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CPR Midterm > Thoracic Cardiology > Flashcards

Thoracic Cardiology Flashcards

1
Q

What are the two divisions of the mediastinum and what divides them?

A
  • superior and inferior mediastinum

- divided by the sternal angle

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2
Q

What are the 3 divisions of the inferior mediastinum?

A

-anterior, middle, posterior

middle = heart

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3
Q

What are the 5 layers of the heart internal to external ?

A
  • endocardium
  • myocardium
  • epicardium/visceral serous pericardium
  • parietal serous pericardium
  • fibrous pericardium
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4
Q

What is the endocardium made of?

A

-internal endothelial tissue and subendothelial layer lining the inside chambers of heart and valves

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5
Q

What are the functions of the fibrous pericardium?

A
  • provide attachment for myocardium
  • AV valves
  • support & strengthen AV and semilunar orifices
  • electrical insulation b/w atria and ventricles
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6
Q

What are the two pericardial sinuses and where are they located?

A

1) oblique pericardial sinus - wide recess posterior to the base of the heart
2) transverse pericardial sinus - transverse passage traversing the origins of the great vessels

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7
Q

What is the surgical significance of the transverse sinus?

A

-space allows cardiac surgeons to access the area posterior to the aorta & pulmonary trunks to clamp or insert tubes of a bypass machine into them

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8
Q

Where does the SVC receives its deO2 blood from ?

A

-posterior thoracic wall, head, neck UE

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9
Q

Where does the IVC receive its deO2 blood from?

A

-posterior abdominal wall, LE, Liver

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10
Q

Where does the aortic arch send O2 blood to?

A

head, neck, UE, anterior thoracic wall

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11
Q

Where does the descending aorta send O2 blood to?

A

-LE, pelvis, posterior thoracic wall, abdomen

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12
Q

What are the external features of the heart?

A

1) apex - inferolateral LV
2) base - Posterior, near LA
3) Surfaces - >sternocostal - RV
- > diaphragmatic - RV & LV
- > pulmonary - RA & LV on cardiac impressions
4) Borders
- right = RA
- Left -> LV
- inferior = RV
- superior = RA & LA, exit point to great vessels

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13
Q

Where is the Right Atrioventricular groove and what runs in it?

A
  • in b/w the RA & RV

- right coronary A.

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14
Q

Where is the Left Atrioventricular groove and what runs in it?

A
  • in b/w the LA & LV

- coronary sinus

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15
Q

Where is the anterior inter ventricular groove and what runs in it?

A

b/w LV and RV on anterior heart

-anterior interventricular a. and great cardiac v.

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16
Q

Where is the posterior inter ventricular groove and what runs in it?

A

b/w RV and LV on posterior heart

-posterior inter ventricular a. and middle cardiac v.

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17
Q

What is the sulcus terminals?

A

an external sulcus on the RA that corresponds to the internal crust terminals

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18
Q

What is the Ligamentum Arteriosum ?

A

the remnant of the ductus arterioles (connect palm trunk and aortic arch in fetus & infancy)

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19
Q

What are the Internal Features of the Right Atrium?

A
  • sinus venarum ( vena cavae & coronary sinus empty into)
  • pectinate m. (right auricle)
  • crista terminalis (internal ridge sep. smooth and rough)
  • interarterial septum (fossa ovalis)
  • opening for coronary sinus
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20
Q

What causes an atrial septal defect?

consequence?

A
  • failure of closure of foramen ovals
  • opening can allow for mix go O2 rich and depleted blood
  • 15-20% of adults
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21
Q

What is the Right Atrioventricular Orifice?

A

-passage way b/e RA & RV occluded by the tricuspid valve

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22
Q

What are the internal features of the RV?

A
  • tricuspid valve
  • trabeculae carnae
  • conus arteriosus
  • pulmonary valve
23
Q

Describe the parts of the tricuspid valve and how they’re attached to the heart?

A

-anterior, posterior, and septal cusps attached to anterior, posterior, and septal papillary m. via chordae tendonae

24
Q

What is the septomarginal trabeculum and what does it do?

A
  • aka the moderator band, part of the trabeculae carnae
  • travels from the IV septum to the anterior papillary m.
  • transmits electrical signal from AV bundle to the anterior papillary m.
25
Q

What is the conus arteriosus located?

A

smooth walled structure, leads into pulmonary trunk

26
Q

Describe the features of the pulmonary valve

A

aka semilunar

  • right, left, anterior cusps
  • separates RV from pulmonary trunk
  • has pulmonary sinuses = space b/w cusps of valve and trunk
27
Q

What is cardiac catheterization?

A

insertion of a catheter into the femoral v. and passes up to IVC to view RA, RV, Pulmonary Trunk and Pulmonary A.

28
Q

What are the internal features of the LA?

A
  • thicker walls than RA
  • left auricle (pectinate m.)
  • openings for 4 pulmonary v.
  • interatrial septum
29
Q

What is the Left Atrioventricular orifice?

A

passages for LA to LV, occluded by the bicuspid/mitral valve

30
Q

What are the internal features of the LV?

A
  • thicker walled than RV
  • bicuspid valve
  • trabeculae carnae
  • aortic vestibule
  • interventricular septum
  • aortic valve
31
Q

Describe the features of the bicuspid valve and how attached to heart

A
  • seperate LA and LV

- anterior & posterior cusps attached to anterior & posterior papillary m. via chordae tendonae

32
Q

What is the aortic vestibule?

A
  • smooth walled structure, leading to aortic valuve

- like conus arteriosus of RV

33
Q

What does the interventricular septum house?

A

AV bundle , R/L bundle branches, subendocardial (Purkinje) branches

34
Q

What are the two parts if the IVS?

A

-membranous and muscular (larger)

35
Q

Describe the aortic valve features

A

semilunar, separates LV from aorta

  • occupies Aortic Orifice
  • R,L,posterior cusps
  • aortic sinus = space b/w wall of ascending aorta and cusps
36
Q

What is a special feature of the aortic sinus?

A

has openings for the R & L coronary a.s

37
Q

What is the fibrous skeleton of the heart made of and what are its 3 features?

A
  • dense collagenous fibers
    1) provides attachment points for myocardium and valves of the AV/cuspid valves
    2) supports & strengthens AV and semilunar orifices
    3) provides electrical insulation b/w atria and ventricles
38
Q

What are the two parts of the pericardium and the sinuses they create?

A
  • visceral and parietal

- oblique and transverse pericardial sinuses

39
Q

What is the conducting system of the heart composed of?

A
  • cardic m. cells
  • conducting fibers
  • two bundles of nodal tissue for coordination
40
Q

Where is the SA node located and what does it do?

A
  • where the SVC meets the RA

- pacemaker

41
Q

Where is the AV node and what does it do?

A
  • interatrial septum near opening of coronary sinus

- responds to SA node and distributes signal thru ventricles

42
Q

What is the path of electrical impulse starting in the SA node?

A

SA node -> AV node-> AV bundle->R/L bundle branches -> subendocardial branches ->interventricular septum->papillary m. -> ventricular wall

43
Q

What is Atrial Fibrillation?

A

irregular twitching to the atria fibers to which ventricles respond at irregular intervals
-CIRCULATION IS OK

44
Q

What is a Ventricular Septal Defect?

A

a lack of development of the IVS the allows for mix of O2 rich and depleted blood

45
Q

What is Ventricular Fibrillation?

A
  • rapid irregular twitching of the ventricles
  • heart unable to properly pump blood
  • defibrillate the heart to stop it in hope the it start beating regularly again
46
Q

What is an artificial cardia pacemaker?

A

electrodes inserted into SVC->RA->tricuspid valve->endocardium of trabeculae carnae of RV that produce regular impulse

(replace SA node)

47
Q

What is cardia referred pain?

A

pain caused by ischemia that stimulates visceral pain fibers of heart/ANS
-perception of pain due to shared spinal ganglion w/ somatic sensory fibers of UE and superior lateral chest wall

48
Q

Where is anginas pain referred to?

A

left medial brachial cutaneous n. ; left substernal area ; left pec ; medial aspect of L UE

49
Q

What is pericarditis?

A

inflammation of the pericardium

  • can lead to pericardial friction rub
  • –> calcification of pericardium if untreated
50
Q

What is pericardial effusion?

A
  • pericarditis which cause fluid of pus to accumulate in pericardial cavity
  • > leads to compression of the heart = cardiac tamponade
51
Q

What is pericardiocentesis?

A

drainage of blood, fluid, pus from pericardial sac

-> relieves cardiac tamponade

52
Q

What is myocardial infarction?

A

lack of blood flow to an area of the myocardium

  • usu. b/c of blocked coronary a.
  • caused by : atherosclerosis = build up of lipids on internal walls of a. narrow it (inc. risk of embolus or complete blockage)
53
Q

What is Angina Pectoris?

A

pain that originates in heart and produces strangling pain of chest
-result of narrowed of obstructed coronary a. that produces ischemia of myocardium

54
Q

What is the difference in MI vs Angina?

A 
MI = complete blockage of vessel
Angina = partial blockage

CPR Midterm (13 decks)

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