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Anatomy > Heart and Great Vessels > Flashcards

Heart and Great Vessels Flashcards

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
Q

what are the two reflections of the pericardium?

A

transverse and oblique sinuses

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26
Q

where is the transverse sinus located?

A

the arterial end where the pulmonary trunk and aorta leave the heart

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27
Q

what is clinical significance of the transverse sinus?

A

during surgery on the aorta or pulmonary artery, you can stop circulation to this area by making a stitch through this sinus

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28
Q

how can you reach the transverse sinus?

A

reach by reaching under the pulmonary trunk and anterior to the SVC

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29
Q

where is the oblique sinus located?

A

the venous end where SVC, IVC pulmonary veins enter the heart

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30
Q

how can you reach the oblique sinus?

A

can reach by inserting finger under apex of the heart and pushing up and right towards the root of the right lung

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31
Q

clinical significance of the oblique sinus

A

assists with frictionless movement of the heart in the pericardial cavity

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32
Q

blood supply to the pericardium is via the (5)

A

pericardiacophrenic arteries
musclophrenic arteries
branches of the thoracic aorta (bronchial, esophageal, and superior phrenic)
coronary arteries

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33
Q

coronary arteries only supply the — layer of the pericardium

A

visceral

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34
Q

venous drainage is via the (3)

A

pericardiophrenic vein
internal thoracic vein
tributaries of the azygous system

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35
Q

somatic sensory innervation to the fibrous and parietal layer is via the

A

phrenic nerves

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36
Q

visceral sensory to the epicardium is via the

A

cardiac plexuses

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37
Q

the epicardium is insensitive to

A

pain

visceral pericardium doesn’t feel pain, same with pleura

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38
Q

vagus innervation is

A

unknown

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39
Q

sympathetic trunk innervation is

A

vasomotor

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40
Q

pericarditis

A

inflammation, usually causes chest pain. the sharp chest pain associated with pericarditis occurs when the irritated layers of the pericardium rub against each other

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41
Q

pericardial effusion

A

the presence of an abnormal amount of fluid and/or an abnormal character to fluid in the pericardial space

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42
Q

what might pericardial effusion be caused by?

A

a variety of local and systemic disorders, or it may be idiopathic

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43
Q

cardiac tamponade

A

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
Q

pericardiocentesis solution

A

subxiphoid approach

45
Q

subxiphoid approach

A

needle inserted between the diploid process and the left costal margin at a 30-45 degree angle

46
Q

with the subxiphoid approach, aim for the

A

L mid-clavicle

47
Q

subxiphoid approach directs the needle toward the

A

anterior wall of the right ventricle

48
Q

think of the heart as a house with (4)

A

4 rooms (chambers)
4 doors (doors)
4 big hallways (vessels)
4 small hallways (vessels)

49
Q

how can the right atrium be divided on the basis of morphology and embryological origin? (2)

A

the sinus centrum

pectinate muscles

50
Q

the sinus venarum

A

the smooth thin walled posterior part the receives the vena cave and coronary sinus

51
Q

the sinus centrum is derived from

A

the embryonic sinus venous

52
Q

the part with the pectinate muscles (including the auricle) is divided from the sinus venarum by the

A

cristra terminalis

53
Q

the intraatrial septum divides the

A

right atrium from the left atrium

54
Q

fossa ovalis

A

remnant of the fetal foramen oval and valve

55
Q

how many individuals gave an atrial septal defect?

A

25%

56
Q

if the patent foramen oval is too large, it allows

A

o2 from the blood to be shunted to the right atrium and resulting in an overloading of the pulmonary system

57
Q

subsequently, what will become enlarged? (3)

A

the right atrium, right ventricle, and pulmonary trunk

58
Q

the right ventricle receives blood from the right atrium through the

A

right atrioventricular orifice

59
Q

the right atrioventricular orifice is guarded by the

A

tricuspid valve

60
Q

the irregular muscular elevations on the internal surface of the right ventricle

A

trabecular carneae

61
Q

what are the two parts of the inter ventricular septum? (2)

A

muscular part

membranous part that is superior and posterior

62
Q

conus arteriosus

A

cone shaped pouch that heads into the pulmonary trunk

63
Q

the pulmonary valve

A

a semilunar valve guarding the pulmonary trunk

64
Q

what path does blood flowing through the right ventricle from the right AV valve to the pulmonary valve follow?

A

a U-shaped path, changing direction about 140 degrees

65
Q

how many cusps does the right atrioventricular valve have?

A

3 (tricuspid valve)

66
Q

what are the three cusps of the right atrioventricular valve?

A

anterior
posterior
septal

67
Q

papillary muscles (3)

A

anterior (septomarginal trabeculum carries the right branch of the AV bundle to it)
posterior
septal

68
Q

what does the chordae tendineae prevent?

A

the cusp from opening upward

keeps the heart and cusps closed so blood only flows sin the direction it is supplied to

69
Q

what is the function of the AV valves?

A

prevent back flow into the atria during ventricular contraction

70
Q

the papillary muscles and chordae tendineae prevent the cusps from

A

prolapsing into the atria

71
Q

the left atrium receives oxygenated blood from the lungs via the

A

four pulmonary veins

72
Q

the left atrium has a smooth interior except for

A

pectinate muscles in the left auricle

73
Q

the walls of the embryonic pulmonary vein and four of its tributaries are incordoparted into the

A

smooth part of the left atrium

74
Q

whereas, the left side of the embryonic atrium contributes to the development of the

A

muscular portion

75
Q

the left ventricle receives lode rom the left atrium through the

A

left atrioventricular orifice

76
Q

the left AV orifice is guarded by the

A

mitral valve

77
Q

the internal surface of the left ventricle is also characterized by the presence of

A

trabeulae carneae

78
Q

trabeulae carneae are

A

finer and more numerous than the RV

79
Q

which wall of the ventricle is thicker? by how much?

A

left, 2x

80
Q

article vestibule (2)

A

smooth walled

the part that leads into the aorta

81
Q

aortic valve

A

semilunar valve guarding the ascending aorta

82
Q

blood flowing through the left ventricle takes - right turns )around the anterior cusp), resulting in a - degree change of direction

A

2

180

83
Q

what percentage of ventricular septal defects (VSDs) are congenital heart defects?

A

25%

84
Q

ventricular septal defects (VSDs) is the opening between

A

the L and R ventricles, associated shunting of blood

85
Q

4 types based on

A

position and severity

86
Q

where do most VSDs occur?

A

in the muscular position (these spontaneously close)

87
Q

membranous defects are more commonly corrected

A

surgically

88
Q

the mitral valve has - cusps

A

2, bicuspid

89
Q

what are the two mitral valves

A

anterior and posterior cusps

90
Q

papillary muscles (2)

A

anterior and posterior

91
Q

what is the most commonly diseased of the valves of the heart?

A

the mitral valve

92
Q

what results from nodules forming on the cusps?

A

turbulent flow

93
Q

prolapse of it may occur in as many as -% of females

A

7%

94
Q

hemodynamics associated with valvular prolapse can erode that endothelial surfaces of the valve and predispose a patient to

A

endocardial infection

95
Q

these infections occur when

A

transient bacterias seed abnormal endothelial surfaces

96
Q

the mitral value prolapse can result in

A

enlargement of the left atrium

97
Q

the pulmonary and aortic valves are

A

tricuspid lunar valves

98
Q

they have three cusps which prevent back flow into the ventricles during

A

ventricular relaxation

99
Q

they are not associated with (2)

A

chordae tendineae and papillary muscles

100
Q

what does each cusp of a semilunar valve have? (2)

A

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
Q

when the valves close, the nodules and lunges meet in the

A

center

102
Q

where do the coronary arteries arise from?

A

aortic sinuses

103
Q

the coronary fill as the aortic sinuses fill following

A

ventricular contraction

104
Q

how are cusps named?

A

based on their embryological origin, not their final position

105
Q

early in development, the common outflow trunk for both ventricles has

A

4 cusps

106
Q

partial rotation of heart results in the

A

final arrangement

Anatomy (29 decks)

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