Cardiovascular anatomy Flashcards
(149 cards)
1
Q
What are the names of the parts of the mediastinum and where can you find them?
A
Superior above T4
Posterior: from T5-T8 vertebral bodies
Middle mediastinum
Anterior mediastinum: T4-T8 posterior to the sternum
Inferior: central tendon of the diaphragm
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Q
What can you find in the Superior mediastinum?
A
SVC, brachiocephalic veins, aortic arch, oesophagus/trachea, vagus. phrenic nerve, thoracic duct
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Q
What can you find in the Posterior mediastinum?
A
oesophagus, descending aorta, vagus nerve, thoracic duct
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Q
What can you find in the inferior mediastinum?
A
Central tendon of the diaphragm
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Q
What can you find in the middle mediastinum?
A
Pericardial sac, heart, roots of great vessels, arch of azygous vein, phrenic nerve
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Q
What can you find in the anterior mediastinum?
A
Thymus, lymph nodes
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Q
What vertebrae enclose the heart?
A
T5-T8
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Q
Where is the apex of the heart?
A
5th intercostal space, mid clavicular line
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Q
What are the 3 layers of the pericardium?
A
Fibrous pericardium: tough external layer, continuous with the central tendon
Serous pericardium: visceral and parietal
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Q
A
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Q
Where can you find the transverse pericardial sinus?
A
Runs within pericardial cavity
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Q
What is the arterial supply for the pericardium layers?
A
Fibrous and parietal= internal thoracic artery
Visceral= coronary arteries
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Q
What is the veinous drainage for the pericardium layers?
A
Pericardiophrenic veins
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Q
What is the nerve supply for the pericardium layers?
A
Fibrous and parietal= phrenic
Visceral= T1-T4 cardiac plexus and vagus nerve
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Q
Which side of the heart receives poorly oxygenated blood and rich oxygenated blood?
A
Right side= poorly oxygenated
Left side= rich oxygenated
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Q
What are the 3 layers of the heart wall?
A
Endocardium= internal layer of the heart
Myocardium= thick muscular layer
Epicardium= thin external layer
17
Q
Where is the base of the heart and where is the apex?
A
base = 3rd costal cartilage (top of the heart)
apex= left 5th intercostal space
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Q
What are the superior borders of the heart?
A
right atrium, left atrium, svc, aorta, pulmonary trunk
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Q
What are the inferior boders of the heart?
A
2/3rd right ventricle, 1/3 rd left ventricle
20
Q
What ventricle is the apex formed from?
A
left ventricle
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Q
What is found in the sternocostal surface
A
Right atrium, right ventricle, left ventricle
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Q
What is found in the diaphragmatic surface of the heart?
A
Right ventricle and left ventricle
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Q
What is found in the posterior surface of the heart?
A
Left atrium, part of the right atrium
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Q
What are auricles? What role do they have in adults?
A
Role in adults= increase the capacity of the atrium and also increase the volume of blood that is able to contain
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What is the relationship between the oval fossa, interatrial septum and oval foramen?
Interatrial septum= between right and left atria
Inside the interatrial septum you can find the oval fossa which is a remnant of the foramen ovale
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What kind of muscle is found on the outside of the right and left atrium?
Musculi pectinati
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In the right ventricle what is the function of the trabeculae carnae?
Their contraction pulls on the chordae tendinae, preventing inversion of the mitral (bicuspid) and tricuspid valves
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What is the moderator band (septomarginal trabeculae)?
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How many papillary muscles are in the right ventricle?
Matches the number of cusps in the tricuspid valve
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What do tendinous cords and papillary muscles do?
Tendinous cords: attach to the free edges and ventricular surfaces and papillary muscles-> together they act like a door stop preventing the inversion of valves
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How many papillary muscles are found in the left ventricle?
2
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What are the 2 grooves found on the heart?
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Where do the right and left coronary arteries arise from?
From left and right coronary sinuses (in the ascending aorta)
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What are the 2 main branches given by the Right coronary artery?
Right Marginal artery and Posterior descending artery
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What are the 2 main branches given by the Left coronary artery?
Left anterior descending artery and left circumflex artery
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The posterior interventricular branch of the RCA anastomoses with which branch of the LCA?
Left anterior descending artery (interventricular)
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After having given origin to its 2 main branches, the RCA continues towards the left in the coronary groove posteriorly and anastomoses with which branch of the LCA?
Circumflex branch of LCA
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Which heart wall layer do the coronary artery's pierce?
the myocardium
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What is the lymphatic drainage of the heart?
Lymph from heart wall drains to the tracheobronchial, bronchopulmonary and paratracheal lymph nodes
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What is the sympathetic innervation of the heart?
From cervical and upper thorcacic sympathetic ganglia via cardiac plexus T1-T4. Causes increase in HR, impulse conduction and increase in blood flow.
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What is the parasympathetic innervation of the heart?
Presynaptic fibres from the vagus nerve. Causes decrease in HR, contraction and conduction and constricts arteries
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How does the stimulating and conducting systems of the heart work?
SA node: at the junction of the SVC and right atrium is the pacemaker of the heart, AP will travel to AV node inferior to interatrial septum, impulse then goes into bundle of his before going through the Purkinje fibres.
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What is the order of the aorta in the trunk? And where do some of these start?
ascending aorta
aortic arch begins and ends at 2nd rib
descending aorta
abdominal aorta start at T12
common illiac arteries starts at L4
internal and external illiac arteries starts at L5-S1
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Where do internal thoracic arteries arise from?
Subclavian arteries
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What do anterior intercostal arteries anastemose with?
Posterior intercostal arteries given off by descending aorta
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What are the deep and superficial veins of the upper limb
:
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What are the superficial and the deep veins of the lower limb?
Superficial= Great/long saphenous and small/short saphenous
Deep= femoral, popliteal and posterior tibial
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What are the 9 steps of the stages of heart development?
1. Formation of blood vessels
2. Formation of pericardium
3. Formation of heart tube
4. Looping of heart tube
5. Formation of atrioventricular canals
6. Septation of primitive atrium
7. Septation of primitive ventricle
8. Formation of heart valves
9. Formation of heart conducting system
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When does the development of the cardiovascular start in the embryo?
4th week
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How are blood vessels formed in the embryo?
Blood vessels first appear in the yolk sac and chorion (cardiogenic field)
Blood vessels in lateral plate of splanchnic mesoderm form 2 heart tubes
The 2 heart tubes fuse and join blood vessels to form the primordial cardiovascular system
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How is the pericardium formed in an embryo?
Cardiac tube is formed superior to pericardial cavity
Parietal layers of serous and fibrous pericardium form from somatic mesoderm
Visceral layers of serous pericardium form from splanchnic mesoderm
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Structures of the primitive heart tube
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What is the bulboventricular loop?
Primitive heart tube invaginates pericardium
the tube loops= bulboventricular loop
Cephalic end= arteries and caudal end= veins
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What happens in the formation of the bulboventricular loop?
Bulbus cordis and ventricle enlarge and loop to the right
Ventricle pushed left and inferiorly
Atria pushed superiorly and posteriorly
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What is Dextrocardia?
Abnormal cardiac looping. Heart tube loops to the left side instead of the right so ventricles face the right
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What are the 4 parts of the primitive heart that need to be partitioned?
1. Single AV canal into left and right AV canals via endocardial cushions
2. Primitive atrium into left and right atria (atrial septum formation)
3. Primitive ventricle into left amd right ventricles (ventricular septum formation)
4. The atria from the ventricles (heart valve formation)
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What is found between the left and right atrioventricular canal when it is formed?
Endocardial cushions
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How is the atria partitioned into left and right?
1. formation of the septum primum and endocardial cushions
2. Septum primum breaks down
3. Septum secundum forms
4. Foramen ovale is formed between the septum primum and septum secundum and the endocardial cushions
Blood can now move from right atria to left atria
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What is the role of the foramen ovale before and after birth?
Before= allows blood to pass from right atrium to the left atrium
After= normally closes, septum primum fuses with septum secundum
Fossa ovalis : depression in the interatrial septum of adult heart remnant of foetal foramen ovale
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What is Patent foramen ovale?
non closure of the foramen ovale, common form of a congenital atrial septal defect
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How do the ventricles partition?
1. Muscular ventricular septum grows upwards
2. Aorticopulmonary septum grows downwards and will fuse with muscular interventricular septum
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What is a ventricular septal defect?
Most common type of congenital heart disease
Can appear in any part of interventricular septum
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What are the aorta and pulmonary trunk formed from in embryology?
Aorticopulmonary septum divides Bulbus cordis and truncus arteriosus into pulmonary trunk and aorta
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What is the transposition of great vessels?
Common cause of cyanotic disease in newborn infants associated with ASD and VSD.
Caused by failure of aorticopulmonary septum to take spiral course and defectuve migration of neural crest cells to heart
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Where do valves develop from?
ventricular wall/tissue as well as from endocardial cushions
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How is the aortic sac formed?
The aortic sac is found superior to the distal outflow tract ( trunks arteriosus). The aortic sac is continuous with the aortic arches.
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How many pairs of aortic arches are formed from the aortic sac?
6 they also unite with the dorsal aortae
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What are the 2 ways in which blood vessels can develop?
Vasculogenesis: new formation of a primitive vascular network
Angiogenesis: growth of new vessels from pre existing blood vessels
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What do each of the aortic arches become?
1st, 2nd, 5th= disappear early
3rd= forms the common carotid arteries
4th right= right subclavian artery and 4th left= aortic arch
6th right= right pulmonary artery and 6th left= left pulmonary artery and ductus arteriosus
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What is a double aortic arch?
The aortic arch splits into 2 around the trachea and oesophagus= difficulty swallowing and breathing
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What happens in patent ductus arteriosus?
Usually associated with maternal rubella infection in early pregnancy
Caused by failure of muscular wall to contract, respiratory distress syndrome and lack of surfactant in the lungs
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What is coarctation of aorta?
Aorta is narrowed (congenital)
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What do vitelline vessels supplying the yolk sac become in adulthood?
gut vessel
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What do umbilical vessels supplying the placenta become in adulthood?
internal illiac
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What do cardinal vessels supplying the rest of the body become in adulthood?
SVC and IVC
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When does the lymphatic system develop in the embryo? Where are they found?
end of 6th week, they are found around the main veins.
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How does the thoracic duct develop?
From two vessels anterior to the aorta, they become the left and right embryonic thoracic ducts. Left one= upper third of the adult thoracic duct and right one= lower 2/3 of the adult duct
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What are the 5 adaptations to the foetal circulation before birth?
1. Umbilical vein: carries blood from placenta
2. Ductus venosus: allows blood to go through umbilical vein and meet the IVC
3. Foramen ovale: As blood is pumped into the right atrium some of the blood can go through the foramen ovale into left atrium because the right atrium has such a high pressure (due to high pressure in lungs= fluid instead of air)
4. Ductus arteriosus: Blood can flow from pulmonary artery to aorta due to the high pressure in the pulmonary artery
5. Umbilical artery: brings blood back to placenta
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What happens to the 5 adaptations in the foetal circulation after birth?
1. Placenta is clamped so increase in Resistance, ductus venosus shuts off (doesn't carry blood from placenta anymore)
2. Deoxygenated blood floods into RA-RV-PA, in lungs fluid is replaced by air= deoxygenated blood can now flow in
3. Blood flows back in LA from lungs, because pressure on right side has now fallen foramen ovale closes
4. Ductus arteriosus senses levels of O2 rising and constricts
5. Umbilical artery doesn't flow into placenta due to resistance of the clamp constriction
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Basic structure of blood vessels
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What is the endocardium and tunica intima made up of ?
Endothelium. BM and connective tissue
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What is the myocardium and tunica media made up of?
Muscle and elastic tissue
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What is the epicardium and tunica externa made up of ?
Fibrous connective tissue and epithelium
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What is the difference between arteries and veins in histology?
Arteries= thick muscular wall, smaller, thin adventitia
Veins= thin muscular wall, larger, thick adventitia
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What are the 3 types of arteries?
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What features does the aorta have in histology?
elastic fibres in Tunica media in the form of laminae
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What features do muscular arteries have in histology?
Thick tunica media with smooth muscle cells, no elastic laminae in T media, Elastic fibres: internal elastic laminae (under epithelium) and thin external elastic lamina (between T media and T adventitia)
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What features do arterioles have in histology?
1-2 layers of smooth muscle in tunica media
No elastic fibres
no tunica adventitia
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What features do capillaries have in histology?
Thin tunica intima
No tunica media or adventitia
Pericytes: incomplete layer surrounding capillaries
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What are the 3 types of capillaries?
Continuous
fenestrated
Discontinuous/sinusoids
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What is a continuous capillary?
can control what is exchanged, material passes between cell ie in muscle cells
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What is a fenestrated capillary?
Have pores, ie endocrine glands, renal corpuscle
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What is discontinuous capillaries?
Gaps between endothelial cells allows free passage of fluid and cells ie liver, spleen, bone marrow
Sinusoids capillaries: large diameter type of discontinuous capillary found where large amounts of gas exchange takes place
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What is the difference between deep and superficial veins in histology?
Mostly in limbs:
Superficial= thick walled
Deep= thin walled, support from fascia, superficial veins drain into deep veins
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What is the histological structure of veins and venuoles?
Tunica intima=thin
Tunica media= thin
Tunica adventitia= thin
Larger less rounded lumen than arteries
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What type of tunica forms the valves in veins?
Tunica intima
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What system does the lymphatic system drain into?
venous system
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What is the blood supply of blood vessels
Vasa vasorum
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What arteries supply the left ventricle?
left anterior descending artery
left marginal artery
left circumflex artery
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What arteries supply the left atrium?
left circumflex artery
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What arteries supply the right ventricle?
Right coronary artery
right marginal artery
left anterior descending artery
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What arteries supply the right atrium?
Right coronary artery
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What is the upper borders of the heart?
Formed by the 2 atria, ascending aorta and pulmonary trunk
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What is the right border of the heart?
Right atrium
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What is the lower border of the heart?
Right ventricle and apex of left ventricle
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What is the left border of the heart?
Left auricle and left ventricle
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Where does the external illiac artery end up?
In femoral artery
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Where is the bundle of His located?
Interventricular septum
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Where do early pacemaker cells and av nodes and bundles come from embryologically?
sinus venosus and primitive atrium
sinus venosus and AV canal
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Where do the right lymphatic duct and thoracic duct drain?
into R and L subclavian veins
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Where do the right lymphatic duct and thoracic duct drain?
into R and L subclavian veins
