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113 Cards in this Set

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About how many times thicker is the wall of the left ventricle than the wall of the right ventricle?
The left ventricle is 2-3 times thicker
What are the extensions (expanded areas) of the atria called?
From the outside they are Auricles
From the inside they are called appendages
Why do we examine the auricles during ultrasound exams?
We are looking for the presence of thrombus
Name the 4 valves of the heart.
Tricuspid
Mitral
Pulomonic
Aortic
What valves of the heart are called semilunar?
The pulmonic and aortic
What heart valve only has 2 leaflets?
Mitral
Name the 3 vessels which bring blood into the right atrium.
The IVC, SVC and CS
What opening exists in the right atrium during fetal life?
The formamen ovalle
What direction does blood flow through the foramen ovalle in fetal life?
Blood flows from the rt atria to the left atria with the assistance of the eustachia valve guiding the flow.
After birth what is the foramen ovalle called? And what if it doesnt close after birth?
After birth the foramen ovalle closes to become the fossa ovalus. If it doesnt close it is called patent foramen ovalle.
What other "bypass" vessel exists before birth?
The ductus arteriosus.
In what direction does blood flow through the ductus arteriosus during fetal life?
Blood flows through the ductus arteriosus from pulmonic valve to the aortic valve.
What is the ductus arteriosus called after birth? And what if it doesnt close?
After birth the ductus arteriosus closes to form the ligamentum arteriosum. If it doesnt close it is called patent ductus arteriosus
What is the purpose of the foramen ovalle and the ductus arteriosum during fetal life?
They bypass the lungs.
What is the roughness of the myocardium in the lower portions of the ventricles called? What purpose does it serve.
These rough surfaces are trabiculae carnea or trabiuculation. They support the heart and strengthen the ventricle walls. They are more prominent in the RT Ventricle.
What is the area where the leaflet attaches to the wall called?
Annulus
Name the leaflets of the tricuspid valve
Anterior
Posterior
Septal aka Media
Name the leaflets of the mitral valve
Anterior
posterior
Name the leaflets of the pulmonic valve
Anterior
Left
Posterior aka right
Name the leaflets of the Aortic valve.
RCC
LCC
NCC
cc= coronary cusp
In the mitral valve, which leaflet is larger?
The anterior leaflet
name the three layers of the heart wall, in order from inner most to outer most.
Endocardium
Myocardium
Epicardium
What is the name of the sac surrounding the heart? Name the 3 layers from inner most to outer most.
Pericardium
- Visceral
-parietal
-Fibrous
Where is the pericardial cavity located? How much fluid is "normal"?
The pericardial cavity is located between the visceral and parietal layers. It contains 5-10 cc of serum
Between which layers of the pericardium is there normally some serous fluid? What is its purpose?
In the pericardial sac between the visceral and parietal layers there is 5-10 cc of serum. This helps the heart move, it reduces friction and allows the heart to slide with each beat.
Which coronary artery branch feeds the right atrium?
Rt Coronary artery
Which coronary artery feeds the anterio-later wall of the LV?
Circumflex
Whcih coronoary artery feeds the inferior wall of the LV?
The PDA and/or RCA
Which coronary artery feeds the right ventricle?
The RCA
Which coronary artery feeds the Anterior IVS?
LAD
Which coronary artery feeds the inferior IVS?
The PDA
Which coronary artery feeds the left atrium?
The circumflex
Which coronary artery feeds the anterior wall of the LV?
The LAD
Which coronary artery feeds the Infero-lateral wall of the LV?
Circumflex
Which Coronary artery feeds the posterior wall of the LV?
Circumflex
In what percentage does the PDA arise from the RCA? What is this referred to as?
in 80-85% the PDA arises from the RCA. This is referred to as Right dominant
What is another name from the right ventricular outflow tract (RVOT) and where does it lead?
The RVOT is aka Infundibulum and it leads to the pulmonic valve/artery
The leaflets, annulus, chordae tendenae, papillary muscles and heart walls at the point of the papillary muscle orgin are all collectively known as what/
Valve apparatus
Damage to any part of the valve apparatus can lead to what?
Damage to any part of the valve apparatus can lead to regurge
Name the 3 vessels that drain the heart tissue. And where do they drain into.
The great cardiac vein drains the LAD & circumflex
The small cardiac vein drains the RCA and the Middle cardiac vein drains the PDA.

All these are drained back into the Coronary sinus and into the rt atrium
Average or normal blood pressure for the Right atrium
2-8 (avg 6)
Avg or normal blood pressure in the Left atrium
2-12 (avg 10)
Ave or normal blood pressure in the right Ventricle
25/5
systole/diastole
Ave or normal blood pressure in the left ventricle
120/7
systole/diastole
Avg or normal blood pressure in the Main pulmonary artery
25/10
systole/diastole
Ave of normal blood pressure in the aorta
120/80
systole/diastole
Normal O2 levels in IVC
72%
Normal O2 levels in SVC
78%
Normal O2 level in CS
60%
**lowest in body
Normal O2 in right atrium
75%
Normal O2 levels in Right ventricle
75%
Normal O2 Levels in Pulmonary arteries
75%
Normal O2 levels in Pulmonary veins
98%
Normal O2 level in Lt atrium
98%
Normal O2 level in Left ventricle
98%
Normal O2 level in aorta
98%
What are the 2 nodes that conduct electrical impulses throughout the heart muslces?
SA node and AV node
Do the SA Node and AV node send impulses at the same time?
No, the SA node sets the rhythm of the pulse. AV node sets the rhythm of the contractions. The delay in the AV node allows the atrium to fully drain and the ventricle to become full.
Name the 3 normal variances sometimes seen in the Rt Atrium.
Chiari network
crista terminalis
Prominent eustachia valve
Name the normal varient seen in the RT Ventricle
Moderator band
Name the normal varient seen in the Left Ventricle
False tendon aka ectopic chordae aka chordal web
Name the normal varient seen in the left atrium
NONE
Does the blood flow into the coronary arteries during diastole or systole? Why?
During diastole. When the base of the aorta is expanded and The blood is trying to get back into the LV but the aortic valves are closed.
Where do the coronary arteries originate?
The sinus of valsalva in the aortic root
Does flow into the atria during systole or diastole? Why?
Blood flow into the atria is constant so it occurs both at systole and diastole because there is no valves from the IVC, SVC or CS.
Name and describe the 4 stages of diastole and what the AV valves are doing in each.
IVRT - End of Systole. AV valves prepare to open
Early diastole - MV opens and 70% of blood is ejected into LV
Mid diastole - Partial closure of the MV. 0-10% of blood is ejected
Atrial contraction/late diastole - remaining 20-30% of blood is ejected.
In m-mode what does the horizontal axis represent?
Time
In m-mode what does the vertical axis represent?
Depth
In m-mode what does the Z axis represent
Amplitude or strength of the dot. Brightness indicates fibrous tissue.
Is velocity indicated in M-mode display?
No, velocity is not indicated in M-mode
When is the Aortic valve open?
Systole
When is the aortic valve closed?
Diastole
When is the mitral valve open?
Diastole
When is the mitral valve closed?
Systole
When is the left ventrical expanded?
Diastole
When does the left ventricle contract?
Systole
What two measurements are used to obtain the Ejection Fraction (EF)?
LV diameter in diastole and in systole.
What is normal EF?
55-75%
When do you measure the Aortic root diameter?
In end diastole (leading edge to leading edge)
When do you measure the Aortic valve leaflet seperation?
Early systole (inner to inner)
When do you measure the LV diameter
End of systole. Outer to inner
Why do you measure the Aortic valve section?
To check for dilation
What are the 3 measurement for the Mitral valve in m-mode?
D to E
E to F
EPSS (E to IVS)
Why do we measure the mitral valve?
To check for dilation and prescence of stenosis
What are the 7 measurements of the LV and when are they measured?
1) RVID(d)
2) IVS(d)
3) LVID(d)
4) LVPW(d)

5) IVS(s)
6) LVID(s)
7) LVPW(s)
Why do we measure the IVS and PW?
To check for thickness
Why do we measure RVID and LVID?
To check for dilation
The pulmonary artery connects between ______
The RT Atrium and the lungs
The pulmonary veins connect between _____
The lungs and LT Atrium
Name the 2 papillary muscles of the LV
Anteriolateral and posteriormedial
Name the 4 sections of the first part of the aorta
1) aortis annulus
2) sinus of valsalva
3) sino-tubular junction
4) ascending aorta
How many coronary arteries do we have?
Two
The RCA supplies what?
The rt atrium and Rt Ventricle
The PDA supplies what part of the heart?
The inferior septum, inferior wall of both ventricles
The Left Main Coronary artery is divided intow what vessels?
The LAD and Circumflex
What part of the heart does the LAD supply?
The LV anterior wall, the anterior IVS and the Apex of LV
What part of the heart does the Circumflex supply?
THe lateral side of the LV (which includes the anterio-lateral or inferio lateral walls also known as posterior walls) and the LT atrium.
Name the differences between the RT Ventricle and the Left (right side differences)
-3 Papillary muscles
- ejects to pulmonary valve
- triburculation is prominent
-triangular shape
- normal varient = moderator band
Name the differences between Lt Ventricle and Rt Ventricle (Left side differences)
- Bigger
- wall is 2-3 times thicker
- 2 papillary muscles
- Apex is formed
- Higher O2 level
-Higher pressures
- Ejects to systemic system
- Shape: bullet/eliptical
- Normal varient = false tendon aka ectopic chordae aka chordal web
Name the 3 layers of the heart wall
Endocardium
myocardium
epicardium
Name the 3 cusps of the aortic valve. Which angle are all 3 seen?
RCC
NCC
LCC

** all three seen in short axis at the aortic level
Name the 3 brances of the aortic arch
-Brachiocephalic
- LCCA
- L Sub clavian
The right atrium receives deoxygenated blood from ....
IVC
SVC
CS
Name the 4 parts of the IVS according to congenital abnormalities
Trabecular (muscular)
Membranous/perimembranous
Inlet
Outlet (aka Subpulmonic/supracristal)
What are the components of the AV valves?
Attached by annulus. located Between atria and ventricles
tricuspid has 3 cusps
Mitral has 2 cusps
cusps are attached to chordae tendinae which are attached to papillary muscles which are attached to ventricle walls
Define Fossa ovalis
The remenant of the foreman ovalle. A hole between the atria during fetal life to bypass lungs.
Define Pericardium
The sac surrounding the heart to protect from surrounding tissue. Acts as a lubricant. Pressure is low to allow heart to expand.
What is a shunt
An opening from left to right ventricle
What unit is pressure measured in?
mmHg
millimeters of mercury
Define Ligamentum arteriosum
Remenant of ductus arteriosum. The vessel connecting pulmonary artery to aorta in fetal life.
Define Sinoatrial node.
SA node is the pacemaker of the heart. it supplies myocardium with electrical impulses. It sets the rhythm of the heart. It is located at the top Rt atrium and sends impulses across the interatrial septum to the LT Atria and to the AV node. Normal rate is 60-90 beats/min
Describe the conductive system of the heart.
SA node to AV node (internodal pathway) to the bundle of hiss (located at IVS) down to the LT and RT branches and then into the Pinkumje fibers
What is the normal rate of the AV node?
40-60 beats/min