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Anatomy II > Heart > Flashcards

Flashcards in Heart Deck (77):
1

Briefly explain the portal circulation

  1. venous blood from unpaired abdominal organs (stomach, intestine, pancreas, spleen) absorbed by intestine
  2. carried to v. portae 
  3. collected in capillary bed in liver
  4. collected by vv. hepaticae 
  5. conveyed to v. cava inferior

2

#1 - 5

1) apex cordis

2) basis cordis

3) sulcus coronarius

4) sulcus interventricularis anterior

5) sulcus interventricularis posterior

3

#6 - 10

 

How is #8 called inside?

6) truncus pulmonalis

7) sinus trunci pulmonalis

8) conus arteriosus → inside: infundibulum cordis

9) atrium dextrum

10) ventriculus dexter

4

#11 - 14

11) aorta

12) v. cava superior

13) auricula sinistra 

14) auricula dextra

5

#1 - 5

1) aorta ascendens

2) arcus aorticus

3) truncus pulmonalis

4) a. pulmonalis sinistra

5) truncus brachiocephalicus

 

6

#6 - 10

6) a. carotis communis dextra

7) a. subclavia dextra

8) a. carotis communis sinistra

9) a. subclavia sinistra

10) lig. arteriosum

7

#1 - 5

1) arcus aorticus

2) aorta descendens

3) aorta ascendens

4) truncus brachiocephalicus

5) a. carotis communis sinistra

8

#6 - 10

6) a. subclavia sinistra

7) v. cava superior

8) a. pulmonalis dextra

9) a. pulmonalis sinistra

10) v. cava inferior

9

#11 - 15

11) vv. pulmonales dextrae

12) vv. pulmonales sinistrae

13) atrium dextrum

14) atrium sinistrum

15) sulcus coronarius

10

#16 - 20

16) sinus coronarius

17) sulcus terminalis

18) auricula sinistra

19) sinus transverus pericardii

20) ventriculus sinister

11

#21 - 25

21) ventriculus dexter

22) sulcus interventricularis posterior

23) apex cordis

24) basis cordis

25) truncus pulmonalis

12

#1 - 5

1) v. cava superior

2) v. cava inferior

3) sinus coronarius

4) vv. pulmonales dextrea

5) vv. pulmonales sinistrae

13

#6 - 10

 

What forms #6?

6) crista terminalis → outside: sulcus terminalis

7) mm. pectinati

8) sinus venarum cavarum

9) valvula Eustachii

10) valvula Thebesii

14

#11 - 15

 

Give another name for #11.

11) valva artrioventricularis dextra → tricuspid valve

12) chordae tendinae

13) m. pappilaris anterior

14) m. pappilaris septalis

15) m. pappilaris posterior

15

#16 - 20

 

Give another name for #17.

16) trabeculae carnae

17) trabecula septomarginalis → moderator band

18) septum interventriculare pars muscularis

19) septum interventriculare pars membranacea

20) septum artrioventriculare

16

#22 - 25

 

Give another name for #25.

22) septum interartriale

23) limbus fossae ovalis

24) fossa ovalis

25) valva artrioventricularis sinistra → bicuspid valve

 

17

#26 - 28

26) m. pappilaris anterior

27) m. pappilaris posterior

28) thicker wall of right ventricle

18

Describe the structure of a semilunar valve

Give another name for the smallest part

  • pars densa: lower part
  • pars flaccida: upper part
    • 2 lunuli: thickened edges
    • 1 nodulus (=corpus Arantii): closes cusps

19

The inflow and outflow tract of the right ventricle are divided by.. ?

 

  • crista supraventricularis
  • trabecula septomarginalis

20

The inflow and outflow tract of the left ventricle is divided by.. ? 

How is the structure called?

anterior cusp of bicuspid valve

→ vestibulum aortae

21

Which vessel leaves the left ventricle?

aorta

22

What are the 3 layers that make up the heart wall?

  • endocardium
  • myocardium
  • epicardium

23

Which structures make up the myocardium? 

 

  • atrial muscle
  • ventricular muscle

24

Differentiate btw atrial muscle layers

  • deep layer: surrounding each atrium
  • superficial layer: covers both atria

25

Differentiate btw ventricle muscle layers

  • stratum subendocardiale: forms trabeculae carnae, mm. papillares, sulcus coronarius, sulcus interventricularis ant./post
  • stratum musculare: only septum interventr., wall of left ventricle
  • stratum subepicardiale: forms vortex cordis

26

Describe the structure of the endocardium

= continuation of inner layer of wall vessels, therefore:

  • endothelium
  • conn. tissue

27

Describe the structure and function of the epicardium

  • mesothelium
  • conn. tissue
  • adipose tissue → smoothes unevenness of heart surface

28

What is the function of the cardiac skeleton?

  • electrical insulation of atria/ventricles
  • attachment site for:
    • myocardium
    • leaflets and cusps of valves
  • keeps orifices of valves stable

29

#1 - 5

1) valva atrioventricularis dextra

2) valva atrioventricularis sinistra

3) valva aortae

4) valva pulmonalis

5) cuspis anterior

30

#6 - 10

6) cuspis posterior

7) cuspis commisuralis

8) cuspis anterior

9) cuspis posterior

10) cuspis septalis

31

#11 - 15

11) cuspis semilunaris sinistra

12) cuspis semilunaris dextra

13) cuspis semilunaris posterior

14) cuspis semilunaris dextra

15) cuspis semilunaris anterior

32

#16 - 22

16) cuspis semilunaris sinistra

17) sinus trunci

18 - 20) sinus aorticus

21) a. coronaria dextra

22) a. coronaria sinistra

33

#23 - 27

Another name for #27?

23) anulus fibrosus dexter

24) anulus fibrosus sinister

25) tendo coni arteriosi

26) trigonum fibrosum dextrum

27) fasciculi atrioventricularis → bundle of HIS

34

#28 - 30

28) trigonum fibrosum sinistrum

29) lunulus valvulae semilunaris

30) nodulus valvulae semilunaris

35

Where do the aa. coronaria originate from?

right + left semilunar valves of sinus aorticus (therefore: left ventricle)

36

Where does all the deoxigenated blood from the vv. coronaria gather?

Where does this structure drain into resp.?

sinus coronarius → right atrium

37

The veins of the heart form which structure on the posterior surface?

crux cordis

38

#1 - 5

1) v. cava superior

2) truncus pulmonalis

3) aorta

4) v. cava inferior

5) apex cordis

39

#6 - 11

 

#7 missing

6) apex cordis

8) a. coronaria sinistra

9) a. coronaria dextra

10) r. interventricularis anterior

11) r. interventricularis posterior

40

#12 - 16

12) r. circumflexus

13) r. marginalis dexter

14) r. marginalis sinister

15) rr. atriales

16) r. atrialis anastomicus

41

#17 - 21

 

Another name for #21?

17) rr. ventriculares

18) r. lateralis

19) rr. interventriculares septales

20) rr. atrioventriculares

21) v. obliqua atrii sinistra (= Marshall vein)

 

42

How is heart dominance determined? 

Describe the variations

Determined by supply of r. interventricularis posterior and AV-node. Usually (70%) right dominance

  • right dominance: supplied by a. coronaria dextra
  • left dominance: supplied by r. circumflexus (of a. coronaria sinistra)
  • co-dominance: supplied by both

43

#22 - 25

22) v. cordis magna

23) sinus coronarius

24) v. cordis parva

25) v. cordis magna

44

What is the name of the structure btw v. pulmonalis dextra and right atrium?

Waterston's groove

45

List the innervation/conduction of the heart step by step

  1. para-/sympathetic innervation pathway
  2. plexus cardiacus
  3. SA-node
  4. AV-node
  5. bundle of HIS
  6. crus dextrum/sinistrum
  7. Purkinje fibers, mm. papillares, myocardium

46

Which structures make up the sympathetic innervation pathway?

Where do they fuse?

What is their function?

Structures

  • n. cardiacus cervicalis superior / medius / inferior
  • rr. cardiaci thoraci
  • ganglion stellatum (= fusion of inf. cerv. ganglion + first thoracic ganglion at C7 level)

→ fuse in plexus cardiacus

 

Function

increase heart rate

47

Which structures make up the parasympathetic innervation pathway?

Where do they fuse?

What is their function?

Structures

  • n. vagus
  • rr. cardiaci thoraci

→ fuse in plexus cardiacus

 

Function

decrease heart rate

48

How can plexus cardiacus be differentied?

Where are these parts located?

  • superficial part: in front of a. pulmonalis dextra
  • deep part: behind arcus aorticus

49

#1 - 5

 

Another name for #1 - 3

1) nodus sinuatrialis (= SA-node)

2) nodus atrioventricularis (=AV-node)

3) fasciculus atrioventricularis (=bundle of HIS)

4) crus dextrum

5) crus sinistrum

50

#6 - 8

 

Another name for #6

6) trabecula septomarginalis (= moderator-band)

7) Purkinje fibers

8) septum interventriculare pars muscularis

51

GIve different names for nodus sinuatrialis.

Where is it located?

  • SA-node, cardiac pacemaker, Keith-Flack-node
  • located in sulcus terminalis near SVC inlet, subepicardiacally

52

GIve different names for nodus atrioventricularis.

Where is it located?

It is innervated by.. ?

  • AV-node, Aschoff-Tawara-node
  • located in Koch's triangle, sub-endocardially
  • innervated by myocardium of right atrium

53

What are the borders of Koch's triangle

  • superiorly: tendon of Todaro
  • inferiorly: tricuspid valve anulus
  • posteriorly: valva Thebesii

54

What does the tendon of Todaro connect?

trigonum fibrosum dextrum → valva Eustachii

55

Give another name for fasciculus atrioventricularis.

Where is it located?

  • bundle of HIS
  • located in trigonum fibrosum dextrum

56

Give another name for crus dextrum/sinistrum.

Which structures are innervated by crus dextrum/sinistrum?

Name a special feature of crus dextrum and what does it innervate?

= right/left Tawara crus

 

  • mm. papillares (through Purkinje fibers)
  • myocardium

 

crus dextrum innervates trabecula septomarginalis → m. papillaris ant. 

57

#1 - 5

 

#1 can be subdivided into?

Give another name for #4

1) pericardium serosum → lamina parietalis/visceralis

2) pericardium fibrosum

3) porta arteriosa

4) porta venosa (= Sappey's T)

5) truncus pulmonalis

58

#6 - 10

6) aorta

7) vv. pulmonales dextrae

8) vv. pulmonales sinistrae

9) v. cava superior

10) v. cava inferior

59

#11 - 15

 

What is the function of #13?

Which additional nerve not shown on the drawing innervates the pericardium?

11) sinus obliquus pericardii

12) n. phrenicus

13) a. + v. pericardiophrenica → blood supply of pericardium

14) n. vagus

15) lig. arteriosum

 

→ truncus sympathicus

60

#16 - 18

 

 

16) centrum tendineum (caudal border)

17) cavitas pleuralis (lateral borders)

18) sinus transversus pericardii

 

 

61

What are the caudal, ventral, dorsal and lateral borders of the pericardium fibrosum?

It is attached to its ventral border by.. ?

  • caudally: centrum tendineum
  • ventrally: sternum (attached to by ligg. sternopericardiaca)
  • dorsally: trachea, spine
  • laterally: cavitas pleuralis

62

Why is the sinus transversus pericardii of clinical importance?

allows surgeon to his fingers in and applies a ligature to stop the circulation for example in heart transplantation surgeries

63

What is the average weight of a male and female heart resp.?

  • female: 250-300g
  • male: 300-350g

64

The mediastinum can be differentiated into..?

It is seperated by.. ?

List their contents.

  • medastinum superius: thymus, blood vessels + nerve pathways

------------- angulus sterni -------------

  • mediastinum inferius:
    • ​mediastinum anterius: conn. tissue
    • mediastinum medium: heart, pericardium, loose conn. tissue, corpus adiposum retrosternalis, lymph vessels
    • mediastinum posterius: esophagus, large blood vessels + nerve pathways

 

 

65

#1 - 5

 

#3 is mainly formed by... ?

1) facies sternocostalis

2) facies diaphragmatica

3) facies posterior cordis → mainly: left atrium

4) facies pulmonales

5) mediastinum posterius

66

#6 - 10

6) mediastinum medium

7) mediastinum anterius

8) pericardium

9) heart

10) esophagus

67

#12 - 14

12) lung

13) pleura / cavitas pleuralis

14) radix pulmonis

 

68

Why does the close relation of the left atrium to the esophagus have a clinical importance?

stenosis of mitral valve → enlargement left atrium → compression of esophagus → dysphagia

69

What is auscultation?

Where can it be done best?

  • listening to heart sounds
  • best heard at point on thoracic wall closest to regarding valve → auscultation sites

70

Give the location of the auscultation sites of the valves. 

Give the location of another very famous auscultation site and explain when it is used.

  • valva aortae: right 2nd interc. space, parasternally
  • valva pulmonalis: left 2nd interc. space, parasternally
  • bicuspid valve: left 5th interc. space, midclavicular line
  • tricuspid valve: right 5th interc. space, parasternally

 

  • punctum quintum: (= Erb's point) left 3rd interc. space, parasternally, esp. high freq. sounds of insufficient valva aortae / pulmonalis 

71

When can the heart sounds be heard? 

Pathological heart sounds can be produced by.. ?

  • 1st heart sound: contraction phase of systole
  • 2nd herat sound: beginning diastole → closure of cuspes semilunares aortae, trunci pulmonali
  • pathological heart sounds: can be produced by stenosis / valvular insufficiency

72

List the different percussion sounds and where they can be heard

  • absolute cardiac dullness: at sternum
  • relative cardiac dullness: at any other point of heart that is covered by lung tissue
  • "undamped" sound: at "pure" lung tissue

73

#1 - 5

 

#4 can be two things

1) intercostal space

2) sulcus coronarius, left edge

3) apex cordis

4) sulcus coronarius, right edge / v. cava inferior, right margin

5) v. cava superior, right margin

74

#6 - 10

6) 2 cm

7) midclavicular line

8) 2 cm

9) 2 cm

10) right atrium

75

#11 - 15


Give another name for #12

11) v. cava superior

12) arcus aorticus, aortic knuckle

13) truncus pulmonalis

14) auricula sinistra

15) left ventricle

76

#16 - 20

 

Give another name for #18

16) auscultation site: valva aortae

17) auscultation site: valva pulmonis

18) auscultation site: punctum quintum (= Erb's point)

19) auscultation site: bicuspid valve

20) auscultation site: tricuspid valve

77

#21 - 23

21) valva trunci pulmonis/aortae

22) bicuspid/tricuspid valve

23) sulcus coronarius