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101 Cards in this Set
- Front
- Back
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What is the enclosed sac that the heart lies in called?
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Pericardium
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What makes up the pericardium? Tell the inner and outer layers.
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fibrous (outer) & serous (inner) pericardium
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What makes up the serous pericardium?
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visceral layer (epicardium)-covers heart
parietal layer (on the wall) |
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What is the purpose of the pericardial cavity and what fills the space?
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-Filled w/ 20mL of lubricating fluid
-allows heart to move freely in a very low friction env |
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What forms the pericardial sinuses?
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reflection of parietal layer of serous pericardium as it surrounds adjacent structures outside of the pericardial cavity
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Name the 2 pericardial sinuses. Where are they located?
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Oblique-dorsal to L atrium, due to reflections of pericardial surrounding pulmonary veins & superior & inferior vena cava
Transverse-between R&L of pericardial cavity, anterior to superior vena cava, posterior to ascending aorta and pulmonary trunk, superior to pulmonary veins and L atrium |
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Which pericardial sinus is useful to cardiothoracic surgeons? What does it help to ID?
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transverse-it allows ID of the great vessels during major heart surgeries
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What is cardiac tamponade?
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Compression of the heart due to rapid accumulation of fluid (usu blood), prevents chambers from fully expanding and limits pumping of blood by the heart
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What is removal of excess fluid from the pericardial sac? What is it used to treat?
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-pericardiocentesis of the pericardium
-cardiac tamponade |
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What is inflammation of the pericardial sac lining usu due to viral or bacterial infections called?
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Pericarditis
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What is it called when the serous layer of the pericardium becomes rough?
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pericardial friction rub
-this is usually secondarily due to viral infections -friction and vibration sounds may occur w/ each cardiac cycle |
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What artery supplies the pericardium?
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pericardiophrenic artery
-the vein is the same name -both run on the external surface of the fibrous pericardium |
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Which nerve carries afferents from the pericardium?
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phrenic nerve (C3,4,5)
-runs w/ the artery and vein |
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Describe the heart.
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-4 chambers
-2 pump blood to lungs -2 pump blood to body -average size males 325, female 275 |
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Describe the 3 layers of the heart.
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epicardium-outer layer, consists of visceral pericardium and subserous CT
myocardium-middle layer, massive, consists of cardiac muscle fibers endocardium-inner layer, lines chambers and is continuous w/ endothelial lining of great vessels |
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Which part of the heart is posterior & formed largely by left atrium along w/ a narrow portion of the right atrium?
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Base
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The blunt descending projection formed by the left ventricle is called what?
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apex
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What is formed largely by the left ventricle along w/ narrow portions of the right ventricle?
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diaphragmatic surface
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What is composed largely of the right atrium and right ventricle along w/ narrow portion of the left ventricle?
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sternocostal surface
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The rounded left side of the heart formed by the left ventricle and to a small extent the left auricle forms what?
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Left border or obtuse margin
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What is the narrrow inferior border where the sternocostal and diaphragmatic surfaces meet?
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Inferior border or acute margin
-this is formed largely by right ventricle |
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What is formed by the superior vena cava & right atrium?
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right margin
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What separates atria from ventricles?
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coronary sulcus
major arteries & veins pass here |
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The skeleton of the heart, which is made up of annuli fibrosi, provides a rigid attachment for what?
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myocardial fiber bundles
pulmonary, aortic, and atrioventricular valves |
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Which atrium has thinner walls?
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right
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What type of muscles does the auricle contain?
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pectinate
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What is the junction of rough pectinate muscles and smooth interior of the sinus venarum called?
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crista terminalis
-its superior end marks location of sinoatrial node |
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Is the sinus venarum smooth or rough?
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smooth
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The site of the foramen ovale is called what?
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fossa ovalis (oval fossa)
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The foramen ovale allows the passage of blood from where to where?
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right atrium to left atrium
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What is the site of venous blood return that passes through the cardiac muscle called?
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opening of coronary sinus
-it receives deoxygenated blood from the pericardium |
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In the embryonic heart, what directs blood from the inferior vena cava through the foramen ovale and into the left atrium?
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valve of inferior vena cava
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What is the large superior opening in the sinus venarum called?
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Superior vena cava
-it brings deoxygenated blood from head and upper limbs |
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What is the large inferior opening in the sinus venarum called?
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Inferior vena cava
-brings deoxygenated blood from abdomen and lower limbs |
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What is the site of blood flow out of the right atrium called?
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right atrioventricular orifice
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Name the cusps of the tricuspid valve.
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anterior, posterior, and septal cusps
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Which valve allows flow of blood from the right atrium to right ventricle?
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tricuspid valve
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What are the irregular muscular elevations on the inner wall of the ventricle called?
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Trabeculae carneae
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What 2 things are important for closure of the tricuspid?
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papillary muscles & chordae tendineae
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What are the fibrous strands that connect papillary muscles to cusps of the atrioventricular valves called?
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chordae tendineae
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Which trabecula conveys the right branch of the atrioventricular bundle to the anterior papillary muscle?
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septomarginal trabecula or moderator band
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What is the smooth-walled outflow tract to the pulmonary trunk called?
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conus arteriosus or infundibulum
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What separates the conus arteriosus from ventricle proper?
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supraventricular crest
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What allows blood to exit the right ventricle and into the pulmonary trunk?
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pulmonary valve
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How many pulmonary veins are there?
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4
2 right and 2 left |
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What is the smooth-walled part of the left atrium derived from?
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incorporaton of pulmonary veins
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What is the slight depression in the left interatraial wall called?
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fossa ovale
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What is the rough-walled part (auricle)of the left atrium derived from?
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embryonic atrium, it contains pectinate muscles
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What allows for blood to move from the left atrium to left ventricle?
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mitral valve
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Which ventricle is thicker?
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left, 2-3 x's thicker than right
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How many papillary muscles are in the right ventricle?
left? |
3, anterior (largest), posterior, and septal (smallest)
2, anterior and posterior |
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Which valve allows blood to exit the left ventricle to the aorta?
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aortic valve
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What is the function of the papillary muscles and chorda tendineae that are attached to the atrioventricular valve cusps?
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contract during ventricular systole and prevent blood from regurgitating back into the atrium
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Which muscles may rupture as a complication of myocardial infarction?
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papillary muscles
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What causes left ventricular hypertrophy?
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chronic hypertension and aortic stenosis
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What is aortic stenosis?
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narrowing of the aortic valve
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Describe mitral valve prolapse. What symptoms are associated w/ it?
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the mitral valve everts into the left atium when the left ventricle contracts during systole
may have chest pain, SOA, cardiac arrhythmia and enlargement of L ventricle |
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Is mitral of tricuspid valve prolapse more common? Why?
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mitral, b/c the L ventricle contracts at higher pressure
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What causes the pulmonary valve to close?
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pressure and elastic recoil in the pulmonary trunk during relaxation of the right ventricle
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Which valves are responsible for the lub sound? Dub?
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lub-tricuspid and mitral
dub-pulmonary and aortic |
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Describe the locations of the 4 valves.
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Aortic-right of sternum at 2nd intercostal space
Pulmonary-left of sternum at 2nd intercostal space Tricuspid-left of sternum at 4th or 5th intercostal space Mitral-left side at 5th intercostal space at midclavicular line |
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Describe the origin, course and distribution of the right coronary artery.
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O-right aortic sinus
C-AV groove D-right atrium, SA and AV nodes, & posterior portion in IV septum |
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Describe the origin, course and distribution of the artery to sinoatrial node for R.
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O-60% right coronary artery
C-ascending to SA node D-SA node & pulmonary trunk |
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Describe the origin, course & distribution of the right marginal.
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O-right coronary artery
C-inferior margin of heart & apex D-R ventricle & apex |
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Describe the origin, course and distribution of the posterior interventricular artery.
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O-right coronary artery
C-posterior interventricular groove D-R&L ventricles & IV septum |
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Describe the origin, course & distribution of the atrioventricular node artery.
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O-80%right coronary artery
C-passes deep to AV nod D-AV node |
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Which arteries branch from the right coronary arteries?
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artery to SA node, right marginal, posterior interventricular, AV node artery
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Describe the origin, course, and distribution of the left cornary artery.
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O-left aortic sinus
C-AV groove D-L atrium & ventricle, IV septum, AV bundle & AV node |
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Describe the origin, course, and distribution of the artery to SA node for L.
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O-40% circumflex branch
C-posterior of left atrium D-SA node and l atrium |
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Describe the origin, course, and distribution of the anterior interventricular artery.
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O-left coronary artery
C-anterior interventricular groove D-R&L ventricles and IV septum |
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Describe the origin, course, and distribution of the circumflex.
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O-left coronary artery
C-AV groove to posterior D-L atrium & ventricle |
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Describe the origin, course, and distribution of the left marginal.
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O-left circumflex
C-L border of heart D-L ventricle |
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What does the right coronary artery supply?
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right atrium
most of R ventricle diaphragmatic surface of L ventricle posterior 1/3 of AV septum SA node in 60% of people AV node in 80% of people |
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What does the left coronary artery supply?
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left atrium
most of left ventricle anterior 2/3 of AV septum SA node in 40% of people AV node in 20% of people |
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Describe the variations in arterial supply, right, left and balanced, and how often they occur.
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right dominant distribution-70%, posterior interventricular artery arises from the right coronary artery
left-10%, circumflex branch of left coronary gives off the posterior interventricular artery balanced-20% both right and left coronary artery supply the posterior interventricular artery |
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What is often used to correct atherosclerosis?
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coronary angioplasty and stents
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When atherosclerosis becomes significant, what is used as treatment? How is it performed?
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coronary artery bypass surgery
the distal end of the internal thoracic (mammary) artery is attached to the coronary artery distal to the blockage |
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What is the largest cardiac vein?
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coronary sinus, it is a direct continuation of the great vein
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Which vein lies in the posterior part of the coronary sulcus and opens into the right atrium?
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coronary sinus
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Which vein lies beside the anterior interventricular artery?
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Great cardiac vein
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Which vein lies alongside the posterior interventricular artery?
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middle cardiac vein
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Which vein runs along the acute margin of the right ventricle, and is parallel to the right marginal artery?
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Small cardiac vein
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What does the posterior vein of the left ventricle drain?
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diaphragmatic surface of left ventricle
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How many small veins is the anterior cardiac vein and where does it drain?
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2 or 3
drains to the sternocostal surface of the right ventricle directly into the right atrium |
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Which part of the heart has the most small cardiac veins?
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right atrium
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How is most of the blood from coronary circulation retruned to the right atrium?
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through the coronary sinus or by a pair of small, anterior cardiac veins
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What does the conductive system of the heart do?
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initiates a careful sequence of atrial and ventricular contractions and estasblishes a common rate at which the chambers will contract
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What makes up the conducting system of the heart?
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modified cardiac muscle cells, just deep to the endocardium
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What is the pacemaker of the heart? Where is it located?
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SA node
the right atrial wall at the superior end of the sulcus terminalis (internally crista terminalis) near the superior vena cava |
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What separates atria and ventricles?
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annuli fibrosi
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What increases the rate of the SA node? decreases?
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SNS
PNS |
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What is the collection of specialized cardiac muscle cells in the interatrial septum near the opening of the coronary sinus in the right atrium called?
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AV node
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What does the AV node do?
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receives impulse that was generated by the SA node and passes it to atrioventricular bundle
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What connects the myocardium of atria and ventricles?
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atrioventricular bundle
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What is responsible for ensuring that ventricular contraction begins in the region of the apex?
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atrioventricular bundle
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What can ischemia injure?
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the conducting system of the heart
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Describe an artificial cardiac pacemaker.
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normally it is placed on the anterior chest wall just inferior to the clavicle
the leads are threaded through the venous system, down the superior vena cava and over to the site of the SA or AV nodes attached to the endocardium |
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What is atrial fibrillation?
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uncoordinated twitching of part or the entire atrial wall in a rapid manner
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What are sympathetic nerves of the heart derived from?
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cardiac branches of the cervical sympathetic ganglia
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Ischemic Cardiac Pain, which is caused by inadequate blood flow to the heart, is carried back to the CNS through what? What do they run with? and what level?
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afferents that run w/ sympathetic nerves (mostly T1-4)
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What are parasympathetic nerves of the heart derived from?
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cardiac branches of the vagus nerves
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