Heart

Question 1

Pericadium

Answer 1

Fibrous pericardium:

• Strong, inflexible layer of pericardium
• Attached to sternum via sternopericardial ligament

Serous pericardium:

• Visceral pericardium (aka epicardium) – adheres to heart
• Parietal epicardium – inner lining of fibrous epicardium

Question 2

Pericardial effusion

Answer 2

Accumulation of serous fluid within pericardial cavity, leading to cardiac tamponade (compression of heart and inability of heart to fully expand)

Treated via pericardiocentesis

Question 3

Pericardial sinuses

Answer 3

Oblique pericardial sinus –formed from reflections onto pulmonary veins

Transverse pericardial sinus – allow separation of aorta + pulmonary trunk from SVC

Question 4

Vessels emptying into RA

Answer 4

1) Coronary sinus
2) Superior vena cava
3) Inferior vena cava
4) Great cardiac veins
5) Thebesian veins

Question 5

Auricle

Answer 5

External, ear-like outpouching of atria

Functions:

1) Preventing sticking of walls of atria
2) Increase holding capacity of atria

Question 6

Crista terminalis

Answer 6

• Extends from IVC to SVC
• Posterior wall is smooth
• Marks boundary between smooth and rough portion of wall of atria

Question 7

Musculi Pectinati (pectinate muscles)

Answer 7

• Anterior to crista terminalis

- Prevent sticking of atrial walls

Question 8

Fossa Ovale

Answer 8

• Remnant of foramen ovale (allowed shunting of blood from RA to LA)

Question 9

Trabeculae carnae

Answer 9

• Muscular, irregular structures

Question 10

Papillary muscles

Answer 10

• Specialised trabeculae carnae attached to chordae tendinae
• Prevents AV valves from turning inside out when ventricles contracts during systole

Question 11

Conus arteriosus (aka infundibulum)

Answer 11

-Only in right ventricle – Smooth wall of ventricles (near pulmonary trunk)

Question 12

Coronary arteries

Answer 12

• Coronary perfusion only occurs during diastole

- Arises from the aortic sinuses

Question 13

Cardiac Dominance

Answer 13

Which artery (RCA/LCA) does posterior interventricular artery arise from

Question 14

RCA

Answer 14

Anastomose with the LCA at the inferoposterior border of heart

Branches:

• Right marginal branch
• Posterior interventricular branch

Question 15

LCA

Answer 15

Branches:

• Circumflex branch
• Anterior interventricular branch

Question 16

Cardiac veins

Answer 16

Tributaries to coronary sinus:

• Great cardiac vein (derivative of anterior interventricular vein)
• Posterior cardiac vein (empties into great cardiac vein)
• Middle cardiac vein (runs in posterior interventricular groove)
• Small cardiac vein (derivative of right marginal vein)

-Anterior cardiac veins empties directly into RA

Question 17

Septomarginal trabeculae (aka moderator band)

Answer 17

• Only found in right ventricle
• Extends from lower interventricular septum to base of anterior papillary muscle
• Carries a portion of conducting system to anterior wall of right ventricle to allow papillary muscle to contract first to prevent eversion of AV valve during systole

Question 18

Tricuspid valve

Answer 18

Cusps:

• Anterior (largest)
• Septal (inconsistent; sometimes absent)
• Posterior (1-3 structures)

Question 19

Mitral valve (bicuspid)

Answer 19

Cusps:

• Anterior
• Posterior

Question 20

Aortic valve

Answer 20

Cusps:

• Posterior
• Left
• Right

Question 21

Pulmonary valve

Answer 21

Cusps:

• Anterior
• Left
• Right

Question 22

Ascultation points

Answer 22

1) Aortic valve – 2nd intercostal space on right sternal edge
2) Pulmonary valve – 2nd intercostal space on left sternal edge
3) Tricuspid valve – 4th intercostal space on left sternal edge
4) Mitral valve – 5th intercostal space in the mid-clavicular line (apex of heart)