Week 1 lecture 2 Ventricular and Coronary Anatomy Flashcards
What are the 3 muscular bands in the RV?
Moderator Band - only one seen in echo
Septal Band - along IVS
Parietal Band - along lateral wall
*Septal and Parietal meet at top to create the Supraventricular crest (the floor of the RVOT)
What are the 3 portions of a ventricle?
Inlet - valve and paps
Apex
Outlet - outflow tract
What is the outlet of the RV called
Conus Arteriosus
or infundibulum
Internal features of RV vs LV:
Shape
Valve/paps
Muscle bands
Outlet
Trabeculations
Shape - RV is crescent, LV is bullet
Valve/paps - RV is tricuspid with multiple small paps, LV is bicuspid with 2 paps
Muscle bands - RV has 3 (only see MB on echo), LV has none but has false tendons (small grey lines)
Outlet - RVOT is separated from RV with muscular bands, LVOT is continuous with LV
Trabeculations - RV has more coarse muscular trabeculations
What are the 3 types of muscle contraction?
Longitudinal - shortens base to apex
Circumferential - shortens short axis
Radial - thickening of layers of wall
Myocardial fiber array from inside to outside (3 layers):
Deep layer (sub-endocardial) - covers RV and LV separately, longitudinal contraction
Middle layer - only in LV, fibers lay horizontally
Superficial layer (sub-epicardium) - covers LV and RV, longitudinal contraction (fibers in spiral)
3 layers of a coronary artery wall from inside to outside:
tunica intima - inner lining
tunica media - muscle/elastic
tunica adventitia - outer CT
What are the 5 grades for RWMAs?
- Normal - wall thickening increases by over 40%
- Hypokinetic - less than 40% wall thickening; tissue still alive
- Akinetic - diastolic walls are thin and no systolic thickening; thin, bright, dead walls
- Dyskinetic - thin diastolic walls and outward bulging in systole
- Aneurysmal - constantly deformed (sys and diastole) and outward bulging in systole
Collateral circulation
When occlusion occurs slowly, vessels develop to bypass the blockage
therefore, echo is not the best test for CAD
