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286 Cards in this Set

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What is the name for the type of epithelium that is the innermost lining of blood vessels and heart chambers?
ENDOTHELIUM
Within an organ, the loose CT and/or fat and or dense CT form...
STROMA
Within an organ, what are the cells that give an organ its unique physiological function?
PARENCHYMA
What are most CT types derived from?
MESENCHYME
What is loose CT also known as?
AREOLAR TISSUE
What type of CT can accept or transmit stresses in single or multiple directions? (depending on subtype)
DENSE CONNECTIVE TISSUE
What type of cartilage forms synchondroses?
HYALINE CARTILEGE
Fibrocartilage resists what types of forces?
COMPRESSION FORCES & SHEARING FORCES
What type of cartilage is involved in symphasis joints?
FIBROCARTILAGE
A layer of epithelial cells with a subjacent layer of CT is a...
MEMBRANE
Name the mucous membranes of the body.
RESPIRATORY TRACT, GUT TUBE, URINARY TRACT, REPRODUCTIVE TRACT
Lines of cleavage are also known as...
LANGER'S LINES
Projections from the __________ into the ______________ makes dissection of these two layers difficult.
DSF, SSF
What is camper's fascia?
SSF located only in the anterior-lateral abdominal wall.
What is Scarpa's fascia?
DSF located only in the anterior-lateral abdominal wall.
What is epimysium?
Deep investing fascia covering skeletal mm.
What is myofascia?
Deep investing fascia covering skeletal mm.
Deep investing fascia may combine with...
PERIOSTEUM OR PERICHONDRIUM of a nearby bone or nearby cartilage (respectively)
What is an aponeurosis?
A broad, flat tendon that often connects two skeletal mm.
At what age do the sacral and coccygeal vertebra completely fuse?
30 y/o
At what age does a human develop its cervical curvature and why?
6 months, develops when the baby starts to lift its head.
At what age does a human develop its lumbar curvature and why?
1 year, develps when the baby assumes upright posture and begins to toddle.
Why do primary curvatures exist?
Due to differences in height between the anterior and posterior parts of vertebrae.
What is the intervertebral foramen formed by?
Superior vertebral notch of 1 vertebra, inferior vertebral notch of the vertebra just superior, and the posterolateral margin of the IVD.
Which vertebrae have transverse processes that articulate with a rib?
T1-T10
Why is cervical ROM greater than other regions ROM?
Due to the cervical IVDs relative thickness to the cervical vertebrae.
What does the ligamentum flavum do?
Vertically joins lamina of adjacent vertebrae. Slows VC flexion and aids in VC extension returning to neutral
The cervical VC is supplied vascularly by....
The vertebral artery (passes through transverse foramen of C6-C1) The vertebral vein passes through transverse foramen of C1-C7
The vertebral artery is a branch off of the...
Subclavian artery.
Vascular supply to the thoracic vertebra comes from...
The thoracic aorta-->posterior intercostal artery--->spinal branches
Vascular supply to the lumbar VC originates from...
The abdominal aorta--->lumbar arteries---->spinal branches
Vascular supply to the sacrum originates from...
The iliolumbar arteries---->m/l sacral arteries
What is responsible for venous drainage in the VC?
Internal & External vertebral venous plexes
What other cavities are contained within the thoracic cavity?
Pulmonary cavities and mediastinal cavity.
Which vessels reside in the costal groove of each rib?
Intercostal nerve and the posterior intercostal artery and vein
The first sternocostal joint is what type?
synchondrosis
Rib 10 may articulate with...
Only T10 or T10 and the T9-10 IVD
How could you identify rib 11 & 12 vs other ribs?
No neck, no tubercle, only one articulating surface at the head of the rib.
What direction does the SAP facet face in thoracic vertebra?
posteriorly and laterally
What direction does the IAP facet face in thoracic vertebra?
anteriorly and medially
Which muscles attach distally to the jugular notch?
SCM, sternothyroid, sternohyoid.
What type of joint is the sternoclavicular joint?
synovial joint
What does the transverse thoracic plane pass through?
IVD between T4&T5 and the manubriosternal joint (sternal angle), 2nd costosternal joint, proximal segment of AA, bifurcation of trachea
What type of joint is a costovertebral joint?
synovial joint
What type of joint is a costotransverse joint?
synovial joint
What type of joint is an intervertebral joint?
symphasis
What type of "joint" is the costochondral junction?
synchondrosis
What type of joints are the sternocostal joints (2-7)
synovial joint
What type of joint is the manubriosternal joint?
symphasis
What type of joint provides NO to very little movement?
synchondrosis
The endothoracic fascia is also known as...
the subserosa to the costal parietal pleura
The posterior region of the thoracolumbar fascia separates...
the superficial muscles of the back from the intrinsic (deep) back muscles
The middle layer of the thoracolumbar fascia separates...
the deep back muscles and the quadratus lumborum
The anterior layer of the thoracolumbar fascia separates...
the quadratus lumborum from the retroperitoneal compartment
What does the suprapleural membrane reinforce?
the cupula
The superficial muscles of the back are innervated by what?
The ventral primary rami of the spinal nerves and the trapezius by CN XI
Splenius group functions:
B: neck extension
U: neck lateral flexion, ipsilateral rotation
Erector spinae group functions:
B: VC extension
U: ipsilateral lateral flexion
Semispinalis functions:
B: VC extension
U: contralateral rotation
Multifidus function:
local VC stabilization, proprioception
At what vertebral level do the R and L crus emerge?
L1-L3
What does the caval foramen transmit? At what level?
IVC and some branches of the R. phrenic n. @ T8
What does the esophageal hiatus transmit? At what level?
Esophagus, esophageal blood vessels, anterior and posterior vagal trunks @ T10
What does the aortic hiatus transmit? At what level?
aorta, thoracic duct, cysterna chyli, azygous v (sometimes) and hemiazygous v (sometimes)@ T12
What structures pass through the diaphragm via anatomically variable paths (not via hiatus or foramen)?
L&R greater splanchnic nerves, L&R sympathetic chains (trunks), azygous v (sometimes), hemiazygous v (sometimes), R phrenic n., L phrenic n.
What is the origin of the posterior intercostal arteries?
superior intercostal artery for interspaces 1&2
thoracic aorta for interspaces 3-11
Where does the internal thoracic artery run? From where?
From the subclavian artery inferior along the costal cartilages.
What are the terminal branches of the internal thoracic arteries?
Musculophrenic artery & superior epigastric artery
What does the inferior phrenic artery supply?
Most of the diaphragm and the pericardial sac
What is the origin of the inferior phrenic artery?
It is the first pair of arteries off of the abdominal aorta
The C1 posterior primary ramus is also know as what?
Suboccipital nerve
The C2 posterior primary ramus is also known as what?
Greater occipital nerve
Intrinsic back muscles and the overlying skin/fascia are innervated by what?
Posterior primary rami of T1-L5
The recurrent meningeal branch stems from what?
Spinal nerve
The T1-T6 anterior primary rami are also known as what?
Intercostal nerves
The T7-T11 anterior primary rami are also known as what?
Thoracoabdominal nerves
The T12 anterior primary ramus is also known as what?
Subcostal nerve
Which are the typical intercostal nerve pairs?
T3-T6
From where do the phrenic nerves originate?
C3-5 anterior primary rami
Where do the R&L phrenic nerves pierce the diaphragm?
R- through or near the caval foramen
L- near the apex of the heart
The phrenic nerve contains GSEs to...?
Diaphragm skeletal muscle
The phrenic nerve contains GSAs from...?
proprioceptors of the diaphragm
pain receptors from: mediastinal parietal pleura, fibrous pericardium, parietal serous pericardium
The phrenic nerve contains GVEs to...?
vascular smooth muscle within the diaphragm
A paralyzed hemidiaphragm does what during inspiration?
Ascends
A paralyzed hemidiaphragm does what during expiration?
Descends
Where is the preganglionic cell body of a GVE located?
In the lateral horn (intermediolateral cell column) of T1-L2/3 spinal cord segments
How many paravertebral ganglion are there?
31 pairs in utero
20-25 at birth due to fusion
What is the ganglion impar?
Where the L&R sympathetic chains unite
Where are the white rami communicans found?
T1-L2 spinal cord segments only
Where do the splanchnic nerves emerge from?
T5 and below
What cranial nerves are part of the parasympathetic NS?
III- occulomotor, VII- facial, IX- glossopharngeal, X- vagus
What levels of gray matter are involved with the parasympathetic NS?
S2-4
What are the four locations of parasympathetic ganglia?
Intramural- within effector tissue walls
Terminal- in CT near effector tissue
Enteric- terminal & intramural ganglia w/i wall of digestive tract
Cranial- (details in H&N unit)
What is the inferior border of the superior mediastinal cavity? The superior border?
Transverse Thoracic Plane, Superior Thoracic Aperture
If a patient was shot through the sternum at the T3 vertebral level, list the structures, in order, the bullet would pass through
Sternum, Thymus Gland, Great vv, Great aa, trachea, esophagus, thoracic duct, spine
If the thymus gland were enlarged, what might it impinge upon?
The great vessels
What is the function of the thymus gland? When is it functional?
Educates T-Lymphocytes in embryo through puberty
Where does the ascending aorta transition into the aortic arch?
TTP
What are the first branches off of the aorta?
L&R Coronary arteries
What spans between the bifurcation of the pulmonary arteries and the aortic arch? What was this structures significance in the fetus?
Ligamentum Arteriorsum, Prenatally it was the Ductus arteriosum which conveyed blood from the pulmonary trunk (RV) to the aorta
The descending aorta first travels posterior to what structure?
root of LEFT lung
The brachiocephalic trunk is posterior to the ___________ and anterior to the ___________.
Manubrium, trachea
What two vessels are formed from the brachiocephalic trunk?
R. Common Carotid a.
R. Subclavian a.
What palpable structure lies directly anterior to the brachiocephalic trunk branch?
R Sternoclavicular joint
Describe the least common structural variant of the aortic arch
Aortic arch gives rise to a L and R brachiocephalic trunk each of which gives rise to a common carotid a. and a subclavian a.
Describe the aortic arch variation 27% of the population possess.
Aortic arch gives rise to a brachiocephalic trunk which branches into the R subclavian a, R common carotid a, and the L common carotid a. L subclavian a. branches from aortic arch.
Describe the spatial relationship of SVC to the trachea, to the ascending aorta.
Anterior-Right to trachea
Posterior-Right to ascending aorta
What are the tributaries to the L & R brachiocephalic veins. What is the significance of the origin of the brachiocephalic veins?
Internal Jugular v and subclavian v bilaterally. The origin of the brachiocephalic veins is also known as the venous angle- where the R & L lymphatic ducts drain.
Which is longer- the R or L BCV?
L BCV
Which vein arches over the root of the R lung to join the SVC?
azygous v
What is the origin of the thoracic duct? How does this structure relate to the diaphragm?
Cysterna Chyli, located at or near the aortic hiatus
The R lymphatic duct drains lymph from...
The R side of the body superior to the diaphragm
What major structures are in the posterior mediastinal cavity?
Thoracic aorta, azygous and hemiazygous v, thoracic duct, R&L sympathetic chains, R&L splanchnic nn, R&L thoracic cardiac visceral nn., esophagus
Does the thoracic aorta move more medial or lateral as it descends?
Medial
What are the first unpaired midline branches off of the aorta?
Esophageal branches, pericardial branches
What is the last pair of segmental branches to come off of the thoracic aorta?
Superior phrenic arteries
What does the AVS drain?
the back, thoracoabdominal wall, and mediastinal viscera
What is the significance of the AVS in IVC pathology?
Alternate route to RA via SVC if IVC is occluded
Name the main thoracic tributaries of the azygous v.
1-11 R post intercostal vv, R subcostal v, vertebral venous plexus of Baston, various esophageal and bronchial vv
What are the main thoracic tributaries to the hemiazygous v? accessory hemiazygous v?
9-11 L post intercostal vv, L subcostal v, inferior esophageal v. L 5-8 L posterior intercostal vv
At approximately what levels of the spine does the esophagus begin and end?
C6, T10
What types of nerve fibers is the esophagus controlled by?
orad 1/3- GSE
middle 1/3- GSE, GVE
aborad 1/3- GVE
Can the esophagus hold a suture? Why?
No- because there is no serosa
Where are the esophageal constrictions?
Pharynx, aortic arch, L primary bronchus, diaphragmatic
What direction and degree of rotation occurs in the esophagus during embryological development? What is the significance of this to the vagus nn?
90 degree clockwise rotation, causes R vagus to course posterior to the esophagus, L vagus to course anterior to the esophagus
From where do the sympathetic postganglionic GVEs innervating the esophagus originate?
T1-T10 L&R sympathetic chains
Where do the parasympathetic preganglionic GVEs originate?
Vagus nn
Where do the GSAs and GSEs of the esophagus run?
Vagus nn
What posterior horns convey pyrosis?
T8-T10
What is the foregut outgrowth that develops into the lungs?
Respiratory diverticulum
What embryonic structure develops into the pleural sacs?
pericardioperitoneal canals
The subserosa of the pleura is also known as....
Endothoracic fascia
Pulmonary cavity volume=
Lung volume + Pleural cavity volume
Does the pulmonary cavity volume change during pneumothorax?
NO, pleural cavity volume increases and lung volume decreases
Name the regions of parietal pleura
Mediastinal, costal, diaphragmatic, cervical
What reinforces the cervical parietal pleura? What is this an extension of?
Suprapleural membrane, endothoracic fascia
The cervical parietal pleura is also known as...
the cupula
What is the pulmonary ligament?
a double layer of pleural mesothelium inferior to the lung root
The sternal line of pleural reflection is the transition point between the _______ and ________
CPP MPP
The costal line of pleural reflection is the transition point between the _______ and the _______
CPP DPP
What occurs in the costodiaphragmatic recess during inspiration? expiration?
lung occupies most of CD recess, lung ascends and recedes from CD recess
What feature of the costodiaphragmatic recess can be visualized in XRay?
Costophrenic angles
Which is larger, the L or R costomediastinal recess? Why?
Left, due to cardiac notch of left lung
How far does the base of the lung move during quiet respiration? Forced respiration?
1.5 cm, 6-10 cm
Which is more inferior- the R or L lung apex? What is the clinical significance of this?
R. You want to insert venous catheters on the R (decreased chance of puncturing pleural sac and causing pneumothorax)
What is a hilum?
2-D area on medial lung surface
What plane is the hilum in?
parasagittal
What is posterior to the R lung root?
R vagus n, posterior pulmonary nerve plexus, ascending portion of azygous vein
What is anterior to the R lung root
R phrenic n, R pericardiophrenic vessels, anterior pulmonary nerve plexus
What is posterior to L lung root?
L vagus n, posterior pulmonary nerve plexus, descending aorta
What is anterior to the L lung root?
L phrenic n, pericardiophrenic vessels, anterior pulmonary nerve plexus
The oblique fissures are deep to what surface features?
T2 spinous process posteriorly to 7th rib anteriorly
The horizontal fissure is deep to what surface features?
R 4th rib posterior-laterally and 4RICS anteriorly
Epithelial inner lining of larynx and tracheobronchial tree and lung parynchyma are derived from what embryological layer?
Endoderm
Cartilaginous, CT, muscular structures of the lung are developed from what embryological layer?
Mesoderm
What is the name for the internal cartilaginous ridge at the TTP?
carina
The left primary bronchus is approximately ________ degrees from vertical
45
The left primary bronchus passes inferior to what structures?
aortic arch and L pulmonary artery
What are the branches of the left primary bronchus?
Superior lobar bronchus- gives lingular bronchus
Inferior lobar bronchus
How many bronchopulomary segments are in the left lung? How are they distributed?
10
5 in superior lobe (2 lingular)
5 in inferior lobe
What is a bronchopulmonary segment?
basic functional unit of the lung, pyramid-shaped tissues that roughly point toward the root
Each bronchopulmonary segment contains...
1 segmental (tertiary) bronchus,
1 pulmonary intrasegmental artery,
pulmonary intersegmental veins,
lymph vessels,
GVEs that innervate bronchial smooth m. and mucus glands,
GVAs
The right main bronchus passes approximately ________ degrees from vertical
25
What are the lobar branches of the R bronchus?
Superior lobar bronchus
interlobar bronchus- branches to middle lobar bronchus & inferior lobar bronchus
How are the bronchopulmonary segments distributed among the R lung lobes?
3 superior, 2 middle, 5 inferior
The pulmonary circuit contains __% of total blood at any single time
9%
Is the pulmonary valve anterior or posterior to the aortic valve?
Anterior
At what level does the pulmonary trunk bifurcate?
TTP
The pulmonary arteries branch into...
pulmonary intrasegmental arteries
What is the origin of the bronchial arteries? What do they supply other than the L&R bronchi?
R bronchial artery from (usually) 3rd R post intercostal artery
L bronchial artery from anterior aorta
Also supply lung visceral pleura
How many pulmonary veins are there?
4
2 superior (L&R) 2 inferior (L&R)
What are the tributaries to the pulmonary veins?
pulmonary intersegmental vv.
What drains the PROXIMAL segments of the tracheobronchial tree? Where does that empty?
Bronchial veins, into the RA
Describe the lymphatic drainage of the right lung (and L lung inferior lobe)
lobar nodes-hilar nodes-carinal nodes-R.paratracheal nodes-R. bronchomediastinal trunk and/or R. deep cervical nodes-R. venous angle
Describe the lymphatic drainage of the L lung superior lobe
L superior lobar node-L hilar nodes-carinal nodes-L paratracheal nodes-L bronchomediastinal trunk and/or L deep cervical nodes-thoracic duct-L venous angle
What innervates the parietal pleura?
intercostal n/subcostal n--Cervical, Costal
phrenic n-- Mediastinal, Diaphragmatic
Describe the route of parasympathetic innervation of the lungs
Medulla gives rise to R & L vagus nerves, fibers split off vagus nn and form cardiac visceral nn that convey preganglionic fibers through cardiac plexus and on to the pulmonary plexuses
Describe the sympathetic preganglionic GVE route of the lungs
Emerge from lateral T1-T5 horns, enter sympathetic trunk and ascend to synapse in cervical ganglia
Describe the sympathetic postganglionic GVE route to the lungs.
Emerge from cervical ganglia and form cardiac visceral nerves, pass through cardiac plexus into the R&L pulmonary plexuses
A GVA traveling antiparallel to a sympathetic GVE would convey information regarding...
pain, stretch (distention), ischemia, irritation
A GVA traveling antiparallel to a parasympathetic GVE would convey information regarding...
nausea, hunger (vagus), fullness, stretch (pelvic splanchnics), blood pressure, blood gas levels
What fuses to form the internal terminal crest?
sinus venosus and primordial atrium
What septum forms the valve of the foramen ovale?
primum
Is the septum secundum on the R or L of the septum primum?
Right
The primordial atrium develops from what portion of the heart tube?
Caudal
The primordial atrium becomes what postnatally?
Right auricle
When does the primordial ventricle become R&L ventricles?
week 7
The fusion of the membranous and muscular interventricular septum finalizes the continuity of what?
RV with pulmonary trunk and LV with ascending aorta
What direction does the heart tube twist normally?
CCW
What is the condition called in which the heart tube twists CW?
Dextrocardia
Is a left to right shunt acyanotic or cyanotic?
Acyanotic
What happens when a neonate takes its first breath?
Air expands in lungs, decreased pulmonary vascular resistance, increase pulmonary blood flow, decreased BP in RA, RV and pulmonary trunk
What happens when a neonate is separated from the placenta?
cut umbilical cord, lose low vascular resistance placenta, increased overall neonate system vascular resistance, increased BP in aorta, LV, LA
Each ventricle pumps ___L/min to its respective circulation
5
The umbilical arteries are supplied by what?
internal iliac arteries from the common iliac arteries from the descending aorta
The umbilical vein branches into...
a hepatic bypass via ductus venosus or through hepatic portal vein
The foramen oval becomes the _____ ________ postnatally
fossa ovalis
The ductus arteriosus becomes the __________ __________ postnatally
ligamentum arteriosus
The ductus venosus becomes the _______ __________ postnatally
ligamentum venosum
The umbilical vein becomes the ___ _______ of the liver near early adulthood
round ligament
The umbilical arteries become ________ ________ _________ postnatally
medial umbilical ligaments
A persistent patent ductus arteriosus is acyanotic/cyanotic?
acyanotic
A persistent patent foramen ovale is acyanotic/cyanotic?
acyanotic
Ventricular septal defects are typically acyanotic/cyanotic?
acyanotic
What is the most common type of heart dysmorphia?
Ventricular septal defects
What is a tetralogy of fallot?
4 simultaneous congenital heart defects: stenosis of infundibulum, VSD, dextroposition of aorta, RV hypertrophy due to patent DA
What is the function of the pericardium?
cardiac seat belt: protects heart, prevents heart from sudden overdilation due to overfilling, stabilizes vigorously beating heart
What outer layer of the great vessels is the fibrous pericardium attached to?
Tunica Adventitia
What is a cardiac tamponade?
When pericardial cavity fills with blood or serous fluid compressing the heart and thus decreasing cardiac output
The transverse pericardial sinus runs between....
the pulmonary trunk and ascending aorta leaving the ventricles anteriorly and the SVC and pulmonary veins entering their atria posteriorly
The oblique pericardial sinus is bounded by...
the left atrium anteriorly, the pericardial reflections surrounding the pulmonary veins and IVC laterally, and the anterior surface of the esophagus posteriorly
What supplies the fibrous and parietal pericardium? What are these a branch of?
R/L pericardiacophrenic aa, Internal thoracic aa.
What does the heart drain to?
Pericardiacophrenic vv are tributaries to either the brachiocephalic vv or internal thoracic vv
What do the GSAs in the phrenic nerves convey? To where?
pain/stretch sensory info from: mediastinal parietal pleura, parietal pericardium, fibrous pericardium back to the C3-C5 posterior horns
Where can you find the apex of the heart (surface feature)?
4th-5th LICS and MCL
The anatomical base of the heart is...
LA some RA
What does the anatomic base of the heart face?
T6-T9 vertebra with oblique sinus, esophagus and descending aorta intervening
What is the clinical base of the heart?
surface projection of superior heart border onto anterior thoracic wall (2LICS to 2RICS)
What can you find in the anterior interventricular sulcus?
Anterior interventricular a, great cardiac v, fat
What is the corresponding internal feature to the terminal groove?
Terminal crest
What can you find in the coronary groove?
coronary sinus, circumflex coronary a, R coronary a.
What can you find in the posterior interventricular sulcus?
posterior interventricular a and middle cardiac v.
The diaphragmatic surface is...
mostly LV, some RV
The left pulmonary surface is...
mostly LV
The sternocostal pulmonary surface is...
mostly RV, slight contribution from RA and LV
The right pulmonary surface is...
mostly RA
The inferior border is..
mostly RV slight LV
The left border is...
mostly LV some left auricle of LA
The right border is...
RA and terminal segments of SVC and IVC
Where do you auscultate for the aortic valve?
sternal border of 2RICS
Where do you auscultate for the pulmonary valve?
sternal border of 2LICS
Where do you auscultate for the tricuspid valve?
sternal border of 4or5LICS
Where do you auscultate for the mitral valve?
9cm L of midline 5LICS
The visceral pericardium is also known as...
epicardium
What parasympathetic structures can you find within myocardium? Where?
distal para pre GVEs, para ganglion, para post GVEs. In or near autorhythmic cell regions
What sympathetic structures can you find within the myocardium? Where?
distal sym post GVEs, sensors and initial segments of GVAs that accompany GVEs
What is included within the endocardium?
Subendocardial layer and endothelium
What layer of the heart contains the distal cardiac conduction system fibers? What are these called?
Subendocardial layer, Purkinje fibers
What is included in the fibrous skeleton of the heart?
fibrous rings around valve orifices
R&L fibrous trigones connecting the fibrous rings
membranous part of the IVS
membranous part of the interatrial septum
What valve does not have a fibrous ring?
Pulmonary valve
What are the cusps of the R AV valve?
A P S
The semilunar cusps of the pulmonary valve are derived from...
the embryological truncus arteriosus
What happens in the pulmonary valve during ventricular diastole?
Sinuses fill with recently ejected blood, expands sinuses, approximates 3 cusps, closes semilunar valve
What percentage of patients have an incomplete fusion of the fossa ovalis valve?
20-25%
Name the cusps of the left atrioventricular valve
Anterior, Posterior
What is the aortic vestibule?
The smooth tapering transition from LV into aorta
The aortic semilunar valve is derived from what embryological structure?
Truncus arteriosus
Name the cusps of the aortic semilunar valve?
P R L sinuses
What structures connect the R&L coronary arteries and the R&L aortic sinus?
ostia
The pressure in the coronary arteries is highest during ventricular systole/diastole?
Diastole
What is included in the central blood volume?
all blood contained in: SVC+thoracic IVC+RA+RV+entire pulmonary circuit+LA
What is included in the peripheral blood volume?
all blood contained in: LV+entire systemic circulation except SVC and thoracic IVC
Describe dominance in regards to the arterial supply of the heart
67% of the population is R dominant, in which the posterior interventricular artery is a branch of the R coronary artery. 15% are left dominant and 18% are codominant
The proximal branch of the R coronary artery that travels posterior between the great vessels is...
sinuatrial nodal a
A second proximal branch may emerge from the R coronary artery and travel ant/inf, what branch is this?
Conus arteriorsus branch
What does the R Marginal artery supply?
RV
On what surface of the heart can you find the AV nodal artery?
posterior/inferior
What does the posterior interventricular artery supply?
R&L ventricles and posterior 1/3 of IVS
The L coronary artery exits the L aortic sinus and immediately branches into the...
circumflex a. and the anterior interventricular artery
What does the anterior interventricular artery supply?
RV, LV, apex, and anterior 2/3 of IVS
Where does the L Marginal artery course? What does it supply?
along L heart border, LV
What does the circumflex artery supply?
LA & LV
What is the distribution territory of the RCA in a R. dominant heart?
RA, most of RV, diaphragmatic surface of LV, posterior 1/3 of IVS, SA node in 60%, AV node in 80%
What is the distribution territory of the RCA in a R. dominant heart?
RA, most of RV, diaphragmatic surface of LV, posterior 1/3 of IVS, SA node in 60%, AV node in 80%
What is the distribution territory of the LCA in a R. dominant heart?
LA, most of LV, some of RV, anterior 2/3 of IVS (including AV bundle), SA node in 40%
What is the distribution territory of the LCA in a R. dominant heart?
LA, most of LV, some of RV, anterior 2/3 of IVS (including AV bundle), SA node in 40%
The coronary sinus lies in the anterior/posterior coronary sulcus?
Posterior
The coronary sinus lies in the anterior/posterior coronary sulcus?
Posterior
What is the course of the great cardiac vein?
begins at apex and courses superior through anterior interventricular sulcus to the coronary sulcus (coronary sinus)
What is the course of the great cardiac vein?
begins at apex and courses superior through anterior interventricular sulcus to the coronary sulcus (coronary sinus)
List the tributaries entering the coronary sinus beginning at the anterior IVS
GCV, L Marginal V, Posterior V, middle V, small V, entry into coronary sinus
List the tributaries entering the coronary sinus beginning at the anterior IVS
GCV, L Marginal V, Posterior V, middle V, small V, entry into coronary sinus
List the primary CCS components in chronological order they reach threshold potential
Sinuatrial node, atrioventricular node, atrioventricular bundle, R&L bundle branches, Purkinje branches
List the primary CCS components in chronological order they reach threshold potential
Sinuatrial node, atrioventricular node, atrioventricular bundle, R&L bundle branches, Purkinje branches
What allows for quick propagation of action potentials through the myocardium?
Gap Junctions
What allows for quick propagation of action potentials through the myocardium?
Gap Junctions
What is the only electrical conduit across the high-resistance fibrous skeleton of the heart and also through the membranous IVS?
AV Bundle (Bundle of His)
What is the only electrical conduit across the high-resistance fibrous skeleton of the heart and also through the membranous IVS?
AV Bundle (Bundle of His)
Cervical cardiac visceral nerves and thoracic cardiac visceral nerves convey which types of nerve fibers?
preganglionic parasympathetic GVEs, postganglionic sympathetic GVEs and accompanying GVAs
Cervical cardiac visceral nerves and thoracic cardiac visceral nerves convey which types of nerve fibers?
preganglionic parasympathetic GVEs, postganglionic sympathetic GVEs and accompanying GVAs
What is the function of the cardiac nerve plexus?
Conveys pre para GVEs, post sym GVEs and accompanying GVAs of the cardiac visceral and thoracic visceral nerves across the great vessels of the heart
What is the function of the cardiac nerve plexus?
Conveys pre para GVEs, post sym GVEs and accompanying GVAs of the cardiac visceral and thoracic visceral nerves across the great vessels of the heart
What are the extensions of the cardiac plexuses?
Coronary Plexus and L&R pulmonary plexuses
If there is pain due to coronary vessel ischemia, what GVA route does it take?
visceral pain from heart to the T1-T4/5 spinal cord segments antiparallel to the sympathetic GVE pathways
If there is referred pain to the dermatomes and sclerotomes what GVA route does it take?
travel up the Vagus nerves and terminate in the medulla. antiparallel to the parasympathetic GVE pathways
If a patient is experiencing angina pectoris, what GVE fibers are the GVA fibers opposing?
sympathetic GVE pathways