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Thorax > Internal Features of the Heart and the Conducting System > Flashcards

Internal Features of the Heart and the Conducting System Flashcards

1
Q

development of heart at 18 days

A

cardiogenic area near the head which distributes primitive blood vessels

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2
Q

heart development at 20 days

A

there is a caudal migration of the cardiogenic area from the head, which splits into two endocardial tubes

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3
Q

development of heart at 21 days

A

fusion of endocardial tubes into one large tube with two tubes on either end

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4
Q

development of heart at 22 days

A

top to bottom - truncus arteriosus, bulbus cordis, primitive ventricle, primitive atrium

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5
Q

development of heart at 23 days

A

central tube starts to twist into an s shape, ventricle and atrium develop, sinus venosus develops

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6
Q

development of heart at 35 days

A

aortic arch arteries have developed, right and left atria have developed separately with a septum primus between them, interventricular septum has begun to develop (ventricles are not yet separate)

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7
Q

heart development at 8 weeks

A

right atrium, tricuspid valve, right ventricle, foramen ovale, left atrium, mitral valve, left ventricle all present

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8
Q

describe liver bypass circuit in foetal hearts

A

nutrients are exchanged in placenta instead of the liver, a single umbilical vein with oxygenated blood and nutrient comes into liver and instead of being distributed around liver for further metabolism (not required) this blood is shunted by ductus stenosis, into inferior vena cava to return to the heart

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9
Q

describe lung bypass in foetal hearts

A

blood doesn’t need to travel to lungs to get oxygen, rather it needs to pass directly from the right to the left atrium - the foramen ovalis is a small hole in the interatrial septum and it shunts blood from the right to the left atrium to be sent around the around the body

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10
Q

describe pulmonary trunk bypass in foetal hearts

A

blood from left ventricle is shunted by the ductus arteriosis directly into aorta - passing by the pulmonary trunk because the lungs are not yet in use

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11
Q

four congenital heart defects

A
  • patent foramen ovale
  • coarctation of the aorta
  • patent ductus arteriosis
  • tetralogy of fallot
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12
Q

describe patent foramen ovale

A
  • Failure of fusion of interatrial septum shortly after birth - foramen ovale remains
  • More common congenital heart defect
  • common in Downs Syndrome
  • Causes problems - an air bubble or thrombus in right atrium will usually travel to the lungs where it can pop but in this heart disease it may pass into system circuit where it could travel as a clot to the brain and cause a stroke
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13
Q

describe coarctation of the aorta

A
  • When the normal fibrotic process of closing the ductus arteriosis spreads to aorta
  • The arch of aorta closes and blood cannot pass through it
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14
Q

describe coarctation of the aorta

A
  • When the normal fibrotic process of closing the ductus arteriosis spreads to aorta
  • The arch of aorta closes and blood cannot pass through it
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15
Q

describe patent ductus arteriosus

A
  • Ductus arteriosus remains open
  • Blood meant for the lungs can pass to the body through the aorta or vice versa
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16
Q

describe tetralogy of fallot

A
  • Aorta emerges from both ventricles (deoxygenated blood can get into the systemic circuit)
  • There is an intraventricular septal defect (meaning oxygenated and deoxygenated blood can mix in the heart)
  • Enlarged right ventricle
  • Stenosed pulmonary semilunar valve (cannot open or close properly)
  • Thankfully quite rare
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17
Q

mitral valve function

A

The anterior cusp of mitral valve forms both inflow tracts of blood into the left ventricle, and outflow tracts of blood out of the left ventricle up to the aorta

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18
Q

mitral valve pathology

A
  • Hypertrophic cardiomyopathy - training causes maldevelopment of ventricles such as over development of ventricular septa and the left ventricular wall
  • This can cause asymmetric swellings of septa - valve is rigid and unyielding
  • This leads to subaortic stenosis - the narrowing of outflow tracts of the left ventricle and is associated with sudden deaths of young athletes
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19
Q

aortic valve stenosis

A
  • Wear and tear as we age can cause valves to degenerate and can lead to aortic stenosis
  • Cusps don’t fit together properly - rigid and unyeilding, meaning they cannot open or close fully -
  • This is detected as a heart murmur
20
Q

parasynpathetuc innervation of the heart

A

The vagus nerve (CN X) originates from the dorsal motor nucleus of the vagus in the medulla → comes out from base of skull through jugular foramen → down carotid sheath → into neck → distributed to cardiac plexus → postganglionic fibres distributed to heart itself → only innervates atria

21
Q

sympathetic innervation of the heart

A

Sympathetic chain begins at the cardioeacceleratory centre → through spinal cord → emerges from upper spinal cord (T1-T6) → forms sympathetic chain → into neck via cervical and sympathetic cardiac nerves → down to heart → innervates artia and ventricles

22
Q

cardiac plexus location

A
  • Anterior part lies near the ligamentum arteriosum
  • Posterior part lies in front of the trachea in the area of the carina
23
Q

conduction system

A

SA node fires action potential → signal travels to atria → atria depolarise and contract → signal travels to AV node → delay occurs to allow ventricles to fill → signals travel through bundle of his and purkinje fibres → ventricles depolarise and contract → blood is expelled through aorta and pulmonary artery

24
Q

identify the congentital heart defect

A

patent foramen ovale

25
Q

identify congenital heart defect

A

coarctation of the aorta

26
Q

identify the congential heart defect

A

patent ductus arteriosis

27
Q

identify the conginetal heart defect

A

Tetralogy of Fallot

28
Q

1

A

superior vena cava

29
Q

2

A

interatrial septum

30
Q

3

A

limbus fossa ovalis

31
Q

4

A

fossa ovalis

32
Q

5

A

inferior vena cava

33
Q

7

A

valve of inferior vena cava

34
Q

8

A

valve on coronary sinus

35
Q

9

A

coronary sinus

36
Q

10

A

pectoralis muscles

37
Q

11

A

crista terminalis

38
Q

1

A

pulmonary valves

39
Q

2

A

left coronary artery

40
Q

3

A

circumflex artery

41
Q

4

A

bicuspid valve

42
Q

5

A

great cardiac vein

43
Q
A

coronary sinus

44
Q

7

A

tricuspid valve

45
Q

8

A

right marginal artery

46
Q

9

A

right coronary artery

47
Q

10

A

aortic valves

Thorax (9 decks)

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