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Phase 1 > Intro and CVS Anatomy > Flashcards

Intro and CVS Anatomy Flashcards

1
Q

What is the sagittal plane?

A

A vertical line which divides the body into a left section and a right section

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2
Q

What is the coronal plane?

A

a vertical line which divides the body into a front (anterior) section and back (posterior) section

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3
Q

What is the transverse plane?

A

a horizontal line which divides the body into an upper (superior) section and a lower (inferior) section.

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4
Q

What is flexion?

A

a movement that decreases the angle between two body parts.

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5
Q

What is extension?

A

a movement that increases the angle between two body parts

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6
Q

What is abduction?

A

Movement away from the midline

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7
Q

What is adduction?

A

Movement towards the midline

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8
Q

What is medial rotation?

A

A rotational movement towards the midline

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9
Q

What is lateral rotation?

A

A rotating movement away from the midline

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10
Q

What is elevation?

A

Movement in a superior direction

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11
Q

What is depression?

A

Movement in an inferior direction

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12
Q

What is supination?

A

Moving into the supine position

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13
Q

What is pronation?

A

Moving into the prone position

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14
Q

What is dorsiflexion?

A

Flexion at the ankle, so that the foot points more superiorly

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15
Q

What is plantarflexion?

A

Extension at the ankle so that the foot points inferiorly

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16
Q

What is inversion?

A

Movement of teh sole towards the median plane

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17
Q

What is eversion?

A

Movement of the sole away from the median plane

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18
Q

What is opposition?

A

Bringing the thumb and little finger together

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19
Q

What is reposition?

A

Moving the thumb and little finger away from each other

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20
Q

What is protraction?

A

the anterolateral movement of the scapula on the thoracic wall that allows the shoulder to move anteriorly.

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21
Q

What is retraction?

A

the posteromedial movement of the scapula on the thoracic wall, which causes the shoulder region to move posteriorly

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22
Q

What is the region of the superior mediastinum?

A

From the sternal angle to the superior thoracic aperture

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23
Q

What is the region of the inferior mediastinum?

A

From the sternal angle to the diaphragm

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24
Q

What are the borders of the superior mediastinum?

A 
Superior – Thoracic inlet.
Inferior – Continuous with the inferior mediastinum at the level of the sternal angle.
Anterior – Manubrium of the sternum.
Posterior – Vertebral bodies of T1-4.
Lateral – Pleurae of the lungs.
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25
Q

What is the path of the path of the right vagus nerve?

A

Runs parallel to the trachea and passes posteriorly to the superior vena cava and the right primary bronchus

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26
Q

What is the path of the left vagus nerve?

A

enters the superior mediastinum between the left common carotid and the left subclavian arteries. It descends anteriorly to the aortic arch, before travelling posterior to the left bronchus.

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27
Q

Where does the left recurrent laryngeal nerve arise from?

A

The left vagus nerve as it passes the aortic arch.

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28
Q

What are the roots of the phernic nerve?

A

C3,C4,C5

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29
Q

Where do the cardiac nerve origionate from?

A

The superior, middle and inferior cardiac ganglion

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30
Q

Where does the superior cardiac plexus sit?

A

Between the aortic arch and right pulmonary vein

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31
Q

Where does the deep cardiac plexus sit?

A

Lies on the surface of the trachea at the point of bifurcation

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32
Q

Where is the thymus gland?

A

Against the posterior surface of the sternum- can often reach into the neck

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33
Q

Where does the oesophagus join the pharynx?

A

The level of C6

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34
Q

What are the borders of the anterior mediastinum?

A

Lateral borders: Mediastinal pleura (part of the parietal pleural membrane).
Anterior border: Body of the sternum and the transversus thoracis muscles.
Posterior border: Pericardium.
Roof: Continuous with the superior mediastinum at the level of the sternal angle.
Floor: Diaphragm.

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35
Q

What are the borders of the middle mediastinum?

A

Anterior: Anterior margin of the pericardium.
Posterior: Posterior border of the pericardium.
Laterally: Mediastinal pleura of the lungs.
Superiorly: Imaginary line extending between the sternal angle (the angle formed by the junction of the sternal body and manubrium) and the T4 vertebrae.
Inferiorly: Superior surface of the diaphragm

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36
Q

What are the sympathetic nerves in the cardiac plexus derived from?

A

T1-T4

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37
Q

What is the parasympathetic innervation to the cardiac plexus?

A

The vagus nerve

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38
Q

What are the borders of the posterior mediastinum?

A

Lateral: Mediastinal pleura (part of the parietal pleural membrane).
Anterior: Pericardium.
Posterior: T5-T12 vertebrae.
Roof: Imaginary line extending between the sternal angle (the angle formed by the junction of the sternal body and manubrium) and the T4 vertebrae.
Floor: Diaphragm.

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39
Q

Where does the thoracic duct originate?

A

The cisterna Chyli in the abdomen

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40
Q

Where does the thoracic duct lie?

A

Anterior to the T6-T12 vertibrae

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41
Q

What is the azygous vein formed from?

A

The union of the right lumbar vein and the right subcostal vein.

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42
Q

What is the hemiazygos vein formed form?

A

The union of the left lumbar vein and left subcostal vein.

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43
Q

What is the accessory hemiaxygos vein formed from?

A

The union of the fourth to eighth intercostal veins. It drains into the azygous vein at T7.

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44
Q

Initially how wide is the aorta?

A

An inch

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45
Q

What are the four sections of the aorta?

A

The ascending aorta
The Aortic arch
The thoracic aorta
The abdominal aorta

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46
Q

Where does the aorta terminate?

A

L4

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47
Q

How long is the ascending aorta?

A

2 inches

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48
Q

How is the aortic arch connected to the pulmonary trunk?

A

The ligamentum arteriosum

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49
Q

What are the three major branches arising from the aortic arch?

A

Brachiocephalic trunk
Left common carotid artery
Left subclavian artery

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50
Q

What are the levels of the thoracic (Descending) aorta?

A

T4 to T12

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51
Q

What does the brachiocephalic trunk supply?

A

The first and largest branch that ascends laterally to split into the right common carotid and right subclavian arteries. These arteries supply the right side of the head and neck, and the right upper limb.

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52
Q

What does the left common carotid artery supply?

A

The left side of the head and neck

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53
Q

What does the left subclavian artery supply?

A

The left upper limb

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54
Q

What are the branches of the thoaracic (descending) aorta (in descending order)?

A 
Bronchial arteries
Mediastinal arteries
Oesophageal arteries 
Pericardial arteries
Superior phrenic arteries
Intercostal and subcostal arteries
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55
Q

What do the bronchial arteries supply?

A

Bronchial, peribronchial tissue and visceral pleura

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56
Q

What do the mediastinal arteries supply?

A

Lymph glands and loose areolar tissue

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57
Q

What do the oesophageal arteries supply?

A

Oesophagus

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58
Q

What do the pericardial arteries supply?

A

The superior portion of the diaphragm

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59
Q

What do the intercostal arteries supply?

A

The intercostal spaces

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60
Q

What do the subcostal arteries supply?

A

The flat abdominal wall muscles

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61
Q

What are the branches of the abdominal aorta in descending order?

A 
Inferior phrenic arteries 
Coeliac artery
Superior mesenteric artery 
Middle suprarenal arteries 
Renal arteries
Gonadal arteries
Inferior mesenteric artery
Median sacral artery
Lumbar arteries
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62
Q

Where do the inferior phrenic arteries arise from the descending aorta?

A

posterior T12

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63
Q

What do the inferior phrenic arteries supply?

A

The diaphragm

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64
Q

Where does the coeliac artery arise from the descending aorta?

A

anterior T12

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65
Q

Where does the superior mesenteric artery arise from the descending aorta?

A

anterior of L1

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66
Q

Where do the middle suprarenal arteries arise from the descending aorta?

A

posterior L1

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67
Q

Where do the renal arteries arise from the descending aorta?

A

Laterally between L1 and L2

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68
Q

Where do the gonadal arteries arise from the descending aorta?

A

Laterally at L2

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69
Q

Where does the inferior mesenteric artery arise from the descending aorta?

A

Anterior L3

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70
Q

Where does the median sacral artery arise from the descending aorta?

A

Posterior L4

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71
Q

Where do the lumbar arteries arise from the descending aorta?

A

Posterolaterally between the levels of L1 and L4

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72
Q

What does the coeliac artery supply?

A

Liver, Stomach, Abdominal oesophagus, spleen, superior duodenum and the superior pancreas

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73
Q

Where does the superior mesenteric artery supply?

A

Distal duodenum, jejuoileum, ascending colon and part of the transverse colon

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74
Q

Where does the middle suprarenal arteries supply?

A

Adrenal glands

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75
Q

Where do the renal arteries supply?

A

The kidneys

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76
Q

Where do the gonadal arteries supply?

A

in males- the testicular artery

in females- the ovarian artery

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77
Q

Where do the inferior mesenteric artery supply?

A

The large intestine from the splenic flexure to the upper part of the rectum

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78
Q

Where does the median sacral artery supply?

A

Coccyx, lumbar vertebrae, and the sacrum

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79
Q

Where do the lumbar arteries supply?

A

The abdominal wall and spinal cord

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80
Q

What are the branches of the coeliac trunk?

A

Left gastric artery
Splenic artery
Common hepatic artery

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81
Q

What does the left gastric artery supply?

A

Stomach, adjacent portion of oesophagus

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82
Q

What does the splenic artery supply?

A

Spleen, stomach, pancreas

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83
Q

What does the common hepatic artery supply?

A

Liver, stomach, gallbladder, duodenum, pancreas

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84
Q

What is an aortic aneurysm?

A

A dilation of the aortic artery to more than 1.5 its original size.

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85
Q

Why may patients with an abdominal aortic aneurysm experience a hoarse voice?

A

The dilation stretching the left recurrent laryngeal nerve

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86
Q

What is the diameter of the superior vena cava?

A

Up to 2cm

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87
Q

How long is the superior vena cava?

A

Approx 7cm

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88
Q

What unites to form the superior vena cava?

A

The right and left brachiocephalic vein

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89
Q

What are the causes of a raised jugular venous pressure?

A

Right-sided heart failure, pulmonary hypertension, and SVC obstruction

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90
Q

At what level does the superior vena cava recieve the azygous vein?

A

T4

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91
Q

What tributaries does the SVC receive from minor vein groups?

A

Mediastinal veins
Oesophageal veins
Pericardial veins

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92
Q

What is Pemberton’s test?

A

A test to assess SVC obstruction.
The patient is asked to raise both arms above their head- a positive test is indicated if facial oedema or cyanosis occurs after approximately 1 minute

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93
Q

How many ribs are there?

A

12 pairs

94
Q

What is the head of a rib?

A

Wedge shaped with two articular facets seperated by a wedge of bone. One facet articulates with the numerically corresponding vertebrae and the other articulates with the vertebrae above.

95
Q

What is the neck of a rib?

A

Bone with no bony prominences, but simply connects the head with the body. Where the neck meets the body there is a roughed tubercle with a facet for articulation with the transverse process of the corresponding vertebrae.

96
Q

What is the body of the rib?

A

The flat, curved area of the bone. The internal surface of the shaft has a groove for the neurovascular supply of the thorax, protecting the vessels and nerves from damage.

97
Q

Which of the ribs are atypical?

A

1, 2, 10, 11 and 12

98
Q

Why is rib 1 atypical?

A

It is shorter and wider than other ribs. It only has one facet on its head for articulation with its corresponding vertebrae. The superior surface is marked by two grooves which make way for the subclavian vessels.

99
Q

Why is rib 2 atypical?

A

It is thinner and longer than rib 1, and has two articular facets on the head as normal. It has a roughened area on its upper surface, where the serratus anterior muscle attaches.

100
Q

Why is rib 10 atypical?

A

It only has one facet – for articulation with its numerically corresponding vertebrae.

101
Q

Why are ribs 11 and 12 atypical?

A

They have no neck and only contain one facet, which is for articulation with their corresponding vertebrae

102
Q

What are the two joints formed by each rib?

A

Costotransverse joint

Costovertebral joint

103
Q

Where are the costotransverse joints?

A

Between the tubercle of the rib, and the transverse costal facet of the corresponding vertebrae.

104
Q

Where are the costovertebral joints?

A

Between the head of the rib, superior costal facet of the corresponding vertebrae and the inferior costal facet of the vertebrae above

105
Q

How do the ribs 1-7 attach to the sternum?

A

Attach independently

106
Q

How do ribs 8-10 attach anteriorly?

A

Attach to the costal cartilages superior to them

107
Q

How do ribs 10 and 11 attach anteriorly?

A

Do not have an anterior attachment- sometimes called floating ribs

108
Q

What are the three parts of the sternum?

A

The manubrium, the body, the xiphoid process

109
Q

What is the most superior portion of the sternum?

A

The manubrium

110
Q

What is the jugular notch?

A

The concave superior aspect of the manubrium which produces a depression

111
Q

Where is the jugular notch?

A

T3

112
Q

What is the sternal angle?

A

Where the manubrium articulates with the body of the sternum

113
Q

What is the level of the sternal angle?

A

T4/5

2nd costal cartilage

114
Q

What ribs do the articular facets of the sternal body articulate with?

A

The costal cartilages of ribs 3-6 and parts of the second and seventh ribs (demifacets)

115
Q

Where is the tip of the xiphoid process?

A

T10

116
Q

What are the distinctive features of the thoracic vertibrae?

A

Vertebral body is heart shaped.
Presence of demi-facets on the sides of each vertebral body – these articulate with the heads of the ribs.
Presence of costal facets on the transverse processes – these articulate with the tubercles of the ribs. They are present on T1-T10 only.
The spinous processes are long and slant inferiorly. This offers increased protection to the spinal cord, preventing an object such as a knife entering the spinal canal.

117
Q

How are adjacent vertebral bodies joined?

A

Intervertebral discs

118
Q

What is the role of the ligamentum flavum?

A

Connects the laminae of adjacent vertebrae

119
Q

What is the role of the interspinous ligament?

A

Connects the spinous processes of adjacent vertebrae

120
Q

What is the role of the supraspinous ligament?

A

Connects the tips of adjacent spinous processes

121
Q

What are the small ligaments that support the costovertebral joints?

A

Radiate ligament of head of rib
Costotransverse ligament
Lateral costotransverse ligament
Superior costotransverse ligament

122
Q

What are the attachments of the external intercostals?

A

Originate at the lower border of the rib, inserting into the superior border of the rib below

123
Q

What direction do the external intercostals run?

A

Inferoanteriorly from the rib above to the rib below (hands into pockets)

124
Q

What are the actions of the external intercostals?

A

Intercostal nerves (T1-T11)

125
Q

In which directions do the internal intercostals run?

A

From the rib above to the rib below inferoposteriorly

126
Q

What are the attachments of the internal intercostals?

A

Originates from the lateral edge of the costal groove and inserts into the superior surface of the rib below.

127
Q

What are the actions of the internal intercostals?

A

The interosseous part reduces the thoracic volume by depressing the ribcage, and the interchondral part elevates the ribs.

128
Q

What is the innervation of the internal intercostals?

A

Intercostal nerves (T1-T11)

129
Q

What are the attachments of the innermost intercostals?

A

Originates from the medial edge of the costal groove and inserts into the superior surface of the rib below.

130
Q

What are the actions of the innermost intercostals?

A

The interosseous part reduces the thoracic volume by depressing the ribcage, and the interchondral part elevates the ribs.

131
Q

What is the innervation of the innermost intercostals?

A

Intercostal nerves (T1-T11)

132
Q

What are the attachments of the transversus thoracis?

A

From the posterior surface of the inferior sternum to the internal surface of costal cartilages 2-6.

133
Q

What are the actions of the transversus thoracis?

A

Weakly depress the ribs

134
Q

What is the innervation of the transversus thoracis?

A

Intercostal nerves (T2-T6)

135
Q

What are the attachments of the subcostals?

A

These originate from the inferior surface of the lower ribs, near the angle of the rib. They then attach to the superior border of the rib 2 or 3 below.

136
Q

What are the actions of the subcostals?

A

Reduces thoracic volume by depressing the ribcage and elevating the ribs

137
Q

Where does the pulmonary trunk split into the right and left pulmonary arteries?

A

T5-T6

138
Q

Is the left or the right pulmonary artery longer and thicker?

A

The right pulmonary artery

139
Q

Where is the oblique pericardial sinus found?

A

Within the pericardium between the left and right veins

140
Q

Where is the inferior left pulmonary vein found?

A

At the hilum of the lung

141
Q

Where is the right inferior pulmonary vein found?

A

Running posteriorly to the superior vena cava and right atrium

142
Q

What veins join to form the inferior vena cava?

A

The common iliac veins , the hepatic, lumbar, gonadal, renal and phrenic veins.

143
Q

What are the four borders of the heart?

A

Right border – Right atrium
Inferior border – Left ventricle and right ventricle
Left border – Left ventricle (and some of the left atrium)
Superior border – Right and left atrium and the great vessels

144
Q

Where is the coronary sulcus?

A

Running transversely around the heart- representing the wall dividing the atria from the ventricles. The sinus contains important vasculature such as the right coronary artery

145
Q

Where are the anterior and posterior sulci?

A

Running vertically on their respective sides of the heart. They represent the wall separating the ventricles.

146
Q

What are pericardial sinuses?

A

Passageways formed the unique way in which the pericardium folds around the great vessels

147
Q

What is the oblique pericardial sinus and where is it found?

A

It is a blind ending passageway located on the posterior surface of the heart

148
Q

Where is the transverse pericardial sinus fund and what is it?

A

It is found superiorly on the heart. It can be used in coronary artery bypass grafting. It is posterior to the ascending aorta and pulmonary trunk, anterior to the SVC, and superior to the left atrium.

149
Q

How does blood flow from the right atrium to the right ventricle?

A

Through the atrioventricular orifice guarded by the tricuspid valve

150
Q

What is the right auricle and where is it found?

A

It is a muscular pouch that acts to increase the capacity of the right atrium. It is found extending from the antero-medial portion of the chamber.

151
Q

How are the sinus venarum and the atrium proper seperated in the right atrium?

A

Via a muscular ridge called thecrista terminalis. (Sinus venarum is posterior, atrium proper is anterior)

152
Q

What is the sinus venarum?

A

The posterior part of the right atrium which receives blood from the superior and inferior vena cavae. It has smooth walls and is derived from the embryonic sinus venosus

153
Q

What is the atrium proper?

A

The anterior part of the right atrium. It includes the right auricle. It is derived from the primitive atrium, and has rough, muscular walls formed by embryonic sinus venosus

154
Q

Where does the coronary sinus open into?

A

The right atrium between the inferior vena cava orifice and the right atrioventricular orifce

155
Q

What is the intratrial septum?

A

A solid muscular wall that seperates the right and left atria

156
Q

Where is the fossa ovalis and what is it?

A

The septal wall in the right atrium. It is a small oval-shaped depression called the fossa ovalis. This is the remnant of the foreman ovale in the foetal heart which allows right to left shunting of blood to bypass the lungs.

157
Q

Where does the left atrium sit in the anatomical position?

A

Forming the posterior border of the heart

158
Q

What is the inflow portion of the left atrium?

A

It receives blood from the pulmonary veins. Its internal surface is smooth and it is derived from the pulmonary veins themselves

159
Q

What is the outflow portion of the left atrium?

A

It is located anteriorly and includes the left auricle. It is lined by pectinate muscles and is derived from the embryonic atrium

160
Q

What is the supraventricular crest?

A

A muscular ridge in the right ventricle which divides it into an inflow and an outflow portion

161
Q

What are the trabeculae carnae?

A

A series of irregular muscular elevations in the interior of the inflow part of the right ventricle. They give the ventricle a ‘sponge-like’.

162
Q

What are the three groups of trabeculae carnae?

A

Ridges
Bridges
Pillars (papillary muscles)

163
Q

What are ridges in the right ventricle?

A

Muscular elevations that are attached along their entire length on one side to form ridges along the interior surface of the ventricle.

164
Q

What are the bridges in the right ventricle?

A

Muscular elevations that are attached to the ventricle at both ends, but free in the middle. The most important example of this type is the moderator band, which spans between the interventricular septum and the anterior wall of the right ventricle. It has an important conductive function, containing the right bundle branches.

165
Q

What are the pillars in the right ventricle?

A

Muscular elevations that are anchored by their base to the ventricles. Their apices are attached to fibrous cords (chordae tendineae), which are in turn attached to the three tricuspid valve cusps. By contracting, the papillary muscles ‘pull’ on the chordae tendineae to prevent prolapse of the valve leaflets during ventricular systole.

166
Q

What is the outflow portion of the right ventricle?

A

Located in the superior aspect of the ventricle. It is derived from the embryonic bulbus cordis. It has smooth walls and no trabeculae carneae

167
Q

Where is the left ventricle when in the anatomical position?

A

Forming the apex of the heart, as well as the left and diaphragmatic borders.

168
Q

Describe the inflow portion of the left ventricle

A

The walls of the inflow portion of the left ventricle are lined by trabeculae carneae, as described with the right ventricle. There are two papillary muscles present which attach to the cusps of the mitral valve.

169
Q

Describe the outflow portion of the left ventricle

A

The outflow part of the left ventricle is known as the aortic vestibule. It is smooth-walled with no trabeculae carneae, and is a derivative of the embryonic bulbus cordis.

170
Q

What are the four abnormalities present in tetralogy of Fallot?

A

Ventricular septal defect
Overriding aorta
Pulmonary valve stenosis
Right ventricular hypertrophy

171
Q

Describe the sequence of electrical events during one full contraction of the heart

A

An excitation signal (an action potential) is created by the sinoatrial (SA) node.
The wave of excitation spreads across the atria, causing them to contract.
Upon reaching the atrioventricular (AV) node, the signal is delayed.
It is then conducted into the bundle of His, down the interventricular septum.
The bundle of His and the Purkinje fibres spread the wave impulses along the ventricles, causing them to contract.

172
Q

Where is the sinoatrial node?

A

The upper wall of the right atrium, at the junction where the SVC enters

173
Q

How do the autonomic nervous system influence the rate of conduction by the SA node?

A

Sympathetic nervous system – increases firing rate of the SA node, and thus increases heart rate.
Parasympathetic nervous system – decreases firing rate of the SA node, and thus decreases heart rate.

174
Q

Where is the atrioventricular node?

A

In the atrioventricular septum, near the opening of the coronary sinus

175
Q

How long does the AV node delay the electrical impulse for?

A

Approx 120ms

176
Q

Why does the AV node delay the impulses?

A

To ensure the atria have enough time to fully eject blood into the ventricles before ventricular systole

177
Q

Where are purkinje fibres located?

A

The subendocardial surface of the ventricular `walls

178
Q

Where is an artificial pacemaker inserted?

A

Under the left clavicle, with wires connected to the heart via the venous system

179
Q

What are the three distinct layers in the heart wall?

A

Endocardium
Myocardium
Epicardium

180
Q

What is the innermost layer of the heart?

A

Endocardium

181
Q

What is the structure of the endocardium?

A

Loose fibrous connective tissue and simple squamous epithelial tissue

182
Q

What is endocarditis?

A

Inflammation of the endocardium. It most commonly occurs on the valves of the heart.

183
Q

What is the structure of the subendocardial layer?

A

Loose fibrous tissue containing the vessels and nerves of the conducting system of the heart. It joins the endocardium and the myocardium

184
Q

What is the structure of the myocardium?

A

Cardiac muscle which is an involuntary striated muscle

185
Q

What are the symptoms of myocarditis?

A

Chest pain, shortness of breath and tachycardia.

186
Q

What is the cause of a myocardial infarction?

A

A blockage in the coronary artery, causing the myocardium to lose oxygen supply

187
Q

What is an NSTEMI?

A

Non S-T elevated myocardial infarction. The coronary artery is only partially blocked. Ischaemic damage to the partial thickness of the myocardium.

188
Q

What is a STEMI?

A

S-T elevated myocardial infarction. The coronary artery is completely blocked. Ischaemic damage to the full thickness of the myocardium

189
Q

What are the risk factors for myocardial infarctions?

A

Obesity, high blood pressure, smoking and diabetes.

190
Q

What happens in angina?

A

The coronary arteries are narrowed but not completely blocked, in the overwhelming majority as a result of atherosclerosis. The reduced blood flow causes intermittent ischaemia when the oxygen demand exceeds supply.

191
Q

What is the difference between stable and unstable angina?

A

Stable angina can be predicted, with symptoms of chest pain developing after exercise or under stress
Unstable angina does not require exertion to set of symptoms

192
Q

What is the structure of the epicardium?

A

It is the outermost layer of the heart, formed by the visceral layer of the pericardium. It is composed of connective tissue and fat. The connective tissue secretes a small amount of lubricating fluid into the pericardial cavity. It is lined on its outer surface by simple squamous epithelial cells

193
Q

What is the pericardium?

A

A fibroserous, fluid-filled sacked that surrounds the muscular body of the heart and the roots of the great vessels

194
Q

What are the two main layers of the pericardium?

A

Fibrous pericardium (tough external layer), serous pericardium (thin, internal layer)

195
Q

What are the two layers of the serous pericardium?

A

Outer perietal layer that lines the interal surface of the fibrous pericardium
Internal visceral layer that forms the outer layer of the heart (epicardium)

196
Q

What is the pericardial cavity?

A

A space between the outer and inner serous layer which contains a small amount of lubricating serous fluid. The serous fluid serves to minimize the friction generated by the heart as it contracts.

197
Q

What are the physiological roles of the pericardium?

A

Fixes the heart in the mediastinum and limits its motion.
Prevents overfilling of the heart.
Lubrication
Protection from infection.

198
Q

What is the transverse pericardial sinus?

A

A passage through the pericardial cavity. It seperates the hearts arterial outflow from its venous inflow

199
Q

How is the pericardium innervated?

A

Somatically via the phrenic nerve (C3-C5).

200
Q

What is cardiac tamponade?

A

Accumulation of fluid in the pericardium (known as pericardial effusion). This means the heart is subjected to increased pressure. The chambers can become compressed thus compromising cardiac output.

201
Q

What is pericarditis?

A

Inflammation of the pericardium. It can be caused by bacterial infection and myocardial infarction. The main symptom is chest pain, and the condition can cause acute cardiac tamponade.

202
Q

Describe the tricuspid valve

A

located between the right atrium and the right ventricle (right atrioventricular orifice). It consists of three cusps (anterior, septal and posterior), with the base of each cusp anchored to a fibrous ring that surrounds the orifice.

203
Q

Describe the mitral valve

A

located between the left atrium and the left ventricle (left atrioventricular orifice). It is also known as the bicuspid valve because it has two cusps (anterior and posterior). Like the tricuspid valve, the base of each cusp is secured to fibrous ring that surrounds the orifice.

204
Q

How are the mitral and tricuspid valves supported?

A

The attachment of fibrous cords (chordae tendineae). which are then attached papillary muscles located on the interior surface of the ventricles.

205
Q

How many papillary muscles are there?

A

5

206
Q

Describe the pulmonary valve

A

located between the right ventricle and the pulmonary trunk (pulmonary orifice). The valve consists of three cusps – left, right and anterior (named by their position in the foetus before the heart undergoes rotation).

207
Q

Describe the aortic valve

A

located between the left ventricle and the ascending aorta (aortic orifice). The aortic valve consists of three cusps – right, left and posterior.

208
Q

What is aortic stenosis?

A

Narrowing of the aortic valve, restricting the flow of blood leaving the heart

209
Q

What are the main causes of aortic stenosis?

A

Age-related calcification
Congenital defects
Rheumatic fever

210
Q

What are the symptoms of aortic stenosis?

A

Shortness of breath, syncope, angina and left ventricular hypertrophy

211
Q

What is the treatment of aortic stenosis?

A

Surgical, and can be achieved via valve replacement or balloon valvuoloplasty

212
Q

What are the two main coronary arteries which branch to supply the entire heart?

A

The right and left coronary arteries

213
Q

Where are the aortic sinuses?

A

Small openings found within the aorta behind the left and right flaps of the aortic valve

214
Q

What are the branches of the left coronary artery?

A

Initially the left anterior descending. Then the left marginal artery and the left circumflex artery. In 20-25% of individuals, the left circumflex artery contributes to the posterior interventricular artery.

215
Q

What are the branches of the right coronary artery?

A

The right marginal artery anteriorly. In the 80-85% of individuals it also branches into the posterior intrerventricular artery posteriorly.

216
Q

What are the five tributaries which drain into the coronary sinus?

A 
The great cardiac vein.
The small cardiac vein
Middle cardiac vein
Left marginal vein
Left posterior ventricular vein
217
Q

Where is the great cardiac vein?

A

It originates at the apex of the heart and follows the anterior interventriular groove into the coronary sulcus and around the left side of the heart to join coronary sinus

218
Q

Where is the small cardiac vein?

A

Located on the anterior surface of the heart. This passes around the right side of the heart to join the coronary sulcus.

219
Q

Where is the middle cardiac vein?

A

The posterior surface of the heart

220
Q

Where is the left marginal vein?

A

The left posterior side of the heart

221
Q

Where is the left posterior ventricular vein?

A

Runs along the posterior interventricular sulcus to join the coronary sinus

222
Q

Where does the left circumflex artery supply?

A

The left atrium and left ventricle

223
Q

Where does the LAD supply?

A

The right ventricle, left ventricle and interventricular septum

224
Q

Where does the left marginal artery supple?

A

The left ventricle

225
Q

Where does the right marginal artery supply?

A

The right ventricle and the apex

226
Q

Where does the right coronary artery supply?

A

The right atrium and right ventricle

227
Q

Where does the posterior interventricular artery supply?

A

The right and left ventricles, and the interventricular septum

228
Q

What is coronary heart disease?

A

A reduction in blood flow to the myocardium

229
Q

What are the causes of coronary heart disease?

A

Atherosclerosis, thrombosis, high blood pressure, diabetes or smoking

230
Q

How can a blockage in the coronary artery be identified?

A

Coronary angiogram

Phase 1 (41 decks)

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