Anatomy of the heart

Question 1

where do the phrenic nerves originate from?

Answer 1

the neck

Question 2

where do the phrenic nerves pass down to eventually reach?

Answer 2

pass down between the lungs and heart to reach the diaphragm

Question 3

what is the phrenic nerve innervation (e.g. C…)?

Answer 3

C3-5

Question 4

where would you anatomically find the phrenic nerves?

Answer 4

descending across the lateral borders of the pericardium

Question 5

what are the 3 membranous layers that encircle the heart in the pericardium called?

Answer 5

1) fibrous
2) parietal
3) visceral

Question 6

what can the visceral layer also be called?

Answer 6

the inner epicardium

Question 7

what is the name given when the parietal and visceral pericardium join together?

Answer 7

the serous pericardium

Question 8

what is the layer of the pericardium that is the outmost layer?

Answer 8

fibrous

Question 9

what is the layer of the pericardium that is the middle layer?

Answer 9

parietal

Question 10

what is the layer of the pericardium that is the innermost layer?

Answer 10

visceral

Question 11

what is the pericardial cavity?

Answer 11

the potential space formed between the two layers of serous pericardium

Question 12

what is the term given if this pericardial cavity fills with blood?

Answer 12

Haemo-pericardium

Question 13

what is cardiac tamponade?

Answer 13

a condition where the pericardial cavity fills with blood therefore increasing the pressure around the heart so much so that it PREVENTS CARDIAC CONTRACTION

Question 14

what is pericardiocentesis?

Answer 14

drainage of fluid from the pericardial cavity

Question 15

where is the pericardiocentesis needle placed?

Answer 15

• instead via infra-sternal angle, directed super-posteiorly
• another location is through the 5th or 6th intercostal space at the left sternal border at the cardiac notch of the left lung

Question 16

what is the transverse pericardial sinus?

Answer 16

= a space within the pericardial cavity, posterosuperiorly

Question 17

where does this transverse pericardial sits lie?

what does it allow cardiac surgeons to identify & isolate?
Name the 5 great vessels,

Answer 17

lies POSTERIOR to the ascending aorta & pulmonary trunk

Identify & isolate great vessels allowing cardiopulmonary bypass.

Great vessels;

• aorta
• SVC
• IVC
• pulmonary artery
• pulmonary vein

Question 18

as the surgeons fingertip emerges from the sinus where is it near to?

Answer 18

it is anterior to the SVC

Question 19

what are the 3 surfaces of the heart?

Answer 19

1) anterior (sternocostal) surface
2) base (posterior) surface
3) inferior (diaphragmatic) surface

Question 20

what are the 4 borders of the heart?

Answer 20

1) right (lateral) border
2) left (lateral) border
3) inferior border
4) superior border

Question 21

what side is the important apex usually on?

Answer 21

the LEFT SIDE

Question 22

where is the apex located?

Answer 22

the 5th left intercostal space in the mid-clavicular line (mitral area)

Question 23

what is special about this apex?

Answer 23

you can palate it

Question 24

the the heat undergoes cardiac enlargement, where does it often shift the apex to?

Answer 24

to the left

Question 25

what does the azygous vein do?

Answer 25

drain the intercostal space

Question 26

what do coronary arteries & their branches do?

Answer 26

they are the arterial blood supply to the epicardium & myocardium

Question 27

where do the coronary arteries arise from?

Answer 27

arise from the ascending aorta.

Question 28

what is the first branch of the aorta?

Answer 28

the coronary artery

Question 29

what are the 2 main branches of the coronary artery?

Answer 29

1) left | 2) right

Question 30

what are the 2 branches of the right branch of the coronary artery?

Answer 30

1) right marginal artery | 2) posterior inter-ventricular artery

Question 31

what does the right marginal artery supply?

Answer 31

supplies the right ventricle

Question 32

what is the posterior inter-ventricular artery?

Answer 32

a continuation of the right coronary artery, it hooks round the back of the heart

Question 33

why is the left branch of the coronary artery much shorter than the right?

Answer 33

as the left branches almost immediately

Question 34

what are the 4 branches of the left branch of the coronary artery?

Answer 34

1) circumflex artery 2) left anterior descending (LAD) - anterior inter-ventricular artery 3) left marginal artery 4) lateral (diagonal) branch

Question 35

what does the circumflex artery join with?

Answer 35

joins with the posterior inter ventricular artery (for the right side)

Question 36

what is the coronary sinus?

Answer 36

a short venous conduit (in the atrioventricular groove posteriorly) which receives deoxygenated blood from most of the cardiac veins & drains into the right atrium

Question 37

what is a simplified explanation of the coronary sinus?

Answer 37

the big vein that receives all the smaller veins

Question 38

what separates the atria of the heart from the ventricles?

Answer 38

the coronary grooves / coronary sulcus

Question 39

what is the function of the septum?

Answer 39

an internal wall that divides the heart into a right & left side

Question 40

what are the 2 parts to the septum?

Answer 40

1) inter-atrial septum | 2) inter-ventricle septum

Question 41

what does the inter-atrial septum do?

Answer 41

separates the two atrial (i.e. the right from the left)

Question 42

what does the inter-ventricular septum do?

Answer 42

separates the two ventricles (i.e. the right from the left)

Question 43

what would you call the defect if there is is a "hole" in the inter-atrial septum?

Answer 43

an atrial septal defect

Question 44

what would you call the defect if there is a "hole". I the inter-ventricular septum?

Answer 44

a ventricular septal defect

Question 45

what can a septal defect cause?

Answer 45

hypoxaemia

Question 46

how can a septal defect cause hypoxaemia?

Answer 46

- a septal defect means that there is the mixing of material & venous blood - therefore reducing the oxygen content of systemic atrial blood in the aorta

Question 47

the right atrium has 3 openings, what are they are?

Answer 47

1) superior vena cava 2) inferior vena cava 3) coronary sinus

Question 48

what separates the rough and smooth part of the right atrium?

Answer 48

= crista termanalis

Question 49

how does the heart ensure that blood flow is uni-directional?

Answer 49

presence of valves

Question 50

what are the 4 valves?

Answer 50

1) pulmonary 2) aortic 3) mitral 4) tricuspid

Question 51

where is the tricuspid valve found?

Answer 51

between right atrium & night ventricle

Question 52

where is the mitral (bicuspid) true found?

Answer 52

between left atrium & left ventricle

Question 53

where is the aortic valve found?

Answer 53

between left ventricle & aorta

Question 54

where is the pulmonary valve found?

Answer 54

between right ventricle & pulmonary trunk

Question 55

where do each of the vales exit from?

Answer 55

each valve exists from each cardiac chamber

Question 56

what are the 3 cusps of the tricuspid valve?

Answer 56

1) anterior 2) posterior 3) septal cusps

Question 57

what are the 2 cusps of the mitral valve?

Answer 57

1) anterior | 2) posterior

Question 58

what are the 3 cusps of the pulmonary valve?

Answer 58

1) anterior cusps 2) right cusp 3) left cusp

Question 59

what are the 3 cusps of the aortic valve?

Answer 59

1) posterior cusps 2) right cusps 3) left cusps

Question 60

when is the first heart sound heart?

Answer 60

when the tricuspid & mitral valves close simultaneously

Question 61

when is the second heart sound heart?

Answer 61

when the pulmonary & aortic valves close

Question 62

where does the coronary arteries arise from?

Answer 62

the right & left aortic sinuses

Question 63

what 2 things prevent prolapse of valves during ventricular contraction?

Answer 63

1) tendinous cords | 2) papillary muscles

Question 64

what does the fibrous skeletal of the heart do?

Answer 64

facilities electrical distribution of the heart to the valves

Question 65

what does the moderator band do? | also known as the septomarginal trabecular do?

Answer 65

= carries fibres of right bundle branch to the papillary muscle of the anterior cusp

Question 66

what are the anatomical positions of the 4 cardiac valves called?

Answer 66

open ellipses

Question 67

describe the 4 places where you can auscultate to find the 4 valves.

Answer 67

1) Aortic = 2nd right intercostal sternal edge 2) tricuspid = 4th left intercostal sternal edge 3) Pulmonary = 2nd left intercostal sternal edge 4) Mitral = 5th left intercostal, mid-clavicular line