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Anatomical sciences > Heart anatomy > Flashcards

Heart anatomy Flashcards

1
Q

anatomical location of heart

A

thoracic region
inferior mediastinum
medially between the lungs
above the diaphragm

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2
Q

what surface is right ventricle

A

antieror/ sternoncostal

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3
Q

what surface is left atrium

A

posterior/base

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4
Q

what surface is left and right ventricles

A

inferior/diaphragmatic

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5
Q

what surface is the right atrium

A

right pulmonary

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6
Q

what surface is the left ventricle

A

left pulmonary

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7
Q

2 layers that surround the hear

A

fibrous pericardium (outer)
serous pericardium (inner)

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8
Q

fibrous pericardium (outer) role

A

thick connective tissue
protects heart and maintains its position

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9
Q

serous pericardium (inner) role

A

helps to lubricate heart

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10
Q

layers of 2 layers serous pericardium (inner)

A

parietal = fused to fibrous pericardium
visceral (epicardium) = fused to heart

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11
Q

pericardial cavity

A

lies between the parietal and visceral layers of the serous pericardium
serous fluid
reduced friction when heart contracts

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12
Q

where is serous fluid released

A

mesothelium

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12
Q

where is serous fluid released

A

mesothelium

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13
Q

where is fat around heart

A

associated with epicardium

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14
Q

auricles

A

thin walled
increase collecting capacity of the atria

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15
Q

sulci (sulcus)

A

contain major coronary blood vessels
coronary sulcus, Anterior interventriclar sulcus, posterior inter ventricular sulcus

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16
Q

coronary sulcus

A

between atria and ventricles

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17
Q

anterior inter ventricular sulcus

A

between 2 ventricles on anterior heart surface

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18
Q

posterior inter ventricular sulcus

A

between 2 ventricles on posterior heart surface

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19
Q

wall of the heart layers

A

epicardium (superficial)
myocardium (middle) - left thicker than right
endocardium (deepest)

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20
Q

interatrial septum

A

between 2 atria
oval shaped depression (fossa ovals) remnant of foramen ovale

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21
Q

atrioventricular septum

A

between atria and ventricles
4 openings = valves are present at openings

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22
Q

cardiac skeleton

A

dense connective tissue surrounding the openings and point of attatchment for heart valves

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23
Q

interventricular septum

A

between 2 ventricles
thicker than intertribal septum

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24
Q

atria

A

left and right
receives blood from connecting vessels

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25
Q

valves between atria and ventricles

A

right - tricuspid
left - bicuspid

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26
Q

pectinate muscle in atria

A

right = pectinate muscle on anterior surface and auricle
left = pectinate in auricle only

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27
Q

where does atria receive blood from

A

right = inferior and superior vena cave
left - pulmonary veins

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28
Q

walls of ventricles are lined with

A

trabecular carneae

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29
Q

valve between ventricle and vessel

A

right = pulmonary valve between right ventricle and pulmonary trunk
left = aortic valve between left ventricle and aorta

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30
Q

features of right and left ventricle

A

right = trabecular carneae
3 papillary muscles

left = trabecular carneae
2 papillary muscle
myocardium thicker than right ventricle

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31
Q

features of the valves in the heart

A

4 valves
2 AV
2 SL
composed of flaps/cusps = made of fibrous connective tissue
situated in openings of heart
unidirectional flow of blood
closing of valves generates heart sounds

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32
Q

AV valves

A

between atria and ventricles
close at start of ventricular contraction
produce first heart sound

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33
Q

tricuspid valve

A

between right atrium and ventricle
3 cusps/leaflets

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34
Q

bicuspid/mitral valve

A

between left atrium and ventricle
2 cusps/leaflets

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35
Q

chord tendinea

A

thin, strong inelastic fibrous cords
extend from free edges of valve cup to papillary muscles

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36
Q

papillary muscles

A

5 in total
on interior surface of ventricle
attach to valve cusps via chord tendinea
3 = tricuspid valave
2 = mitral vavle

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37
Q

purpose of chordae/papillary muscle complex

A

support for AV valves
prevents prolapsing of valve into atrium when ventricle contracts

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38
Q

SL valves

A

between ventricles and arteries
close at beginning of ventricular relaxation
second heart sound
no papillary muscle or chord tendineae associated with these valves

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39
Q

pulmonary valve

A

between right ventricle and pulmonary trunk
3 flaps

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40
Q

aortic valve

A

between left ventricle and aorta
3 flaps (some have 2)

41
Q

2 main coronary arteries

A

left and right coronary artery

42
Q

left coronary artery

A

80% of blood to heart tissue
supplies left atrium, most of left ventricle and Interventricular septum
left anterior descending and left circumflex branches

43
Q

right coronary artery

A

along coronary sulcus
supplies right t ventricle, right atrium , SA, AV node , inter ventricular septum and inferior part of the left ventricle
posterior inter ventricular artery

44
Q

coronary veins

A

drains deoxygenated blood from myocardium to right atrium
e.g vena cave, great cardiac vein, small cardiac vein, coronary sinus, middle cardiac vein, anterior cardiac vein, great cardiac vein

45
Q

coronary sinus

A

most of veins come together into coronary sinus -> right atrium
anterior cardiac and small veins directly drain into cardiac chambers

46
Q

nerve supply to heart

A

sympathetic and parasympathetic stimulation
through cardiac plexus located at the base of the heart

47
Q

Vagus nerve

A

parasympathetic
decreases HR

48
Q

Sympathetic cardiac nerve

A

increase HR and force of contraction

49
Q

conduction system of the heart

A
  1. SA node
  2. AV node
  3. bundle of his
  4. purkinje fibres
50
Q

sinoatrial node

A
  • junction of superior vena cave and right atrium
  • specialised myocardial conducting cells
  • main pacemaker of heart
51
Q

atrioventricular node

A

inferior portion of right atrium within AV septum
myocardial conducting cells
slowing of impulse to allow full atrial contraction

52
Q

purkinjie fibres

A

conducts impulses to ventricular contractile fibres

53
Q

small pause before AV node transmits the impulse to AV bundle

A

his allows the atrial cadiomyoctes to complete contraction and pump blood into ventricles before the inpluse is transmitted to the ventircular cells

54
Q

heart conduction steps

A
  • SA node depolarises
  • impulse spreads through the atria to AV node via internal pathways
  • AV node provides a slowing of impulse to allow full atrial contraction
  • impulse proceeds down atrio-ventriclar bundle and its right and left bundle branches to apex of heart
  • purkinjie fibres conduct impulse to ventricular contractile fibres
  • ventricles contract
55
Q

ventricular diastole steps

A
  • ventricles and atria relax
  • all valves closed
  • blood enters right and left atrium
  • blood pools in atria
  • pressure in atrium exceeds pressure in ventricles mitral and tricuspid valves open
  • SL valves still closed
  • blood flows into relaxed ventricle
  • SA node fires causing atrial contraction
  • ejects residual blood into ventricles
  • ventricular filling finishes
  • impulse travels through AV node -> atrioventricular bundle -> purkinje fibres
56
Q

ventricular systole steps

A

-ventricular contraction begins
-pressure in ventricles exceeds corresponding atrial pressure
-closure of AV valves
-when ventricular pressure exceeds pressure in —-connecting arteries
-SL valves open
-blood ejected into corresponding arteries
(right - pulmonary trunk, left - aorta)
-pressure changes result in closure of SL valves at –end of systole

57
Q

4 valves we can hear when examining

A

aortic
pulmonary
tricuspid
mitral

58
Q

heart sound 1

A

Lub
signals the start of systole
corresponds with closure of AV (mitral and tricuspid) valves

59
Q

heart sound 2

A

dub
signals Strat of diastole
correspond with closure of semolina (aortic and pulmonary) valves

60
Q

ECG

A

records electrical signalling of heart
involved placement of electrodes over chest and on each limb

61
Q

P wave on ECG

A

electrical signal from SA node desolate atria
atrial contraction starts just after start of P wave

62
Q

PR interval

A

start of P wave to attract of QRS complex
electrical signal passes from atria to ventricles

63
Q

QRS complex

A

electrical signal depolarises ventricles
ventricular contraction starts near peak of R wave

64
Q

T wave

A

ventricles repolarise
following depolarisation - ventricles relax

65
Q

QT interval

A

beginning of QRS complex to end of T wave
time taken for ventricles to depolarise and depolarise (ventricles contract and relax)

66
Q

blood pressure

A

pressure against the walls of arteries

67
Q

what measure does blood pressure record

A

systolic = peak in arterial pressure during systole
diastolic = represents minimum arterial pressure during diastole

68
Q

healthy BP

A

120/80 mmHg

69
Q

hypertension BP

A

140/90 mmHg
many levels of hypertension - heart attack, stroke, renal disease

70
Q

hypotension BP

A

90/60 mmHg
many levels of hypertension - heart attack, stroke, renal disease

71
Q

chest x ray provides info about the

A

shape of the heart
size of the heart
cardiothoracic ratio
presence of abnormalities (calcification)

72
Q

normal cardiothoracic ratio

A

0.42-0.5

73
Q

enlarged cardiothoracic ratio

A

> 0.5

74
Q

tetralogy of fallot

A

congenital heart condition
infant born with it
structural cardiac abnormalities = calcified lesion

75
Q

upturned apex

A

right ventricular hypertrophy or enlargement
boot shaped heart

76
Q

echocardiogram

A

ultrasound scan
size and structure of heart
movement of heart valves, septum, walls of heart chambers
doppler ECHO = speed and direction of blood flow

77
Q

dextrocardia

A

heart on wrong side of the body

78
Q

coronary disease

A

narrow of coronary arteries due to atherosclerosis
myocardium supplied by affected artery becomes ischemia

79
Q

what can coronary disease cause

A

angina (narrowing of artery / arteries results in symptoms upon exertion )
actor coronary syndrome (heart attack)

80
Q

treatment of coronary disease

A

severity and patients clinical condition
some interventions involve the coronary arteries themselves

81
Q

angioplasty

A

occlusion in artery = mechanicaly widened with a balloon
stent (wire mesh) inserted at site of occlusion to maintain patency

82
Q

coronary artery bypass graft

A

when there is widespread CAD (triple vessel disease)
blockages = coronary arteries are bypassed with harvested venous or arterial vessels from patients body

83
Q

common vessels used as grafts

A

left internal mammary artery and saphenous vein

84
Q

atrioventricular block/ heart block

A
  • delay/ disturbance of transmission of electrical impulse from atria to ventricles
    impairment in heart conduction system at the level of the AV node or below
85
Q

first degree heart block

A

prolonged PR interval
delayed conduction of impulse from atrium to ventricle
no symptoms

86
Q

second degree heart block

A

not all p waves are followed by QRS complex
regular patter (2:1, 3:1)
intermittent conduction of atrial signal to ventricles
can range from asymptomatic to haemodynamic instability

87
Q

third degree heart block

A

p waves are never related to the QRS complex
absence of AV node conduction
atria and ventricles conduct independent of each other
range from fatigue / chest pain / syncope to haemodynamic instability

88
Q

treatment of heart block

A

sometimes don’t require treatment = sometimes have serves damage to their conduction system - more severe arrhythmias = may require a pacemaker

89
Q

valvular heart disorders

A

dysfunction of heart valves
benign to fatal
various cause (cognenital, infection, trauma)
any valve affected
some more common than others (mitral , aortic)
patients have heart murmur - dependent on type of valvular disease

90
Q

2 main categories of valvular heart disorders

A

valvular stenosis
valvular insufficiency/regurgitation

91
Q

valvular stenosis

A

heart valve does not fully open
stiff or fused leaflets = valves not fully opening
limits blood flow out of the atria or ventricle
heart has to pump with increased force to push blood through stenotic valve
weekend heart resulting in heart failure

92
Q

aortic vavle stenosis cause

A

age related calcification
associated with ejection systolic murmur

93
Q

ventricular insufficiency (regurgitation)

A

valve does not close tightly
some blood leaks backwards across the valve
less blood exits heart if severe insufficiency
heart has to work harder to compensate for blood regurgitating back
Leaky valve = does not close tightly = backward leaking = heart has to work harder to make up for it = mitral regurgitation
can lead to heart failure

94
Q

mitral regurgitation causes

A

various causes
mitral vale prolapse, rheumatic fever, coronary heart disease
pan systolic murmur

95
Q

patent foramen ovale

A

in the foetus - foramen ovale directs blood flow directly from the right to the left atrium
bypassing the pulmonary circulation
following birth of foramen ovale closes (fossa ovals)
failure of closure = patent foramen ovale - small intertribal shunt
often asymptomatic = may have faint systolic murmur

96
Q

ventricular septal defect

A

incomplete development of interventriculr septum
various types depending on part of septum affected
results in a shunt between right and left ventricles

97
Q

what does size and location determine

A
  • amount and direction of blood shunted
  • symptoms of affected individual = often have pansystolic murmur
98
Q

what 4 structural abnormalities are in tetralogy of fallot

A

congenital heart disease
1. ventricular septal defect
2. pulmonary stenosis (narrowing)
3. misplaced aorta
4. ventricular hypertrophy (thicker)

99
Q

symptoms of tetralogy of fallot

A

hyper cyanotic episodes when crying or feeding
loud systolic ejection murmur

Anatomical sciences (12 decks)

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