CVS anatomy Flashcards
(142 cards)
1
Q
where does the heart lie
A
in the middle mediastinum
2
Q
what is the heart next to anteriorly
A
Sternum & costal cartilages 4-7
3
Q
what is the heart next to posteriorly
A
Oesophagus & Descending aorta
4
Q
what is the heart next to laterally
A
Pleura & Phrenic nn.
5
Q
what is the heart next to inferiorly
A
Central tendon of diaphragm
6
Q
what vertebrae does the heart lie anteriorly to
A
T5-T8
7
Q
where is the apex of the heart
A
5th left ic space, midclavicular line
8
Q
what is the right border of heart
A
RA
9
Q
what is the left border of heart
A
LV
10
Q
what is the superior border of heart
A
auricles and great vessels
11
Q
what is the inferior border of heart
A
RA, RV + LV
12
Q
what is the sternocostal (anterior) surface of heart
A
1/3 RA, 2/3 RV + LV
13
Q
what is the diaphragmatic (inferiro) surface of heart
A
RV + LV
14
Q
what is the posterior surface of heart (base)
A
LA
15
Q
what rib is the left superior part of the heart at
A
rib 2
16
Q
what rib is the right superior part of the heart at
A
rib 3
17
Q
what rib is the right inferior part of the heart at
A
rib 6
18
Q
what rib is the left inferior part of the heart at
A
rib 5
19
Q
what is the pericardium
what are the 2 layers
A
covers the heart
fibrous
serous
20
Q
what is the fibrous pericardium
A
dense connective tissue sac
21
Q
what is the serous pericardium
A
Outer parietal layer
Inner visceral layer = Epicardium
pericardial cavity filled w fluid
22
Q
what are the 2 main coronary arteries
A
right and left CA
23
Q
where does RCoronary artery arise from and where does it run
A
r. aortic sinus of asc. aorta
runs in in coronary (atrioventricular) sulcus
24
Q
where does LCoronary artery arise from and where does it run
A
Arises from l. aortic sinus of asc. aorta
Runs in coronary sulcus
25
what does RCA branch off into
At inferior margin of heart it gives off r. marginal a.
post. interventricualr a.
26
what does LCA branch off into
circumflex a.
l. ant. interventricular a.
27
what are the 2 anatomoses on the heart (junction of vessels)
Ant + Post descending
Circumflex + RCA
on post surface
28
what are the 2 major sulci
Coronary (Atrioventricular) sulcus - between atria + ventricles
Interventricular sulcus - between r + l ventricles
29
what does the right coronary artery supply
RA and RV
30
what does right marginal artery supply
RV and apex
31
what does left marginal artery supply
LV
32
what does left anterior descending artery supply
RV LV and interventricular septum
33
what are the 3 main veins of the heart wall and where do they drain
Great cardiac vein lies alongside
ant interventricular a.
Middle cardiac vein lies alongside post interventricular a.
Small cardiac vein lies alongside r. marginal a.
drain into coronary sinus lying alongside circumflex - drain into RA
34
where do the anterior cardiac veins drain
directly into RA
35
what is the hearts rate of contraction set by
pacemakers cells found in the SA node
36
what innervates the heart
autonomic NS
37
what innervates fibrous pericardium + parietal layer of serous
Phrenic nerve
| carries pain sensation
38
what innervates heart and visceral layer of serous pericardium
Vagus nerve (parasympathetic
39
what sympathetic nerves innervate heart + visceral layer
T1-4 ganglia
40
where does the aortic arch end
T4 vertebrae
41
what controls the direction of blood flow in heart
valves
42
what opening are there in RA
IVC, SVC, Coronary sinus
43
what valve is between RA and RV
Tricuspid valve
44
what is attached to tricuspid valve in RV
Tricuspid valve
3 valve cusps
Chordae tendineae
Papillary muscles x3
45
what are trabeculae carneae and where r they
contractile fleshy struts
| on anterior inner wall in RV and LV
46
what openings does LA have
l + r superior pulmonary veins
| l + r inferior pulmonary veins
47
what valve between LA and LV
Bicuspid (mitral) valve
48
what does left atrium lie against posteriorly
lying wholly postero-superiorly against oesophagus.
49
how much thicker is the wall of LV to the RV
Wall 3x as thick as right ventricular wall.
50
what is the pathway of intrinsic innervation in the heart
signals in SA node -> AV node -> bundle of His -> Purkinje fibres -> endocardium at apex -> ventricles -> epicardium
51
where is the aortic valve
right 2nd ICS
52
where do you auscultate pulmonary valve
left 2nd ICS
53
where is mitral valve aucultated
left 5th ICS at midclavicular line
54
where is tricuspid valve
left 5th ICS next to sternum
55
what are the main vessels of anterior chest wall
Internal Thoracic a.
Gives off anterior intercostal arteries
Internal Thoracic v.
Receives anterior thoracic veins
56
what are the main vessels of posterior chest wall and trunk
IVC and SVC
descending aorta
azygous vein, drain posterior Intercostal veins into SVC
thoracic and right lymphatic duct
57
where does subclavian artery arise from
Subclavian arises from aortic arch
58
what are the main arteries of upper limb, in order
```
subclavian artery
axillary artery
brachial artery
radial (thumb side) and ulnar
digital a. in palm
```
59
what are the superficial veins of upper limb
cephalic vein - lateral side
basilic - medial
median cubital vein connects them across cubital fossa
60
what are the main arteries of lower limb, in order
Ext. iliac becomes common femoral in ant. thigh
superficial and deep femoral
superficial -> popliteal in popliteal fossa
-> anterior and post tibial in leg
ant tibial -> dorsalis pedis between 1st & 2nd toes
post tibial -> fibular artery to plantar of foot
61
where do superficial veins arise from in the upper limb
from the dorsal venous arch on the back of the hand
62
where does common femoral a in leg come from
external iliac
63
what are the superficial veins of lower limb
veins arise from dorsal arch of foot
long saphenous travels up medially to drain into femoral
short saphenous travels up posteriorly into popliteal
64
what are the main arterial pulse points
```
carotid
brachial
radial
femoral
popliteal
post. tibial
dorsalis pedis
```
65
what are the 3 layers of the heart
Epicardium - outer layer.
Myocardium
Endocardium
66
what are the layers of the heart wall
endocardium, myocardium, epicardium
67
what is the t.media made up of
muscle and elastic tissue
68
what is the t.intima made up of
epithelium, bm, connective tissue
69
what is the t.adventita made up of
fibrous connective tissue
70
what does the endocardium form
valves
71
what epithelium type is the endocardium
simple squamous
72
what are the features of the myocardium
thick, myocytes, striated muscle, muscle bundles in dif planes to close down chamber lumen, myocytes connected by intercalated discs
73
what is the epicardium
Outer layer of heart wall
| Epithelium = visceral layer of serous pericardium
74
what are the features of arteries
thick muscle wall,
smaller, rounded
thin adventitia
75
what are the features of veins
- thin muscle wall
- large flattened
- thick adventitia
- valves to prevent back flow
76
what are the types of arteries
Elastic - large conducting, aorta
Muscular - distributing, coronary arteries
Arterioles - terminal branches, supply capillaries
77
describe elastic arteries
pressure revoir
Stretched during systole
Elastic fibres in t.media in form of layers = laminae
Purple bits are elastic laminae
elastic fibres secreted by the smooth muscle cells
78
describe muscular arteries
thick t.media has smooth muscle cells
No elastic laminae between muscle cells in media
Elastic fibres in 2 sheets, internal elastic lamina under epithelium and external elastic lamina between t media and adventitia
79
describe arterioles
1-2 layers of smooth muscle in t.media
No adventitia
Rich sympathetic nerve innervation
80
describe capillaries
v thin t.intima, no other layers
Pericytes - incomplete layers of cells, have contractile properties to control blood flow
Pressure is low
81
what are pericytes
on capillaries
| incomplete layers of cells, have contractile properties to control blood flow
82
what are the 3 types of capillaries
continuous, fenestrated, sinusoids
83
what are continuous capillaries
control what is exchanged
Selective transport mechanisms
e.g. in muscle
no clefts or pores
84
what are fenestrated capillaries
has pores
Diaphragms filter molecules by MW or charge
Endocrine glands or kidney
85
what are discontinuous capillaries
gaps between endothelial cells
Allow free passage of fluid and cells
liver, spleen, bm
86
what are atriovenous shunts
bypass capillary beds
| Arteriole -> venule
87
what are sinusoids
Large diameter discontinuous capillaries
Found where large amount of exchange takes place
T. intima contains phagocytic cells
88
all 3 layers thin of veins and venules
ff
89
what forms valves in veins
folds of t. intima
90
describe superficial veins
thick walls
| No surrounding support
91
describe deep veins
thin walled
Support from deep fascia and muscles
Superficial drain into deep veins
92
where are lymphatic nodes found
Nodes found alongside major veins and around origins of major arteries
93
describe lymph capillaries
blind ended
Lined by v thin endothelium
Anchoring filaments - fine collagenous filaments link endothelial cell to surrounding tissue to keep lumen open
no rbc in lumen
94
how are blood vessels organs
recieve own nerve supply, symp and parasymp
- blood supply, vasa vasorum
- lymphatics in T.adventita
95
what are the 5 main stages of development for heart in the embryo
```
bilateral heart primordial
Primitive heart tube
Heart looping
Atrial and ventricular septation
Outflow tract septation
```
96
when does cvs start functioning in embryo
in 4th week
97
where do blood vessels first appear
first appear in the yolk sac, allantois, connecting stalk and chorion
called the cardiogenic field
98
what forms the two heart tubes
blood vessels in lateral plate splanchnic mesoderm form two heart tubes
99
how is primordial cardiovascular system formed
Heart tubes fuse and join blood vessels in other areas
100
why is heart tube dorsal to pericardial cavity
cranial folding of embryo heart tube comes to lie dorsal to pericardial cavity
101
what does the pericardial cavity form from
from intra-embryonic coelom
102
what are the areas of the fused primitive heart tube
```
truncus arteriosus
bulbus cordis
primitive ventricle
primitive atrium
sinus venosus
```
103
what does primitive heart tube invaginate
pericardium
104
whats it called when heart tube becomes too large for pericardium so needs to loop
bulboventricular loop
105
what happens when the heart loops
Bulbs cordis and ventricle looped to the right
Ventricle pushed left and inferiorly
Atria pushed superiorly and posteriorly
106
what is dextrocardia
heart loops to left
107
how are left and right atrioventricular canals formed
Endocardial cushion growth in the middle
108
how are right and left atria formed
Septum premium grows down, osmium primum grows up. Ostium secondum forms and septum secondum.
closure of ostium primum as septum primum meets endocardial cushions
foramen ovale - gap between RA and LA
109
whats the purpose of foramen ovale
shunt blood from right atrium to left
110
how is foramen ovale closed
Septum primum fuses with septum secundum
| Fossa ovalis in adults
111
how are primitive ventricles partitioned
Muscular ventricular septum forms. Opening is called interventricular foramen.
Bottom of spiral aorticopulmonary septum fuses with muscular ventricular septum and endocardial cushions to form membranous interventricular septum, closing interventricular foramen.
112
what does aorticopulmonary septum do
divides bulbis cordis and truncus arteriosus into aorta and pulmonary trunk
spirals
113
whats Ventricular Septal Defect (VSD)
hole in interventricular septum
114
what is the Transposition of great vessels
two main blood vessels leaving the heart, the pulmonary artery and the aorta are swapped over
115
what can cause Transposition of great vessels
Failure of aorticopulmonary septum to take a spiral course
| - 2) Defective migration of neural crest cells to heart
116
how are atrioventricular valves formed
develop from the ventricular wall
117
what are semilunar valves formed from
subendocardial valve tissue
118
explain development of conducting system in heart
Early pacemakers are cardiomyocytes in primitive atrium and sinus venosus
SA node develops during 5th week, in RA high
AV node and bundle develops from cells of AV canal and sinus venosus
119
what are the First arteries to appear in the embryo
right and left primitive aortae
| have ventral and dorsal bit
120
how is aortic sac formed
from fusion of the 2 ventral aortae
| aortic sac then becomes an extension of truncus arteriosus
121
where does aortic arch branches arise from
Aortic arch arise from aortic sac in 4th and 5th week
122
how many branches of aortic arches are there and what do they unite with
6 pairs of aortic arches, unite w dorsal aortae
123
what is vasculogenesis
new formation of primitive vascular network
124
what is angiogenesis
growth of new vessels from pre-existing blood vessels
125
what are the adult derivates of the aortic arches
1 + 2 + 5 disappear
3 - carotid artery
4 - right subclavian vein
Left - aortic arch
6 - r+l pulmonary arteries and ductus arteriosus
126
what does 3rd aortic arch become
forms the common carotid artery
127
what does 4th aortic arch become
right arch forms the right subclavian artery
The 4th left arch forms the aortic arch
128
how does a double aortic arch abnormality form
non-regression of the right aortic arch (4th) forming a vascular ring around the trachea and oesophagus, which usually causes difficulty in breathing and swallowing.
129
what is patent ductus arteriosus
ductus arteriosus fails to close after birth
oxygenated blood from the left heart to flow back to the lungs by flowing from the aorta to the pulmonary artery.
failure of muscular wall to contract
130
what is coarctation if the artery
constriction of aorta
| aorta is narrow
131
what does Vitelline vessels supply and what does it become in adult
supply yolk sac
| adult gut vessels
132
what does Umbilical vessels supply and what does it become in adult
supply placenta
| internal iliac
133
what does Cardinal vessels supply and what does it become in adult
supply rest of body
| SVC & IVC
134
when does lymphatic system develop
end of 6th week
Six primary lymph sacs develops
Thoracic Duct develops from two vessels anterior to the aorta
135
how does foetal IVC receive oxygenated blood from placenta
via umbilical vein
136
what are the 3 foetal circulation shunts
Ductus venosus - shunts blood from left umbilical v -> IFC
Foramen ovale - ra -> la
Ductus arteriosus - rv + pulm a -> aorta
137
what is the ductus venosus shunt
shunts blood from left umbilical v -> IFC
| oxygenated blood from the placenta to bypass the liver.
138
what is the Foramen ovale shunt
ra -> la
139
what is the Ductus arteriosusshunt
rv + pulm a -> aorta
| blood bypass lungs
140
what does ductus venosus become after birth
ligamentum venosum of the liver
141
what does ductus arteriosus become after birth
ligamentum arteriosum between left pulmonary artery and aorta
142
what do umbilical arteries become after birth
medial umbilical ligaments of the anterior abdominal wall
