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

2. Anatomy of the Heart & Coronary Vessels Flashcards

1
Q

What are the 4 functions of the pericardium?

A

Fixes heart in mediastinum

Protection from infections from other organs

Prevents excessive heart dilation

Lubrication

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2
Q

What is this?

A

Pericardial effusion leading to pericardial tamponade

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3
Q

Give 3 factors leading to cardiac tamponade.

A
  1. rate of accumulation
  2. fluid amount in pericardium
  3. compliance of pericardium
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4
Q

How can cardiac tamponade lead to MI?

A

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

OR

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

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5
Q

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

A

A: Endocardium

B: Myocardium

C: Epicardium

D: Atrioventricular valve

E: Branch of the coronary artery

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6
Q

Describe the flow of blood through the heart.

A

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

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7
Q

What is the coronary groove (atrioventricular sulcus)?

A

Oblique plane which seperates atria and ventricles

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8
Q

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

A

Overlie intervetricular septum which seperates L and R ventricles

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9
Q

Give 2 features of the R. ventricle.

Give 3 features of the L. ventricle.

A

R. ventricle: 2/3 anterior, pulmonary trunk

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

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10
Q

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

A

A: R. atrium

B: R. ventricle

C: L. ventricle

D: Pulmonary trunk

E: ligamentim arteriosum

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11
Q

What are A - G?

A

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

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12
Q

What are A-F?

A

A: coronary sinus

B: fossa ovalis

C: tricuspid valve

D: chordae tendinae

E: papillary muscles

F: trabeculae carnae

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13
Q

What are A-F?

A

A: SVC

B: fossa ovalis

C: IVC

D: coronary sinus

E: tricuspid valve

F: pectinate muscle

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14
Q

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

A

R: right border and anterior surface

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

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15
Q

Label the coronary blood supply

A

A: L. coronary artery

B: R. coronary artery

C: mitral valve

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16
Q

Describe the coronoray artery supply.

A

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

17
Q

What are A-C?

A

A: Left Coronary Artery

B: L. circumflex

C: Anterior interventricular (LAD)

18
Q

What coronary arteries are usually the cause of MI?

A

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

RCA (30-40%)

LCA circumflex (15-20%)

19
Q

What branches of coronary arteries supply AVN and SAN?

A

AVN: RCA & LAD

SAN: RCA

20
Q

What is the path of coronary veins?

A

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

21
Q

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?

A
  1. support valves
  2. prevent overstretching of valves
  3. insertion point of cardiac muscle bundles
  4. electrical insulator between atria and ventricles
22
Q

What do valves do in diastole?

A

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

Chordae tendinae slack, papillary muscles relaxed.

SL valves closed.

23
Q

What do the valves do in systole?

A

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

Chordae tendinae taut, papillary muscles contract to pull chords.

Sl valves open.

24
Q

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

A
  1. L coronary aortic sinus
  2. R. coronary aortic sinus
  3. Non-coronary aortic sinus
25
Q

Describe the conduction system of the heart

A

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

26
Q

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.

A
  1. Anterior to carina and posterior to aortic arch
  2. parasympathetic from vagus, sympathetic (from sympathetic trunk), visceral general afferents (VGA)
27
Q

What is the path for cardiac sympathetic innervation?

A

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

28
Q

What is the path for cardiac parasympathetic innervation?

A

Cardioinhibitory centre in reticular formation in medulla

Vagus nerve to SAN and AVN

Slows HR

29
Q

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

A

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.

Year 1 - Term 2: Carriage of Oxygen (53 decks)

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