Anatomy of the Heart I & II Flashcards Preview

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Flashcards in Anatomy of the Heart I & II Deck (73):


pericardial sac: ___

posterior to ___ & ___

anterior to ___

composed of two portions: ___ & ___

fibroserous sac that encloses the heart & roots of the great vessels

body of sternum, 2nd - 6th ribs

T5 - T8

fibrous pericardium, serous pericardium


fibrous pericardium:

firmly attached infererioly to ___ & anteriorly to ___ via ___

blends superiorly w/ ___

the ___ nerves & the ___ vessels are embedded in its surface & pass in ___ of the roots of the lungs

functions: ___

central tendon of diaphragm, sternum, sternopericardial ligaments

outer coats of the great vessels passing through it

phrenic, pericardiophrenic, front

anchors the heart & limits distention


serous pericardium:

___ layered ___ sac

parietal layer (parietal pericardium):
- inner lining of the ___
- reflected around the ___ to become continuous with the ___

visceral layer (visceral pericardium, epicardium):
- closely applied to the ___
- potential space exists b/n the ___ & ___ layers which contains a small amount of ___ fluid

function: ___

double, serous

fibrous pericardium
roots of the great vessels, visceral pericardium

parietal, visceral, lubricating serous

lubricates the moving surfaces of the heart



located on the ___

consist of enlargements of the ___ created by ___

posterior surface of the heart

pericardial cavity, reflections of the serous pericardium around the vessels


transverse sinus:

space b/n the ___ & the ___

passage from the ___ to the ___

aorta/pulmonary trunk, superior vena cava

right, left side of the pericardial cavity


oblique sinus:

___ rather than a passageway created by ___

lies ___

cul-de-sac, reflections of the serous pericardium around the six major veins entering the heart

behind the left atrium


surface of heart: apex:

location: ___

points ___

found in ___

tip of left ventrical

anteriorly, inferiorly, & to the left

left 5th intercostal space, approximately 8-10 cm from the midline


surface of heart: sternocostal surface

mostly right atrium & right ventricle

small part of left ventricle


surface of heart: diaphragmatic surface

mostly left ventrical

smaller part of right ventricle


surface of heart: base

mostly left atrium

smaller portion of right atrium (most superior part of the heart)


right border of heart

right atrium


left border of heart

arch of aorta
pulmonary trunk
left auricle
left ventricle


superior border of heart

great vessels


inferior border of heart

right ventricle
part of left ventricle


right atrium:

partially divided internally into two main parts by the ___

smooth muscular ridge commencing on ___ just in front of ___& extending ___

cavity posterior to the crista terminals is the ___ which receives the ___ & has ___ walls

walls of anterior half of atrium, including auricle, are ridged by the ___ (comb-like) which fan out from the crista terminalis into the auricle

crista terminalis

roof of atrium, opening of the superior vena cava, downward to the anterior lip of the inferior vena cava

sinus venarum, superior & inferior vena cava, smooth

pectinate muscles


right atrium: atrium proper

anterior half of chamber including right auricle


right atrium: sulcus terminalis

position of the crista terminalis is represented on the surface of this groove which extends between the superior & inferior vena cava


openings into the right atrium: superior vena cava

opens into the superior, posterior, part of the right atrium


openings into the right atrium: inferior vena cava

opens into the inferior, posterio part of the right atrium almost in line w/ the SVC

contains a non-functioning valve of embryonic importance


openings into the right atrium: coronary sinus

opens into the right atrium b/n the orifice of the inferior vena cava & the right atrioventricular orifice

contains a non-functioning valve (Thebesian valve) of embryonic origin


openings into the right atrium: right atrioventricular orifice

lies anterior to the orifice of the IVC, guarded by the tricuspid valve


right atrium: fossa ovalis:

depression in the ___

marks the location of the ___

has a prominent upper margin called the ___

interatrial septum just above the opening of the inferior vena cava

embryonic foramen ovale (aperture for right to left shunting of embryonic blood)

limbus fossa ovalis


right ventricle:

communicates w/ the ___ via the ___ & w/ the ___ via the ___

partially divided into ___ & ___ by the smooth muscular crest ___

right atrium, right atrioventricular orifice, pulmonary trunk, pulmonary orifice

inflow tract (posterior), outflow tract (anterior), supraventricular crest


right ventricle: outflow tract

has a funnel-shaped surface appearance & is called the ___ or ___

internal walls are ___

infundibulum, conus arteriosus



right ventricle: inflow tract

behind the ___

contains prominent fleshy ridges called ___ which give rise to column-like or nipple-like projections called ___

crista supraventricularis

trabeculae carnae, papillary muscles


right ventricle:

three sets of papillary muscles named according to the location of their bases: ___

from the apex of each papillary muscle, several fibrous cords extend to the cusps of the tricuspid valve: ___

anterior, posterior, septal

chordae tendinae


right ventricle: anterior papillary muscle

most constant & most prominent


right ventricle: septal papillary muscle

may be absent, in which case, the chordae tendinae spring directly from the wall of the septum


right ventricle: posterior papillary muscles

there may be several small ones


right ventricle: papillary muscles & chordae tendinae

prevent eversion of the atrioventricular valve into the atrium during ventricular systole


right ventricle: tricuspid valve (right atrioventricular valve):

composed of ___

bases of the cusps are secured to the ___

anterior, posterior, & septal cusps

fibrous ring of the heart


right ventricle: septomarginal trabeculae (moderator band)

specialized trabeculae carnae running from the interventricular septum to the base of the anterior papillary muscle

carries right branch of the bundle of His to the anterior papillary muscle


right ventricle: pulmonary valve

composed of ___

one cusp is ___ placed, the other two are situated to the ___ & named accordingly

center of the free margin of each cusp: ___

thin margins on each side of the above: ___

in the "pocket" of each cusp is a ___ of the pulmonary trunk

the cusps attach along the ___ of each sinus

backflow of blood during ___ fills the sinuses & causes ___ preventing ___

three delicate cup-shaped cusps (valvules)

anteriorly, right & left posteriorly



"sinus" or dilation

curved, inferior margins

ventricular diastole, approximation of the edges of the cusps, regurgitation of blood


left atrium:

similar to the right with ___, but there is ___

posterior portion which receives the ___ has ___ walls

anterior wall & left auricle contain ___ as in the right atrium

in contact posteriorly w/ the ___ through the ___ & ___

two internal sections, no definite line of demarcation

four pulmonary veins, smooth

musculi pectinati

esophagus, oblique sinus, pericardium


left ventricle:

walls are approximately ___ as thick as the right ventricle

the ___ are not as well developed as those of the right ventricle

the ___ is the outflow tract of the left ventricle & corresponds to the ___ of the right ventricle

three times

trabeculae carnae

aortic vestibule, conus arteriosus


left ventricle: interventricular septum (two portions)

thick muscular portion (pars muscularis)

thin membranous portion (pars membranacea) - above the muscularis & close to the atrioventricular orifices


left ventricle: mitral valve

guards the ___

two cusps: ___ & ___

anterior cusp is ___ & intervenes b/n the ___ & ___

two large ___ muscles (anterior & posterior) attach to the free margins of the valve cusps by ___

each muscle is attached by ___ to ___ cusps

left atrioventricular orifice

anterior & posterior

larger, atrioventricular, aortic orifices

papillary, chordae tendinae

chordae tendinae, both


left venctricle: aortic valve

guards the ___

contains ___ cusps similar to those of the ___

arranged w/ one lying ___ & left & right ___ cusps

sinuses are located ___ as in the pulmonary cusps

the right & left coronary arteries arise from the right & left ___

the posterior aortic sinus lacks a ___, so the posterior sinus & cusp are referred to as the ___

aortic orifice

three, pulmonary valve

posteriorly, anterior

above the bases of the cusps

aortic sinuses

coronary artery, noncoronary sinus & cusp


cardiac skeleton:

consists of ___ which forms the ___

four fibrous rings provide ___

the rings help reduce ___

fibrous connective tissue, central support of the heart

attachment for the valvules & cusps of the heart vavles & the bundles of atrial & ventricular muscle fibers

excessive valve stretching & give origin to the myocardial muscle bundles


physiological significance of cardiac skeleton:

the ___ are attached to the upper borders of the rings

the ___ are attached to the lower borders of the rings

therefore, the two sets of muscle bundles are ___ except through the ___

atrial bundles

ventricular bundles

electrically separated, specialized conducting system


right coronary artery:

arises from the ___ & emerges on the ___

runs through the ___ b/n the ___ & ___

right aortic sinus, right side of the pulmonary trunk

right coronary sulcus, right atrium, right ventricle


right coronary artery: branches

sinuatrial nodal branch: ___

right marginal branch (___): ___

AV nodal branch: ___

posterior interventricular branch (___) - ___

usually given off from atrial branch near the origin of RCA

acute marginal, supplies right border

given off at crux of the heart

posterior descending artery (PDA), runs in the posterior interventricular sulcus


summary of right coronary artery supply

right atrium
right ventricle (most)
part of left ventricle (diaphragmatic surface)
posterior 1/3 of IV septum
SA & AV nodes (most of the time)


left coronary artery:

arises from the ___ & emerges on the ___

shortly after its origin usually while it is still behind the left auricle, it branches into the ___ & ___

left aortic sinus, left side of the pulmonary trunk

anteior interventricular branch (left anterior descending (LAD)), circumflex branch


left coronary artery: anterior interventricular artery

descends toward the apex in the anterior interventricular sulcus


left coronary artery: circumflex artery:

runs to the left in the ___ b/n the ___ & ___ & then continues onto the ___

usually doesn't reach the ___, but when it does, it may give rise to the ___

left coronary sulcus, left auricle, left ventricle, posterior of the heart

posterior interventricular sulcus, posterior interventricular artery


left coronary artery: left coronary dominance

approximately 10% of cases

the left coronary artery (by way of the circumflex branch) gives rise to the posterior interventricular artery


left coronary artery: branches of the circumflex artery

left marginal branch (obtuse marginal) - supplies left border

SA & AV nodal branches (occasionally)


summary of left coronary artery supply

left atrium
left ventricle (most)
part of right ventricle
anterior 2/3 of IV septum including the bundle of His
SA & AV node (occasionally)


cardiac veins: coronary sinus:

lies in the ___

receives ___

left coronary sulcus from the left margin of the heart to its orifice in the right atrium

most of the veins of the heart


cardiac veins: great cardiac vein:

lies in the ___ & passes ___

becomes continuous w/ the ___ after receiving the ___

anterior interventricular sulcus, upward & to the left in the left coronary sulcus

coronary sinus at the left margin of the heart, oblique vein of the left atrium


cardiac veins: middle cardiac vein:

runs in the ___

empties into the ___

posterior interventricular sulcus

coronary sinus on posterior surface of heart


cardiac veins: small cardiac vein:

parallels the ___

passes in the ___ & drains into the ___

right marginal artery

right coronary sulcus to the posterior of the hear, coronary sinus


cardiac veins: anterior cardiac veins

arise on the ___, pass across the ___, & penetrate the ___

anterior surface of the right ventricle

right coronary sulcus

anterior wall of the right atrium directly


cardiac veins: least cardiac veins (venae cordis minimis):

minute veins in the ___ that empty directly into the ___

most numerous in the ___ & least numerous in the ___

muscular walls of the heart, cardiac chambers

wall of the right atrium, wall of the left ventricle


cardiac plexus:

diffuse network of ___ extending in front of the ___ to the ___

receives ___ input

delicate nerve fibers
aortic arch, pulmonary trunk, & ligamentum arteriosum

both sympathetic & parasympathetic


sympathetic cardiac branches: three cervical cardiac nerves

superior cervical - from superior cervical ganglion

middle cervical - from middle cervical ganglion

inferior cervical - from inferior cervical ganglion


sympathetic cardiac branches: thoracic cardiac nerves

from upper four or five thoracic ganglia of the sympathetic trunk


sympathetic cardiac branches:

sympathetic fibers of plexus are all ___

preganglionic fibers for all of the sympathetic cardiac nerves arise in the ___


upper four or five thoracic segments of the spinal cord


sympathetic cardiac branches: functions

accelerate heart rate

increase force of heart beat

dilate the coronary arteries


parasympathetic cardiac branches: arise from the ___

vagus nerves


parasympathetic cardiac branches:

two cervical cardiac nerves

arise from the ___

superior cervical & inferior cervical

vagus nerves in the neck


parasympathetic cardiac branches: several thoracic cardiac branches arise from ___

either the vagal trunks or from the recurrent laryngeal branches of the vagus


parasympathetic cardiac branches: parasympathetic fibers of the plexus originating from the vagi are ___ & synapse w/ ___ within the ___


small ganglia

plexus or in the walls of the heart


parasympathetic cardiac branches: functions

decrease the heart rate

reduces the force of contraction

constricts the coronary arteries


afferent (sensory) fibers of the plexus:

visceral afferents from the heart join the ___ & pass along the ___

the vagal afferents are concerned w/ ___

the afferents in the sympathetic cardiac nerves are concerned w/ ___

cardiac plexus, sympathetic & vagal cardiac branches

cardiac reflexes

the conduction of pain sensations from the heart


afferent (sensory) fibers of the plexus: cardiac afferents conducting "pain"

the fibers travel from the heart w/ ___ fibers to spinal cord levels ___

all pain afferents enter the ___ of the ___nerves (the same spinal cord segments giving rise to ___ efferent fibers)

sympathetic, T1 - T5

dorsal roots, upper four or five thoracic, preganglionic


afferent (sensory) fibers of the plexus: cardiac afferents conducting "pain"

because visceral afferent fibers concerned w/ ___ terminate in the ___ of the same spinal cord segments as ___ in upper thoracic spinal nerves, the pain of ___ may be "referred" along the dermatomes supplied by these upper thoracic spinal nerves

the patient often interprets pain along the ___ (dermatomes T1 & T2) & the ___ (dermatomes T2 - T5)

cardiac pain, dorsal horns, somatic afferents, angina pectoris

ulnar border of the upper limb, upper part of the thorax


conducting system of the heart: components

sinuatrial node

atrioventricular node

atrioventricular bundle (of His)


conducting system of the heart: sinuatrial node (Pacemaker):



crescent-shaped structure (5-8 mm in length), occupying whole thickness of the wall of the right atrium

located on the anterior lip of the superior vena cava orifice near the top of the crista terminalis


conducting system of the heart: atrioventricular node:

embedded in the ___ close to the ___

it rests on the ___ close to the attachment of the ___

within the septum, the node extends ___

its cells continue anteriorly into the ___

interatrial septum, opening of the coronary sinus

fibrous atrioventricular ring, septal cusp of the tricuspid valve

forward from the opening of the coronary sinus

atrioventricular bundle


conducting system of the heart: atrioventricular bundle:

commences as the forward continuation of the ___

the only connection b/n the ___

the bundle runs downward & forward into the ___ & then ___ where it divides into ___

atrioventricular node

myocardium of the atria & ventricles

membranous, muscular interventricular septa, right & left bundle branches


conducting system of the heart: atrioventricular bundle:

the right bundle branch runs beneath the ___ & enters the ___ to supply the ___ & then breaks up into fine fibers which supply the remainder of the ___

the left bundle follows a similar course beneath the ___ in the ___, but breaks up into branches which reach the ___ along several ___

the fine terminal branches of each bundle end in ___ of specialized conducting cells called ___ which are continuous with ___ muscle fibers

septomarginal trabecula
papillary muscles
right ventricle

left ventricle
ventricular wall
trabeculae carnae

subendocardial plexus
Purkinje fibers
ventricular myocardial

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