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128 Cards in this Set
- Front
- Back
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The region outlined by the heart is called the ______ mediastinum.
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Middle mediastinum
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Where is the inferior mediastinum defined?
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No where! It doesn't exist
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The heart is contained in a sac called the...
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...pericardium
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Most of the LHS of the heart is seen when looking at it from the front
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F, most of the RHS is seen
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Which blood vessel drains into the right atrium?
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The vena cava
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Which vessel feeds into the left atrium?
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The pulmonary veins
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Which part of the diaphragm does the heart rest on?
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The central tendon
(The heart is resting entirely on its right and left ventricular walls) |
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What is the left auricular appendage?
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A muscular pouch connected to the left atrium of the heart. (In atrial fibrillation, blood clots arise from the left atrial appendage in more than 90% of cases)
Same thing exists for the right atrium |
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A muscular pouch connected to the left atrium of the heart.
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The left auricular appendage. (In atrial fibrillation, blood clots arise from the left atrial appendage in more than 90% of cases)
Same thing exists for the right atrium |
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If you look at the right atrium from the front of the heart, what is it capped by?
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The right auricular appendage
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If the front wall of the right atrium is opened, part of the interior is seen to be roughened by raised horizontal ridges of muscle called...
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...musculi pectinati (comb like)
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What is the name for the roughened part of the right atrium (aside from musculi pectinati)?
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No name! The rest of the right atrium is smooth walled
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What is the 'crista terminalis'?
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The junction between the rough and smooth parts of the right atrium
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The sulcus terminalis, a groove that corresponds to the ridge of the crista terminalis, is present only in some individuals T/F
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T
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What are the two chambers of the embryonic heart?
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The sinus venosus (represented in adult heart by the smooth-walled part of the right atrium)and common atrium
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Which action causes the common atrium to fuse into two separate atria?
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Fusion of the two different septa (Septum primum and ?endocardial cushion)
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Via what vein does the foetus receive oxygenated blood?
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Via the umbilical vein
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Venous blood drains into the right atrium from three areas - upper and lower provided by the S/I VC. What is the name for the vein that drains the blood from the heart muscle itself, into the right atrium?
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The 'coronary sinus'
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What is the 'coronary sinus'?
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A collection of veins that drains into the right atrium. It drains blood from the heart muscle itself
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The inferior vena cava has no valves at the opening to the right atrium T/F
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F. The IVC and coronary sinus has rudimentary valves, whereas the SVC has none.
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What is the name for the valve between the right atrium and the right ventricle?
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The 'right atrioventricular valve' or 'tRicuspid valve' (Think R for RHS of heart)
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The right ventricle is a crescent when seen from a inferior-posterior cross section. Why is this?
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The walls of the left ventricle are so thick that the septum that separates the RV and LV is pushed into the side of the RV
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The inner walls of the right ventricle are lined with muscular ridges called...
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Trabeculae carneae
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One of the trabeculaes of the right ventricle lies free, and crosses the cavity of the ventricle as a muscular rod from septal to anterior wall. What is the name for this trabecula?
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The 'septomarginal trabecula'/Moderator band
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What is the 'septomarginal trabecula'/moderator band?
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One of the trabeculaes of the right ventricle lies free, and crosses the cavity of the ventricle as a muscular rod from septal to anterior wall.
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What is special and important about the septomarginal trabecula of the right ventricle?
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It contains specialised conducting tissue through which impulses spread to the wall of the right ventricle
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It contains specialised conducting tissue through which impulses spread to the wall of the right ventricle
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The septomarginal trabecula
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How many cusps does the tricuspid valve have? In which direction do they point?
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Three cusps (anterior, posterior and septal), point inward to the right ventricle (at all times)
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What are the names for the cusps of the tricuspid valve?
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The anterior, posterior and septal cusps
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The base of the tricuspid valve's cusps are attached to the _______ ring and their edges are tethered to the ventricular wall by a series of delicate fibrous strands called _______ _________
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Fibrous ring
Chordae tendineae |
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What are the papillary muscles of the right ventricle?
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Conical muscular projections of the ventricular wall that anchor the chordae (delicate fibrous strands that connect the cusps to the wall of the RV)
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Conical muscular projections of the ventricular wall that anchor the chordae (delicate fibrous strands that connect the cusps to the wall of the RV)
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The papillary muscles
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The chordae from each papillary muscle inserts into the correspondingly named cusp T/F
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F! They insert into the edges of *adjacent* cusps to prevent the cusps being driven back into the atrium and turned inside out
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The outflow from which camber of the heart leads into the pulmonary trunk?
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The right ventricle
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What is the 'infundibulum' of the right ventricle?
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The outflow portion of the right ventricle, it means 'funnel'.
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What is the name for the valve between the right ventricle and the pulmonary trunk? How many cusps does it have?
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The valve, three cusps or 'valvules'
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There are two 'type's of valves which are subdivided.
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The atrioventricular and semi lunar valves. The AV valves are the mitral and tricuspid valve and the SL are the aortic and pulmonary valves
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Which types of valves have fibrous nodules?
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The semilunar valvules
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What are the names for the valvules in the pulmonary valve?
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Anterior, right and left valvules
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How is regurgitation of blood back into the right ventricle from the pulmonary arteries prevented?
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By the *shape* of the valvules. There are *no chordae or papillary muscles in the pulmonary trunk*
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Chordae and papillary muscles are present and attach to valves in the pulmonary trunk T/F
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F
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The wall of the pulmonary trunk opposite each valvule is slightly dilated to form a...
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'sinus'
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What is the name for the wall that separates the right and left ventricle?
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The 'interventricular septum' (between the ventricles) septum
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What is the interatrial septum?
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The septum that separates the left and right atria
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Blood returns from the lungs to the ____ atrium via the _________ veins
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Left atrium
Pulmonary veins |
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Is the left atrium smooth or rough?
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Smooth, except the auricular appendage is trabeculated
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How many pulmonary veins are there? What chamber do they feed into?
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Four, feed into the left atrium.
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What is the valve between the LA and LV?
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Mitral or 'atrioventricular' valve
(Think mitraL, L for LHS of the heart, cf tRicuspid) |
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Does the LV have any trabeculae carneae?
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Yes, and to a more numerous extent than the RV
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There are 'chordae tendineae' and 'trabeculae carneae' and they are the same thing T/F
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F! They are different.
Chordae tendineae are cord-like tendons that connect the papillary muscles to the tricuspid valve (heart strings) Trabeculae carneae are rounded or irregular muscular columns which project from the inner surface of the right and left ventricles of the heart. |
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What is the function of the trabeculae carneae?
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Most likely to prevent suction that would occur with a flat surfaced membrane and thus impair the heart's ability to pump efficiently.
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'Most likely to prevent suction that would occur with a flat surfaced membrane and thus impair the heart's ability to pump efficiently.' describes the function of...
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Trabeculae carneae
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Which atrioventricular orifice is larger, the right or the left?
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The right.
The left one is smaller, and has only two cusps (mitral valve) |
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What is the name for the cusps in the mitral valve?
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The anterior and posterior cusps
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How many papillary muscles are there in the LV?
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Two - anterior and posterior
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What is the name for the valve out of the LV and into the aorta? How many cusps does it have?
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The 'aortic valve' - three cusps
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'The portion of the left ventricle immediately inferior to the aortic orifice, it possesses fibrous instead of muscular walls'
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The 'aortic vestibule'
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What is the aortic vestibule?
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The portion of the left ventricle immediately inferior to the aortic orifice, it possesses fibrous instead of muscular walls
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What are the three positions of the aortic valvules?
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Posterior, right and left
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The way the aortic valvules work (sinuses, etc.) are very similar to the workings of the pulmonary valvules - see those flashcards!
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.
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How are the fibrous rings of the four valves associated with each other? What do they form? What's the importance of this?
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They are all continuous with each other. They form an electrical barrier between the atrial and ventricular muscle of the heart called the 'fibrous skeleton' - the AP can therefore not pass from the atria to the ventricles (except at AVN)
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The bundle of his splits in the interventricular septum into 'bundle branches', but what is their other name?
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Right and left cura
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The left and right cura of the bundle of His supply the papillary muscles T/F
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T
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What causes the atrioventricular valves to close? (wrt muscle)
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The bundles of his reach the papillary muscles and their contraction closes both atrioventricular valves
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Which division of the autonomic NS is responsible for heart rate?
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The autonomic division
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If the SA node is destroyed, will the heart still beat?
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Yes, at a slower rate
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What is the name for the plexus that lies beneath the arch of the aorta?
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The superficial cardiac plexus
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Where does the superficial cardiac plexus lie?
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Beneath the arch of the aorta
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Where does the deep cardiac plexus lie?
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In front of the bifurcation of the trachea
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Which cardiac plexus lies in front of the bifurcation of the trachea?
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The deep cardiac plexus
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Where do the sympathetic fibres to the heart arise?
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In the upper four thoracic segments of the spinal cord
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What number cranial nerve is the vagus nerve?
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X
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Where do preganglionic spinal sympathetic nerves that supply the heart synapse?
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In the sympathetic chain at their own segmental level or high in the cervical sympathetic trunk
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Where do postganglionic sympathetic nerves that supply the heart pass to, starting at their synapse?
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They pass to the cardiac plexus
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Where do preganglionic parasympathetic fibres from the vagus nerve pass to to synapse?
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The cardiac plexus or in the walls of the atria itself.
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From this plexus all autonomic nerves innervate the SA node
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Cardiac plexus
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Which sinuses do the coronary arteries arise from? What are they called?
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The right and left aortic sinuses.
Called the right and left coronary arteries |
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What course do the coronary arteries follow? What's it called?
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They follow a groove between the atria and ventricles (giving off branches). It is called the coronary sulcus
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What is the coronary sulcus?
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The groove that the coronary arteries follow between the atria and ventricles
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What is the name for the largest branch of the right coronary artery that runs along the right margin of the heart?
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The marginal branch
2134160111 |
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What does the marginal branch of the right coronary artery supply?
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The right ventricular wall
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The right ventricular wall is supplied by...
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The marginal branch of the right coronary artery
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What is the name for the outright largest branch of the right coronary artery? What groove does it run along?
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The posterior interventricular artery
Runs along the interventricular groove |
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The posterior interventricular artery is a branch off...
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The right coronary artery
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Which artery runs on the diaphragmatic surface of the heart, towards the apex?
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The posterior interventricular artery
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Which parts of the heart does the right coronary artery supply?
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All of the right atrium and most of the right ventricle. Also the AV node and AV bundle
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Does the arterial branch to the SAN arise from the left or right coronary artery?
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The right coronary artery (in 60% of cases)
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In 90% of cases, what supplies the AVN?
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The posterior interventricular branch of the right coronary artery
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Where does the left coronary artery arise from?
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The left aortic sinus
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What are the two terminal branches of the left coronary artery?
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The anterior interventricular artery and the circumflex artery
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Which chambers does the left coronary artery supply?
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The LA and LV
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Where do coronary veins ultimately drain to? (Two locations)
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Some drain directly into the cavities (venae cordis minimae) of the heart on the right side most drain towards the *coronary sinus*
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The coronary sinus and sulcus are the same thing T/F
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F
The atria of the heart are separated from the ventricles by the *coronary sulcus* The coronary sinus is a collection of veins joined together to form a large vessel that collects blood from the myocardium of the heart. The coronary sinus opens into the right atrium |
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Where does the coronary sinus drain into?
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The RA
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Give the name of the three main coronary veins and the one which drains directly into the RA
(Not that hard!) |
Great cardiac vein, middle cardiac vein, small cardiac vein (all these drain into the *coronary sinus*)
The anterior cardiac veins drain directly into the right atrium |
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What are venae cordis minimae?
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Small myocardial (coronary) veins that drain directly into the heart chambers
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What is the name for the outer layer of the pericardium?
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The fibrous pericardium
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What is the bottom part of the pericardium fused to?
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The central tendon of the diaphragm
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The pericardium is connected by fibrous tissue to the upper and lower parts of the sternum. What is this tissue termed?
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The sternopericardial ligaments
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What are the sternopericardial ligaments?
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The ligaments that connect the anterior portion of the pericardium to the upper and lower parts of the sternum
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This double-layered sac envelops the heart and comes to be applied both to the inner wall of the fibrous pericardium and to the outer aspect of the heart.
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The 'serous pericardium'
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What is the name for the inner layer of the serous pericardium that is in contact with the heart?
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The visceral pericardium
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What is the visceral pericardium?
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The inner layer of the serous pericardium that is in contact with the heart
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What is the name for the outer layer of the serous pericardium that is in adherent to the fibrous pericardium?
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The parietal pericardium
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What is the parietal pericardium?
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The name for the outer layer of the serous pericardium that is in adherent to the fibrous pericardium
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What's the name for the area inbetween the visceral and parietal pericardium? What's in it, and why is it important?
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Called the pericardial cavity, contains a thin film of fluid (pericardial fluid) that allows the heart free frictionless movement within the pericardium
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The epicardium (outermost layer of the heart) and visceral pericardium are synonymous
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i.e. There isn't an outer layer of the heart THEN the visceral pericardium :)
Hence the free frictionless movement the heart enjoys |
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What is the 'transverse sinus' of the pericardium? How is it clinically relevant?
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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.
The aorta and pulmonary trunk share an envelope of the pericardium whilst the SVC has its own. (Look at a diagram) Clinically relevant as area can be used to pass ligature during cardiac surgery. |
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What is the 'oblique sinus' of the pericardium? How is it clinically relevant?
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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.
(Look at a diagram) Clinically relevant as area can be used to pass ligature during cardiac surgery. |
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The position of the apex of the heart corresponds to the position of the apex beat of the heart in adults and can usally be felt in the R/L _th intercostal space and close to the...
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Left
5th intercostal space Mid-clavicular line |
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The sound from a heart valve is carried in the *direction of blood flowing through the valve*
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The aucusltatory sites reflect this - they are where you will hear the sounds best
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Which, if any, is the heart sensitive to?:
Touch Ischaemia (a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue) Cutting Temperature |
Ischaemia only
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What is ischaemia?
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A restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue
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'A restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue' defines...
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Ischaemia
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Where do the nerve impulses from the heart that are responsible for relation pain from the myocardium run back to? What with?
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The upper four or five thoracic segments on the left side. They do this in company with motor sympathetic nerve fibres travelling in the opposite direction.
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Why can pain in the heart be referred to the arm?
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Segments T1 and T2 also contribute to the medial cutaneous nerve of the arm
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What is a pericardial effusion?
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An abnormal accumulation of fluid in the pericardial cavity. Because of the limited amount of space in the pericardial cavity, fluid accumulation will lead to an increased intrapericardial pressure and this can negatively affect heart function
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'An abnormal accumulation of fluid in the pericardial cavity. Because of the limited amount of space in the pericardial cavity, fluid accumulation will lead to an increased intrapericardial pressure and this can negatively affect heart function' defines...
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Pericardial effusion
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If one has a pericardial effusion, where is the fluid drawn out? Why is it done here? What is this procedure called?
Think! |
Through the 5th or 6th intercostal space on the left, close to the stenum. Done here because the fluid can be drained without piercing the pleural cavity. Called 'paracentesis of the pericardium'.
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What is 'paracentesis of the pericardium'?
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Removing excess fluid in the pericardial cavity (pericardial effusion)
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What are the three main developmental origins of the diaphragm? (Just learn it!)
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Septum transversum
Pleuroperitoneal folds Dorsal mesentery (central portion of the diaphragm) |
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Embryologically speaking, what is the common cause of congenital hernia of the diaphragm?
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Failure of the fusion between the septum transversum and the left pleuroperitoneal fold
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'Failure of the fusion between the septum transversum and the left pleuroperitoneal fold' is the most common cause of...
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Congenital hernia
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What is a congenital disorder?
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One existing from birth, or that develops from the first month of life
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What is ASD? Why is it caused?
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Atrial septal defect. Where a small probe can be passed across the left and right atria. Represents incomplete adhesion of the septum primum and septum secundum
(Normally of no clinical significance unless significant amounts of blood are passing through, in which case, repair is necessary) |
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Where a small probe can be passed across the left and right atria. Represents incomplete adhesion of the septum primum and septum secundum
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ASD or 'atrial septal defect'
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What is tetralogy of Fallot?
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A congenital heart defect which is classically understood to involve four anatomical abnormalities (although only three of them are always present). It is the most common cyanotic heart defect, and the most common cause of blue baby syndrome.
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'A congenital heart defect which is classically understood to involve four anatomical abnormalities (although only three of them are always present). It is the most common cyanotic heart defect, and the most common cause of blue baby syndrome.'
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Tetralogy of Fallot
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