Flashcards in Heart Deck (40)
What are the two layers of the pericardial sac? What are they made of?
1. Fibrous pericardium - dense fibroelastic connective tissue
2. Serous pericardium - Loose connective + squamous epithelium called mesothelium
What are the two layers of the serous pericardium?
1. Parietal layer - adjacent to fibrous pericardium
2. Visceral layer - adjacent to myocardium also called epicardium
Where are the parietal and visceral layers of serous pericardium continuous?
At the reflexion at that base of the heart called the superior reflexion. Because they are continuous, they form the pericardial sac
What is the pericardial cavity and what is in it? What is its function?
A narrow space formed by the serous pericardium, containing a thin film of pericardial fluid (several mL). Function is to prevent friction during heart beating
What is pericarditis?
Inflammation of the pericardium that causes friction between layers and restricts beating of heart
What is pericardial effusion?
Abnormal collection of fluid in pericardial cavity which interferes with normal heart contraction
What is the cardiac skeleton? What is it composed of?
Central supporting structure of heart which some of the cardiac muscle fibers are attached to, and what supports the valves
Made of dense irregular connective tissue
What are the three components of the cardiac skeleton?
1. Annuli fibrosi
2. Trigona fibrosi
3. Septum membranaceum
What is the annuli fibrosi?
Part of the cardiac skeleton - surrounds each of the four cardiac valves to stabilize them. Its connective tissue also gives rise to the core of the leaflets / cusps of the valves
What is the trigona fibrosi?
Part of cardiac skeleton, consists of right and left fibrous trigones. They are triangular islands of connective tissue which serve to strengthen the annuli fibrosi.
The right one has an opening for the bundle of His
What is the septum membranaceum?
An extension of the cardiac skeleton into the IV septum
What are the functions of the cardiac skeleton?
1. Separate atrial from ventricular musculature
2. Origin of cardiac muscle
3. Localizes / stabilizes valves
4. Limits valve diameter
5. Prevents spread of electrical impulses except via the conducting system of heart
What are the three components of the heart wall?
1. Epicardium (visceral layer of serous pericardium)
What makes up the epicardium and what is it analogous to? What its inner layer called?
Simple squamous epithelium called mesothelium associated with its basal lamina.
Epicardial connective tissue with collagen, elastic fibers, arteries, veins, nerves, and FAT
Analogous to tunica adventitia
Inner layer bordering the myocardium is sometimes called the subepicardium
What is found in the epicardium?
Coronary arteries, cardiac veins, and nerves that supply the heart. They are located in the connective tissue and are typically surrounded by adipose.
It is the only place of fat storage for the heart.
What is the myocardium and what is it analogous to?
Middle layer of heart wall containing cardiac muscles, analogous to the tunica media
What defines cardiac muscle cells?
One or two centrally located nuclei, packed with myofibrils and large mitochondria, connected to eachother via intercalated discs
What are the components of the intercalated discs?
1. Fascia adherens (FA) - connect two cells and anchor actin filaments in each cell
2. Desmosomes - connect two cells via intermediate filaments desmin and vimentin
3. Gap junctions - ionic communication and coupling between cardiac muscle cells
How does myocardial thickness vary between atria and ventricles?
Atrial myocardium is thinner than ventricular, since it only needs to provide the force to open the AV valves to let blood in.
Left ventricle myocardium is 3x thicker than right ventricle
How do atrial myocardial cells differ from ventricular?
They are smaller than ventricular. They thus have less elaborate T-tubule system, but more gap junctions (perhaps for electrical communication)
Also, they produce, store, and secrete ANF
What is ANF and its function?
Atrial natriuretic factor. It is stored in electron dense granules in atrial cardiomyocytes and released into surrounding continuous capillaries.
Target: Adrenal cortex, kidney, and vascular smooth muscle
Function: Decreases arterial blood pressure by stimulating kidney to secrete Na+, and regulates fluid balance / electrolyte balance
How are muscle cells / fibers arranged in the ventricular wall?
Arranged into complex spiral / helical patterns called trabeculae carneae
What are papillary muscles?
Fingerlike projections from the ventricular wall into the lumen of the ventricle, which hold onto the chordae tendineae
How are muscle cells / fibers arranged in the atrial wall?
In a latticework that gives a ridged appearance known as the pectinate musculature
What is the endocardium and what is it analogous to?
Internal layer of heart wall, borders anything that touches blood. It is analogous to the tunica intima of blood vessels
What does the endocardium consist of?
1. Endothelium - Simple squamous + basal lamina
2. Endocardial connective tissue - fibroblasts, collagen, elastic fibers, smooth muscle.
->3. Subendocardial layer - deepest layer of endocardial connective tissue, where it connects to myocardium
What is the path of the conduction system in the heart?
SA node (pacemaker under sympathetic control) -> atrial muscle and internodal fibers -> AV node -> Bundle of His -> left and right bundle branches -> Purkinje fibers (very fast, 4 m/s) -> gap junctions in ventricular cardiac muscles stimualte others
What is an EKG / ECG?
Electrocardiogram - voltage trace of depolarization in heart can be traced via PQRS waves
Where are SA nodal cells and what is their function?
Located in the wall of the right atrium close to the SVC, often surrounding a branch of the coronary artery.
They are the pacemaker cells which initiate the contraction of the heart, which spreads along the tracts of modified cardiac muscle fibers (internodal fibers) to AV node