Thorax: viscera (Heart) Flashcards by Irene Xiao

middle mediastinum: features

centrally placed in thoracic cavity containing:
pericardium
heart
roots of great vessels
nerves

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pericardium: features

fibro-serous sac enclosing heart and roots of great vessels
fibrous pericardium
serous pericardium
(parietal and visceral)

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pericardium: fibrous pericardium bounded to

diaphragm:
- pericardiodiaphragmatic lig

sternum:
- sternopericardial lig

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pericardium: nerve supply originates from

phrenic n
vagus n
parasympathetic trunks

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pericardium: pain sensation from parietal pericardium conveyed by:

phrenic nn

- commonly referred to skin in supraclavicular and neck region

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heart: base directed and consists of

superior and posterior

L atrium
small bit of R atrium
pulmonary veins
superior/ inf vena cava

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heart: apex directed and consists of

inferior, anterior and to the left

- L ventricle

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heart: name surfaces

anterior
inferior
left

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heart: ant surface

sterno-costal

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heart: inf surface

diaphragmatic

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heart: left

pulmonary

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heart: name borders

R
L
inferior
superior

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heart: R border

R atrium

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heart: inferior border

mainly R ventricle and slightly L ventricle

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heart: L border

L ventricle and L atrium

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heart: superior border

L and R atria, SVC, aorta, pulmonary trunk

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name parts of cardiac cycle:

diastole

- systole

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cardiac cycle: diastole

ventricular filling

cardiac cycle: systole

ventricular emptying

R atrium: features incl. musuli pectinati, crista terminalis, sinus venosum

R border of heart
receives deoxygenated blood from SVC, IVC and coronary sinus
has auricle overlapping ascending aorta
oval fossa (oval foramen in foetus)
musculi pectinati (pectinate muscles)

crista terminalis: (smooth muscular ridge btw IVC and SVC)

embryonic sinus venosum (small tissue folds indicate remnants btw coronary sinus and IVC)

development: derived from

splanchnoplueric mesenchyme in neural plate

development: formation process

cardiogenic region - 2 endocardial tubes form/ fuse = tubular heart - heart chambers develop foramen ovalis (allow blood btw atria) - septum primum seals foramen ovalis at birth

R ventricle: features

forms most of inf border
interior of chamber has trabecular carneae/ papillary muscles (muscular elevations) and conus arteriosus (smooth walls), OUTFLOW part

R ventricle: receives blood from

R atrium through AV (atrioventricular) orifice guarded by tricuspid valve

R ventricle: tricuspid valve features

- three cusps - chordae tendinae attach to free edge of cusps - papillary muscles (trabeculae carneae) attach cords to ventricular surface

R ventricle: main papillary muscles and attachments

- anterior (largest) - post (1-3) - septal (small or absent) at cone base: attached to ventricular walls - chordae tendinae arise from apices

R ventricle: pulmonary valve

at apex of conus arteriosus consist of 3 semilunar cusps

L atrium: features

- forms most of base of heart - interior: larger smooth-walled part - smaller muscular part (auricle) - 4 pulmonary veins enter post wall - interatrial septum w depression of fossa ovale - AV orifice

L ventricle: interior features

- AV orifice guarded by bicuspid (mitral) valve - thickest layer of myocardium - largest conical chamber - finer trabeculae carneae - 2 papillary muscles (ant/ post) larger than R ventricle - aortic valve similar to pulmonary valve (3 semilunar cusps)

aortic valve:

- 3 semilunar cusps project into aorta - R and L coronary arteries (og. from R and L aortic sinuses) - blood recoil after ventricular retraction fills aortic sinuses and feeds coronary aa

auscultation: aortic valve

R upper chest, below clavicle

auscultation: pulmonary valve

L upper chest below clavicle

auscultation: tricuspid valve

L mid chest medial, next to nipple

auscultation: mitral valve

L lower chest, laterally under nipple

cardiac skeleton: features

- fibrous ct around AV and aortic orifices, | - pulmonary trunk opening interconnected by L and R trigones

cardiac skeleton: function

- attachment for cusps - separates atrial musculature from ventricular - electrical insulator, independent contraction of atria and ventricle

coronary circulation: coronary aa

- branches of ascending aorta | - originate from R and L aortic sinuses

R coronary artery: branches

- sinuatrial nodal branch - R marginal branch - post interventricular branch

L coronary artery: branches

- anterior interventricular branch - circumflex branch - L marginal aa

cardiac veins:

- great cardiac vein begins at apex of heart - ascends w ant interventricular aa - curves into diaphragmatic surface and coronary sulcus - enlarges and forms coronary sinus which enters R atrium - middle cardiac v - small cardiac v - ant veins of R ventricle

cardiac inn:

- autonomic nervous fibres from cardiac plexuses: - sympathetic fibres (T1-6) thoracic segments of spinal cord - parasympathetic fibres (vagus nn)

eg. myocardial infarction:

- blocked blood supply in heart - usually by excess plaque - tissue death

eg. referred pain:

- referred to T1-4 dermatomes

eg. angina

chest pain