Thoracic Cardiology Flashcards
What separates the mediastinum into and superior and inferior portion?
the sternal angle
what is the inferior mediastinum further broken down into?
an anterior, middle, and posterior mediastinum
what does the middle mediastinum contain?
the heart
what does the right side of the heart receive and what does it do with this?
it receives blood from the superior and inferior vena cava and pumps it out to the lungs for oxygenation
what does the left side of the heart receive and what does it do with this?
it receives oxygen rich blood from the lungs and pumps it out to the entire body via the Aorta
what is pulmonary circulation?
from the superior and inferior vena cava into the right atrium, past the tricuspid valve into the right ventricle out of the heart past the pulmonary valve into the pulmonary trunk, through the right and left lungs and back to the heart through the pulmonary veins
which is thicker, the wall of the right ventricle or the wall of the left ventricle? Why?
the wall of the left ventricle- it needs to pump blood everywhere
what is the outermost layer of the heart?
the epicardium
what is the innermost layer of the heart?
the endocardium (just a thin internal endothelial layer)
what is a myocardial infarction and what is it usually the result of?
lack of blood flow to a specific area of the myocardium, usually the result of a blockage in a coronary a., coronary atherosclerosis, or a buildup of lipids
what is angina pectoris?
pain that originates in the heart and produces a strangling pain in the chest; usually the result of narrow or obstructed coronary arteries that produces ischemia of the myocardium
what is the function of the fibrous skeleton of the heart?
it supports and strengthens the atrioventricular and semilunar orifices and it provides an electrically insulated barrier between the atria and the ventricles
what makes up the base of the lung?
the inferior border of the lung and the diaphragmatic surface of the lung= base of the lung
what is the base of the heart mostly occupied by?
the atrium
what are the three surfaces of the heart?
the sternocostal surface, the diaphragmatic surface, and the pulmonary surface (paired- one on the right one on the left)
what can you see when looking at the sternocostal surface of the heart?
the right ventricle
what does the right atrioventricular groove transmit?
the right coronary artery
what does the anterior interventricular groove transmit?
the anterior interventricular artery and the great cardiac vein
what does the left atrioventricular groove transmit?
the coronary sinus
what does the posterior interventricular groove transmit?
the posterior interventricular artery
what is the ligamentum arteriosum?
an embryological remnant of the ductus arterosis- communication between the pulmonary trunk and the arch of the aorta
what loops around the aortic arch and the ligamentum arteriosum then ascends to the larynx?
the left recurrent laryngeal nerve of the vagus nerve
why is the ligamentum arteriosum clinically relevant?
if we are going to have a weak spot in either the pulmonary trunk or the aorta- this is a potential spot where we can end up with a weak spot or an aneurysm- that then hits the left recurrent laryngeal nerve and causes laryngitis
what is the smooth wall that makes up the right atrium?
sinus venarum
what is the rough wall that makes up the right atrium?
pectinate muscle
what separates the sinus venarum from the pectinate muscle?
the crista terminalis
where is the fossa ovalis found and what is this feature?
it is found in the interatrial septum; it is an embryonic remnant of the foramen ovalis
what could cause an atrial septal wall defect?
incomplete closure of the foramen ovale; if large enough it could allow mixture of oxygen rich blood with oxygen depleted blood
how do we get from right atrium to right ventricle?
right atrioventricular orifice
what is the right atrioventricular orifice partially occluded by?
the tricuspid valve
what is the smooth wall found in the right ventricle?
conus arteriosus
what is the rough wall found within the right ventricle?
trabecula carnae
how does the tricuspid valve close?
they require the pressure of the right atrium to close
how are the free edges of the three cusps anchored to papillary muscles?
via chordae tendineae
where is the septomarginal trabeculum found?
in most right ventricles from the rough muscular region- trabecula carnae
what separates the right ventricle from the pulmonary trunk?
the pulmonary valve
how many cusps does the pulmonary valve have?
3- a right, left, and anterior
what is cardiac catheterization?
insertion of a catheter into the femoral vein which is then passed up to the inferior vena cava allowing radiographic visualization of the right atrium, right ventricle, pulmonary trunk, and pulmonary arteries
How do you get from the left atrium to the left ventricle?
left atrioventricular orifice, which is mostly occluded by the bicuspid valve (aka the mitral valve)
what is the smooth wall of the left ventricle?
the aortic vestibule
what is the wall separating the two ventricles?
the interventricular septum
what parts make up the interventricular septum?
a membranous part and a muscular part
how is the interventricular septum clinically relevant?
there can be ventricular septal defects: due to the embryologically divergent tissues that make up the interventricular septum- it is susceptible to defects, which allow the mixture of oxygen rich blood with oxygen depleted blood
what separates the the left ventricle from the ascending aorta?
the aortic valve in the aortic orifice
what is the aortic sinus?
the space between the wall of the ascending aorta and the cusps of the aortic valve
what do the right and left aortic sinuses house?
the openings for the right and left coronary artery
what makes the heart contract?
some specialized cardiac muscle cells clustered together where the superior vena cava meets the right atrium- the sinuatrial node
what can be said about the sinuatrial node?
it is self-initializing; it causes contractions on regular intervals; the sinuatrial node is thought to be the pacemaker of the heart
what is the atrioventricular node?
a small bundle of specialized cardiac muscle fibers located in the interatrial septum
what can be said about the atrioventricular node?
it is not self-initializing- it requires external stimuli to fire (the stimulus from the electrical signal going through the wall of the atrium from the sinuatrial node
what happens when the atrioventricular node is stimulated?
it goes on to be an atrioventricular bundle, then right and left bundle branches and then subendocardial branches (aka purkinje fibers)
if the sinuatrial node is not behaving as it should, what would you need to do?
place an artificial cardiac pacemaker, which normally is fed right into the ventricle and skips over the atrium
what is atrial fibrillation?
irregular twitching of the atrial cardiac muscle fibers to which the ventricles respond at irregular intervals
what is ventricular fibrillation?
rapid irregular twitching of the ventricles rendering the heart unable to pump blood; an electric shock may be administered in the hopes that the heart may begin beating regularly
what is the outermost layer of pericardium?
fibrous (tough and fibrous)
what is synonymous with epicardium?
visceral serous pericardium
what is attached to the inside of the fibrous pericardium?
parietal serous pericardium
what is the surgical significance of the transverse pericardial sinus?
this space allows cardiac surgeons to access the area posterior to the aorta and pulmonary trunk to clamp or insert the tubes of a bypass machine into these large vessels
what is pericarditis?
inflammation of the pericardium, which can make the pericardium rough and produce friction
what is pericardial friction rub?
it can be observed with a stethoscope and if left untreated the pericardium will calcify
what is pericardial effusion?
inflammation of the pericardium can result in the accumulation of fluid or pus in the pericardial sac, which can compress the heart
what is heart compression known as?
cardiac tamponade
what is a pericardiocentesis?
drainage of blood, fluid or pus from the pericardial sac; usually done to relieve cardiac tamponade
