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Module Three > Heart anatomy > Flashcards

Heart anatomy Flashcards

1
Q

Name the three layers of the pericardium

A

Serous (visceral and parietal) and fibrous

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2
Q

How many millimetres of fluid might be found in the pericardial cavity?

A

15-50ml

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3
Q

What nerve carries pain signals from the pericardium?

A

Phrenic nerve

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4
Q

Where does the phrenic nerve originate from?

A

C3-C5

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5
Q

What ligaments make up the fibrous pericardium?

A

Sternopericardial, pericardiophrenic and adventitia

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6
Q

What chamber is most anterior?

A

Right ventricle

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7
Q

What chamber is found on the right pulmonary surface?

A

Right atrium

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8
Q

What chambers are found on the left pulmonary surface?

A

Left atrium and left ventricle

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9
Q

What chamber is found at the apex of the heart?

A

Left ventricle

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10
Q

What chamber is most posterior?

A

Left atrium

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11
Q

Describe the blood flow in and out of the heart

A

Deoxygenated blood arrives from the body through the superior and inferior Vena Cava into the right atrium. The blood travels through the tricuspid valve into the right ventricle. It is pumped to the lungs via the pulmonary artery through the pulmonary valve. Oxygenated blood arrives back into the left atrium via the pulmonary vein. Travels through the mitral (bicuspid) valve into the left ventricle. It is pumped out of the aorta through the aortic valve to the body.

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12
Q

What separates the two atria?

A

Interatrial septum

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13
Q

What separates the two ventricles?

A

Interventricular septum

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14
Q

What separates the atria from the ventricles?

A

Atrioventricular septum

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15
Q

What cells make up the pericardium?

A

Single layer epithelium, called mesothelium

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16
Q

Between what costal cartilages does the heart lie?

A

2nd-6th cc

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17
Q

What is the function of the serous pericardium?

A

Contains fluid to minimise friction when the heart beats

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18
Q

Describe the inferior attachment if the fibrous pericardium

A

pericardiacophrenic ligament to the diaphragm

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19
Q

At the SVC, what happens to the pericardium?

A

It is continuous with the tunica adventitia

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20
Q

Describe the anterior attachment if the fibrous pericardium

A

sternopericardial ligament to the sternum

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21
Q

Where does the pericardium attach to the mediastinal pleura?

A

Laterally

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22
Q

What are the three layers of the pericardium?

A

Outer fibrous, parietal and visceral

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23
Q

What cranial nerve supplies the visceral pleura?

A

Vagus (X)

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24
Q

What nerve supplies the two outermost layers of the pericardium?

A

Phrenic

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25
Q

Branches of what two arteries supplies the pericardium?

A

Thoracic aorta and internal thoracic artery

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26
Q

Name the two pericardial sinuses

A

Oblique and transverse

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27
Q

Describe the position of the transverse pericardial sinus

A

Posterior to the ascending aorta and pulmonary trunk, anterior to the SVC, superior to the left atrium

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28
Q

What chamber dominates the anterior (sternocostal) surface of the heart?

A

Right ventricle

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29
Q

What heart surfaces would the left ventricle mainly occupy?

A

posterior-inferior (base-diaphragmatic)

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30
Q

The apex of the heart is formed by which ventricle?

A

Left ventricle

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31
Q

What anterior surface marker would describe the position of the heart apex?

A

5th intercostal space, near the mid-clavicular line

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32
Q

What structure lies just posterior to the base of the heart?

A

Oesophegus

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33
Q

What structures make up the base of the heart?

A

Left atrium, small part of right atrium, proximal SVC and IVC, pulmonary veins

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34
Q

What chambers make up the inferior border of the heart?

A

Right ventricle and small part of left ventricle

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35
Q

Which chambers make up the left border of the heart?

A

Left ventricle and left atria

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36
Q

What is the cardiac skeleton?

A

Dense, fibrous connective tissue consisting of four rings that electrically isolates the ventricles and the atria.

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37
Q

What is the bicuspid valve’s other name and what does it separate?

A

Mitral valve, left ventricle from left atrium

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38
Q

Which AV valve has three cusps?

A

Tricuspid

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39
Q

What structures keep the AV valves closed during ventricular contraction?

A

Papillary muscles and chordae tendineae

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40
Q

What does the chordae tendineae connect?

A

Papillary muscles of ventricular wall to the AV valves

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41
Q

What vertebral level would you find the base of the heart?

A

T5-T8

42
Q

What is the oblique pericardial sinus?

A

J shaped zone of reflection, posterior to the left atrium and in between the left and right pulmonary veins.

43
Q

What is the job of the visceral afferents?

A

To relay pain and sensory information from the internal organs, glands and blood vessels to the CNS.

44
Q

What provides the parasympathetic innervation of the heart?

A

Vagus nerve (X)

45
Q

Describe the location of the deep cardiac plexus

A

Posterior to the aortic arch and surrounding the distal trachea and carina.

46
Q

Describe the location of the superficial cardiac plexus

A

Anterior-inferior to the aortic arch

47
Q

What branches of the internal thoracic artery supply the pericardium?

A

pericardiacophrenic and musculophrenic

48
Q

The left pulmonary surface faces which lung?

A

Left lung

49
Q

Which chamber receives blood from the SVC and IVC?

A

Right atrium

50
Q

Describe the position of the right auricle

A

Anterior (sternocostal) face of the heart, to the upper right of the right atrium, overlapping the root of the ascending aorta.

51
Q

What is the shallow vertical groove called that extends between the SVC and IVC, and what does it correspond with on the interior face of the right atrium?

A

Sulcus terminalis, crista terminalis

52
Q

Where can the SA node be found?

A

At the top of the sulcus terminalis

53
Q

Where can the right coronary artery be located?

A

The right coronary sulcus (or atrioventricular groove)

54
Q

What runs alongside the right coronary artery?

A

Small cardiac vein

55
Q

What is the sinus venarum?

A

The smooth posterior part of the interior right atrium

56
Q

What is the atrium proper?

A

The rough anterior part of the interior right atrium

57
Q

What separates the two parts of the internal right atrium?

A

Crista terminalis

58
Q

What features can be seen on the septal wall of the right atrium?

A

Fossa ovalis, annulus ovalis, triangle of Koch, coronary sinus, IVC opening, SVC opening, AV orifice, torus aorticus

59
Q

What is the significance of the fossa ovalis?

A

It is a oval shaped depression in the septal wall that represents the site of the foramen ovale in developing foetus’

60
Q

What is continuous with the left end of the valve of the IVC?

A

Inferior end of annulus ovalis

61
Q

What is found superior to the triangle of Koch?

A

Subendocardial ridge

62
Q

What is found inferior to the triangle of Koch?

A

opening of the coronary sinus

63
Q

How can the AV node easily be located?

A

Found at the apex of the traingle of Koch

64
Q

What cardiac catheter procedure may the triangle of Koch be useful?

A

Catheter ablation of the right atrium

65
Q

What is torus aorticus?

A

Ridge in the superior portion of the septal wall of the right atrium, created by the ascending aorta sinus.

66
Q

Does the SVC have any valves?

A

No

67
Q

Does the IVC have any valves?

A

Yes, a non-functioning semi lunar valve

68
Q

What is the Thesbian valve?

A

non-functioning valve of the coronary sinus

69
Q

What are the rings of the cardiac skeleton known as?

A

Annulus fibrosus

70
Q

What may cause valve prolapse after MI?

A

Necrosis of the papillary muscles

71
Q

What closes the semilunar valves of the aorta and pulmonary trunk?

A

the recoil of the blood during diastole that is caught in the pouch of the semilunar valve and forces it shut

72
Q

What is the most common type of valve disease?

A

Aortic stenosis

73
Q

Where can the mitral valve be best heard?

A

5th intercostal space, midclavicular line

74
Q

Where can the pulmonary valve be best heart?

A

2nd intercostal space, left sternal edge

75
Q

Where can the aortic valve best be heard?

A

2nd intercostal space, right sternal edge

76
Q

Where can the tricuspid valve best be heard?

A

4th intercostal space, left sternal edge

77
Q

The sternal angle corresponds with which costal cartilage?

A

2nd

78
Q

The inferior part of the sternal body corresponds with which costal cartilage?

A

5th

79
Q

What is responsible for the S1 heart sound?

A

closure of the AV valves at the beginning of ventricular systole

80
Q

What is responsible for the S2 heart sound?

A

closure of the pulmonary and aortic valves at the end of ventricular systole.

81
Q

What is the S3 heart sound called?

A

Protodiastolic gallop or ventricular gallop

82
Q

What is the S4 heart sound called?

A

Presystolic gallop or atrial gallop

83
Q

What separates the inflow and outflow portions of the right ventricle?

A

Supraventricular crest

84
Q

The inflow portion of the ventricles are covered by what?

A

trabeculae carnae

85
Q

What are the three main types of trabeculae carnae?

A

Ridges, bridges and pillars (papillary muscles)

86
Q

The outflow portion of the ventricles are smooth: true or false?

A

True

87
Q

The left auricle is smooth: true or false?

A

False, it is continuous with the rough outflow portion of the left atrium

88
Q

What vessels drain into the left atrium?

A

Four pulmonary veins

89
Q

What are the vessels to branch off the ascending aorta?

A

right and left coronary arteries

90
Q

When do the coronary arteries receive blood flow, why is this significant?

A

During ventricular diastole, they are the only arteries to do so.

91
Q

Which coronary artery is usually bigger?

A

Left

92
Q

Where is the right coronary sulcus?

A

Between the right atrium and ventricle

93
Q

Which branch of coronary artery supplies the apex of the heart?

A

Right marginal branch of RCA

94
Q

Which branch of coronary artery supplies the SA node?

A

SA nodal branch of RCA

95
Q

What structures does the RCA supply in a left dominant person (approx 10%)?

A

Whole right atrium, most right ventricle, small portion of left ventricle and left atrium, SA node and AV node

96
Q

Where does the left coronary artery divide?

A

As it enters the left coronary sulcus, the LCx travels in the sulcus and the LAD descends to the apex

97
Q

Where does the left coronary artery pass through after arising from the ascending aorta?

A

Between the left auricle and pulmonary trunk

98
Q

What areas are supplied by the left coronary artery in a left dominant person (approx 10%)?

A

Most of left atrium and ventricle, a small part of right ventricle, Bundle of His and LBB/RBB

99
Q

What changes with blood supply to the heart chambers in someone that is right coronary artery dominant (approx 90% population)?

A

RCA supplies large majority of left ventricle

100
Q

Where do the coronary lymph vessels drain?

A

brachiocephalic and tracheobronchial nodes

101
Q

Describe the location of the SA node

A

In the superior part of the right atrium, close to the SVC opening

Module Three (5 decks)

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