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55 Cards in this Set
- Front
- Back
The central area of the thorax, located btwn the two pleural cavities is known as the what?
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mediastinum
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What are the borders of the mediastinum?
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-superior to inferior: superior thoracic aperture to diaphram
-anterior to posterior: sternum to vertebral bodies -laterally: two pleural cavities |
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The mediastiunum is divided into superior and inferior mediastinum, above and below the _______________
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sternal angle
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The inferior mediastinum is subdivided into what 3 mediastinums?
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anterior
middle posterior |
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The pericardium serves as the border for the (anterior/middle/posterior) mediastinum.
What does this mediastinum contains? |
middle mediastinum
contains: pericardial sac heart origins of great vessels phrenic nerves (C3,4,5) pericardiacophrenic vessels |
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The pericardium consists of two layers,what are they?
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Fibrous (outer) & serous (inner)
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The serous pericardium is further divided into the parietal and visceral layer, differentiate btwn the two
What is the potential space btwn the two layers called? |
parietal layer- lines inner surface of fibrous pericardium
visceral layer- tightly adherent to myocardium (epicardium) pericardial cavity |
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The arterial supply to the pericardium is mainly from what arteries?
Branches from what other 2 arteries may also contribute? |
mainly pericardiacophrenic arteries
(pericardiacophrenic from internal thoracic from subclavian*) musculophrenic arteries & thoracic aorta may also contribute |
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Innervation of pericardium
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Vagus nerve
Symphathetic trunks Phrenic nerve |
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Pain sensation from the pericardium is carried by what nerve?
Thus referred pericardium pain would likely be present where? |
phrenic nerve
neck/top of shoulder |
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The serous pericardium forms 2 reflections where?
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1. around the aorta & pulmonary trunk
2. around the pulmonary veins & superior & inferior vena cava |
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The reflection onto the pulmonary veins form the _____________________
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oblique pericardial sinus
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The two reflections form a passage behind the aorta & pulmonary trunk called the _________________________
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transverse pericardial sinus
*important surgical landmark, can put finger through sinus to separate and clamp ascending aorta & pulmonary trunk |
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During development, the primordial arterial and venous ends are brought together to from __________________
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transverse pericardial sinus
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During developement, as the _____________ expand, the pericardial reflection is carried out around them to form the oblique pericardial sinus
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pulmonary veins
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Recognize structures on the anterior heart
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Recognize structures on the posterior heart
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notice vena cava runs straight vertically
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The base of the heart is directed posteriorly & consits of the ________________, a portion of the right atrium, and the proximal parts of the _____ veins
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left atrium
great veins |
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The apex of the heart is directed anteriorly and to the left and formed by the inferolateral part of the ___________
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left ventricle
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The heart has 4 surfaces and 4 chambers, what are they?
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surfaces: anterior, diaphragmatic, right and left pulmonary
chambers: right and left atriums, right and left ventricles |
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Differentiate btwn the inferior and obtuse margins of the heart
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inferior margin- sharp edge btwn anterior & diaphragmatic surfaces
obtuse margin- separates the anterior and left pulmonary surfaces |
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Identify the features w/i the Right Atrium
-Crista terminalis (sulcus terminalis) -Sinus venarum (smooth posterior wall of artium) -Fossa ovails & limbus -pectinate muscule -opening of superior vena cava & valve -opening of inferior vena cava & valve -right A-V orifice |
*sinus venarum is from sinus venosus
*fossa ovalis from foramen ovale (probepatency = flap of tissue from foramen ovale that is not sealed, help shut by blood, present in 25% of people) |
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Identify features w/i the Right Ventricle
-trabeculae carneae -tricuspid valve (anterior, posterior, & septal cusps) -chordae tendineae -papillary muscle -septomarginal trabecula (moderator band) -conus arteriosus -pulmonary valve (anterior, right, left cusps, nodule & lunule) |
cusps are named for their embryological position*
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Identify features w/i left atrium:
-pectinate muscle -openings for pulmonary veins -interatrial septum (valve of foramen ovale) -left A-V opening |
*valve of foramen ovale less pronounced
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Features w/i left ventricle:
-trabeculae carnae -left A-V valve/ bicuspid valve, mitral valve (anterior and posterior cusps) -chordae tendineae -anterior and posterior papillary muscle -aortic vestibule -aortic valve (posterior, right, & left cusps, nodule & lunule) |
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The ventricle wall of the (left/right) ventricle is MUCH thicker than the other.
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Left ventricle thicker
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Blood flow through the heart:
right side left side |
right side -
body--> sup/inf VC--> right atrium-->tricuspid valve-->right ventricle-->pulmonary valve-->pulmonary trunk/aa-->lungs left side- lungs-->pulmonary veins-->L atrium--> bicuspid(mitral) valve--> L ventricle--> aortic valve--> body |
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When atria contract, blood is forced into ventricles and AV valves are (closed/open)
when ventricles contract blood is forced to exit via aorta & pulmonary trunk, AV valves are (closed/open) |
atria contract= open
ventricle contracts= closed |
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The _______________act to prevent valve prolapse.
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chordae tendinae (tendinious cords)
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Closure of the A-V valves produces the (first/second) heart sound
Closure of the aortica and pulmonary valves produces the (first/second) heart sound |
first (lubb) sound
second (dubb) sound |
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The pulmonary & aortic valves are open during (aortic/ventricular) contraction, allowing blood to escape
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ventricular contraction
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After ventricular contraction, the recoil of blood fills the ________ & __________ sinuses, forcing the valves closed (& preventing backflow into ventricles)
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aortic & pulmonary sinuses
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The proper examination of the heart includes:
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visual inspection
palpation percussion ausculation ****know where you are!! |
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Where are the heart borders in relation to surface anatomy?
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Upper limit:
3rd costal cartilage (R) 2nd intercostal space (L) Right margin: 3rd to 6th costal cartilage Left marigin: 2nd(near sternum) to 5th intercostal (near midclavicularline) space Lower Limit: 6th costal cartilage at sternum (R) to 5th intercosta space near midclavicular line (L) |
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Where do you listen to heart sounds on chest and w/i heart?
(hint: A PeT Monkey) |
Aortic valve
-medial end of R 2nd intercostal space Pulmonary valve -medial end of L 2nd intercostal space Tricuspid valve -slightly L of sternum near 5th intercostal space Mitral valve -L 5ht intercostal space at mid-clavicular line |
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T/F
heart sound are best heard upstream from the flow of blood through the valve |
FALSE!
best heard DOWNSTREAM from flow! |
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calcific aortic stenosis is primarily age related but will usually occur earlier & more aggressively when?
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in someone w/ a congenital valve malformation
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What may calcific aortic stenosis cause?
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systolic murmur, L ventricle hypertrophy, angina, syncope, heart failure, arrhythmia
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What is mitral stenosis?
What are 99% of cases secondary to? |
narrowing of the orific of the mitral valve
rheumatic fever |
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In Mitral stenosis, blood flow from the L atrium to L ventricle is restricted, leading to what?
what may develop as a result of increased workload? |
blood pressure increaese in L atrium & pulmonary arteries
R ventricular hypertrophy |
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The myocardium is supplied by what arteries?
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coronary arteries (R & L)
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What are the branches off the left (left main stem) and right coronary arteries?
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Left-
Anterior interventricular branch (LAD) circumflex branch left marginal branch Right- SA nodal branch (60% of time) right marginal branch posterior interventricular branch (PDA)(80% of time) |
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How can you tell if a heart is right or left dominant/dominant coronary artery?
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Right dominant-
posterior interventricular branch arises from the RIGHT coronary artery (most people) Left dominant- posterior interventricular branch arises from an enlarged circumflex branch of the LEFT coronary artery |
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Blood from the myocardium returns to the right atrium via the __________
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cardiac veins
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Cardiac veins:
Anterior, small, middle, & great All drain into the coronary sinus except _______ |
anterior cardiac vein does not
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What can happen when a coronary artery is blocked?
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angina pectoris= intermittent chest pain cuased by REVERSIBLE cardiac ischemia
or myocardial infarction= localized area of myocardial necrosis induced by IRREVERSIBLE local ischemia (1.4 million per year in US) |
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What is the most common cause of death in the US?
1/2 million or more deaths per year |
Coronary artery disease (CAD)
**50% of ppl die w/o receiving treatment |
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Where are the 3 most common sites of coronary artery occlusion?
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1. anterior interventricular branch of LCA (40-50%)
2. RCA (30-40%) 3. circumflex branch of LCA (15-20%) |
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2 most common treatments for occlusion?
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angioplasty
-use catheter to compact arterial walls, expanding lumen coronary artery bypass surgery -use another vessel to bypass occlusion |
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T/F
Atherosclerosis leads to the formation of plaque along the walls of blood vessels |
FALSE!!!!!
plaque forms WITHIN the vessel wall |
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What is the cardiac skeleton and what is its function?
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dense, fibrous CT, sits btwn atria & ventricles & forms a rings around each of the 4 heart valves
Functions: -maintain structural integrity of openings -provide attachment point for valve cusps -electrically isolates atria from ventricles |
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T/F
The heart consist of neural tissue |
FALSE
consists of specialized myocardial cells NOT neural tissue |
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The heart is it's own conducting system & does not need input from the nervous system to beat rhythmically, HOWEVER the rate or force of contraction may be influenced by outside input via _____________
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cardiac plexus
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The cardiac plexus gets its main contributions from what?
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vagus nerve and cardiac branches from sympathetic trunk (T1-T4 cord levels)
-has deep and superficial parts |
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The heart's conducting system consists of what?
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sinoatrial node (SA node)
atrioventricular node (AV node) AV bundle R & L bundle branches Purkinje fibers |