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Question 1

what are the main functions of the fibrous pericardium

Answer 1

anchor heart in place
attach great vessels, aorta, pulmonary artery and veins
attach pericardiophrenic nerve of diaphragm

Question 2

parietal layer attaches what structure on the outside

Answer 2

fibrous pericardium

Question 3

What is the pericardium made up of

Answer 3

fibrous pericardium and serous membranes (parietal and visceral)

Question 4

function of pericardium

Answer 4

fixes heart in mediastinum
limits heart movements
prevents infection from neighbouring organs
prevents over dilation of heart in cases of acute volume overload
lubrication

Question 5

what is the cause of cardiac tamponade

Answer 5

pleural effusion, abnormal accumulation of fluid in pericardial cavity, increase in intrapericardial cavity, compression of heart chambers, impairment of diastolic filling of both ventricles.

decrease in SV so CO so hypotension and shock and reflex tachycardia

increase of venous pressure so pulmonary congestion (can hear rales) and systemic circulation leads to high IJVP

Question 6

what pressure of intrapericardial cavity can lead to death

Answer 6

10-20mmHg

Question 7

Treatment of cardiac tamponade, and types

Answer 7

pericardiocentesis (catheter and needle to remove excess fluid)
Subxiphoid - most common and safest
parasternal
apical

use ultrasound to tell where accumulation is bc pericardial effusion isn’t always equally distributed

Question 8

what type of cells make up the epicardium (visceral layer of pericardium)

Answer 8

simple squamous epithelia
loose CT
fat

Question 9

what type of cells make up the myocardium

Answer 9

cardiac muscle fibre

Question 10

what type of cells make up the endocardium

Answer 10

continuous w endothelium, lines chambers and valves with projections called trabecular carnae

Question 11

is the blood propelled by left and right heart the same volume

Answer 11

not necessarily on a beat to beat measure but overall yes

Question 12

What are some external landmarks of the heart

Answer 12

coronary groove = atrioventricular sulcus = division entre atria and ventricle on the outside

anterior inter ventricular sulcus

posterior inter ventricular sulcus on the right side

Question 13

what’s another name for left and right auricles

Answer 13

atrial appendage

Question 14

where are left and right auricles

Answer 14

they are attached to atria and overlap root of aorta

Question 15

how many pulmonary veins are there

Answer 15

4

Question 16

what fraction of right ventricle is anterior

Answer 16

2/3

Question 17

what fraction of left ventricle is posterior

Answer 17

2/3

Question 18

What are some internal landmarks of the heart

Answer 18

papillary muscles
septal papillary muscle 
moderator band
chordae tendinae
trabeculae carne
fossa ovalis
pectinate muscle
cristae terminali
coronary sinus

Question 19

how many papillary muscles in right side

Answer 19

3

Question 20

how many papillary muscles in right side

Answer 20

2

Question 21

what does the moderator band connect

Answer 21

anterior papillary muscle to ventricular septum

Question 22

what is the fossa ovalis

Answer 22

depression in Right atrium near entry of sup vena cava

Question 23

what are trabeculae carne

Answer 23

msucular projections from inner surface of left and right ventricle

Question 24

what is the coronary sinus

Answer 24

blood vessel that vascularise myocardium. takes low oxygen blood to right atrium

Question 25

what is the cristae terminali

Answer 25

heart muscle at opening of right auricle

Question 26

what is the pectinate muscle?

Answer 26

wall of atria

Question 27

Name right atrium and ventricle landmarks

Answer 27

``` coronary sinus fossa ovalis tricuspid valve valve cusps chordae tendinae papillary muscle trabeculae carnae pulmonary trunk pulmonary semi-lunar valve moderator band ```

Question 28

Name left atrium and ventricle landmarks

Answer 28

``` fossa ovalis mitral valve chordae tendinae papillary muscle trabeculae carnae ascending aorta aortic semilunar valve ```

Question 29

how many cusps are there in aortic valve and what are their key features

Answer 29

openings for left and right coronary artery. | the cusp with no opening is called the non-coronary aortic sinus

Question 30

what does the Right coronary artery anastomose with

Answer 30

RCA anastomoses with circumflex LCA after RCA branches to posterior interventricular

Question 31

what does the Left anterior descending artery anastomose with

Answer 31

LAD loops around apex and anastomoses with post inter ventricular artery.

Question 32

most MI occur due to blockage in which artery

Answer 32

Left anterior descending artery (LAD) off LCA (40-50%) RCA (30-40%) circumflex of LCA (15-20%)

Question 33

which artery supplies SA and AV nodes

Answer 33

RCA. so damage there like isechemia can lead to heart block | LAD supplies septal branches which supply AV node

Question 34

what's a heart block

Answer 34

if atria and ventricles beat at different times, out of synchrony

Question 35

where do coronary veins drain to

Answer 35

coronary sinus

Question 36

where does coronary sinus empty

Answer 36

right atrium direct

Question 37

what's the fibrous skeleton of the heart

Answer 37

Dense CT which electrically isolates atria and ventricles insertion of cardiac muscle bundle prevents valves outstretching supports valves

Question 38

when do valves open

Answer 38

when ventricular pressure is lower than atrium pressure so ventricles are relaxed chordae tendinae are slack papillary muscles are relaxed

Question 39

when do valves close

Answer 39

when ventricular pressure is higher than atrium pressure so ventricles contract chordae tendinae are pulled tight papillary muscles are taut tight

Question 40

what separates the atrial and ventricular networks (in terms of conducting system)

Answer 40

fibrous skeleton of the heart

Question 41

explain the process of heart contraction

Answer 41

SA node generates impulse atria contract impulse pauses 0.1s so ventricles can fill AV bundle branches conduct impulse through inter ventricular septum Purkinje fibres stimulate the contractile cells of both ventricles starting at apex then up

Question 42

how many impulses does SA node generate per minute

Answer 42

70-80

Question 43

what supplies heart innervation

Answer 43

cardiac plexus

Question 44

where is the cardiac plexus located

Answer 44

anterior of bifurcation of trachea and posterior to arch of aorta

Question 45

what kinds of neurones does the cardiac plexus contain

Answer 45

sympathetic (from sympathetic trunk) parasympathetic (from vagus) visceral sensory afferent

Question 46

what structure is referred to as the cardioaccelerator and cardioinhibitor

Answer 46

medullary reticular formation

Question 47

what nerve does cardiac pain stimulate

Answer 47

visceral sensory afferent nerve endings in myocardium

Question 48

where would pain be felt for a infarct on inferior wall

Answer 48

epigastrium

Question 49

why is pain generally referred

Answer 49

bc it comes from somatic areas