Unit 1: Cardiac Anatomy Flashcards

1
Q

What is the size of the heart?

A

Size of a clenched fist

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2
Q

Where is the apex of the heart located?

A
  • Bottom of left ventricle
    • When supine: 5th intercostal space
    • When upright: 6th intercostal space
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3
Q

Where is the base of the heart?

A

Left and Right Atria

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4
Q

Where is the heart situated in the chest?

A

2/3 on the left, rotated so when you open you see more of right ventricle

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5
Q

What are the 4 coverings of the heart from the outside to the inside?

A

Pericardium → epicardium → myocardium → endocardium

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6
Q

In prenatal circulation, what is the ductus venosus?

A

Oxygenated blood flows from placenta, skips the liver and goes directly to the IVC through the dectus venosus

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7
Q

In prenatal circulation, what is the foramen ovale?

A

This valve is open between in utero and allows blood to flow from the right atirum to the left atrium

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8
Q

Which side of the heart has higher pressure during prenatal circulation?

A

Right side has higher pressure.

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9
Q

In prenatal circulation, what is the ductus arteriosus?

A

Blood leaving the right ventricle is pumped up into the pulmonary trunk. Only a small amount of blood goes to the lung. The rest goes through the ductus arteriosus, bypassing the lungs, and into the aorta to the rest of the body.

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10
Q

Why do prenatal lungs recieve blood if they are not using their lungs to breathe?

A

For nutritional purposes, NOT gas exchange.

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11
Q

Where does gas exchange occur in prenatal circulation?

A

The placenta

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12
Q

In postnatal circulation, what causes the foramen ovale to close?

A

After birth, dec pressure in right atrium and increased pressure in left atrium changes pressure gradient and forces it closed

  • anatomical closur occurs at 2-3 months (up to 1 y/o)
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13
Q

In postnatal circulation, what is it call when the foramen ovale remains open? What happens?

A

Patent Foramen Ovale: Heart acts like it did in utero - fluid remains in lungs and blood mixes from the righ atrium to the left atrium.

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14
Q

What is meconium aspiration and what can it lead to?

A
  • Aspiration of baby black poop during birth process
  • Leads to increased pulmonary vascular resistance resulting in a right-to-left shunt → keeps foramen ovale open.
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15
Q

In postnatal circulation, the ductus arteriosus closes after 2-3 weeks (up to 3 months). How does it close?

A

Duct actively constricts in response to the presence of oxygen

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16
Q

In postnatal circulation, what is it called if the ductus arteriosus does not close? What happens as a result?

A

Patent Ductus Arteriosus: Hypoxia will cause duct to remain open and could cause left-to-right shunt

  • Blood stays in loop and does not circulate to lungs
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17
Q

What is the total blood volume in an adult?

A

5-5.5 liters

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18
Q

Blood enters the right atrium of the heart through what 3 vessels?

A
  1. Sup vena cava
  2. Inf vena cava
  3. **coronary sinus **(heart)
19
Q

What are the two main branches coming off the aorta that feed the heart?

A
  1. Left coronary artery (LCA)
  2. Right coronary artery (LCA)
20
Q

What 2 arteries does the left coronary artery divide into?

A

Left ant descending (LAD) & circumflex (circ) arteries

21
Q

Most damage in the heart comes from occulusion of what artery?

A

Left anterior descending (LAD)

22
Q

What does the left anterior descending feed in the heart?

A
  • Most of L ventricle
  • Most of interventricular septum
  • Anterior wall of R ventricul
  • AV node (10% of people)
23
Q

Where does the circumflex artery run?

A

runs along the atrioventricular groove

24
Q

What are the branches called than come off the left nat descending (LAD)?

A

Diagonals

25
Q

What aretery becomes the posterior descending artery? What are the variations called?

A
  • 88% of the time - Right coronary artery (right dominant heart)
  • 12% of time - Circumflex artery (left dominant herat)
26
Q

What does the circumflex artery feed in the heart?

A
  • Superior, marginal and posterior L ventricle
  • Left atrium
  • SA node (40% of people)
27
Q

Where does the Right coronary artery (RCA) run?

A

R atrioventricular groove

28
Q

What does the Right coronary artery (RCA) feed in the heart?

A
  • Most of R ventricle
  • R atrium
  • Interior surface of L ventricle (post descending artery)
  • Part of post L ventricle and interventricular septum
  • SA Node (60% of people)
  • AV Node (90% of people)
29
Q

What is collateral circulation?

A
  • Extra routes in heart → available to open atrial supply is hindered.
  • Takes 8-24 hours to open
30
Q

Where do most cardiac veins drain? Where does the Thebesian vein drain?

A
  • Most drain to into coronary sinus → right atrium
  • Thesbian drains DIRECTLY into L & R Ventricles
31
Q

What nervous system inervates the heart? What effects does it have on the heart?

A

Autonomic nervous system

  • PNS
      • Chronotropic effect (dec HR)
  • SNS
      • Chronotropic effect (inc HR)
      • Inotropic effect (inc SV)
32
Q

What is syncytia?

A

Cells act together succinctly together like ONE cell

33
Q

What are the differences between cardiac and skeletal muscle cells?

A
  • Cardiac:
    • Striated
    • Series
    • Less developed sarcoplasmic reticulum
    • Innervated by autonomic system (PNS & SNS)
    • More mitochondria (Aerobic metabolism)
34
Q

What is the path of electrical stimulation in the heart?

A

Sa Node → AV Node → Bundle of His → Purkinjie Fibers

35
Q

What is the rate of depolarization in each of the atonomic cells types in the heart?

A
  • SA Node: 70-80 action potentials/min
  • AV Node: 40-60 action potentials/min
  • Bundle of His and Purkinjie Fibers: 20-40 action potentials/min
36
Q

Cardiac cells create own action potentials and never rest. What elements are involved in its depolarization and reploarization?

A
  • Na+ in
  • Ca++ in (initial repolarization)
  • K+ Out
37
Q

What is the S1 heart sound?

A
  • First heart sound
  • Loudest at apex
  • “lub” sound
  • closing of mitral and tricuspid valve
    • mitral (left) closes slghtly faster
38
Q

What is the S2 heart sound?

A
  • The second heart sound
  • Loudest at aortic area
  • “dub”
  • closing of aortic and pulmonic semilunar valves
    • aortic closes slightly before
39
Q

What is the S3 heart sound?

A
  • ventricle vibration - passive distension
  • “Ventricular Gallop”
  • Can be normal
  • Indicates CHF
  • sounds like: lub dub-ub
40
Q

What is the S4 heart sound?

A
  • Artial contraction
  • “Atrial Gallop”
  • Sound: “du-lub dub”
  • Normally in trained athletes with left ventricular hypertrophy (LVH)
  • Abnormal with
    • CAD
    • Hypertensive cardiac disease
    • pulmonic disease
    • history of MI or CABG
41
Q

What does Bachman’s Bundle do?

A

Delivers impulse from R to L atrium

42
Q

What do the internodal tracts do?

A

Deliver impulse directly to AV node

43
Q

Why does the electrical imulse of the heart pause briefly at the AV Node?

A

Allows time for blood to get out of atria and into ventricles