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Flashcards in corazon Deck (23):

where is the heart located

in the middle mediastinum


what surrounds the heart

the pericardium / epicardium
- the fibrous pericardium: tough, outer layer that reflects onto great vessels
- serous pericardium: layer that lines inner aspect of fibrous pericardium (parietal layer); reflects onto heart as epicardium (visceral layer)


features of the right atrium

- auricle: pouchlike appendage of atrium, embryonic heart tube derivative
- pectinate muscles: ridges of myocardium inside auricle
- crista terminalis: ridge that runs from the inferior to the superior vena cava openings, its superior extent masks the site of the SA node
- fossa ovalis: depression in interatrial septum' former site of foramen ovale
- atrial openings: one of each for superior vena cava, inferior vena cava and coronary sinus (venous return from cardiac veins)


features of the right ventricle

- tuberculae carneae: irregular ridges of ventricular myocardium
- papillary muscles: anterior, posterior and septal projections of myocardium extending into ventricular cavity; prevent valve leaflet prolapse
- chordae tendineae: fibrous cords that connect papillary muscles to valve leaflets
- moderator band: muscular band that conveys AV bundle from septum to base of ventricle at site of anterior papillary muscle
- ventricular openings: one to pulmonary trunk through pulmonary valve; one to receive blood from right atrium through triscuspid valve


name the valves of the right side of the heart

- tricuspid valve (RIGHT AV valve) (has two valve leaflets)
- pulmonary valve (pulmonic semilunar valve) (has three valve leaflets)


features of the left atrium

- auricle: small appendage representing primitive embryonic atrium whose wall has pectinate muscles
- atrial wall: wall slightly thicker than thin-walled right atrium
- atrial openings: usually four openings for four pulmonary veins (2 superior and 2 inferior)


features of the left ventricle

- papillary muscles: anterior and posterior muscles, larger than those of right ventricle
- chordea tendineae: fibrous cords that connect papillary muscles to valve leaflets
- ventricular wall: wall much thicker than that of right ventricle
- membranous septum: very thin superior portion of interventricular septum (IVS) and site of most ventricular septal defects
- ventricular openings: one to aorta through aortic valve; one to receive blood from left atrium through mitral valve


name the valves of the left side of the heart

- mitral valve (LEFT AV valve)
- aortic valve (aoritc semilunar valve)


Donde se escucha el foco aortico

segundo espacio intercostal linea paraesternal derecha


donde de escucha el foco pulmonar

segundo espacio intercostal linea paraesternal izquierda


donde de escucha el foco tricuspideo

cuarto espacio intercostal linea paraesternal izquierda


donde de escucha el foco mitral / apex

quinto espacio intercostal linea media clavicular izquierda


what innervates the pericardium and the heart

- the pericardium is innervated by somatic pain fibers that course in the phrenic nerves (C3 - C5)
- the heart itself is innervated by the autonomic nervous system


what are the chief components of the hear innervation

- parasympathetics: derived from the vagus nerge (X), which courses to the cardiac plexus; parasympathetic stimulation slows the hear rate and decreases the force of contraction
- sympathetics: derived from cervical and thoracic cardiac nerves originating in the T1-T4 intermediolateral cell column,these fibers course to the cardia plexus; sympathetic stimulation increases heart rate and force of contraction
- afferents: sensory nerve fibers course from the heart in the sympathetic nerves to dorsal root ganglia associated with T1-T4 spinal cord levels; these fibers convey pain associated with myocardial ischemia.


what is the SA node

it's the pacemaker of the heart; site where action potential is initiated, located in the right atrium


what is the AV node

node that receives impulses from the SA node and conveys them to the common AV bundle (of His), locate in the right atrium


what are the bundle branches

right and left bundles ahta convey impulses down either side of IVS to subendocardial Purkinje system


what are the first set of arteries that arise from the ascending aorta

the coronary arteries (left and right)


name the major branches of the right coronary artery

- sinuatrial (SA) nodal
- right marginal
- posterior interventricular (posterior descending)
- atrioventricular (AV) nodal


name the major branches of the left coronary artery

- circumflex
- anterior interventricular (left anterior descending / LAD)
- left marginal (can sometimes be a branch of the circumflex)


name the major cardiac veins

- small cardiac vein: parallelrs right marginal atery and drains into coronary sinus
- middle cardiac vein: parallels posterior descending artery and drains into coronary sinus
- great cardiac vein: parallels LAD artery and drains into coronary sinus


nombra las arterias que se ocluyen en el infarto al miocardio con mas frecuencia

- la rama IV anterior de la ACI (40 - 50%)
- ACD (30 - 40%)
- rama circunfleja de la ACI (15 - 20%)


name the conduction path of the heart

SA node (60-100bpm) --> AV node (40-60bpm) --> common AV bundle of His --> purkinje system (20-40bpm)