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MRCEM Primary > Cardiology anatomy > Flashcards

Cardiology anatomy Flashcards

1
Q

What are the 2 layers of the pericardium?

A

Fibrous and serous

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2
Q

What is the fibrous pericardium continuous with?

A

Central tendon of the diaphragm

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3
Q

Which layer of the pericardium is the tough, external layer?

A

Fibrous pericardium

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4
Q

What is the purpose of the fibrous pericardium being non-distensible?

A

Rigid structure prevents rapid over-filling of the heart.

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5
Q

What are the 2 subdivisions of the serous pericardium?

A

Outer parietal layer and inner visceral layer

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6
Q

What is the internal visceral layer also known as?

A

Epicardium

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7
Q

The outer parietal layer lines what?

A

The internal surface of the fibrous pericardium

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8
Q

The inner visceral layer forms what?

A

The outer layer of the heart

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9
Q

Where is the pericardial cavity?

A

Between the outer parietal and inner visceral layers of the serous cavity

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10
Q

What is the function of the serous fluid within the pericardial cavity?

A

Minimises friction generated by the heart as it contracts.

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11
Q

What are the 4 main functions of the pericardium?

A

Fixes the heart
Prevents overfilling
Lubrication
Protection from infection

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12
Q

What is the innervation of the pericardium?

A

C3 - C5 (why you get shoulder pain with pericarditis)

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13
Q

What is the order of the layers of the pericardium from most external to most internal?

A

Fibrous layer
Parietal layer
Serous fluid
Visceral layer

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14
Q

Where is the SAN located?

A

Upper wall of right atrium at the junction where the superior vena cava enters.

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15
Q

What does the sympathetic nervous system do to the firing rate of the SAN?

A

Increases firing rate = increased HR

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16
Q

What does the parasympathetic nervous system do to the firing rate of the SAN?

A

Decreases firing rate = decreased HR

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17
Q

Where is the AVN located?

A

Within AV septum, near the opening of the coronary sinus

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18
Q

Why does the AVN delay impulses by ~120miliseconds?

A

To ensure the atria have enough time to fully eject blood into the ventricles before ventricular systole

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19
Q

What is the standard approach for pericardiocentesis?

A

Subxiphoid approach

20
Q

Why does a patient need to be sat at 30-45 degrees for pericardiocentesis?

A

To allow pericardial fluid to pool inferiorly.

21
Q

Where should a needle be inserted for pericardiocentesis?

A

1cm below the left xipho-costal angle.

22
Q

What angle should the needle be inserted at for pericardiocentesis and where should it be aimed?

A

Inserted at a 30 degree angle and aimed at the midpoint of the left clavicle.

23
Q

Where are the aortic sinuses?

A

Small openings found within the aorta behind the left and right flaps of the aortic valve.

24
Q

Which areas of the heart are supplied by the LAD?

A

RV
LV
Anterior 2/3rds IV septum

25
Q

Which areas of the heart are supplied by the left marginal artery?

A

LV

26
Q

Which areas of the heart are supplied by the left circumflex artery?

A

LA
LV

27
Q

Which areas of the heart are supplied by the RCA?

A

RA
SAN
AVN
Posterior IV septum

28
Q

Which areas of the heart are supplied by the right marginal artery?

A

RV
Apex

29
Q

Which areas of the heart are supplied by the posterior inter ventricular artery?

A

RV
LV
Posterior 1/3rd of IVS

30
Q

Which ECG leads correspond to the inferior region of the heart?

A

II, III, aVF

31
Q

Which ECG leads correspond to the anterolateral region of the heart?

A

I, aVL, V5, V6

32
Q

Which ECG leads correspond to the anteroseptal region of the heart?

A

V1, V2

33
Q

Which ECG leads correspond to the anteroapical region of the heart?

A

V3, V4

34
Q

Which ECG leads correspond to the extensive anterior region of the heart?

A

I, aVL, V2-V6

35
Q

Which ECG leads correspond to the posterior region of the heart?

A

Tall R in V1

36
Q

ECG changes in leads II, III and aVF suggest blockage in which artery?

A

RCA

37
Q

ECG changes in leads I, aVL, V5 and V6 suggest blockage in which artery?

A

Left circumflex

38
Q

ECG changes in leads V1, V2 suggest blockage in which artery?

A

LAD

39
Q

ECG changes in leads V3, V4 suggest blockage in which artery?

A

Distal LAD

40
Q

ECG changes in leads I, aVL and V2-V6 suggest blockage in which artery?

A

Proximal LCA

41
Q

The LCA gives rise to which coronary arteries?

A

LAD
Lcx
Left marginal

42
Q

The RCA gives rise to which coronary arteries?

A

Right marginal

43
Q

What is the nerve supply to the fibrous pericardium?

A

Phrenic nerve

44
Q

Which layer of the serous pericardium is supplied by the phrenic nerve?

A

Parietal layer

45
Q
A

MRCEM Primary (39 decks)

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