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Anatomy - Year 1 > CVS anatomy > Flashcards

CVS anatomy Flashcards

1
Q

where does the heart lie

A

in the middle mediastinum

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2
Q

what is the heart next to anteriorly

A

Sternum & costal cartilages 4-7

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3
Q

what is the heart next to posteriorly

A

Oesophagus & Descending aorta

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4
Q

what is the heart next to laterally

A

Pleura & Phrenic nn.

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5
Q

what is the heart next to inferiorly

A

Central tendon of diaphragm

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6
Q

what vertebrae does the heart lie anteriorly to

A

T5-T8

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7
Q

where is the apex of the heart

A

5th left ic space, midclavicular line

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8
Q

what is the right border of heart

A

RA

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9
Q

what is the left border of heart

A

LV

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10
Q

what is the superior border of heart

A

auricles and great vessels

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11
Q

what is the inferior border of heart

A

RA, RV + LV

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12
Q

what is the sternocostal (anterior) surface of heart

A

1/3 RA, 2/3 RV + LV

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13
Q

what is the diaphragmatic (inferiro) surface of heart

A

RV + LV

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14
Q

what is the posterior surface of heart (base)

A

LA

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15
Q

what rib is the left superior part of the heart at

A

rib 2

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16
Q

what rib is the right superior part of the heart at

A

rib 3

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17
Q

what rib is the right inferior part of the heart at

A

rib 6

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18
Q

what rib is the left inferior part of the heart at

A

rib 5

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19
Q

what is the pericardium

what are the 2 layers

A

covers the heart
fibrous
serous

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20
Q

what is the fibrous pericardium

A

dense connective tissue sac

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21
Q

what is the serous pericardium

A

Outer parietal layer
Inner visceral layer = Epicardium

pericardial cavity filled w fluid

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22
Q

what are the 2 main coronary arteries

A

right and left CA

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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

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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

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25
Q

what does RCA branch off into

A

At inferior margin of heart it gives off r. marginal a.

post. interventricualr a.

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26
Q

what does LCA branch off into

A

circumflex a.

l. ant. interventricular a.

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27
Q

what are the 2 anatomoses on the heart (junction of vessels)

A

Ant + Post descending
Circumflex + RCA

on post surface

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28
Q

what are the 2 major sulci

A

Coronary (Atrioventricular) sulcus - between atria + ventricles
Interventricular sulcus - between r + l ventricles

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29
Q

what does the right coronary artery supply

A

RA and RV

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30
Q

what does right marginal artery supply

A

RV and apex

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31
Q

what does left marginal artery supply

A

LV

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32
Q

what does left anterior descending artery supply

A

RV LV and interventricular septum

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33
Q

what are the 3 main veins of the heart wall and where do they drain

A

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

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34
Q

where do the anterior cardiac veins drain

A

directly into RA

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35
Q

what is the hearts rate of contraction set by

A

pacemakers cells found in the SA node

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36
Q

what innervates the heart

A

autonomic NS

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37
Q

what innervates fibrous pericardium + parietal layer of serous

A

Phrenic nerve

carries pain sensation

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38
Q

what innervates heart and visceral layer of serous pericardium

A

Vagus nerve (parasympathetic

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39
Q

what sympathetic nerves innervate heart + visceral layer

A

T1-4 ganglia

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40
Q

where does the aortic arch end

A

T4 vertebrae

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41
Q

what controls the direction of blood flow in heart

A

valves

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42
Q

what opening are there in RA

A

IVC, SVC, Coronary sinus

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43
Q

what valve is between RA and RV

A

Tricuspid valve

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44
Q

what is attached to tricuspid valve in RV

A

Tricuspid valve
3 valve cusps
Chordae tendineae
Papillary muscles x3

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45
Q

what are trabeculae carneae and where r they

A

contractile fleshy struts

on anterior inner wall in RV and LV

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46
Q

what openings does LA have

A

l + r superior pulmonary veins

l + r inferior pulmonary veins

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47
Q

what valve between LA and LV

A

Bicuspid (mitral) valve

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48
Q

what does left atrium lie against posteriorly

A

lying wholly postero-superiorly against oesophagus.

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49
Q

how much thicker is the wall of LV to the RV

A

Wall 3x as thick as right ventricular wall.

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50
Q

what is the pathway of intrinsic innervation in the heart

A

signals in SA node -> AV node -> bundle of His -> Purkinje fibres -> endocardium at apex -> ventricles -> epicardium

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51
Q

where is the aortic valve

A

right 2nd ICS

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52
Q

where do you auscultate pulmonary valve

A

left 2nd ICS

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53
Q

where is mitral valve aucultated

A

left 5th ICS at midclavicular line

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54
Q

where is tricuspid valve

A

left 5th ICS next to sternum

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55
Q

what are the main vessels of anterior chest wall

A

Internal Thoracic a.
Gives off anterior intercostal arteries

Internal Thoracic v.
Receives anterior thoracic veins

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56
Q

what are the main vessels of posterior chest wall and trunk

A

IVC and SVC
descending aorta
azygous vein, drain posterior Intercostal veins into SVC
thoracic and right lymphatic duct

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57
Q

where does subclavian artery arise from

A

Subclavian arises from aortic arch

58
Q

what are the main arteries of upper limb, in order

A 
subclavian artery
axillary artery
brachial artery
radial (thumb side) and ulnar 
digital a. in palm
59
Q

what are the superficial veins of upper limb

A

cephalic vein - lateral side
basilic - medial
median cubital vein connects them across cubital fossa

60
Q

what are the main arteries of lower limb, in order

A

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
Q

where do superficial veins arise from in the upper limb

A

from the dorsal venous arch on the back of the hand

62
Q

where does common femoral a in leg come from

A

external iliac

63
Q

what are the superficial veins of lower limb

A

veins arise from dorsal arch of foot
long saphenous travels up medially to drain into femoral
short saphenous travels up posteriorly into popliteal

64
Q

what are the main arterial pulse points

A 
carotid 
brachial
radial 
femoral 
popliteal 
post. tibial 
dorsalis pedis
65
Q

what are the 3 layers of the heart

A

Epicardium - outer layer.
Myocardium
Endocardium

66
Q

what are the layers of the heart wall

A

endocardium, myocardium, epicardium

67
Q

what is the t.media made up of

A

muscle and elastic tissue

68
Q

what is the t.intima made up of

A

epithelium, bm, connective tissue

69
Q

what is the t.adventita made up of

A

fibrous connective tissue

70
Q

what does the endocardium form

A

valves

71
Q

what epithelium type is the endocardium

A

simple squamous

72
Q

what are the features of the myocardium

A

thick, myocytes, striated muscle, muscle bundles in dif planes to close down chamber lumen, myocytes connected by intercalated discs

73
Q

what is the epicardium

A

Outer layer of heart wall

Epithelium = visceral layer of serous pericardium

74
Q

what are the features of arteries

A

thick muscle wall,
smaller, rounded
thin adventitia

75
Q

what are the features of veins

A
  • thin muscle wall
  • large flattened
  • thick adventitia
  • valves to prevent back flow
76
Q

what are the types of arteries

A

Elastic - large conducting, aorta
Muscular - distributing, coronary arteries
Arterioles - terminal branches, supply capillaries

77
Q

describe elastic arteries

A

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
Q

describe muscular arteries

A

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
Q

describe arterioles

A

1-2 layers of smooth muscle in t.media
No adventitia
Rich sympathetic nerve innervation

80
Q

describe capillaries

A

v thin t.intima, no other layers
Pericytes - incomplete layers of cells, have contractile properties to control blood flow
Pressure is low

81
Q

what are pericytes

A

on capillaries

incomplete layers of cells, have contractile properties to control blood flow

82
Q

what are the 3 types of capillaries

A

continuous, fenestrated, sinusoids

83
Q

what are continuous capillaries

A

control what is exchanged
Selective transport mechanisms
e.g. in muscle
no clefts or pores

84
Q

what are fenestrated capillaries

A

has pores
Diaphragms filter molecules by MW or charge
Endocrine glands or kidney

85
Q

what are discontinuous capillaries

A

gaps between endothelial cells
Allow free passage of fluid and cells
liver, spleen, bm

86
Q

what are atriovenous shunts

A

bypass capillary beds

Arteriole -> venule

87
Q

what are sinusoids

A

Large diameter discontinuous capillaries

Found where large amount of exchange takes place

T. intima contains phagocytic cells

88
Q

all 3 layers thin of veins and venules

A

ff

89
Q

what forms valves in veins

A

folds of t. intima

90
Q

describe superficial veins

A

thick walls

No surrounding support

91
Q

describe deep veins

A

thin walled
Support from deep fascia and muscles
Superficial drain into deep veins

92
Q

where are lymphatic nodes found

A

Nodes found alongside major veins and around origins of major arteries

93
Q

describe lymph capillaries

A

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
Q

how are blood vessels organs

A

recieve own nerve supply, symp and parasymp

  • blood supply, vasa vasorum
  • lymphatics in T.adventita
95
Q

what are the 5 main stages of development for heart in the embryo

A 
bilateral heart primordial
Primitive heart tube 
Heart looping 
Atrial and ventricular septation 
Outflow tract septation
96
Q

when does cvs start functioning in embryo

A

in 4th week

97
Q

where do blood vessels first appear

A

first appear in the yolk sac, allantois, connecting stalk and chorion
called the cardiogenic field

98
Q

what forms the two heart tubes

A

blood vessels in lateral plate splanchnic mesoderm form two heart tubes

99
Q

how is primordial cardiovascular system formed

A

Heart tubes fuse and join blood vessels in other areas

100
Q

why is heart tube dorsal to pericardial cavity

A

cranial folding of embryo heart tube comes to lie dorsal to pericardial cavity

101
Q

what does the pericardial cavity form from

A

from intra-embryonic coelom

102
Q

what are the areas of the fused primitive heart tube

A 
truncus arteriosus
bulbus cordis
primitive ventricle 
primitive atrium 
sinus venosus
103
Q

what does primitive heart tube invaginate

A

pericardium

104
Q

whats it called when heart tube becomes too large for pericardium so needs to loop

A

bulboventricular loop

105
Q

what happens when the heart loops

A

Bulbs cordis and ventricle looped to the right
Ventricle pushed left and inferiorly
Atria pushed superiorly and posteriorly

106
Q

what is dextrocardia

A

heart loops to left

107
Q

how are left and right atrioventricular canals formed

A

Endocardial cushion growth in the middle

108
Q

how are right and left atria formed

A

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
Q

whats the purpose of foramen ovale

A

shunt blood from right atrium to left

110
Q

how is foramen ovale closed

A

Septum primum fuses with septum secundum

Fossa ovalis in adults

111
Q

how are primitive ventricles partitioned

A

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
Q

what does aorticopulmonary septum do

A

divides bulbis cordis and truncus arteriosus into aorta and pulmonary trunk
spirals

113
Q

whats Ventricular Septal Defect (VSD)

A

hole in interventricular septum

114
Q

what is the Transposition of great vessels

A

two main blood vessels leaving the heart, the pulmonary artery and the aorta are swapped over

115
Q

what can cause Transposition of great vessels

A

Failure of aorticopulmonary septum to take a spiral course

- 2) Defective migration of neural crest cells to heart

116
Q

how are atrioventricular valves formed

A

develop from the ventricular wall

117
Q

what are semilunar valves formed from

A

subendocardial valve tissue

118
Q

explain development of conducting system in heart

A

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
Q

what are the First arteries to appear in the embryo

A

right and left primitive aortae

have ventral and dorsal bit

120
Q

how is aortic sac formed

A

from fusion of the 2 ventral aortae

aortic sac then becomes an extension of truncus arteriosus

121
Q

where does aortic arch branches arise from

A

Aortic arch arise from aortic sac in 4th and 5th week

122
Q

how many branches of aortic arches are there and what do they unite with

A

6 pairs of aortic arches, unite w dorsal aortae

123
Q

what is vasculogenesis

A

new formation of primitive vascular network

124
Q

what is angiogenesis

A

growth of new vessels from pre-existing blood vessels

125
Q

what are the adult derivates of the aortic arches

A

1 + 2 + 5 disappear

3 - carotid artery
4 - right subclavian vein
Left - aortic arch
6 - r+l pulmonary arteries and ductus arteriosus

126
Q

what does 3rd aortic arch become

A

forms the common carotid artery

127
Q

what does 4th aortic arch become

A

right archforms theright subclavian artery

The 4th left arch forms the aortic arch

128
Q

how does a double aortic arch abnormality form

A

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
Q

what is patent ductus arteriosus

A

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
Q

what is coarctation if the artery

A

constriction of aorta

aortais narrow

131
Q

what does Vitelline vessels supply and what does it become in adult

A

supply yolk sac

adult gut vessels

132
Q

what does Umbilical vessels supply and what does it become in adult

A

supply placenta

internal iliac

133
Q

what does Cardinal vessels supply and what does it become in adult

A

supply rest of body

SVC & IVC

134
Q

when does lymphatic system develop

A

end of 6th week

Six primary lymph sacs develops
ThoracicDuctdevelopsfrom two vessels anterior to the aorta

135
Q

how does foetal IVC receive oxygenated blood from placenta

A

via umbilical vein

136
Q

what are the 3 foetal circulation shunts

A

Ductus venosus - shunts blood from left umbilical v -> IFC
Foramen ovale - ra -> la
Ductus arteriosus - rv + pulm a -> aorta

137
Q

what is the ductus venosus shunt

A

shunts blood from left umbilical v -> IFC

oxygenated blood from the placenta to bypass the liver.

138
Q

what is the Foramen ovale shunt

A

ra -> la

139
Q

what is the Ductus arteriosusshunt

A

rv + pulm a -> aorta

blood bypass lungs

140
Q

what does ductus venosus become after birth

A

ligamentum venosum of the liver

141
Q

what does ductus arteriosus become after birth

A

ligamentum arteriosum between left pulmonary artery and aorta

142
Q

what do umbilical arteries become after birth

A

medial umbilical ligaments of the anterior abdominal wall

Anatomy - Year 1 (10 decks)

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