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120 Cards in this Set

  • Front
  • Back
What are the 2 parts of the serous pericardium?
parietal layer: lines inner surface of fibrous layer

visceral layer: (epicardium) adheres to heart and forms its outer covering
What is the apex and base of the fibrous pericardium attached too?
apex is continuous with the adventita of the great vessels

base is attached to central tendon of diaphragm and to small muscular area on left side of diaphragm
What are the superior and inferior sternopericardial ligaments?
anteriorly, they attach pericardium to posterior surface of sternum
What is the nerve supply of the fibrous pericardium?
C3,C4,C5 keeps the fibrous pericardium alive?
Which vessels give blood to the diaphragm?
periocardiacophrenic vessels
What are the 2 pericardial sinusus?
There are two Pericardial sinuses: transverse and oblique.

The cul-de-sac enclosed between the limbs of the inverted U of the venous mesocardium lies behind the left atrium and is known as the oblique sinus. .

The passage between the venous and arterial mesocardia—i.e., between the aorta and pulmonary artery in front and the superior vena cava behind—is termed the transverse sinus.[1] Also, the sinus that forms in the pericardial cavity where the dorso-mesentary pericardium reside.
Can be used to pass ligature during cardiac surgery.
What are the vessels and nerves of the entire pericardium (fibrous and serous?
nerves: vagus, phrenic, and sympathetic trunk

arteries: internal thoracic, pericardiacophrenic, musculophrenic, inferior arteries, thoracic aorta

veins: azygos system of veins, internal thoracic and inferior phrenic veins
How can you differentiate between myocardial infarction and pericarditis?
an electrocardiogram (ECG) can distinguish between them and pericarditis may be relieved by sitting forward
When do primordium of heart and blood vascular system appear?
middle of 3rd week
When does heart start functioning?
beginning of 4th week
What is vasculogenesis and angiogenesis?

What gene factor regulates these?
vasculogenesis - formation of blood vessels

angiogenesis - formation of blood cells

VEGF is the gene, its a major regulator of both cell types and controls how these cells work.
What are the steps of vasculogenesis?
mesenchymal cells differentiate into angioblasts which form isolated cell clusters called blood islands. Small cavities appear, and angioblasts flatten to form endothelial cells around the cavities in the blood island to make endothelium. The endothelial cells fuse together to form channels
What controls the function of hematopoeisis during fetal life?
goes from yolk sac to liver and spleen to bone marrow
On what day do blood islands form in extra-embryonic mesoderm?
Day 17
On what day do blood islands form in intra-embryonic mesoderm?
day 18
On what day do blood islands form in cardiogenic mesoderm and come together to make a pair of endothelial heart tubes?
day 19
What is the cardiogenic area?
first forms between cranial edge of trilamminar germ disc, and neural plate just lateral to cranial end of neural plate.

This happens on day 19.
Where is the cardiogenic area in relation to the buccopharyngeal membrane?
The cardiogenic area, a horseshoe shaped area cranial and lateral to the buccopharyngeal membrane
How is the primitive heart tube formed?
splanchnopleric mesodermal cells in cardiogenic area form angioblasts that form vascular cords which come together into paired lateral endocardial tubes. Then the tubes, fold, fuse, and become primitive heart tube.

heart tubes derived from cardiogenic mesoderm situated next to pericardial cavity, the cranial most end of intra-embryonic coelem
For the primitive heart tube, which side has arteries and which side has veins?
arteries on cranial end and veins on caudal end
What is the location of the cardiogenic area?
at first horseshoe shaped cardiogenic area lies lateral and cranial to neural tube.

Later it changes it postion (due to folding) and lies in front of foregut (primitive pharynx)
What is the origin of the endocardial heart tubes and where do they form?
mesodermal origin, and they form in the cardiogenic region.

As lateral folding occurs, the endocardial heart tubes fuse to form the primitive heart tube. The primitive heart tube develops into the endocardium
What are the dilatations of the primitive heart tube?
truncus, arteriosus, bulbus cordis, primitive ventricle, primitive atrium, and sinus venosus. These 5 dilatations develop into the adult structures of the heart
What does the truncus asteriosus develop into?
Truncus arteriosus develops into the aorta and pulmonary trunk
What does the bulbus cordis develop into?
Bulbus cordis develops into smooth part of right ventricle (conus arteriosus) and smooth part of left ventricle (aortic vestibule)
what does the primitive ventricle develope into?
Primitive ventricle develops into trabeculated part of right and left ventricle
What does the primitive atrium develop into?
Primitive atrium develops into trabeculated part of right and left atrium
What does the sinus venosus develop into?
Left horn of sinus venosus develops into the coronary sinus
Right horn of sinus venosus develops into smooth part of right atrium
What the fudge is dextral looping?
in primitive heart tube, venous blood flows through left ventricle prior to right ventricle. This must be corrected becausein normal adult heart venous blood flows into right ventricle.

Dextral looping is key event in this correction such that location of atrioventricular canal and conoventricula canal become properly aligned
How does myocardium form?
splanchnic mesoderm around endocardium forms myocardium, which secretes a layer of of extracellular matrix proteins called cardiac jelly. Cardiac jelly is structure-less mass of cells which have very
What is the major fuel of the heart?
fatty acids
Where is myocardium thickest and thinnest at?
thinnest in atria and thickest in left ventricle
How many layers does myocardium have?
2, superficial and deep layers
where is cardiac muscle found?
only in myocardium!
it is branched and has intercalated discs
Describe the cells of the cardiac muscle?
size - 100 micrometers and 15 micrometers
nucleus - usually single large oval
sarcolemma - t-tubules not regularly arranged, at lie at Z-lines
More sarcoplasm than skeletal
Organelles has more mitochondria, GA,
Inclusions that are found are glycogen granules, fat droplets, lipfuscin pigment
What is a diad?
A T-tubule system with a sarcoplasmic reticulum on one side for cardiac muscle
What type of cell junctions are found in intercalated discs?
desmosomes and gap junctions and intermediate junctions
What are some general features of cardiac muscle cells?
1. contract spontaneously and display a rhythmic beat, which is modified by hormonal and neural (sympathetic and parasympathetic) stimuli
2. possess thick and thin filaments arranged in poorly defined myofibrils
3. do not regenerate, injuries to cardiac muscle are repaired by formation of fibrous connective (scar) tissue by fibroblasts
What is the role of calcium ions in cardiac muscle?
1. during relaxation, Ca leaks into sarcoplasm at slow rate, resulting in automatic rhythm. Ca also enters cardiac muscle cells from extracellular environment via voltage gated Ca channels of T tubules and sarcolemma
2. in response to calcium entering through the voltage gated Ca channels, Ca is released from SR (via ryanodine receptors) to ause contraction of cardiac muscle
3. force of cardiac muscle contraction is directly dependant on availability of Ca in sarcoplasm.
What do the atrial granules in the atrial cardiac muscle contain?
they contain atrial natreuretic peptide, which acts to decrease resorption of sodium and water in kidneys, reducing body fluid volume and blood pressure
What are purkinje fibers?
Purkinje fibers (Purkyne tissue or Subendocardial branches) are located in the inner ventricular walls of the heart, just beneath the endocardium. These fibers are specialized myocardial fibers that conduct an electrical stimulus or impulse that enables the heart to contract in a coordinated fashion.

they are modified cardiac muscle cells. Specialized for conduction and contain few peripheral myofibrils. they are large, pale cells rich in glycogen and mitochondria. they form gap junctions, fasciae adherentes (intermediate junctions), and desmosomes
Describe division of bulbus Cordis
midpart is called conus cordis, and will form outflow tract of both ventricles. the distal part of bulbus cordis along with truncus arteriosus form roots and proximal portion of aorta and pulmonary artery
What is derivitive of truncus arteriosus?
roots and proximal portion of aorta and pulmonary artery
derivative of bulbus cordia?
smooth part of right and left ventricle
derivative of primitive atrium
trabeculated part of right and left atria
derivative of left horn of sinus veinosus?
coronary sinus
derivative of right horn of sinus veinosus?
smooth part of right atrium
note: smooth part of left atrium from pulmonary veins
What does each horn of the sinus veinosus have?
1. umbilical vein
2. viteline vein
3. common cardinal vein
discuss dev. of right atrium?
the sinus veinosus incorporates itself into the dorsal heart wall
the right sinus horn and veins enlarge greatly and become the only communication between the original sinus veinosus and atrium
discuss dev. of left atrium?
original embryonic left atrium becomes trabeculated left auricle
smooth left atrium develops mainly from primitive pulmonary vein
left horn of sinus veinosus becomes coronary sinus
proximal part of left common cardinal vein become oblique vein of left atrium
when do interarticular and interventricular septa form?
between 4th and 7th week. days 27-37.

many heart problems arise during this time
What is heart composed of?
its a myocardial muscular pump consisting of 4 chambers, 2 auricles, 4 valves, and a muscular septum all enclosed within a fluid filled sac, the pericardium
What is the right border of the heart made of?
consists of right atrium
What is the inferior border of the heart made of?
made up mostly of right ventricle with small portion of left ventricle
What is the left border of the heart made of?
mostly left ventricle, auricle of left atrium forming uppermost part
What does the anterior or sternocostal surface of the heart conist of?
right atrium, vertical atrioventricular groove, right ventricle with a narrow strip of left ventricle
What does the inferior or diaphragmatic surface consist of?
right atrium receiving inferior vena cava, anteroposterior atrioventricular groove
What does the posteror surface of base of the heart consist of?
left atrium, receiving 4 pulmonary veins
How does the posterior surface of the heart move around during inspiration and expiration?
in full inspiration, apex of heart descends more than relatively fixed base, and heart occupies somewhat more vertical postion

in full expiration, ascent of diaphragm forces heart into a more horizontal postion
What are the functions of the pericardium?
protects and anchors the heart, prevents overfilling of heart with blood, allows heart to work in relatively friction free environment
How does coronary circulation work?
it is the functional blood supply to the heart itself

collateral routes ensure blood delivery to heart even if major vessels are occludede
What is the function of the chordae tendonae
they anchor AV valves to papillary muscles. AV valves prevent backflow of blood from ventricle to atria
What is the function of the semilunar valves?
prevent backflow of blood into ventricles.

aortic semilunar valve lies between left ventricle and aorta

pulmonary semilunar valve lies between right ventricle and pulmonary trunk
Discuss AV valves?
They are the tricuspid and mitral valves which prevent blood to flow into atria from ventricles. flaps of these valves attached to walls of ventricles by tendonae chordae
What are the 2 parts of the right atrium?
main cavity is called sinus venarum, and anterior portion called auricula
What are the openings of the right atrium?
superior vena cava - has no valve
inferior vena cava - eustachian valve
coronary sinus
foramina venarum - orifices of minute veins
atrioventricular opening
What are the valves of the right atrium?
valve of inferior vena cava - semilunar valve
valve of coronary sinus - semicircular fold
fossa ovalis - oval depression on the septal wall of the atrium
tricuspid valve - between right atrium and right ventricle
Discuss right ventricle features
extends from right atrium to near apex of heart
inferior border rests of diaphragm
anteriosuperior surface is post sternal
interventricular septum makes the posterior surface
What are openings of the right ventricle?
right atrioventricular orifice - communication between right atrum and ventricle
4cm diameter, has a tricuspid valve
pulmonary orifice - circular in form, guarded by pulmonary semilunar valves
What are the valves of the right ventricle?
tricuspid valve- has 3 triangular cusps: anterior of infundibular cusp, posterior or marginal cusp, medial or septal cusp
pulmonary valve - 3 in number, attached to wall of artery at the junction of artery and ventricle
Discuss left atrium?
smaller than right atrium
walls are thick
consists of principal cavity and auricula
What are the openings of the left atrium?
pulmonary veins : 4 in number, opens in posterior surface and has no valves
left atrioventricular orifice - between left atrium and ventricle, has a mitral valve
Discuss left ventricle
longer and 3 times thicker than right
conical in shape
forms apex of heart
what are the openings of the left ventricle?
left atrioventricular orifice: below and left to aortic orifice, has a mitral valve
aortic orifice: circular aperture, has an aortic semilunar valve
What are the valves of left ventricle?
bicuspid or mitral valve- consists of 2 cusps, anterior or aortic cusp and posterior cusp
aortic semilunar valves - controls flow of blood out of left ventricle to aorta. there are 3 in number, 2 anterior and 1 posterior
What are trabeculae carneae (fleshy beams)?

What are the 3 types?
they are rounded or irregular musuclar columns which project from whole of inner surface of ventricle, with exception of the conus arteriosus

3 types are:
1. fixed along their entire length
2. fixed at edges free in middle
3. papillary muscles
What are papillary muscles?
muscles that are attacked to AV valve cusps to limit movement of mitral and tricuspid valves
what is cordae tendineae?
cord like tendons, which connect papillary muscles to tricuspid valve and mitral valve in the heart
what is the ventricular septum?
is the wall separating the lower chamber of heart form one another
it is directed obliquely backward and to the right, and is curved with the convexity toward the right ventricle
what does the transverse part of the intercalated discs contain?
consist of fascia adherens and numerous desmosomes
what does the longitudinal parts of intercalated discs contain?
they contain gap junctions
How many times does the normal heart contract rhythmically in a minute?
70-90 times
Where is SA node located?
wall of right atrium, upper part of suclus terminalis, right of superior vena cava
Where is AV node located?
lower part of atrial septum, above attachment of septal cusp of tricuspid valve,
What is the time delay in AV nodes?
0.12 sec. this allows atria to empty blood into ventricles
What is the course of the anterior internodal pathway?
beginnning: leaves anterior end of SA node

course: passes anterior to superior vena caval opening, descends on atrial septum

termination: in atrioventricular node
What is course of middle internodal pathway?
beginning: leaves posterior end of SA node

course: passes posterior to superior vena caval opening; descends on atrial septum

termination: atrioventricular node
What is the course of the posterior internodal pathway?
beginning: leaves posterior part of SA node

course: descends through crista terminalis and valve of inferior vena cava

termination: AV node
Discuss left HIS bundle branch pathway?
pierces interventricular septum
passes down left side beneath endocardium, and then divides into anterior and posterior branch. It eventually becomes continuous with fibers of purkinje plexus of left ventricle
Discuss right HIS bundle branch pathway?
passes right side of ventricular septum. reaches moderatior band.

Moderator band - a band of muscle found in right side only. 70% of right HIS goes and stays in moderator band (right side only), and rest of HIS turns into purkunje fibers and go around right ventricle
What is the origin and course of right coronary artery?
origin: arises from anterior aortic sinus of ascending aorta

course: runs forward between pulmonary trunk and right auricle. Runs down in right AV groove. At inferior border it turns posteriorly and connects w/LCA at posterior interventricular branch
What are all the branches of the right coronary artery?
right conus artery
anterior ventricular branches (marginal branches)
posterior ventricular branches (descending artery)
atrial branches
What does the right conus artery supply?
the anterior surface of the pulmonary conus (infundibulum of right ventricle)

upper part of anterior wall of right ventricle
What does the anterior ventricular branches supply?
2 or 3 in number;

supplies anterior surface of right ventricle
How does the marginal branch course?
its the largest branch and runs along costal surface to reach the apex
What does the posterior ventricular branches supply?
usually 2 in number, and supplies the diaphragmatic surface of the right ventricle
What does the posterior interventricular artery supply?
supplies posterior part of ventricular septum but not to apical part

A large septal branch supplies AV node
What do the atrial branches supply?
supply anterior and lateral and posterior surfaces of right atrium

artery of SA node supplies the node and the right and left atria
What is the origin and course of the left coronary artery?
usually larger than right coronary artery

origin: left posterior aortic sinus of ascending aorta

course: passes forward between pulmonary trunk and left auricle, and enters interventricular groove
What are the branches of the left coronary artery?
anterior interventricular (descending) branch

circumflex artery
What is the course of the anterior IV branch?
runs downward in anterior IV groove to apex of heart
What artery supplies SA node?
usually right, but sometimes left coronary artery
What artery supplies AV node and AV bundle?
right coronary artery
the right bundle branch of AV bundle is supplied by which artery?
left coronary artery
the left bundle branch of AV bundle is supplied by which artery?
right and left coronary arteries
What does the coronary sinus receive?
anterior interventricular vein or great cardiac vein at left

posterior interventricular or middle cardiac vein

left marginal vein also opens into coronary sinus

small anterior cardiac vein

small cardiac vein at right
Where does the sympathetic supply come from for the heart?
cervical and upper thoracic portions of sympathetic trunks. increases conductivity and contractility
Where does the parasympathetic supply come from for the heart?
the vagus nerves, decrease conductivity and contractility
where do aortic arches arise from?
the aortic sac, the most distal part of the truncus arteriosus
where do the aortic arches terminate?
aortic arches are embedded in mesenchyme of pharyngeal arches and terminate in the right and left dorsal aortae
what are the aortic arches?
1,2,3,4,6

5th one either never forms or forms incompletely and then regresses
what does first aortic arch form?
by day 27 it forms the maxillary artery
what does the 2nd aortic arch form?
hyoid and stapedial arteries
what does third aortic arch form?
common carotid artery and first part of internal coritid artery
what comes off sprout of 3rd aortic arch?
external carotid artery
the left side of the 4th aortic arch forms what?
the arch of aorta
the right side of the 4th aortic arch forms what?
proximal segment of right subclavian artery
what forms from 6th aortic arch?
6th aortic arch known as pulmonary arch, becomes proximal segment of right pulmonary artery
what are the vitelline arteries?
they supply the yolk sac. they develop into vascular supply of gut
what do vitelline arteries differentiate into as adult?
celiac, superior mesentric, inferior mesentric artery