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Gross Anatomy > Thorax: Heart > Flashcards

Thorax: Heart Flashcards

1
Q

Fibrous Skeleton of the Heart

A
  • Formed by 4 fibrous rings, 2 fibrous trigones, and the membranous septum
  • Separates atria from the ventricles
  • Supports and provides attachment for heart valves
  • Electrical insulation
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2
Q

Surfaces of the Heart

A
  • Anterior (sternocostal): right ventricle
  • Inferior (diaphragmatic): mostly left ventricle, some right
  • Left pulmonary: left ventricle
  • Right pulmonary: right atrium
  • Posterior: left atrium
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3
Q

Anterior (Sternocostal) Surface of the Heart

A
  • Right ventricle
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4
Q

Inferior (Diaphragmatic) Surface of the Heart

A
  • Mostly left ventricle, some right
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5
Q

Left Pulmonary Surface of the Heart

A
  • Left ventricle
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6
Q

Right Pulmonary Surface of the Heart

A
  • Right atrium
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7
Q

Posterior Surface of the Heart

A
  • Left atrium
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8
Q

Coronary Sulcus (AV Sulcus)

A
  • Groove that separates atria from ventricles (external feature)
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9
Q

Anterior and Posterior Interventricular Sulci

A
  • Groove over the ventricular septum
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10
Q

Borders of the Heart

A
  • Right: right atrium
  • Inferior: right and left ventricle
  • Left: left ventricle
  • Superior: left and right atria
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11
Q

Crux of the Heart

A
  • Junction of AV sulcus and posterior interventricular sulcus
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12
Q

Apex of Heart

A
  • Formed by left ventricle
  • Located 5th intercostal space about midclavicular line
  • About a hands width from sternum, ~ 9cm
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13
Q

Base of Heart

A
  • Formed by mostly the left atrium (some right atrium)
  • Faces posteriorly
  • Anterior to esophagus, aorta, T6-9 vertebrae
  • Receives inflow vessels
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14
Q

Coronary Arteries

A
  • Travel in coronary sulcus (atrioventricular sulcus)

- Deep to epicardium embedded in fat

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15
Q

Left and Right Coronary Arteries

A
  • 1st branches off the aorta (ascending)

- Arises from the aortic sinuses

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16
Q

Right Coronary Bracnhes

A
  • Conal artery
  • Sino-atrial nodal (~60% of people)
  • Right marginal artery
  • Posterior interventricular (posterior descending) in ~ 70% of people (right heart dominant)
  • AV nodal artery (~80% of people)
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17
Q

Left Coronary Branches

A
  • Anterior interventricular (left anterior descending) artery
  • Circumflex
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18
Q

Anterior Interventricular (Left Anterior Descending) Artery

A
  • Diagonal branches

- Septal branches

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19
Q

Circumflex

A
  • SA nodal (40%)
  • Left posterior ventricular branches
  • Left marginal artery
  • Posterior interventricular, in ~10% (left dominant heart)
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20
Q

Coronary Sinus

A
  • Main vein of the heart

- Drains into the right atrium

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21
Q

Tributaries of Coronary Sinus

A
  • Great cardiac vein
  • Middle cardiac vein
  • Small cardiac vein
  • Posterior vein of the left atrium
  • Oblique vein of left atrium
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22
Q

Left Marginal Vein

A
  • Drains into great cardiac vein
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23
Q

Anterior Cardiac Veins

A
  • Drain directly into the right atrium
24
Q

Right Atrium

A
  • Right auricle
25
Q

Internal Right Atrium

A
  • Sinus venarum
  • Crista terminalis
  • Pectinate muscle
  • Interatrial septum
  • Fossa ovalis
26
Q

Right Atrium Openings

A
  • SVC
  • IVC
  • Coronary sinus
  • Right atrioventricular orifice
  • Anterior cardiac veins
27
Q

Left Atrium

A
  • Left auricle
  • Smooth wall except for pectinate muscle
  • Slightly thicker wall vs. right atrium
  • Interatrial septum
  • Depression (floor of the fossa ovalis)
28
Q

Left Atrium Openings

A
  • Left atrioventricular orifice

- 4 pulmonary veins

29
Q

Right Ventricle Openings

A
  • Right AV orifice

- Pulmonary orifice

30
Q

Interior Right Ventricle

A
  • Trabeculae carneae
  • Tricuspid valve (right AV valve)
  • Chordae tendinae
  • Papillary muscle
  • Pulmonary valve
  • Septomarginal trabeculae (moderator band)
  • Right bundle branch
31
Q

Trabeculae Carneae

A
  • Muscle elevations in right ventricle
32
Q

Tricuspid Valve (Right AV Valve)

A
  • Contains chordae tendinae
33
Q

Papillary Muscles in Right Atrium

A
  • Anterior (A)
  • Posterior (P)
  • Septal (S)
34
Q

Septomarginal Trabeculae (Moderator Band)

A
  • Holds right bundle branch in right ventricle
35
Q

Left Ventricle

A
  • Thicker myocardium
  • Trabeculae carneae
  • Larger papillary muscles (anterior and posterior)
  • Left AV orifice
  • Mitral valve (left AV valve, bicuspid valve)
  • Chordae tendinae
  • Papillary muscle
  • Aortic orifice
  • Aortic valve
36
Q

Heart Septum

A
  • Interatrial septum
  • Interventricular septum
  • Muscular part (thick)
  • Membranous part (thin)
  • Interventricular part
  • Atrioventricular septum
37
Q

Heart Valves

A
  • Prevent retrograde blood flow
38
Q

AV Valves

A
  • Papillary muscle contraction puts tension on chordae tendinea
  • Prevents AV valve prolapse during systole
39
Q

Regurgitation

A
  • AV valve prolapse during systole
40
Q

Semilunar Valves

A
  • No chordae tendineae

- Closed by back pressure of ejected blood into the pulmonary trunk and aorta

41
Q

Semilunar Valves

A
  • Each has 3 cusp, each with:
  • Lunules and a nodule
  • Aortic: posterior, right, left cusps
  • Pulmonary: anterior, right, left cusps
42
Q

Auscultatory Sites

A
  • Isolates potential valve sounds from other valves
  • Pulmonary valve
  • Aortic valve
  • Mitral valve
  • Tricuspid valve
43
Q

Pulmonary Valve Auscultatory Site

A
  • 2nd left intercostal space, left sternal border
44
Q

Aortic Valve Auscultatory Site

A
  • 2nd right intercostal space, right sternal border
45
Q

Mitral Valve Auscultatory Site

A
  • 5th left intercostal space, ~ midclavicular line
46
Q

Tricuspid Valve Auscultatory Site

A
  • 4th left intercostal space, left sternal border
  • Left sternal border at the inferior aspect of the sternum
  • 5th at left or right sternal border also used
47
Q

Intrinsic Conduction System

A
  • SA node
  • AV node
  • AV Bundle
  • Left and right bundle branches
  • Subendocardial branches (Purkinje fibers)
48
Q

Sinu-Atrial (SA) Node

A
  • Located at junction of SVC and right atrium
49
Q

Atrioventircular (AV) Node

A
  • Located near opening of coronary sinus in the right atrium
50
Q

Atrioventricular (AV) Bundle

A
  • Bridges atrium and ventricle, passes through fibrous skeleton
51
Q

Left and Right Bundle Branches

A
  • Travel through muscular IVS

- Branches of the right pass through moderator band (septomarginal trabecula)

52
Q

Extrinsic Regulation by Autonomic Nervous System

A
  • Influence HR, impulse conduction speed, contractile force, blood flow
53
Q

Autonomic Innervation of the Heart

A
  • Sympathetic

- Parasympathetic

54
Q

Presynaptic (Preganglionic) Innervation of SNS

A
  • Originate IML of T1-4(5) levels
  • Synapse in cervical sympathetic ganglia
  • Upper thoracic paravertebral ganglia
55
Q

Postsynaptic (Postganglionic) Innervation of SNS

A
  • Superior, middle, inferior cardiac nerves from cervical paravertebral ganglia
  • Cardiac branches from thoracic paravertebral ganglia
56
Q

Parasympathetic (Preganglionic) Innervation

A
  • Originate brainstem

- Travel in Vagus nerve to cardiac plexus

57
Q

Cardiac Plexus

A
  • Autonomics pass through this
  • Postsynaptic sympathetic neurons from cervical and upper thoracic paravertebral ganglia
  • Presynaptic neurons traveling in the vagus

Gross Anatomy (50 decks)

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