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Clinical Anatomy > Thorax 3 - The Heart (gross anatomy) > Flashcards

Thorax 3 - The Heart (gross anatomy) Flashcards

1
Q

what part of the mediastinum is the heart located?

A

middle mediastinum

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2
Q

what axis does the heart lie on? why is this clinically important?

A

oblique axis/ orientation - important for proper ECG interpretation

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3
Q

what are the 5 main surfaces of the heart?

A

anterior/sternocostal
posterior/base
inferior/ diaphragmatic
right pulmonary
left pulmonary

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4
Q

there are 5 surfaces of the heart - list the heart chambers that (mainly) contribute to forming these surfaces

A

anterior - right ventricle (+ right auricle/atrium, left ventricle

posterior - left atrium (+ right atrium)

inferior - left ventricle (+ right ventricle)

right pulmonary - right atrium

left pulmonary - left auricle & ventricle

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5
Q

which heart chamber is most likely to be injured in midline penetration injuries?
A: right auricle
B: right atrium
C: right ventricle
D: left atrium
E: left auricle

A

C: right ventricle (largely constitutes anterior surface of heart)

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6
Q

which chamber mainly forms the anterior (sternocostal) surface of the heart?
A: right auricle
B: right atrium
C: right ventricle
D: left atrium
E: left auricle

A

C: right ventricle

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7
Q

which chamber mainly forms the posterior (base) surface of the heart?
A: left atrium
B: left ventricle
C: right atrium
D: right ventricle
E: right auricle

A

A: left atrium

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8
Q

which chamber mainly forms the inferior (diaphragmatic) surface of the heart?
A: left atrium
B: left ventricle
C: right atrium
D: right ventricle
E: right auricle

A

B: left ventricle (+ small part of right ventricle)

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9
Q

which chamber mainly forms the right pulmonary surface of the heart?
A: left atrium
B: left ventricle
C: right atrium
D: right ventricle
E: right auricle

A

C: right atrium

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10
Q

which chamber mainly forms the left pulmonary surface of the heart?
A: left atrium
B: left ventricle
C: right atrium
D: right ventricle
E: right auricle

A

B: left ventricle

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11
Q

which of these structures doesn’t contribute to the anterior/sternocostal surfaces of the heart?
a) right atrium
b) right ventricle
c) left atrium
d) left ventricle

A

C: left atrium - contributes to posterior/base surface

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12
Q

beyond the left atrium, what other chamber gives a small contribution to the posterior surfaces of the heart?
A: left ventricle
B: right atrium
C: right ventricle
D: right auricle

A

B: right atrium

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13
Q

what are the 4 main borders of the heart?

A

right border
left border
inferior border
superior border

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14
Q

what chambers contribute to the superior border?

A

right & left atrium
roots of great vessels (aorta & pulmonary trunk)

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15
Q

what chambers contribute to the inferior border?

A

right ventricle
left ventricle

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16
Q

what chambers contribute to the right border?

A

right atrium

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17
Q

what chambers contribute to the left border?

A

left atrium
left ventricle

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18
Q

the left & right ventricles contribute to WHAT border of the heart?
A: right
B: left
C: superior
D: inferior

A

D: inferior

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19
Q

what vessel does the atrioventricular (coronary) sulcus contain?

A

right & left coronary arteries

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20
Q

what vessels (one vein, one artery) does the anterior interventricular sulcus contain?

A

anterior interventricular artery/ left anterior descending artery (LAD)
great cardiac vein

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21
Q

what vessels (one vein, one artery) does the posterior interventricular sulcus contain?

A

posterior interventricular artery
middle cardiac vein

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22
Q

what structure separates the two atria?

A

interatrial septum

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23
Q

what structure separates the two ventricles?

A

interventricular septum

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24
Q

what does the right pump of the heart do?

A

receives deoxygenated blood from the body > right atrium > right ventricle > pulmonary artery > lungs for oxygenation

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25
what does the left pump of the heart do?
receives oxygenated blood from the lungs via pulmonary veins > left atrium > left ventricle > aorta > systemic circulation
26
what is the clinical significance of the cardiac silhouette on a chest X-ray?
helps assess heart size & shape - aids in diagnosis of different cardiac and/or pulmonary conditions
27
the right atrium has a smooth & rough part - is the smooth part anterior OR posterior?
smooth posterior rough anterior (pectinate muscles)
28
what is the difference between the smooth posterior & rough anterior parts of the right atrium's internal anatomy?
smooth POSTERIOR part contains the openings of the SVC, IVC & coronary sinus (receives deoxygenated blood) - allows for laminar flow of blood into right atrium rough ANTERIOR part contains pectinate muscles
29
what is the crista terminalis? what does it separate?
C-shaped muscular ridge - separates smooth posterior wall from the rough anterior wall
30
what feature on the external surface of the heart corresponds to the presence of the crista terminalis?
sulcus terminalis (a shallow groove)
31
what are the pectinate muscles? why are there more present in the RIGHT atrium?
ridged muscular structures present in the atria - help increase the contractile strength of the atrial walls more present in the right atrium as venous system blood has a lower pressure - more muscle needed for stronger atrial contractions
32
what are the major openings into the right atrium? (4)
SVC IVC coronary sinus right atrioventricular orifice
33
what valve guards the right atrioventricular orifice?
tricuspid valve (3 cusps) - blood from RA > RV
34
what internal feature of the right atrium has the fossa ovale?
interatrial septum (separates RA & LA)
35
what is the significance of the fossa ovale?
remnant of the embryological foramen ovale - used to shunt oxygenated blood from RA to LA as foetal lungs aren't developed closes once foetus is born
36
what can failure of closure of the foramen ovale lead to?
leads to a *patent foramen ovale* - mixing of oxygenated & deoxygenated blood
37
what are the three main muscular projections inside the right ventricle?
trabeculae carnae papillary muscles moderator band/ septomarginal trabeculae
38
what are the trabeculae carnae?
irregular muscular ridges - provide structural support and aid contraction (during systole)
39
what is the function of the papillary muscles in the right ventricle?
papillary muscles contract to tighten the chordae tendinea - prevent tricuspid valve prolapse & backflow of blood
40
describe the base & apex attachments of the papillary muscles
base of muscles projects from ventricular wall apex of muscles attached to chordae tendinea (tendinous cords)
41
what is the role of the moderator band?
contains the right bundle branch of the cardiac conduction system which moderates conduction in the right ventricle
42
what are the two main openings in the right ventricle? (2)
right atrioventricular orifice pulmonary veins (4) - 2 on left, 2 on right
43
what valve guards the pulmonary trunk? how many cusps?
pulmonary valve - 3 cusps (no chordae tendinae)
44
which valves have chordae tendinea attachments?
tricuspid & mitral valves
45
which valve only has 2 cusps?
mitral/ bicuspid valve (between LA > LV)
46
what is the conus arteriosus (infundibulum)?
feature of the right ventricle - smooth uppermost part of RV that leads blood to the pulmonary trunk, ensures smooth blood flow
47
what condition can damage to the papillary muscles in the right ventricle cause?
tricuspid valve regurgitation - valves prolapse, causes the backflow of blood into RA from RV
48
what surface of the heart does the left atrium contribute to?
base/ posterior surface
49
what part of the left atrium contains the pectinate muscles?
left auricle - small, anterior projection of the left atrium
50
in what structure of the heart is the fossa ovalis present?
in the *interatrial septum* (marks the foetal remnant of the foramen ovale that shunted oxygenated blood from RA > LA)
51
how many pulmonary veins open into the left atrium?
4 (superior & inferior PVs from left and right sides)
52
what are the openings present in the left atrium?
left atrioventricular orifice (guarded by the mitral valve) pulmonary openings (4 - from pulmonary veins)
53
what valve guards the left atrioventricular orifice?
bicuspid/ mitral valve - allows blood to flow from LA > LV during diastole
54
how does the left ventricle differ from the right ventricle in wall thickness? why?
wall is 2-3 times thicker = needs higher pressure needed to pump blood into systemic circulation
55
which surface/part of the heart does the left ventricle form exclusively?
the apex of the heart
56
what muscular projections are present in the left ventricle?
trabecular carnae - more numerous and finer than in RV papillary muscles - attached to chordae tendineae which anchor the mitral valve
57
does the left ventricle have the moderator band?
NO - the right ventricle does (has the RIGHT bundle branch of the cardiac conduction system)
58
does the left ventricle have the crista terminalis?
NO - present in right ventricle
59
what are the main openings of the left ventricle? what guards them?
left atrioventricular orifice - guarded by the mitral valve aortic orifice - guarded by aortic valve
60
what is the aortic vestibule?
smooth non-muscular portion of the left ventricle below the aortic orifice - ensures smooth blood flow from LV > aorta
61
describe the position of the auscultation point for the aortic valve
medial end of the 2nd intercostal space of the right side of the sternum
62
describe the position of the auscultation point for the pulmonary valve
medial end of the 2nd intercostal space of the LEFT side of the sternum
63
which valve can be auscultated at the 5th left intercostal space along the midclavicular line?
mitral valve
64
describe the position of the auscultation point for the tricuspid valve
4th-5th left intercostal space at the lower sternal border
65
which valve can be auscultated on the right side of the sternum?
aortic valve
66
why do auscultation points differ from the actual anatomical location of the heart valves?
auscultation points are chosen based on the direction of blood flow and how sound propagates through the chest wall rather than their exact anatomical location the best place to hear the closing sounds of heart valves is where the blood flows immediately after passing through them instead of directly over the valves
67
how do the right and left ventricles differ structurally? (5)
1. LV wall is 2-3 times thicker than the right 2. no moderator band or cristae terminalis present in LV 3. trabeculae carnae are finer & more in number in LV compared to RV 4. LV forms the apex of the heart, RV forms majority of the anterior surface 5. RV has the conus arteriosus/infundibulum leading to the pulmonary trunk; LV has the aortic vestibule leading to the aorta
68
what are congenital abnormalities of the interatrial septum known as? which is the most common of these?
atrial septal defects patent foramen ovale is the most common - (failure of the foramen ovale to close following birth)
69
what sort of blood shunting occurs with atrial septal defects?
left-to-right shunting (oxygenated blood from LA > RA)
70
what occurs to the right sided chambers of the heart & pulmonary trunk as a result of atrial septal defects?
right atrium & ventricle enlarge dilation of pulmonary trunk
71
what consequence would a patent foramen ovale have on the right-sided chambers of the heart?
RA & RV enlarge and pulmonary trunk dilation - because of left-to-right shunt of oxygenated blood from LA > RA
72
what direction of blood shunting occurs in ventricular septal defects?
left-to-right shunting (oxygenated blood from LV > RV)
73
what is the clinical consequence of the large shunting of blood that occurs with ventricular septal defects?
increases pulmonary flow - causes severe pulmonary disease (e.g. pulmonary hypertension) can lead to heart failure
74
how can ventricular septal defects lead to heart failure?
ventricular septal defects lead to a *left-to-right* shunt of oxygenated blood from LV > RV increases pulmonary blood flow, leads to pulmonary hypertension, can then lead to heart failure
75
list the structures contained within the right atrium (openings & gross anatomy)
smooth posterior part & rough anterior part with pectinate muscles cristae terminalis (separates smooth & rough parts) fossa ovale - present in interatrial septum openings for: SVC, IVC, coronary sinus, right atrioventricular orifice (guarded by tricuspid valve)
76
list the structures in the right ventricle (openings & gross anatomy)
3 muscular projections - trabecular carnae, papillary muscles (with chordae tendineae attachments), moderator band/ septomarginal trabeculae conus arteriosus (smooth non-muscular part between RV and pulmonary trunk) openings for: right atrioventricular orifice, pulmonary openings (from RV > pulmonary trunk)
77
which heart chamber has the septomarginal trabeculae?
right ventricle
78
which heart chamber has the conus arteriosus/ infundibulum?
right ventricle
79
list the structures & openings present in the left atrium
left auricle - only rough part of LA with pectinate muscles interatrial septum - fossa ovale & valve of fossa ovale openings for: pulmonary veins (4) & left atrioventricular orifice (guarded by mitral/ bicuspid valve)
80
list the structures present in the left ventricle
trabecular carnae papillary muscles - chordae tendineae attachments with mitral valve (NO cristae terminalis & moderator band) aortic vestibule - smooth non-muscular part below aortic orifice openings for: left atrioventricular orifice, aortic orifice
81
A patient presents with hypotension, jugular venous distension, and muffled heart sounds. Which condition is most likely? A) Pericarditis B) Aortic dissection C) Cardiac tamponade D) Pulmonary embolism
C) Cardiac tamponade (Beck’s Triad)

Clinical Anatomy (54 decks)

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