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Heart and Great Vessels Flashcards

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1
Q

pericardium

A

fibrous sac surrounding the heart and roots of the great vessels

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2
Q

what does the fibrous pericardium fuse with superiorly? (3)

A

tunica adventitia of SVC, ascending aorta, and pulmonary arteries

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3
Q

what does the fibrous pericardium fuse with inferiorly?

A

the central tendon of the diaphragm

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4
Q

what is the pericardium reinforced by?

A

2 sternopericardial ligaments anteriorly and posteriorly by loose connective tissue

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5
Q

the 2 sternopericardial ligaments attach the pericardium to the (2)

A

tracheal bifurcation and the main bronchi

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6
Q

what do the attachments do? (2)

A

keep the heart in position

limit cardiac distention (overfilling of the heart)

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7
Q

what is the pericardium overlapped by? (2)

A

two pleural sacs and lungs

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8
Q

where the pleural sacs deviate, it connects the

A

posterior surface of the sternum and the 4th and 5th left intercostal spaces

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9
Q

laterally, the mediastinal pleura drapes over the surface of the pericardium with the — — and — — — — sandwiched between pleura and pericardium

A

phrenic nerve

pericardiaophrenic artery and vein

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10
Q

what does the pericardium contact posteriorly? (3)

A

esophagus
descending thoracic aorta
main bronchi

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11
Q

what is the outer layer of dense connective tissue of the pericardium called?

A

fibrous pericardium

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12
Q

what does the inner serous part of the pericardium include? (2)

A

visceral and parietal layer

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13
Q

serous portion

A

in the form of an enclosed sac with the pericardial cavity

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14
Q

pericardial cavity

A

potential space between the parietal and visceral layers

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15
Q

what does the pericardial cavity contain?

A

film of fluid that enables the heart to move and beat in a relatively frictionless environment

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16
Q

is the fibrous pericardium elastic?

A

no, inelastic

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17
Q

the fibrous pericardium is inelastic and functions to (3)

A

retain the heart in position
limit its distention
prevents sudden overflowing

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18
Q

epicardium

A

the visceral layer of the serous pericardium, more loosely bound to the heart

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19
Q

the heart is completely invested in epicardium except the

A

posterior, irregular area between the vena cave and pulmonary vv. where myocardium contacts fibrous pericardium

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20
Q

when do the heart and pericardial sinuses form?

A

during embryonic life due to folding of embryonic heart tube

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21
Q

as the heart folds, venous ends move

A

posteriorly and up, so the venous end is up by the arterial end

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22
Q

transverse sinus

A

separates the venous end from the arterial end

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23
Q

as the veins of the heart grow and expand, what is formed?

A

oblique sinus

a recess, a blind sac behind posteriorly side of the heart

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24
Q

reflections of the pericardium

A

where 2 layers of pericardium meet each other

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25
what are the two reflections of the pericardium?
transverse and oblique sinuses
26
where is the transverse sinus located?
the arterial end where the pulmonary trunk and aorta leave the heart
27
what is clinical significance of the transverse sinus?
during surgery on the aorta or pulmonary artery, you can stop circulation to this area by making a stitch through this sinus
28
how can you reach the transverse sinus?
reach by reaching under the pulmonary trunk and anterior to the SVC
29
where is the oblique sinus located?
the venous end where SVC, IVC pulmonary veins enter the heart
30
how can you reach the oblique sinus?
can reach by inserting finger under apex of the heart and pushing up and right towards the root of the right lung
31
clinical significance of the oblique sinus
assists with frictionless movement of the heart in the pericardial cavity
32
blood supply to the pericardium is via the (5)
pericardiacophrenic arteries musclophrenic arteries branches of the thoracic aorta (bronchial, esophageal, and superior phrenic) coronary arteries
33
coronary arteries only supply the --- layer of the pericardium
visceral
34
venous drainage is via the (3)
pericardiophrenic vein internal thoracic vein tributaries of the azygous system
35
somatic sensory innervation to the fibrous and parietal layer is via the
phrenic nerves
36
visceral sensory to the epicardium is via the
cardiac plexuses
37
the epicardium is insensitive to
pain | visceral pericardium doesn't feel pain, same with pleura
38
vagus innervation is
unknown
39
sympathetic trunk innervation is
vasomotor
40
pericarditis
inflammation, usually causes chest pain. the sharp chest pain associated with pericarditis occurs when the irritated layers of the pericardium rub against each other
41
pericardial effusion
the presence of an abnormal amount of fluid and/or an abnormal character to fluid in the pericardial space
42
what might pericardial effusion be caused by?
a variety of local and systemic disorders, or it may be idiopathic
43
cardiac tamponade
a build up of blood or other fluid in the pericardial sac puts pressure on the heart, which may prevent it from pumping effectively
44
pericardiocentesis solution
subxiphoid approach
45
subxiphoid approach
needle inserted between the diploid process and the left costal margin at a 30-45 degree angle
46
with the subxiphoid approach, aim for the
L mid-clavicle
47
subxiphoid approach directs the needle toward the
anterior wall of the right ventricle
48
think of the heart as a house with (4)
4 rooms (chambers) 4 doors (doors) 4 big hallways (vessels) 4 small hallways (vessels)
49
how can the right atrium be divided on the basis of morphology and embryological origin? (2)
the sinus centrum | pectinate muscles
50
the sinus venarum
the smooth thin walled posterior part the receives the vena cave and coronary sinus
51
the sinus centrum is derived from
the embryonic sinus venous
52
the part with the pectinate muscles (including the auricle) is divided from the sinus venarum by the
cristra terminalis
53
the intraatrial septum divides the
right atrium from the left atrium
54
fossa ovalis
remnant of the fetal foramen oval and valve
55
how many individuals gave an atrial septal defect?
25%
56
if the patent foramen oval is too large, it allows
o2 from the blood to be shunted to the right atrium and resulting in an overloading of the pulmonary system
57
subsequently, what will become enlarged? (3)
the right atrium, right ventricle, and pulmonary trunk
58
the right ventricle receives blood from the right atrium through the
right atrioventricular orifice
59
the right atrioventricular orifice is guarded by the
tricuspid valve
60
the irregular muscular elevations on the internal surface of the right ventricle
trabecular carneae
61
what are the two parts of the inter ventricular septum? (2)
muscular part | membranous part that is superior and posterior
62
conus arteriosus
cone shaped pouch that heads into the pulmonary trunk
63
the pulmonary valve
a semilunar valve guarding the pulmonary trunk
64
what path does blood flowing through the right ventricle from the right AV valve to the pulmonary valve follow?
a U-shaped path, changing direction about 140 degrees
65
how many cusps does the right atrioventricular valve have?
3 (tricuspid valve)
66
what are the three cusps of the right atrioventricular valve?
anterior posterior septal
67
papillary muscles (3)
anterior (septomarginal trabeculum carries the right branch of the AV bundle to it) posterior septal
68
what does the chordae tendineae prevent?
the cusp from opening upward | keeps the heart and cusps closed so blood only flows sin the direction it is supplied to
69
what is the function of the AV valves?
prevent back flow into the atria during ventricular contraction
70
the papillary muscles and chordae tendineae prevent the cusps from
prolapsing into the atria
71
the left atrium receives oxygenated blood from the lungs via the
four pulmonary veins
72
the left atrium has a smooth interior except for
pectinate muscles in the left auricle
73
the walls of the embryonic pulmonary vein and four of its tributaries are incordoparted into the
smooth part of the left atrium
74
whereas, the left side of the embryonic atrium contributes to the development of the
muscular portion
75
the left ventricle receives lode rom the left atrium through the
left atrioventricular orifice
76
the left AV orifice is guarded by the
mitral valve
77
the internal surface of the left ventricle is also characterized by the presence of
trabeulae carneae
78
trabeulae carneae are
finer and more numerous than the RV
79
which wall of the ventricle is thicker? by how much?
left, 2x
80
article vestibule (2)
smooth walled | the part that leads into the aorta
81
aortic valve
semilunar valve guarding the ascending aorta
82
blood flowing through the left ventricle takes - right turns )around the anterior cusp), resulting in a - degree change of direction
2 | 180
83
what percentage of ventricular septal defects (VSDs) are congenital heart defects?
25%
84
ventricular septal defects (VSDs) is the opening between
the L and R ventricles, associated shunting of blood
85
4 types based on
position and severity
86
where do most VSDs occur?
in the muscular position (these spontaneously close)
87
membranous defects are more commonly corrected
surgically
88
the mitral valve has - cusps
2, bicuspid
89
what are the two mitral valves
anterior and posterior cusps
90
papillary muscles (2)
anterior and posterior
91
what is the most commonly diseased of the valves of the heart?
the mitral valve
92
what results from nodules forming on the cusps?
turbulent flow
93
prolapse of it may occur in as many as -% of females
7%
94
hemodynamics associated with valvular prolapse can erode that endothelial surfaces of the valve and predispose a patient to
endocardial infection
95
these infections occur when
transient bacterias seed abnormal endothelial surfaces
96
the mitral value prolapse can result in
enlargement of the left atrium
97
the pulmonary and aortic valves are
tricuspid lunar valves
98
they have three cusps which prevent back flow into the ventricles during
ventricular relaxation
99
they are not associated with (2)
chordae tendineae and papillary muscles
100
what does each cusp of a semilunar valve have? (2)
a fibrous nodule at the midpoint of its free edge | a thin connective tissue ear on either side of the nodule called the lunule
101
when the valves close, the nodules and lunges meet in the
center
102
where do the coronary arteries arise from?
aortic sinuses
103
the coronary fill as the aortic sinuses fill following
ventricular contraction
104
how are cusps named?
based on their embryological origin, not their final position
105
early in development, the common outflow trunk for both ventricles has
4 cusps
106
partial rotation of heart results in the
final arrangement

Anatomy (29 decks)

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