2. Anatomy of the Heart & Coronary Vessels Flashcards Preview

Year 1 - Term 2: Carriage of Oxygen > 2. Anatomy of the Heart & Coronary Vessels > Flashcards

Flashcards in 2. Anatomy of the Heart & Coronary Vessels Deck (29)
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What are the 4 functions of the pericardium?



Fixes heart in mediastinum

Protection from infections from other organs

Prevents excessive heart dilation




What is this?


Pericardial effusion leading to pericardial tamponade



Give 3 factors leading to cardiac tamponade.


1. rate of accumulation

2. fluid amount in pericardium

3. compliance of pericardium



How can cardiac tamponade lead to MI?


CT from e.g. fluid amount in pericardium/accumulation rate -> increase in volume compresses atria, vena cava and pulmonary veins -> R ventricle collapse



CT from e.g. fluid amount in pericardium/accumulation rate -> decreased R. ventricle filling in diastole, stroke volume and C.O. 



What are A, B, C, D and E?


A: Endocardium

B: Myocardium

C: Epicardium 

D: Atrioventricular valve

E: Branch of the coronary artery



Describe the flow of blood through the heart.


SVC, IVC, Coronary sinus -> R. atrium -> (tricuspid valve) -> R. ventricle -> (pulmonary semi lunar valve) -> pulmonary trunk -> pulmonary arteries to lungs -> pulmonary capillaries -> 4 pulmonary veins -> L. atrium -> (mitral valve) -> L. ventricle -> (aortic semi lunar valve) -> aorta -> (body) -> systemic capillaries -> veins -> heart



What is the coronary groove (atrioventricular sulcus)?


Oblique plane which seperates atria and ventricles



What are the (ant. and post.) interventricular grooves?


Overlie intervetricular septum which seperates L and R ventricles



Give 2 features of the R. ventricle.

Give 3 features of the L. ventricle.


R. ventricle: 2/3 anterior, pulmonary trunk

L. ventricle: apex (L. border), inferior surface (2/3 posterior), aorta



What are A, B, C, D and E?


A: R. atrium

B: R. ventricle

C: L. ventricle 

D: Pulmonary trunk

E: ligamentim arteriosum



What are A - G?


A: auricle of LA

B: L ventricle

C: coronary sinus

D: PIG (post. interventricular groove)

E: R. ventricle

F: L. atrium

G: L pulmonary arteries



What are A-F?


A: coronary sinus

B: fossa ovalis

C: tricuspid valve

D: chordae tendinae

E: papillary muscles

F: trabeculae carnae



What are A-F?


B: fossa ovalis


D: coronary sinus

E: tricuspid valve

F: pectinate muscle



Where are the R. atrium and ventricle in relation to the L. atrium and ventricle?

 R: right border and anterior surface

L: posterior or base of heart (plus thicker myocardium)



Label the coronary blood supply 


A: L. coronary artery

B: R. coronary artery

C: mitral valve



Describe the coronoray artery supply.


RCA gives rise to post. interventricular artery and then anastomoses with circumflex branch of LCA

Anterior interventricular (LAD) loops around apex and anastamoses with post. interventricular artery



What are A-C?


A: Left Coronary Artery

B: L. circumflex

C: Anterior interventricular (LAD)



What coronary arteries are usually the cause of MI?


LAD (ant. interventricular) of LCA (40-50%)

RCA (30-40%)

LCA circumflex (15-20%)



What branches of coronary arteries supply AVN and SAN?






What is the path of coronary veins?


Collect waste from cardiac muscle -> drain to coronary sinus on post. heart -> R. atrium



The dense CT fibrous skeleton of the heart surrounds AV and outflow vessel valves. It merges with the interventricular septum. What are its 4 main functions?

1. support valves

2. prevent overstretching of valves

3. insertion point of cardiac muscle bundles

4. electrical insulator between atria and ventricles



What do valves do in diastole?


AV valves open. blood flows A -> V when vent. pressre < atrial pressure.

Chordae tendinae slack, papillary muscles relaxed.

SL valves closed.



What do the valves do in systole?


AV valves close preventing backflow (when vent. contract, pushes valve cusps closed).

Chordae tendinae taut, papillary muscles contract to pull chords.

Sl valves open.



How many cusps do semilunar valves have, and what are they?


1. L coronary aortic sinus

2. R. coronary aortic sinus

3. Non-coronary aortic sinus



Describe the conduction system of the heart


SAN (pacemaker cells) impulses contract atria -> impulses pause 0.1s at AVN so ventricles fill -> AV bundle connects A & V -> AVN branches conduct impulse through interventricular septum -> purkinje fibres stimulate contractile cells of both ventricles, start at apex and move up



The heart is innervated by the cardiac plexus of nerves. Where it is located, and what does it contain?


It extends to coronary vasculature and components fo conducting system.


1. Anterior to carina and posterior to aortic arch

2. parasympathetic from vagus, sympathetic (from sympathetic trunk), visceral general afferents (VGA)




What is the path for cardiac sympathetic innervation?



Cardioacceleratory centre in medullary retiuclar formation

Preganglionic sympathetic neurons in thoracic spinal cord

Postganglionis sympathetic neurons to SAN, AVN and coronary vascular SM

Increase HT and contraction force



What is the path for cardiac parasympathetic innervation?


Cardioinhibitory centre in reticular formation in medulla

Vagus nerve to SAN and AVN

Slows HR



Pain is not felt in the heart - referred pain. Descrive the path of pain caused by ischaemia and damage to cardiac muscle.


Stimuates visceral sensory nerve endings in myocardium -> afferent ascends to CNS through cardiac branches of sympathetic trunk -> (organ and skin pain fibres travel together) -> interpreted as it if came from somatic areas e.g skin supplied by T1-5 L side of chest, neck, face and L. arm. Infarct on inferior wall referred to epigastrium T7-9.

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