Heart

Question 1

What are the big picture ideas of the heart?

Answer 1

Location
Pericardium
External Structure
Circulation
Internal Structure
Coronary Circulation
Conduction

Question 2

Describe the location of the heart

Answer 2

Superiorly - the heart is suspended in the rib cage by the great vessels
Anteriorly - body of the sternum and the thymus
Anterolateral/lateral/posterolateral - lungs and its pleura
Posteriorly - right and left lung/esophagus/aorta
Inferiorly - inferior vena cava penetrates diaphragm on the right side - diaphragmatic portion of parietal pericardium/pericardial sac is fused with central tendon of the diaphragm

Question 3

Describe what is superior to the heart

Answer 3

The heart is suspended in the rib cage by the great vessels

Question 4

Describe what is anterior to the heart

Answer 4

The body of the sternum and the thymus

Question 5

Describe what is anterolateral/lateral/posterolateral to the heart

Answer 5

Lungs and its pleura

Question 6

Describe what is posterior to the heart

Answer 6

Parts of the lungs
Esophagus
Aorta

Question 7

Describe what is inferior to the heart and their relationship

Answer 7

Diaphragm - pericardial sac is firmly fused to the central tendon of the diaphragm

Question 8

What structure of the heart pierces the diaphragm?

Answer 8

Inferior vena cava

Question 9

What structure encloses the heart and the proximal portion of the great vessels, originating and terminating in the heart, consisting of a parietal and visceral component?

Answer 9

Pericardium

Question 10

Define and describe the pericardium

Answer 10

Originating and terminating in the heart, the pericardium encloses the heart and the proximal portions of the great vessels - consists of both a parietal and a visceral component

Question 11

Describe the parietal pericardium

Answer 11

Fibrous pericardium with a serous lining

Question 12

Describe the visceral pericardium

Answer 12

Inner layer of serous pericardium that covers the origins and terminations of great vessels and the heart

Question 13

What is another term for visceral pericardium

Answer 13

Epicardium

Question 14

Describe the pericardial cavity

Answer 14

Between the parietal and the visceral pericardium - surfaces are in contact but are covered in a watery fluid to reduce friction during contractions

Question 15

What are the external structures of the heart?

Answer 15

Base
Apex
Coronary Sulcus
Anterior and Posterior Interventricular Sulci
Auricle
Cardiac Fat

Question 16

Describe the base of the heart

Answer 16

Top of the heart - heart is suspected at its base by the great vessels

Question 17

Describe the apex of the heart

Answer 17

The apex is the area at which the heart comes to a point at the bottom - points anteriorly, inferiorly, and towards the left

Question 18

Describe the coronary sulcus of the heart

Answer 18

Groove in the heart separating the ventricles

Question 19

Describe the anterior and posterior interventricular sulci of the heart

Answer 19

Groove on the anterior and posterior of the heart that divide the right and left ventricles - meeting at the notch near the apex

Question 20

Describe the auricle of the heart

Answer 20

An appendage of the atrium - strong muscles that help empty the atrium

Question 21

Describe cardiac fat

Answer 21

Varying amounts of fat the occupy the sulci of the heart

Question 22

In relation to the chambers of the heart, which is mostly posterior?

Answer 22

Left atrium

Question 23

In relation to the chambers of the heart, which sits most anteriorly, occupying most of the sternocostal surface?

Answer 23

Right ventricle

Question 24

In regards to basic circulation by the heart, what are the primary divisions?

Answer 24

Systemic circulation

Pulmonary Circulation

Question 25

What are the internal structures of the heart?

Answer 25

Left and Right Atria | Left and Right Ventricles

Question 26

What are the main functions of atria of the heart?

Answer 26

Receive blood

Question 27

What are the main functions of the ventricles of the heart?

Answer 27

Pump blood to body and lungs

Question 28

What is the sequence of blood flow in the heart?

Answer 28

Right atrium to right ventricle to the lungs for oxygenation back to the left atrium to the left ventricle to pump to the body

Question 29

What are the parts of the right atrium of the heart?

Answer 29

Principal cavity | Auricle

Question 30

Which vessels empty blood into the right atrium of the heart?

Answer 30

``` Anterior cardiac veins Superior vena cava Inferior vena cava Coronary sinus Thebesian veins (venarum minimarum) ```

Question 31

How many vessels empty blood into the right atrium of the heart?

Answer 31

5

Question 32

Of the vessels that empty blood into the right atrium of the heart, how many are myocardial?

Answer 32

3 myocardial vessels - coronary sinus - anterior cardiac veins - Thebesian veins

Question 33

Of the vessels that empty blood into the right atrium of the heart, which are not myocardial vessels?

Answer 33

Superior vena cava | Inferior vena cava

Question 34

Which structure of the heart separates the right atrium from the left atrium?

Answer 34

Interatrial septum

Question 35

Describe the fossa ovalis of the heart

Answer 35

The remains of the aperture of the foramen ovale in the interatrial septum through which blood flows from the right atrium to the left atrium before birth

Question 36

Describe the foramen ovale of the heart

Answer 36

The foramen of the heart through which blood flows from the right to the left atrium in the fetus before birth (since blood does not go to the lungs to get oxygenated in the fetus)

Question 37

What is the limbus of the fossa ovalis of the heart?

Answer 37

A raised margin of the fossa located above and anteriorly to the fossa

Question 38

What is the purpose of the limbus of the fossa ovalis?

Answer 38

Directs blood flow

Question 39

What are the valves associated with the right atrium of the heart?

Answer 39

Valve of the inferior vena cava Valve of the coronary sinus Tricuspid Valve

Question 40

Describe the valve of the inferior vena cava of the right atrium of the heart

Answer 40

Falciform fold (much larger in fetus) directs blood from inferior vena cava directly through foramen ovale into atrium in fetal life

Question 41

Describe the valve of the coronary sinus of the right atrium of the heart

Answer 41

A small fold - incompetent in preventing back-flow into coronary sinus

Question 42

Describe the tricuspid valve of the right atrium of the heart

Answer 42

Guards the right atrioventricular ostium

Question 43

Describe the crista terminal is of the right atrium of the heart

Answer 43

Muscular ridge extends downward from near the ostium of the superior vena cava towards the front of the inferior vena cava (smooth from pectinate)

Question 44

Describe the pectinate muscles of the right atrium of the heart

Answer 44

Muscular ridges within the right auricle of the right atrium of the heart

Question 45

Describe the right auricle of the right atrium of the heart

Answer 45

Blind ear-shaped pouch extending anteroinferiorly from the heart

Question 46

What is the function of right ventricle of the heart?

Answer 46

Pumps blood from the heart to the lungs for oxygenation of the blood

Question 47

How do the walls of the right ventricle differ from the walls of the left ventricle of the heart and why?

Answer 47

Walls of the right ventricle are generally about a 1/3 of the thickness of the walls of the left ventricle because the right ventricle pumps blood only to the lungs

Question 48

Describe the conus arteriosus of the right ventricle of the heart

Answer 48

Funnel-shaped upper end of right ventricle which gives rise to pulmonary trunk

Question 49

Describe the chordae tendineae of the right ventricle of the heart

Answer 49

Fibrous cords extending from the cusps of the tricuspid valve to the ends of the papillary muscles

Question 50

Describe the trabeculae carneae of the right ventricle of the heart

Answer 50

Ridge-like bundles of muscles which project into the cavity of the ventricle - a particularly prominent muscle of this group is the moderator band - contains the right crus of the AV bundle

Question 51

What is the other term for the moderator band of the right ventricle of the heart?

Answer 51

Septomarginal trabecula

Question 52

What are the valves associated with the left ventricle of the heart?

Answer 52

``` Tricuspid valve Pulmonary valve (semilunar) ```

Question 53

Describe the pulmonary valve of the right ventricle of the heart

Answer 53

Lies anterior to the aortic valve and consists of a semilunar valve

Question 54

What is the function of the left atrium of the heart?

Answer 54

Receive oxygenated blood from the lungs

Question 55

How does the left atrium compare in size to the right atrium?

Answer 55

The left atrium is smaller than the right atrium

Question 56

What are the vessels that empty into the left atrium of the heart?

Answer 56

4 pulmonary veins

Question 57

What are the structures of the left atrium of the heart?

Answer 57

Interatrial septum | Left auricle

Question 58

What is the function of the left ventricle?

Answer 58

Pump oxygenated blood to the body

Question 59

True or false: The apex of the left ventricle is also the apex of the heart

Answer 59

True

Question 60

What are the structures of the left ventricle?

Answer 60

Chordae tendineae Papillary muscles Trabeculae carneae Interventricular septum

Question 61

What are the valves associated with the left ventricle?

Answer 61

Bicuspid/mitral valve | Aortic valve

Question 62

Describe the bicuspid/mitral valve of the left ventricle of the heart

Answer 62

Guards the left AV ostium (large opening from left atrium to left ventricle)

Question 63

How many cusps does the mitral valve of the left ventricle have?

Answer 63

2 cusps - bicuspid

Question 64

Describe the aortic valve of the left ventricle of the heart

Answer 64

Located behind the pulmonary valve Composed of 3 cusps Prevents regurgitation of blood into the ventricle while pressure in aorta is high

Question 65

Of the valves of the heart, which wears out most frequently?

Answer 65

Mitral valve of the left ventricle - creates regurgitation of blood back into left atrium

Question 66

Viewed from above the heart (having removed atria and arteries), which valve is most anterior?

Answer 66

Pulmonary valve

Question 67

Viewed from above the heart (having removed atria and arteries), which valve is most in the “middle”?

Answer 67

Aortic valve

Question 68

Viewed from above the heart (having removed atria and arteries), which valve is on the left?

Answer 68

Bicuspid valve

Question 69

Viewed from above the heart (having removed atria and arteries), which valve is on the right?

Answer 69

Tricuspid Valve

Question 70

Describe stenosis and calcium deposits in terms of the heart

Answer 70

Stenosis describes hardening of the valves after calcium deposits within the valves

Question 71

What happens to the heart in response to stenosis of the valves?

Answer 71

Growth of the heart muscle occurs in response to stenosis of the valves - myocardium can be anywhere from 1/4”-1/2” thick but with stenosis can enlarge to approx an 1” thick

Question 72

Describe myocardial infarction

Answer 72

Obstruction of a coronary artery that leads to anoxia of the heart area supplied, resulting in a heart attack

Question 73

True or false: Coronary arteries and cardiac veins are quite variable in origin, course, and termination

Answer 73

True