13 - Heart Flashcards
(76 cards)
1
Q
Layers of the Heart Wall
A
Epicardium
Myocardium
Endocardium
2
Q
Epicardium =
A
visceral layer of serous pericardium
3
Q
Endocardium =
A
lining the chambers (endothelium)
4
Q
Atrioventricular (AV) valves
A
Separate atria & ventricles
5
Q
Semilunar valves
A
Between ventricles & ejecting vessels
6
Q
Interatrial (IA) septum
A
Separates R & L atria
7
Q
Interventricular (IV) septum
A
Separates R & L ventricles
8
Q
Smooth wall portion
: Derived from
A
sinus venosus
9
Q
Auricle (roof)
rough with
A
Rough with pectinate mm.
10
Q
Crista terminalis
A
Vertical ridge separating smooth part from rough
11
Q
Fossa ovalis
Remnant of
A
foramen ovale in IA wall
12
Q
The right atrium will receive deoxygenated blood from
A
SVC, IVC, & coronary sinus. This deoxygenated blood will flow towards the AV orifice to get to the right ventricle.\
13
Q
Right AV Valve
A
Tricuspid valve
Anterior cusp
Septal cusp
Posterior cusp
14
Q
Right AV Valve: Anchored via
A
chordae tendineae to papillary mm.
15
Q
Interior wall – rough with Left Ventricle
A
trabeculae carneae
16
Q
Septomarginal trabecula (moderator band) – located Left Ventricle
A
medially; this structure makes up part of conduction system of heart
17
Q
Conus arteriosus (infundibulum) – funnel to
A
pulmonary trunk
18
Q
Pulmonary Valve
A
In pulmonary trunk
At apex of infundibulum
19
Q
Pulmonary valve consists of
A
Consists of 3 cusps
Left
Right
Anterior
20
Q
Auricle (roof) – rough with
A
pectinate mm.
21
Q
4 pulmonary vv. enter
A
atrium posteriorly
22
Q
Valve of foramen ovale – define
A
fossa ovalis in IA wall
23
Q
Left AV Valve
A
Bicuspid (mitral) valve
Anterior cusp
Posterior cusp
24
Q
Left AV Valve: Anchored via
A
chordae tendineae to papillary mm.
Anterior & posterior papillary mm control both cusps
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Left Ventricle: Interior wall – rough with
trabeculae carneae
26
Left Ventricle: Aortic orifice – leads into
ascending aorta
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Left Ventricle:
| no
```
moderator band
muscle wall (myocardium) is typically 3x thicker (normally ~ 1 to 1.5 cm thick)
```
28
Aortic Valve
Consists of 3 cusps
Left
Right
Posterior
29
The four valves of the heart (along with the myocardium) are attached to this
fibrous skeleton which is composed of dense collagen rings (4) & trigones
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The fibrous skeleton provides
attachment, support, & insulation
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Coronary arteries arise from
either side of the aortic sinuses
| will give off multiple branches
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Most cardiac veins will drain into the
```
coronary sinus (located on the posterior of the heart)
drains into right atrium
```
33
Right Coronary Artery
```
Supplies
Right atrium
Right ventricle
Sinu-atrial node
Atrioventricular nodes
Interatrial septum
Portion left atrium
Posteroinferior 1/3 IV septum
Portion posterior part left ventricle
```
34
Right coronary artery: Travels in
coronary sulcus around right side of heart
35
Right coronary artery: Turns inferior to become
posterior interventricular a.
36
Right coronary artery: Lies in the
posterior interventricular sulcus
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Right Coronary Artery Branches:
Ant. right atrial a.
-Sinu-atrial nodal a.
Right marginal
Posterior interventricular a.
38
Right Coronary Artery: Right coronary a. travels in
coronary sulcus around right side of heart
Turns inferior to become posterior interventricular a.
Lies in the posterior interventricular sulcus
39
Right Coronary Artery supplies
The right coronary artery supplies the right atrium and right ventricle, the sinu-atrial and atrioventricular nodes, the interatrial septum, a portion of the left atrium, the posteroinferior one third of the interventricular septum, and a portion of the posterior part of the left ventricle.
40
Left Coronary Artery: supplies most of
Left atrium
Left ventricle
Interventricular septum,
Atrioventricular bundle and its branches
41
Left coronary a (proper) actually
very short
| Divides into anterior interventricular a. & circumflex aa.
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Left Coronary Artery Branches
Ant. interventricular a. (also called left ant. descending a. – LAD)
Circumflex a.
Left marginal a.
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Ant. interventricular a. runs in
anterior IV sulcus
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Circumflex a. runs in
coronary sulcus
Gives off L marginal br. to supply lateral L ventricle
Circles around L side of heart
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The distribution pattern of the .
left coronary artery enables it to supply most of the left atrium and left ventricle, and most of the interventricular septum, including the atrioventricular bundle and its branches
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Frequently one coronary a. is more
dominant
| This means that it gives off the posterior interventricular artery and supplies more of the heart.
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R coronary a. = dominant in
~65% of cases
| crosses over to supply L ventricle posteriorly
48
L coronary a. = dominant in
~15% of cases
| crosses over to supply R ventricle posteriorly
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Balanced arterial pattern
~ 20% of cases
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Most vv of heart are tributaries to
coronary sinus
Lies in posterior portion of coronary sulcus
Opens into right atrium (between the IVC & AV orifice)
51
Venous Drainage of Heart – Great Cardiac Vein: Travels with
anterior IV a. in anterior IV sulcus
Turns left to run in coronary sulcus superiorly
Travels with circumflex a. around left side of heart
Empties into coronary sinus posteriorly
52
Venous Drainage of Heart – Middle Cardiac Vein: Travels with
posterior interventricular a. in posterior IV sulcus
| Empties into coronary sinus superiorly
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Venous Drainage of Heart – Small Cardiac Vein
Travels with right marginal a. along lateral right ventricle
Turns right to run in coronary sulcus superiorly
Travels with right coronary a. around right side of heart
Empties into coronary sinus posteriorly
54
Venous Drainage of Heart – Anterior Cardiac Veins: travels with
Travels with anterior right ventricular aa. along anterior right ventricle
Ascend toward right auricle empty directly into right atrium
Do NOT empty into coronary sinus
55
Cardiac Catherization
A procedure used to diagnose and treat cardiovascular conditions. During cardiac catheterization, a long thin tube called a catheter is inserted in an artery or vein in the groin, neck or arm and threaded through blood vessels to the heart.
56
Occlusion of major coronary artery, usually due to
atherosclerosis, leads to inadequate oxygenation of an area of myocardium and eventually cell death
57
Great Saphenous v. – commonly used for
bypass grafts
Harvested from the anterior/medial region of the thigh or leg
Can be sutured into aorta & distal branch of a coronary a.
Must consider the arrangement of valves within the saphenous vein
Int. Thoracic a. & Radial a. may also be used
58
Heart has its own
conduction system
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Heart Does not REQUIRE
CNS innervation to initiate heartbeat
With sufficient O2 & nutrition, heart will beat without CNS initiation
Normal ~70 beats per min
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Damage to Conduction System causes
cardiac arrhythmias
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Damage to AV node will cause
heart block
| uncoordinated contraction
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Pacemaker may be inserted to control the
```
contractions
Different types:
single chamber
dual chamber
biventricular
```
63
Placement of a Pacemaker
| battery pack inserted
subcutaneously below clavicle
Electrode threaded down thru SVC to R atrium
Passed thru AV valve into R ventricle
Electrode terminal firmly fixed to trabeculae carneae
Placed in contact with endocardium of ventricular wall
64
A chest x-ray can be very useful in detecting abnormalities in the
structure of the heart and great vessels.
| This requires an understanding of the cardiac and vascular structure anatomy
65
ANS does affect rate of
heartbeat
66
Heart receives sympathetic innervation from
T1-T5
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Heart receives parasympathetic innervation from the
Vagus n. (CN X)
68
Both sympathetic & parasympathetics contribute to both
superficial and deep cardiac plexuses of nerves
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Impulses initiated by
SA node travel to AV node
| Propagation allow for atrial contraction
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Impulses then travel to
AV bundle & IV septum
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Bundle divides into
R & L bundle branches
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Purkinje fibers travel to
ventricles for contraction
also supply
papillary muscles
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The heart's conduction system is formed
by specialized cardiac muscle cells that form nodes and by unidirectional conduction pathways that initiate and coordinate excitation and contraction of the myocardium
Consists of SA node, AV node & AV bundle, bundle branches & purkinje fibers
74
The SA node is called the
“pacemaker” where the initiation of action potentials occurs
| in crista terminalis between R atrium & SVC
75
AV Node & Bundle
| in
IA septum near coronary sinus opening
76
Bundle branches course down the
IV septum (R&L)
