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ANAT 214 > Heart and Pericardium > Flashcards

Heart and Pericardium Flashcards

(105 cards)

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1
Q

Describe general position of heart

A

In thoracic cavity
Deviated towards left side
In middle mediastinum - heart occupies most of this space

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2
Q

Describe boundaries of heart - all = 4

A

Sup = sternal angle, manubriosternal joint - t4/5, rib 2
Inferior = xiphisternal joint - level of t9
Left = left midclavicular line - lines up with apex of heart, at level of t9 (apex)
Parasternal lines = parallel, lateral borders of sternum

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3
Q

What is mediastinum

A

Compartment in thoracic cavity

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4
Q

What is mediastinum bounded by

A

1st rib
Diaphragm
Rib cage
Thoracic vertebrae

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5
Q

Name and explain regions of mediastinum - gen

A

Extrapulmonary = non lung organs, divided into 4 regions = sup and inf (ant, mid, post)

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6
Q

Describe superior mediastinum

A

Sup = Rib 1 - thoracic inlet
Inf = sternal angle, rib 2, t4/5

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7
Q

Describe inferior mediastinum

A

Sup = sternal angle, rib 2, t4/5
Inf = diaphragm
ANTERIOR, MIDDLE AND POSTERIOR MEDIASTINUM

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8
Q

Describe what is in middle mediastinum

A

Heart
Roots of great vessels
Nv
Respiratory system

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9
Q

Describe heart in middle mediastinum

A

2 serous and 1 fibrous pericardial coverings

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10
Q

Describe roots of great vessels in middle mediastinum

A

Aorta and pulmonary trunk (t junction)= away and towards heart
Arteries= right and left pulmonary arteries, biggest in body, 4 pulmonary veins
Svc = head, neck and upper limbs
Ivc = abdomen and below and lower ribs

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11
Q

Describe neurovasculature in middle mediastinum

A

INSIDE pericardium = for heart, coronary circulation and cardiac plexus
OUTSIDE pericardium =phrenic nerves and pericardiophrenic arteries and veins

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12
Q

Describe respiratory system in middle mediastinum

A

Left and right primary bronchi

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13
Q

What is heart enveloped by

A

Continuous double layer of serous membrane= pericardium

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14
Q

Describe pericardiums - gen

A

serous pericardium, encloses potential space = pericardial cavity
Has additional outer membrane = fibrous pericardium (tough ct layer, outside pericardial membrane)

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15
Q

Name all the layers of pericardium from superficial to deep

A

Fibrous pericaridum
Serous parietal pericardium
Serous visceral pericardium

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16
Q

Describe fibrous pericardium

A

Outermost
Dense ct
Anchored to roots of great vessels (pulm trunk), diaphragm and thoracic wall (sternum)
Covered in pericardial fat (above diaphragm=bottom of pericardium)

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17
Q

Describe serous pericardium - parietal layer

A

Adhered to fibrous pericardium
Deep surface- if flip = inner surface of fibrous
Hard to separate

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18
Q

Describe serous pericardium - visceral layer

A

Innermost
Shrink wraps heart
Nv visible within
Variable amounts epicardial fat - deep to serous pericardium, upon heart

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19
Q

What is pericardial cavity

A

Potential space between layers of serous pericardium

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20
Q

Are the visceral and parietal pericardium’s continuous

A

Visceral reflects and becomes continuous with parietal at where pulmonary trunk meets heart wall

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21
Q

Describe function of pericardial cavity and fibrous pericardium

A

Pericardial cavity normally contains few ml serous fluid = ease gliding of beating heart against surrounding tissues
Tough fibrous pericardium = restricts expansion of heart to help direct blood out vessels, rigid wall so when expands = helps direct blood away from heart

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22
Q

What is pericardial effusion

A

Build up of excess fluid in pericardial cavity between serous layers
May be slow = allows fibrous pericardium to stretch in response

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23
Q

What is cardiac tamponade

A

Large or rapid pericardial effusion = causes heart to accelerate to maintain volume of blood pumped despise diminishing pericardial space
Heart may stop beating - since less blood pumping = hr increase so much that heart will stop beating (decreasing space, so less blood pumped)

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24
Q

What is intervention to treat cardiac tamponade

A

Pericardiocentesis = syringe and drain space

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25
Describe external presentation of heart
2 pumps = right and left Each divided into 2 chambers = atrium and ventricle
26
Describe heart in ANATomical position
Heart rotated around longitudinal axis towards left and its inferior end (apex) tilted towards left and anterior
27
Describe chambers of heart and their visibilities from ant and post
Ant = see mostly right ventricle - in situ view Post = see mainly left atrium and ventricle
28
Describe grooves - sulci
Muscular walls of 4 chambers of heart create sulci = shallow grooves on external surface with coronary circulation (vasculature-paired arteries and veins) And variable fat within
29
Name the sulci of heart
Atrioventricular sulcus Interventricular sulcus
30
Describe atrioventricular sulcus
Ring around heart between atria and ventricles = separates them Transverse plane
31
Describe interventricular sulcus
Anterior = seen in anatomical position Posterior = flips to posterior view Between left and right ventricles, ant to post (sup to inf and back superiorly)
32
Describe heart - conceptual overview
Muscular organ divided into right and left pumps (Normally do not communicate in adults) Each pump divided into 2 communicating chambers = atrium collects blood and ventricle discharges blood
33
Describe the 2 circuits of blood circulation
They have different roles in circulation of blood throughout body Right pump = moves blood from heart to lungs for gas exchange = pulmonary circulation, short and nearby Left pump = moves blood from heart to all tissues of body = systemic circulation (includes heart and bronchial circulation)
34
Describe cardiac blood flow = 1
Venous deoxygenated blood from systemic circulation collects into right atrium from ivc, svc, coronary sinus or directly (anterior cardiac veins) and passes into right ventricle (through valve)
35
Describe cardiac blood flow = 2
Deoxygenated blood then pumped from right ventricle —> pulmonary trunk/arteries and into pulmonary circulation (to lungs)= now oxygenated blood
36
Describe cardiac blood flow = 3
Oxygenated blood from pulmonary circulation collects in left atrium from pulmonary veins and passes into left ventricle (through valve)
37
Describe cardiac blood flow = 4
Oxygenated blood pumped from left ventricle —> pumped into systemic circulation through aorta and all its branches (to periphery)
38
Describe where right atrium collects blood from
From systemic circulation via Svc = head, neck and upper limbs Ivc = everything below heart Coronary sinus = locally around heart
39
Which vessels/things that drain into right atrium have valves
Svc = no valve since gravity helps Have valves to prevent back flow (passive, flaps shut in response to tendency of blood —> bc gravity to flow back)
40
Describe posterior atrial wall of right atrium
Where vessels enter = smooth
41
Describe anterior/lateral atrial wall of right atrium
Contains parallel folds of pectinate muscles, extending into right auricle = helps expand atrial volume while minimizing atrial wall stress - to accept more of that blood coming from system
42
Describe how blood passes into right ventricle
Via right av valve = tricuspid
43
What are auricles
Left and right = blinds sacs at the end of atria = allows more blood to be collected there
44
What is crista terminalis
Crest at transition between smooth wall and pectinate muscle
45
Where is fossa ovalis
In smooth wall between the 2 atria =depression called fossa ovalis
46
Describe in utero - fossa ovalis
In utero = fetal lungs and pulmonary circulation are offline, bc gas exchange occurs through placenta —> prenatal circulation includes a system of shunts that allows pulmonary circulation to be bypassed
47
What is foramen ovale
Opening in wall between atria = allows oxygenated blood from ivc to bypass right ventricle and go into left atrium instead
48
What happens to foramen ovale after birth
Shortly after birth = seals over and leaves impression in atrial wall = fossa ovalis (seals, heals over due to blood pressure differences) In 25-30% of people = foramen ovale fails to close = leads to patent foramen ovale (depends on size, can lead to oxygen insufficiency so Need surgical intervention)
49
Describe fetal circulation with respect to foramen ovale
Oxygenated blood comes back up from navel and umbilical vein —> ivc of developing embryo Bit of oxygenated and deoxygenated mis Then allows blood to be shunted from right to left atrium = bypass pulmonary trunk
50
Describe right ventricle
Deoxygenated blood enters right ventricle through right av valve
51
Describe right av valve
Has 3 cusps, linked by chordae tendinae —> 3 sets papillary muscles 3x cusps (ant, post, septal), sets of chordae, sets of papillary muscles (Cusps —> chordae —> papillary muscles)
52
What is the purpose of papillary muscles and chordae tendinae
Hold onto cusps and prevent them from prolapsing into right atrium during ventricular contraction = systole So blood wont flow back from ventricle to aorta Prevent prolapse into atria during systole (ventricular systole)
53
What are trabeculae carnae
Assists ventricualr walls Meaty struts Pumps deoxygenated blood out the pulmonary valve (right semilunar) into pulmonary trunk Also helps prevent walls from sticking to each other
54
Describe left atrium
Pulmonary veins enter here
55
Describe left auricle
With less pectinate muscle - smaller than right
56
Describe left av valve
Bicuspid, mitral valve Only 2 sets of cusps/chordae/papillary muscles = anterior and posterior
57
Describe left ventricular wall
Aortic valve, left semilunar to aorta Wall much thicker = left needs to send blood with enough pressure to reach tips of the toes - strong pump
58
Where is ligamentus arteriosum
At level of sternal angle
59
What is ductus arteriosus
Second shunt to bypass pulmonary circulation = shunts blood from pulmonary trunk to aorta All the blood hat does make it into pulmonary trunk does not go to pulmonary arteries = bypasses
60
Describe what happens after birth to ductus arteriosus
First few months postnatal life = both shunts regress/disappear = ductus arteriosus —> ligamentum arteriosum
61
Name the 2 developmental remnants we can see in adult heart
Fossa ovalis Ligamentum arteriosum
62
Name the 2 phases of cardiac cycle
Ventricular diastole Ventricular systole
63
Describe ventricular diastole - gen
Longer phase Both ventricles relax and expand in volume and bring in blood from atria Blood refills both chambers
64
Describe ventricular systole - gen
Shorter phase Both ventricles contract Blood pumped out of them
65
Describe valves during ventricular diastole
Open av = blood flows into ventricles from atria, chordae tendinae not active Closed semilunar = no blood flows back into ventricles (since ventricles, just pumped blood out)
66
Describe valves during ventricular systole
Open semilunar= blood flows into pulmonary trunk/aorta Closed av = prevent back flow into atria
67
Describe what heart auscultation is
Listening to sound of valves closing Valves snap shut = make audible sound that can be heart by placing stethoscope in right place = auscultation
68
Describe LUB sound
Closing of mitral and tricuspid valves Louder sound Snapping of av valves = shut in response to forceful contraction of ventricles (systole)- ventricular pressure spikes, short, powerful phase
69
Describe DUB sound
Closing of aortic and pulmonary semilunar valves Shorter
70
Describe heart auscultation - parasternal lines
Where we can place stethoscope and heart sounds Landmarks Heard to hear since bone in the way so place where we can hear echo Parasternal and midcalvicular lines
71
Where to hear left semilunar - aortic valve
Right 2nd intercostal space at parasternal line
72
Where to hear right semilunar - pulmonary valve
Left second intercostal space at parasternal line
73
Where to heart right av valve
Left fifth intercostal space at parasternal line
74
Where to heart left av valve
Left fifth intercostal space at midclavicular line
75
Describe coronary arteries and openings
Heart needs own blood supply Right and left coronary arteries, first 2 branches of aorta Openings located in sinuses created by aortic valve cusps (2 openings into coronary arteries)
76
When do coronary arteries fill with blood
Aortic valve sinuses and coronary arteries fill with blood when aortic valve shut = during ventricular diastole - semilunar must be shut for blood to get into coronary arteries Offset compared to systemic blood (cardiac cycle)
77
Describe right coronary artery
Emerges at anterior/right base of aorta (tip of auricle), runs to the right av sulcus, around posterior surface (loops to)
78
Name branches of right coronary artery
Sinoatrial nodal artery Right marginal artery Posterior interventricular artery
79
Describe sinoatrial nodal artery - branch of right coronary
Runs under auricle of right atrium, loops around svc, supplies sinoatrial node and right atrium (Sinoatrial node = pacemaker of heart)
80
Describe right marginal artery - branch of right coronary
Runs towards apex on right border (margin) of heart, supplies most of right ventricle
81
Describe posterior interventricular artery - branch of right coronary
Piva On posterior surface, runs towards apex in posterior av sulcus, supplies posterior ventricles, and posterior 1/3 of interventricular septum (big, muscle wall)
82
Describe left coronary artery
Emerges at posterior/left base of aorta, runs to the left, posterior to (behind) pulmonary trunk
83
Name the 2 main branches of left coronary artery
Anterior interventricular artery Circumflex artery (—> left marginal artery)
84
Describe anterior interventricular artery - left coronary artery
Aiva Runs towards apex in anterior interventricular sulcus, supplied anterior ventricles and anterior 2/3 of interventricular septum
85
Describe circumflex artery - left coronary artery
Runs under auricle of left atrium = runs around to posterior side in av sulcus - coronary, onto posterior surface Supplies left atrium via left marginal artery = branch of circumflex, runs towards apex on left borders (margin or heart, supplies most of left ventricle)
86
Name and describe the 2 important anastomoses of coronary arteries
Arterial connections, alternatives, continuous alternate connections = for blood, make sure muscle receives enough blood to function properly Between end of right coronary and circumflex Between piva and aiva
87
Describe venous drainage of heart
Cardiac veins = heart drained by network cardiac veins -paired with coronary arteries and branches, usually in sulci Most join coronary sinus before going into right atrium
88
Describe coronary sinus
Swelling in av sulcus that collects venous blood from great, middle and small cardiac veins, opens into right atrium near ivc
89
Name the 4 cardiac veins
Great cardiac vein Middle cardiac vein Small Cardiac vein Anterior cardiac veins
90
Describe great cardiac vein
Biggest Runs with aiva - parallel then circumflex in left post av sulcus Onto posterior heart —> into coronary sinus, drains anterior ventricles and left atrium
91
Describe middle cardaic vein
Runs with piva in post interventricular sulcus Into coronary sinus directly Drains posterior interventricular septum
92
Describe small cardiac vein
Runs with right marginal then right coronary In av sulcus Onto posterior heart Into coronary sinus Drains right atrium and ventricle
93
Describe anterior cardiac veins
Runs with local branches right coronary a Very small Opens DIRECTLY into right atrium = not coronary sinus Drains ant right ventricle
94
Describe how the cardiac veins drain
Ant cardiac veins = right atrium Great, middle and small cardiac veins = coronary sinus then right atrium
95
Describe innervation of heart and pericardium = sympathetic
Fibers arise from spinal cord levels t1-t4 and the cervical ganglia in neck as sympathetic cardiac nerves = cause hr to increase
96
Describe innervation of heart and pericardium = parasympathetic
Fibers come from vagus nerves as cardiac branches —>cause hr to decrease
97
Describe cardiac plexus
Sns and pans Fibers mesh to form a cardiac plexus Providing branches to conduction system of heart, coronary vasculature and myocardium (heart muscle wall)
98
Name the 4 components of the hearts conduction system
Sa node Av node Av bundle Purkinje Fibers
99
Describe sa node - conduction
Group of cells near base svc Sends signal to another node via internodal branches
100
Describe av node - conduction
Near coronary sinus opening Sits between atria and gives big bundle
101
Describe av bundle - conduction
Runs down av septum = gives 2 branches = right and left bundle branch Need both to be beating at same time so both ventricles contract at same time = systole
102
Describe purkinje fibres - conduction
Branch to trabeculae carnae and myocardial walls
103
Describe septomarginal (moderator band) - conduction
Bridge across inferior right ventricle for better conductance to right anterior papillary muscles (from interventricular wall to papillary) Shortcut so signal coming from right bundle branch can jump across to synchronize action of papillary muscle on right side, so can properly function during systole and hold on to chordae to keep the av valve closed
104
Describe clinical consideration - pacemaker
Sa node = Natural pacemaker of heart Can have artificial pacemaker = pulls electrical current that sits where av or sa node normally is = Stabilized hr
105
Can we see nodes and bundles of conduction system
Nodes and bundles not visible = in walls of myocardium

ANAT 214 (34 decks)

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