Anatomy of the Heart Flashcards

1
Q

Most of the important clinical aspects of the heart take place where?

A

The sternal angle (around T4 or T5). The second rib attaches to the sternum here. It defines the base, which is superior to the apex. The trachea also divides here.

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2
Q

What is found in the pericardium (other than the heart)?

A

Only serous fluid

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3
Q

2 fluid layers in the pericardium

A

-Visceral pericardium aka Epicardium (on the heart) -

Parietal (just inside the pericardium)

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4
Q

Function of fibrous pericardia

A

To protect heart as it beats

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5
Q

Oblique sinus

Transverse sinus

A
  • Space in pericardium behind heart (larger)

- Space in pericardium just above pulmonary veins (smaller)

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6
Q

What kind of blood does the right side of the heart handle? The left side?

A

Right: deoxygenated
Left: oxygenated

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7
Q

Where does the blood that flows through the superior vena cava come from? Inferior vena cava?

Where do they both drain into?

A

Superior: Head, neck, upper limbs

Inferior: Rest of the body

They both drain into the right atrium

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8
Q

What valve is associated with flow into the right ventricle?

A

Tricuspid

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9
Q

What valve is associated with flow into the pulmonary trunk?

A

Pulmonary Semilunar

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10
Q

Valve associated with flow into the left ventricle?

A

Mitral aka Biscuspid. This is a source of a lot of heart murmurs.

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11
Q

Valve associated with flow into the aorta

A

Aortic Semilunar

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12
Q

Oracle

A

Projection off of the right and left atria which serve as overflow area for extra blood

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13
Q

Valve in the Superior Vena Cava

A

There is none. It relies on gravity

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14
Q

Is there a valve in the Inferior Vena Cava?

A

Yes, one small one to prohibit backflow of blood

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15
Q

Fossa Ovalase

A

Depression in interatrial septum on the right atria side. A remnant of embryological circulation in heart, as the fetal circulation kept blood away from the lungs.

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16
Q

The rough part of the atrium and ventricle and what function they hold.

A

Atrium: Pectinante muscle (right atrium only)

Ventricle: Trabeculae carneae muscles

Myocytes which help in contraction of these spaces

17
Q

Coronary sinus

A

Used for the venous drainage of the heart walls themselves. That coronary sinus then drains to the right atrium to be recirculated to the lungs.

18
Q

Boundaries of the Middle Mediastinum

A

Superiorly: Sternal angle (T4/5)
Inferiorly: Xiphisternum (T9)
Left Lateral: 5th intercostal space in midaxillary line
Right Lateral: Along sternal border

19
Q

The valves of the bicuspids/ tricuspids are tied to the walls of the ventricles via what?

A

Chorda Tendoni- strong tendonous extensions

20
Q

Papillary muscles

A

Extensions from the side wall of the ventricle which attach to the chorda tendoni’s and help keep the valve from regurgitating into the atria upon contraction of the ventricle.

21
Q

Moderator Band

A

Aka septomarginal band. Extension of the anterior papillary muscle. Contains conductions of purkinje fibers which are important for coordinating contraction of the heart. Found in the right Ventricle.

Extends from the base of the anterior papillary muscle to the ventricular septum.

22
Q

How are the left and right atrium different?

A

The left atrium is fairly non-descript. It doesn’t have the pectinante muscles and has a fairly nonprominent Fossa Ovalase. It is mostly smooth wall.

23
Q

Difference between the papillary muscles in the right and the left ventricles.

A

They are only anterior posterior on the left side, they lack the septal component that is seen with the right side (because they have one less cusp)

24
Q

Coronary (arterial) circulation to heart

A
  • Delivers oxygenated blood and therefore comes off the ascending aorta.
  • There is a left and right coronary
25
Q

Branches of the left coronary artery

A
  • Left anterior descending (interventricular) a. (runs along septum between the ventricles and supplies them both)– aka the widow maker
  • Circumflex a. (winds around atrioventricular groove)
  • Left Marginal a.
26
Q

Branches of the right coronary

A
  • Right marginal a.

- Posterior descending (interventricular) a.

27
Q

Cardiac Veins

A
  • Great cardiac v. (runs with the anterior descending interventricular a., then follows the circumflex artery and drains into the coronary sinus)
  • Middle Cardiac (also goes to cardiac sinus)
  • Small cardiac v.
28
Q

Describe the autonomic input that the heart receives.

A
  • Large parasympathetic plexuses from CN X

- Sympathetic plexuses from the sympathetic cervical ganglion (upper thoracic region)

29
Q

SA node

A

Sino-atrial node. Specialized heart cells which are part of the intrinsic innervation of the heart. The “pacemaker”. They receive both sympathetic and parasympathetic input.

30
Q

AV node

A

Atrio-ventricular node. Made up of highly specialized myocytes with conductive properties. Electrically connects the right atrium and ventricle.

31
Q

How is rate of contraction regulated in heart (basics)

A

SA node sets the pace and communicates it to AV node. AV node then passes the signal to the purkinje fibers. These go out into different bundles and regulate the rate of contraction.

32
Q

Projection vs Auscultation

A

Projection: The part of the anterior chest wall directly over where the valve actually is.

Auscultation: Where the sound projects when the valve closes.

33
Q

Projection locations of the heart valves

A
  • Pulmonary Semilunar: Junction between 3rd rib and the sternum
  • Aortic Semilunar: Junction between 4th rib and the sternum.
  • Mitral (Bicuspid): 4th rib, just to the left of the Aortic Semilunar.
  • Tricuspid: Middle of sternum, about the 5th or 6th rib
34
Q

Auscultation locations of the heart valves

A
  • Pulmonary Semilunar: Second intercostal space, left of the sternum.
  • Aortic Semilunar: Second intercostal space, right of the sternum.
  • Mitral (Bicuspid): Apex of heart, just below the nipple (5th intercostal space– mid-axillary line)
  • Tricuspid: Fourth intercostal space, left of the sternum
35
Q

Which chamber will you find the moderator band?

A

Right Ventricle