Lecture - CVS (Jones Anatomy of Heart)

Question 1

Whereabouts is the heart located in the chest:

1. What is the position called where the right atrium sits like, the most lateral part (I think)?
2. With your hand, you can imitate the heart and its position - how do you do this?
3. Whereabouts does the apex of the heart sit? So you put your stethoscope here to hear the loudest sound

Answer 1

1. 4icsRSE

Question 2

1. On this image, label: arch of aorta, pulmonary trunk, apex of heart, right atrium, superior vena cava, and left ventricle.
2. What is the definition of an enlarged heart? Tie in the definition with a dsicussion including the words; diaphragm, pericardial sac, silhouette of the heart.
   - Tell me also in terms of the red and yellow lines what enlarged heart is - does this person have an enlarged heart?

Answer 2

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Question 3

1. Label in this the right ventricle and left atrium
2. When does the aorta become known as the abdominal aorta?
3. What does the diaphragm look like?

Answer 3

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Question 4

Posterior pericardial sac:

1. What is the balloon analogy with this pericardial sac thing? Like imagine it out
2. Of the pericardial sac, what is the layer called that sits against the heart’s epicardial layer and what is the layer called that sits not against the heart?
3. What does the sac actually do?
4. Okay, whereabouts is the oblique pericardial sinus - how do you get to it with finger and what is it formed by?
5. Transverse pericardial sinus - where it is, what does it separate and how to get there from fingers?

Answer 4

3. Potential space and serous fluid to beat frictionlessly
4. It’s like behind heart according to my understanding. You get to it by: you take your hand over the apex on anterior, slide it to posterior, and put it up the back - your fingers come into blind-ended space. It is formed by reflection onto the pulmonary veins of heart
5. So take your hand on the anterior surface, run it around on the left lateral margin and side it around, you’ll get to a point where (if you have a v small finger), you can slide it across that posterior plane in transverse direction and then your finger will go into this opening here (look black arrow on diagram) and your finger will be separating inferiorly the pulmonary veins and superiorly the pulmonary trunk (an artery) and the ascending aorta. Finger through here will separate inflow veins and outflow arteries

Question 5

Label this yo

Answer 5

Good job

Question 6

Right atrium:

1. What is the sinus of venae cavae? What tissue is it from embrologically?
2. What is the fossa ovalis? How is this related to the sinus of venae cavae?
3. What is the other two structures you find in the sinus of venae cavae?
4. There are three sources from where the blood arrives in the right atrium - what are they?
5. What is the atrium proper? What does this include? What is it embryologically derived from?
6. What are the pectinate muscles called and what happens if the chamber is not pumping properly?
7. What is the ridge that separates the sinus of venae cavae and the pectinate muscles?

Answer 6

1. It’s a surface that’s rather smooth - it is from the sinus venosus. It’s a surface that smooth on one side of the right atrium.
2. It is an impression in the wall on the surface of sinus venae cavae. Before brith, we have the foramen ovali (hole in the right atrium to let the blood go to the left side). At birth, there is contraction of muscles that close over and there is fibrosis - leaves this
3. Valve of inferior vena cava and valve of coronary sinus - but he says it should be called the lip of inf vena cava bc it’s not exactly like a valve
4. Superior vena cava, inferior vena cava and coronary sinus
5. Atrium proper is the surface in the right atrium that has musculi pectinati on its surface? I think? It also includes auricles (residual holding space that is part of atrial chamber). It is derived from primitive atrium.
6. They are within the atrium proper. The fibres are in different directions. If chamber is not pumping properly then this mesh of fibres will get blood to stagnate there and bloodclots can form which can break off and travel around (embolise) and can cause things like cardioembolic stroke.
7. Crista terminalis

Question 7

Right ventricle

1. What are three cusps of the tricuspid valve called? Actually between what two ventricles/atria is the tricuspid valve?
2. What are the names of the papillary muscles called that are associated with the three leaflets? What are the pap muscles for and the chordae tendineae - purpose?
3. What are the three names of the structure which channels the blood from the right ventricle to the pulmonary valve?
4. What are the three cusps of the pulmonary valve called? (so like, right side of the heart has 3 leaflets per valve and left side of the heart has 2 then 3 in aorta). What type of valve is the pulonary and aortic?

Answer 7

4. Both are semi-lunar valves

Question 8

Left atria:

1. How many pulmonary veins are there, where do they come from and what are their names?
2. In this image - label what we are seeing

Answer 8

1. Four - from lungs - superior and inferior

Question 9

Left ventricle

1. What valve sits between this and the left atrium? How many leaflets and what are they called? What are the names of the papillary muscles
2. What is the trabeculae carneae?
3. What is the name of the thing that channels the blood to the aortic valve?

4, What are the names of the leaflets of the semilunar aortic valve?

Answer 9

2. So it’s bundles of muscles with spiral arrangement of muscle fibres so heart contracts like a wrining motion - they’re the muscles that confer the contraction throug the heart

Question 10

Semilunar Valves:

1. What do they have at the end of the valves? What’s the purpose of this?
2. How to tell difference between the 2 semi-lunar valves?

Histology of SL valves:

1. What are the three layers of the valves? What is the content (elastin or collagen) of each layer and what’s the purpose of each layer? What’s the colour of each in the histology slide with Elastic Van Gieson Stain?
2. What does a stenotic valve look like?

Answer 10

1. Nodules
2. Aortic will have coronary artery branches just above 2 of the 3 leaflets - the right and left coronary artery orifices

Question 11

How do you hear heart sounds of the valves? Wherabouts on the heart for each of the valves?

Question 12

1. What do the left and right coronary arteries come off?
2. What does the left coronary artery become?
3. Whereabouts is the coronary sinus and where does it drain?

Answer 12

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Question 13

1. Describe, step-by-step, where the electrical signals go in the heart (5 places)
2. What do the purkinje cells look like? What actually are they?

Answer 13

1. SA
2. AV
3. Bundle of His
4. Bundle branches
5. Purkinje fibres
6. They’re modified peripheral myofibrils - larger than contractile cardiomyocytes

Question 14

What does a cardiac muscle cell look like?

Answer 14

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Question 15

Nerves:

1. What are the two plexuses called at the heart/base of heart?
2. Where do the parasym fibres come from and where do the symp fibres come from?
3. What does the cardic plexus send the visceral sensory fibres through?
4. What happens in the dorsal root interneuron in terms of visceral and somatic sensory nerves?
5. Phrenic nerve pain is from what dermatomes? So what part of body will you feel the visceral pain around he pericardial sac as somatic pain?

Answer 15

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