Flashcards in Heart and Pericardium Deck (35):
What are the three layers of the pericardium
Fibrous, Parietal (Serous), Visceral (Serous)
Is the pericardium continuous with the great vessels and if so what is the structure called?
The fibrous pericardium is as the tunica adventita
Sources of innervation to the pericardium and which parts each innervates
Phrenic nerves (fibrous and parietal pericardium, sense pain), Fibers from Sympathetic Trunks (muscle and vessels)
Arterial supplies to the pericardium and where each comes from
Pericardiophrenic and Musculophrenic arteries (from Internal Thoracic Artery), Coronary Arteries (from Aorta), Bronchial, Esophageal, and Superior Phrenic Arteries (from Descending Aorta)
What are pericarditis, pericardial effusion, and cardiac tamponade respectively?
Inflammation of pericardium, excess fluid in pericardium, and squeezing (excess pressure on) heart
Where is the bare area of pericardium?
Between the xiphoid process and left costal margin
List the great vessels in order from inferiormost to superiormost
Pulmonary veins, Pulmonary Arteries, Arch of Aorta, Superiormost portion of Superior Vena Cava (where brachiocephalic veins meet)
What is the intersection of the pulmonary arteries called?
The pulmonary trunk
What connects the pulmonary trunk to the arch of the aorta
Which artery is known as the widowmaker and why?
The Left Anterior Descending (LAD, aka Anterior IV Artery), because stenosis is common and serious here
Name the coronary arteries and the branches of each
Left Coronary Artery (Anterior IV artery or LAD, Circumflex branch), Right Coronary Artery (Right Marginal Branch, Posterior IV artery)
What empties into the coronary sinus?
Venous blood from the great, middle, and small cardiac veins
What are the two pericardial sinuses?
The transverse and oblique pericardial sinuses
Describe the locations of the two pericardial sinuses
The transverse is just inferior to the pulmonary trunk and just superior to pulmonary veins. The oblique is medial and posterior to pulmonary veins (behind the left atrium)
List the structures behind the pericardium moving posteriorly
Lungs, descending aorta, esophagus
A muscular ridge separating smooth right atrium from rough right atrium
Give the internal features of the right atrium from anterior to posterior
Musculi pectinati (on anterior wall), Cristi terminalis, Smooth Right Atrium, Fossa Ovalis (on interatrial septum)
What three major vessels drain into the right atrium?
Superior Vena Cava, Inferior Vena Cava, Coronary Sinus
What does blood flow out of the RV through?
The conus arteriosus (infundibulum) through pulmonary valve into pulmonary arteries
What large muscular structure in the RV is not present in the LV and what is it?
The septomarginal band. It is the largest of the trabeculae carnae (bridgelike network of cardiac muscle) which runs from IV septum to anterior papillary muscles and carries much of right bundle branch
What do the papillary muscles do and what are the names of the papillary muscles in each ventricle?
Hold AV valves closed tight during ventricle contraction, Anterior, Posterior and Septal in RV, and Anterior, Posterior in LV
What attaches papillary muscles to the cusps of the valves
Chordae Tendinae (heartstrings)
What are the four heart valves and what junction does each guard?
Tricuspid valve (Right AV), Pulmonary (Right Ventricle to Pulmonary Trunk), Mitral (Left AV), Aortic (Left Ventricle to Aorta)
What are the cusps of the aortic valve called and which one is unique from the other two?
Left, Right, and Posterior. The sinus of the posterior does not associate with a coronary artery
What are the parts of the IV septum and which is thinner and smaller?
Membranous (thinner and smaller upper part) and Muscular (lower part)
What are the three cusps of the pulmonary valve?
Left, Right, Anterior
What are the sinuses of valsalva and what is their significance?
Dilated areas behind the cusps of the aortic valve. The left and right sinuses of valsalva give rise to the LCA and RCA
What are the four functions of the fibrous skeleton of the heart?
Prevent overdistention of valve orafices, Attachment for valve cusps, Attachment for myocardial fibers, Electrical insulator
Major parts of the conducting system of the heart in order of conduction
SA node, AV node, AV bundle of His (in membranous IV septum), Right and Left Bundle Branches (at intersection of membranous and muscular IV septum)
Give the intercostal space where each heart valve should be auscultated
Aortic (2nd RICS), Pulmonic (2nd LICS), Tricuspid (4th LICS), Mitral (5th LICS)
Acronym for sites of heart valve auscultation
Why are heart valve sounds not auscultated directly on top of that valves location?
Because the sound travels with the blood flowing in that vessel
Give the presentation, significance, and two causes of heart murmurs
Longer duration than heart sounds, clinical significance varies widely, and caused by stenosis (obstruction) or regurgitation (valve fails to close)
Where do afferent neurons from the heart enter the spinal cord?
From T1 through T4 or T5 (hence the referral of cardiac pain to dermatones of those areas)