Chapter 4 (Middle Mediastinum - Pt II)

Question 1

(Vasculature of Heart)

Primarily comes from the ___ and ___ ____ ___, which branch from the ____ ____.

Answer 1

right and left coronary arteries; ascending aorta.

Question 2

(Vasculature of Heart)
The ____ ____ ____ will transverse the coronary (atrioventricular sulcus), which separates the two atria from the two ventricles.

Answer 2

right coronary artery

Question 3

(Right Coronary Artery)

Branches:

Answer 3

• Sinoatrial nodal artery to the SA node
• Right marginal artery along the acute (inferior) margin
• Atrioventricular nodal artery to the AV node
• Posterior interventricular artery in the posterior interventricular sulcus

Question 4

(Right Coronary Artery)

SA node

Answer 4

The pacemaker of the heart’s conducting system

Question 5

(Right Coronary Artery)

AV node

Answer 5

sends impulses to the ventricles through the AV bundle

Question 6

(Left Coronary Artery)

Branches:

Answer 6

• Anterior interventricular (left anterior descending) artery in the anterior interventricular sulcus
• Circumflex branch in the coronary sulcus
• Left marginal artery along the obtuse margin

Question 7

(Vasculature of Heart)

The primary veins of the heart include:

Answer 7

• Small cardiac vein
• Middle cardiac vein
• Great cardiac vein

Question 8

(Vasculature of Heart)

Small cardiac vein runs with the ____ ____ ___

Answer 8

Right marginal artery

Question 9

(Vasculature of Heart)

Middle cardiac vein runs with the ____ ____ ____.

Answer 9

posterior interventricular artery

Question 10

(Vasculature of Heart)

Great cardiac vein runs with the ____ ____; it continues as the ____ ____ when it reaches the coronary sulcus.

Answer 10

interventricular artery; coronary sinus

Question 11

(Heart Murmer)

Any of the various valves of the heart may on occasion be ____ or otherwise ____ and may fail to close properly.

Answer 11

thickened; defective

Question 12

(Heart Murmer)

This may result in allowing blood under high pressure to …

Answer 12

flow back into the region of less pressure

Question 13

(Heart Murmer)

This is referred to as a ____ or ___ ___ and produces a sound known as a heart murmur.

Answer 13

leaking or insufficient valve

Question 14

(Fibrillation of Heart)
In ___ ____, the normal regular rhythmical contractions of the atria are replaced by ____ ____ and _____ ____ of the different parts of the atrial walls.

Answer 14

atrial fibrillation; rapid irregular and uncoordinated twitching

Question 15

(Fibrillation of Heart)
In ____ ____, the normal ventricular contractions are replaced by ____, _____ _____ that do not pump sufficiently to maintain systemic circulation.

Answer 15

ventricular fibrillation; rapid, irregular twitching

Question 16

(Fibrillation of Heart - Ventricular Fibrillation)

The damaged conducting system of the heart does not function normally and is considered the …

Answer 16

most disorganized of all dysrhythmias due to the lack of effective cardiac output.

Question 17

(Cardiac Referred Pain)
A phenomenon where ____ ___ originated in the heart are perceived by a person as ____ ____ from the ____ part of the body.

Answer 17

noxious (painful) stimuli; pain arising from the superficial

Question 18

(Cardiac Referred Pain)
____ ____ is commonly felt as radiating from the substernal and left pectoral regions to the left shoulder and medial aspect of the upper extremity.

Answer 18

Anginal pain

Question 19

(Cardiac Referred Pain)
Cardiac pain is referred to the upper exremity because the _________________ are common to the visceral afferent terminations for the coronary arteries.

Answer 19

spinal cord segments of the cutaneous nerves T1-T3

Question 20

(Coronary Artery/Heart Disease)

One of the leading cause of death and has many causes, all of which result in a …

Answer 20

reduced blood supply to the vital myocardial tissue

Question 21

(Coronary Artery/Heart Disease)
Myocardial infarction (MI):

Answer 21

Occurs due to sudden occlusion of a major artery by an embolus.

Question 22

(Coronary Artery/Heart Disease)

The region of the myocardium supplied by the occluded vessels becomes ____ and under goes _____.

Answer 22

infarcted (rendering virtually bloodless); necrosis (tissue death)

Question 23

(Coronary Artery/Heart Disease)

The 3 most common sites for coronary artery occlusion are:

Answer 23

• Anterior interventricular artery, branch of the left coronary artery (40%-50%)
• Right coronary artery (30%-40%)
• Circumflex branch of the left coronary artery (15-20%)

Question 24

(Coronary Artery/Heart Disease)

Coronary atherosclerosis:

Answer 24

Characterized by lipid deposits in the lining of the coronary arteries.

Question 25

(Coronary Artery/Heart Disease)

Begins during ____ ___ and slowly results in the ____ ___ ___ ___ of the arteries.

Answer 25

early adulthood; stenosis of the lumina.

Question 26

(Coronary Artery/Heart Disease)

The ___ ___ connecting one coronary artery with another will expand to try and compensate for the relative inactivity.

Answer 26

collateral channels

Question 27

(Coronary Artery/Heart Disease)

Despite the compensation, the myocardium may not …

Answer 27

receive enough oxygen when the heart needs to perform increased amounts of work