaries
through venous system
back to heart via IVC and SVC
describe the flow of pulmonary circulation
from SVC and IVC into right atrium past tricuspid valve
into right ventricle out of heart
past pulmonary valve into pulmonary trunk
through lungs back into heart via pulmonary veins
what are the layers of the heart
epicardium (outermost)
myocardium
endocardium
fibrous skeleton of heart
what is epicardium made up of?
visceral serous pericardium
what is myocardium made up of?
overlapping layer of muscles
what does a MI come from? what happens?
due to blockage of coronary artery, coronary atherosclerosis, buildup of lipids in coronary arteries
size of coronary arteries is reduced, increasing likelihood of embolism
what is angina pectoris?
pain that comes from heart, strangling pain in chest
due to narrow or obstructed coronary arteries which causes ischemia
what is the endocardium?
thin internal endothelial and subendothelial layer that lines inside of heart chambers
what is the fibroskeleton of heart?
attachment points of myocardium
attachment points of cuspid valves
supports AV and semilunar orifices
insulated barrier between atria and ventricles
what makes up the apex of the heart?
left ventricle
what makes up the base of the heart?
left atrium
what are the 3 surfaces of the heart, what makes them up?
sternocostal (right ventricle)
diaphragmatic (right and left ventricles)
pulmonary( right atrium and left ventricle)
what make up the borders of the heart?
right (right atrium)
inferior (right ventricle)
left (left ventricle)
superior (right and left atria, exit point for aorta, pulmonary trunk)
what does the right atrioventricular groove transmit?
right coronary artery
what does the left atrioventricular groove transmit?
coronary sinus
what does the anterior atrioventricular groove transmit?
anterior interventricular a and great cardiac v
what does the posterior atrioventricular groove transmit?
posterior interventricular a and middle cardiac v
what does the sulcus terminalis correspond to?
internal crista terminalis
what is the ligamentum arteriosum?
remnant of ductus arteriosus
communication between superior pulmonary trunk and inferior arch of aorta
what wraps arounf aortic arch and ligamentum arteriosum before going to larunx?
left recurrent laryngeal n
and
vagus n
what are the internal features of right atrium?
sinus venarum
pectinate muscles
crista terminalis
interatrial septum
opening for coronary sinus
what is sinus venarum?
posterior, thin
where venae cavae and coronary sinus empty
what is the pectinate muscles
anterior, rough
what is crista terminalis?
separates smooth and rough regions of right atrium
what is contained in interatrial septum?
fossa ovalis
what is a septal defect in adults?
incomplete closure of foramen ovale
can cause oxygen rich and oxygen poor blood to mix
what occludes the right atrioventricular orrifice?
tricuspid valve
what are the three cusps of the tricuspid valve, what do they attach to?
anterior, posterior ,septal
attach to corresponding papillary m via chorda tendinae
what are the main landmarks of the right ventricle?
tricuspid valve
trabeculae carnae
conus arteriosus
pulmonary valve
trabeculae carnae contains what?
septomarginal trabeculum , which goes from intervenricular septum to base of anterior papillary m
what does septomarginal trabculum do?
transmits right bundle branch of AV bundle to anterior papillary m
what does the conus arteriosus do?
leads from right ventricle into pulmonary trunk
what makes up the pulmonary valve? what does it seperate
right, left, anterior cusp, seperates right ventricle from pulmonary trunk
what is a pulmonary sinus?
between pulmonary trunk and cusp of pulmonary valve
what is cardiac catherization?
insert a catheter into femoral vein, pased up IVC to visualie right atrium, right ventricle, pulmonary trunk and arteries
what does the left atrium contain?
how is it different from right atrium?
left auricle, which contains pectinate m
openings for pulmonary vein
interatrial septum
thicker than right
what does the eft atrioventricular orifice contain?
bicuspid valve
how is the left ventricle different from right ventricle?
thicker
what does the left ventricle contain?
bicuspid valve
trabecula carnae
aortic vestibule
IV septum
Aortic valve
what are the cusps of the mitral valve?
anterior and posterior cusp
where does the aortic vestibule lead?
left ventricle to aorta
what does the inerventricular septum contain?
has atrioventricular bundle
right and left bundle branches
subendocardial branches
membranous and muscular(larger) parts
why are ventricular septal defects relevant?
divergent tissues make up interventricular septum, more susceptible to defects
mix oxygen rich and oxygen poor blood
what makes up aortic valve?
what does it do?
left, right and posterior cusps
separates left ventricle from ascending aorta
what does the conducting system of the heart consist of ?
cardiac muscle cells, conducting fibers, bundles of nodal tissue that coordinates cardiac cycle
what are aortic sinuses?
between wall of ascending aorta and cusps of aortic valve
house openings of right and left coronary artery
what happens at the beginning of diastole?
closure of aortic and pulmonary valvs due to drop in pressure in ventrivles
what happens during early diastole?
AV valves open, flooding ventricles with blood
what happens during diastole?
atrial contraction takes place, blood sent to ventricles
what happens at the beginning of systole?
AV valves close due to increased pressure in ventricles
what happens at early systole?
ventricles contract, increasing pressure, opening aortic and pulmonary valves
what happens during systole?
ventricular contraction, expulsion of blood into ascending aorta and pulmonary trunk
where is SA node located, what does it do?
in myocardium, SVC meets right atrium, small bundle of muscle fivers that initiate and regulate impulses
propgate through atrial walls
“PACEMAKER OF HEART”
“MAKES DIASTOLE”
where is AV node located, what does it do?
located in interatrial septum near opening of coronary sinus
receives impulse from SA node, sends to ventricles
what does the atrioventricular bundle do?
distributes impulse from AV node to right and left AV bundles, which send to subendocardial branches
what does the subendocardial branches do?
distribute signal from AV bundles to IV septum, then to papillary muscles, then to ventricular wall
“purkinje fibers”
what does artifical cardiac pacemaker do?
provides electric impulse that is carried to ventricles via electrodes that are inserted to SVC into right atrium, past tricuspid valve
into endocardium of trabecula carnae of right ventricle
what is atrial fibrillation?
irregular twitching of atrial cardiac muscle, ventricles respond,
circulation is fine
what is ventricular fibrillation?
irregular twitching of ventricles that make heart unable to pump blood
defibrillation can be done to restart heart
what is cardiac referred pain?
ischemia that stimulate viceral pain sensory fibers in heart
share ganglion with somatic sensory fibers of upper limb or superior lateral chest wall
referred angina pain by left medial brachial cutaneous nerve
where is cardiac referred pain felt mostly?
left substernal area, left pectoral area, medial aspect of left upper limb
What are the layers of the pericardium?
serous
fibrous
oblique
transverse pericardial sinus
what are the parts of the serous pericardium?
explain them
parietal: adheres to fibrous
visceral: adheres to heart, makes up epicardium?
what is so significant about transverse pericardial sinus?
traverses origins of great vessels
how is transverse pericardial sinus relevant to surgery?
cardiac surgeons can access area posterior to aorta and pulmonary trunk to clamp bypass into vessels
what is pericarditis?
inflammation of pericardium, can calcify, makes pericardium rough
what is pericardial effusion?
inflammaion of pericardium, accumulation of fluid, which can compress heart
“TAMPONADE”
what is pericardiocentesis?
drainage of fluid from pericardial sac, releiving cardiac tamponade
