Cardiac Anatomy Flashcards Preview

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Flashcards in Cardiac Anatomy Deck (69):
1

Circumflex Artery

-runs along atrioventricular groove
-12% cases continues and gives off posterior descending artery
-has branches called obtuse marginal Aa

2

RCA

-runs in right atrioventricular groove
-88% of the time it runs around to become posterior descending artery

3

Part of blood from right ventricle goes _____ but most goes _____
(baby in utero)

-through pulmonary trunk to lungs
-through ductus arteriosus to descending aorta to rest of body and placenta

4

Heart Apex

-toward left
-listen here for CHF
-medial to midclavicular line at:
--5th intercostal space in supine
--6th in standing
-4th in obese/pregnant

5

Pericardium

-loose serous sac around heart
-parietal and visceral layers
-lubricates moving parts and holds heart in place

6

Heart Size

2 clenched fists

7

Heart Base

-top, central chest
-at rib 3

8

Heart Location

-2/3 on left side
-Rotated: left ventricle toward anterior/axilla

9

pericarditis

-increased amount of fluid in pericardium
-especially after MI
-causes discomfort &/or decreased venous return

10

Myocardium

-muscle layer of heart
-thickness in proportion of work done
-Left ventricle thickest

11

Foramen Ovale

-valves between L & R atria
-normally closes at birth

12

Epicardium

-outside surface of heart
-shiny red

13

Endocardium

-inner most layer of heart
-shiny and smooth

14

Prenatal Oxygenation of Blood

-occurs across placenta, not the lungs

15

At birth, decreased pressure in R atrium and increase pressure in left atrium cause______

-closing of the foramen ovale

-anatomical closure by 2-3 months

16

Arterial Supply to Heart

-LCA & RCA
(branch from base of aorta)

17

Patent foramen ovale

-pathology causing foramen ovale to remain open
-results in R to L shunt
(blood flows from R atrium to L atrium)

18

Sarcoplasmic Reticulum of Myocardium

less developed so the heart muscle relies on extracellular Ca++

19

Autorhythmic Cells

-(create their own action potential)
-SA/AV nodes
-Bundle of His
-Purkinje Fibers

20

Action Potential of Autorhythmic Cells

-slowly depolarizes until threshold met
-due to slow leak of Na+ into cell that then opens long lasting Ca++ gates

21

Ductus Arteriorsus After Birth

-closes w/n 15-72 hours
-due to increased arterial O2 saturation
-Anatomic closure in 2-3 weeks

22

Coronary Flow Pattern
(when heart muscle gets blood flow)

-L & R atria and R ventricle get blood supply to during systole
-L ventricle gets blood during diastole (b/c pressure too high during systole)

23

Divisions of LCA

-Left Anterior Descending Artery
-Circumflex Artery

24

Heart Dominance

-Right Dominant=posterior Descending Artery from RCA (80%)

-Left Dominant=Posterior Descending Artery from LCA--Circumflex Artery (5%)

25

Part of blood from right atria goes to the______ & other 1/2 goes to the _____
(baby in utero)

-right ventricle

-left atrium via foramen ovale

26

Patent Ductus Arteriosus

-failure of ductus arteriosus to close
-due to hypoxia
-causes L to R shunting
(blood from aorta to pulmonary artery)

27

LAD

-runs along interventricular groove
-branches into diagonals

28

Venous Drainage

-most veins drain into coronary sinus to R atrium
-Thebesian Vv drain directly into L & R ventricles

29

Collateral Circulation

-Amount determined by birth
-collaterals available if arterial supply hindered
-Ischemia-->opening of collaterals

-(takes 8-24 hours)

30

Action Potential from ______ to cause heart contraction

-SA node
-AV node
-Bundle of His
-Purkinje Fibers

31

Cardiac Muscle Fibers

-striated
-cells in series with intercalated discs
-less developed sarcoplasmic reticulum
-innervated by autonomic NS
-ventrical myocardium similar to type I fibers but have more mitochondria

32

Depolarization/contraction of heart from _____ to allow ____

-bottom to top
-allow ventricle to squeeze out blood

33

Heart Muscle Depolarization from____

Na+ in

34

Heart Muscle Repolarization from _____

K+ out

35

Heart Sounds

-S1, S2 (normal)
-S3, S4 (abnormal)

36

M1 & T1 Sounds

-2 components of S1 sound
-when mitral valve closes slightly before tricuspid

37

A2 and P2 Sounds

-2 components of S2
-when aortic valve closes slightly before pulmonic valve

38

S3 sound pattern

-Lub Dub-ub
-1 2-3

-VOLUME PROBLEM
(CHF)

39

Myocardium action potential plateau from:

Na+ in allows Ca++ into cell so lots of (+) going in while less (+) going out (K+)

40

S3 & S4 sounds due to:

loss of ventricular compliance

41

Fiber types of ventricles

type I but more mitochondria

42

Heart Impulse Pathway

1. SA Node
2. Bachman's Bundle & Internodal Tracts
3. AV Node
4. Bundle of His
5. L/R Bundle Branches
6. Purkinje Fibers

43

Internodal Tracts

-deliver impulses directly from SA node to AV node

44

S1

-"Lub"
-1st heart sound
-Loudest at Apex
-2 components (M1, T1)
-Sound from closure of AV valves

45

S2

-"Dub"
-2nd heart sound
-2 components (A2, P2)
-Loudest at Aortal Area
-Sound from closure of semilunar valves

46

S3 sound occurs in

middle 1/3 of diastole

47

S4 Sound Pattern

-"du-lub dub"
-4-1 2
-mechanical problem

48

S4 abnormal if:

-there is resistance to ventricular filling
-like with CAD, hypertensive cardiac disease, pulmonic disease, history of MI or CABG

49

S4 normal in:

-trained athlete with left ventricular hypertrophy
(LVH)

50

S3 indicates:

loss of ventricular compliance
-key for CHF diagnosis

51

S3

-caused by vibrations in ventricles as it switches from rapid diastolic filling to passive distention
-VENTRICULAR GALLOP
-Heart over apex (pt in lateral decubitus; with bell)
-Key diagnosis of CHF

52

Key Diagnosis of CHF

-S3 heart sound

53

S4

-during 2nd phase of diastole due to atrial contraction
-ATRIAL GALLOP
-Heard over apex (pt in left lateral decubitus; bell)
-heard before S1

54

Ventricular Gallop

S3

55

Atrial Gallop

S4

56

Left Ventricular Diastole

-pressure in L atrium > pressure in L Ventricle so Mitral valve is open

57

Isovolumic Systole

-Mitral & Aortic Valve closed
-mitral closed and aorta yet to open
-(pressure increased in ventricle)

58

QRS Complex

EKG of ventricular contraction

59

Isovolumetric Diastole

-aortic and mitral valves closed
-aortic closed, mitral yet to open
(pressure decreased in ventricle)

60

Autorhythmic Cells depolarize due to:

Ca++ in

61

Autorhythmic Cells repolarize due to:

K+ out

62

SA Node

-top of R atrium
-pacemaker (depolarizes fastest)
-70-80/min

63

AV Node

-40-60/min
-becomes pacemaker if SA damaged

64

Bachman's Bundle

delivers impulse from R to L atrium

65

Bundle of His and Purkinje fibers

20-40/min

66

Circumflex and marginal Aa supply:

-Superior and marginal portions of L ventricle
-Part of Post L Ventricle
-L Atrium
-SA Node (in 40% of people)

67

SA Node blood supply

-Circumflex/Marginal Aa (40% of people)
-RCA (60%)

68

AV Node Blood Supply

-LAD/Diagonals (10% of people)
-RCA (90%)

69

RCA Supplies

-most of R ventricle
-part interventricular septum
-R atrium
-part posterior L ventricle
-inferior surface of L ventricle
-SA Node (60%)
-AV Node (90%)