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Flashcards in Heart Structures Deck (135)
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1
Q

pericardium is made up of two parts:

A

fibrous and serous pericardium

2
Q

serous pericardium has two anatomical regions:

A

visceral serous pericardium on the heart itself and parietal serous pericardium which forms the inner surface of the wall of the pericardial sac.

3
Q

fibrous pericardium is tough, indistensible outer portion of the pericardium that fuses with the .. of the great arteries and veins …. cm above the heart

A

adventitia, 2-4

4
Q

serous pericardium is a … sac that covers the heart as the visceral layer or the … and on the inner surface of the fibrous pericardium as the … layer.

A

closed, epicardium, parietal

5
Q

outer surface of the fibrous pericardium …with the fibrous portions of the diaphragm inferiorly. With each contraction of the diaphragm, the heart is pulled ….

A

fuses, inferiorly

6
Q

pericardial cavity is a space normally filled with … ml of lubricating fluid.

A

15-50 or ~20

7
Q

pericardial fluid is though to be produced by the … and is essentially an ultrafiltrate of plasma.

A

visceral pericardium

8
Q

transverse pericardial sinus is a …. between the right and left sides of the ….cavity.

A

passageway, pericardial

9
Q

oblique pericardial sinus is a blind …. dorsal to the ….atrium formed by pericardial reflections surrounding the pulmonary veins and superior and inferior vena cava

A

pocket, left

10
Q

oblique pericardial sinus is the most ….portion of the pericardial sac laying supine.

A

dependent (lowest)

11
Q

cardiac tamponade

A

compression of the heart due to rapid accumulation of fluid in the pericardial sac.

12
Q

Indications of cardiac tamponade

A

jugular venous distention, distant heart sounds, hypotension with dyspnea

13
Q

The internal jugular and brachiocephalic veins have …. but the external jugular does not.

A

valves

14
Q

pain often worsens in pericarditis when …

A

laying down

15
Q

pericardial friction rub

A

highly specific for acute pericarditis

16
Q

most of the blood to and from the pericardium comes through the …

A

pericardiophrenic artery and vein

17
Q

innervation of the pericardium is via the

A

phrenic nerve (C3,4,5)

18
Q

male hearts pump …gm and women …. gm

A

325, 275

19
Q

S2 dub sound is produced by …

A

closing of aortic and pulmonary valves

20
Q

S1 lub sound is produced by…

A

closing of the AV valave

21
Q

base of the heart is ….

A

posterior aspect formed by left atrium along with a narrow portion of right atrium

22
Q

apex of the heart is…

A

blunt descending projection formed by left ventricle

23
Q

diaphragmatic surface of the heart is..

A

formed largely by left ventricle along with narrow portion of right ventricle

24
Q

sternocostal surface of the heart..

A

composed largely of right atrium and right ventricles along with narrow portion of left ventricle

25
Q

obtuse margin or left margin of the heart

A

formed by left ventricle and a little bit of left auricle

26
Q

acute margin of the heart or inferior border

A

narrowed inferior boreder where sternocostal and diaphragmatic surfaces meet and is formed largely by right ventricle

27
Q

right margin formed by…

A

superior vena cava and right atrium

28
Q

coronary sulcus separates

A

atria from ventricles

29
Q

fibrous skeleton of the heart…

A

surrounds heart valves

30
Q

fibrous skeleton has clinical significance only if it becomes …meaning…

A

stretched; heart valves failed

31
Q

right atrium volume

A

75-80 ml

32
Q

walls are …in right atrium than left

A

thicker

33
Q

sinus venarum is in … and is a smooth region derived from incorporation of …of sinus venosus.

A

right atrium; right horn

34
Q

auricle more common name; corresponds to primitive…of embryonic heart and contains… muscles

A

R. atrial appendage; atrium; pectinate

35
Q

pectinate muscles

A

ridges of myocardium; only in atria

36
Q

crista terminalis is the junction of …vs…of the sinus venarum; superior end marks the location of…

A

pectinate muscles vs smooth interior; SA node

37
Q

fossa ovalis marks the site of the embryonic …through which blood passes from right atrium to left after birth.

A

foramen ovale

38
Q

opening of coronary sinus

A

site of venous blood return that has passed through the cardiac muscle

39
Q

valve of inferior vena cava: in embryonic heart, it directs blood from …through … into ….

A

inferior vena cava through foramen ovale and into left atrium

40
Q

superior vena cava is a large superior opening in the … that brings …oxygenated blood from the head and upper limbs

A

sinus venarum that brings poorly oxygenated blood from the head and upper limbs

41
Q

inferior vena cava is a large inferior opening in the … that brings …oxygenated blood from the …and …

A

sinus venarum that brings poorly oxygenated blood from the abdomen and lower limb

42
Q

right AV orifice is the site of blood flow out of the …atrium and into the …ventricle

A

right, right

43
Q

right ventricle has a wall that is … think and holds …ml

A

4-8mm; 120ml

44
Q

cusps of the tricuspid valve

A

anterior, posterior and septal cusps of the AV valve

45
Q

trabeculae carneae are …muscular elevations on the …

A

irregular; inner wall of the ventricle

46
Q

papillary muscles are … ,…and … in right ventricle

A

anterior (largest), posterior (smaller) and septal (smallest)

47
Q

chordae tendineae

A

fibrous strands connecting papillary muscles to cusps of AV valves

48
Q

septomarginal trabecula aka…

A

moderator band

49
Q

conus arteriosus aka…is a smooth-walled …tract to the pulmonary trunk and is separated from ventricle by …

A

infundibulum; outflow; supraventricular crest

50
Q

pulmonary valve allows blood to exit…

A

right ventricle and into pulmonary trucnk past the 3 semilunar cusps

51
Q

left atrium holds … ml and is the …chamber…..to esophagus

A

55-65; posterior; anterior

52
Q

pulmonary veins have …right and …left… and they carry ….blood to left atrium.

A

2,2,oxygenated

53
Q

smooth-walled part is derived from incorporation of ….veins

A

pulmonary

54
Q

fossa ovale

A

a slight depression in the interatrial wall

55
Q

rough-walled part

A

derived from embryonic atrium and contains pectinate muscles

56
Q

left atrial appendage or auricle is often …in patients with A-fib due to clots

A

closed

57
Q

AV orifice is where

A

blood exits into the left ventricle through the mitral valve

58
Q

left ventricle holds …. ml

A

125

59
Q

wall of left ventricle is …to…times thicker than right

A

2-3

60
Q

mitral valve cusps have … and … cusps of the AV valve

A

anterior and posterior

61
Q

trabeculae carneae are

A

irregular muscular elevations on the inner wall of the ventricle

62
Q

papillary muscles

A

only anterior and posterior

63
Q

chordae tendineae

A

fibrous strands connecting papillary muscles to each cusp of the mitral valve

64
Q

aortic valve allows blood to exit …ventricle past the …semilunar cusps of the aortic valve leading to the ….

A

left; 3; ascending aorta

65
Q

function of papillary muscles and chordae tendineae attached to the AV valve cusps is to …

A

contract during ventricular systole and prevent blood from regurgitating back into the atrial chambers.

66
Q

papillary muscles may occasionally…which is due to…

A

rupture; heart attack complication

67
Q

if one of the papillary muscles in the left ventricle ruptures, then the …. becomes incompetent and cardiac output is diminished thus fluid accumulates in the lung necessitating sleeping on … due to pulmonary edema.

A

mitral valve; multiple pillows

68
Q

What causes left ventricular hypertrophy?

A

chronic hypertension and aortic valve stenosis

69
Q

….can cause blood regurgitation

A

aortic valve insufficiency

70
Q

tricuspid valve contains…

A

anterior, posterior and septal cusps

71
Q

tricuspid valve allows…

A

blood to flow from right atrium to right ventricle during diastole

72
Q

tricuspid valve closes at the…

A

beginning of systole which is the S1 sound

73
Q

mitral valve contains…

A

anterior and posterior cusps

74
Q

mitral valve prolapse is when the valve …into the left atrium when left ventricle contracts.

A

everts

75
Q

pulmonary valve has …,…and,,, cusps and sinuses. part of …sound

A

right, left, anterior semilunar; S2

76
Q

aortic valve has…, … and …semilunar cusps and sinuses

A

right, left and posterior

77
Q

right and left coronary arteries open into ….and ….aortic sinuses

A

right and left

78
Q

aorta ends up slightly ….and has a …cusp

A

posterior

79
Q

pulmonary trunk ends up …and has an …cusp

A

anterior

80
Q

Both aortic and pulmonic valves have …and … cusps

A

left and right

81
Q

First sounds (…) coincides with the closure of the…. valve at the start of systole.

A

S1 (lub); AV

82
Q

second sound (…) is produced by the closure of the … and …. valves at the end of systole.

A

S2 (dub); aortic and pulmonary

83
Q

blood flow into the coronary arteries is greatest during…

A

diastole

84
Q

the blood flow into coronary arteries optimizes blood flow when cardiac tissue is…

A

most capable of receiving blood

85
Q

aortic sinus is the ….space above each valve cusp.

A

blood filled

86
Q

most common congenital heart anomaly

A

bicuspid aortic valve

87
Q

bicuspid valve is more likely to cause ….than a normal tricuspid aortic valve.

A

aortic valve stenosis

88
Q

stenosis of the aortic valve often causes …which long term can cause …..

A

excessive turbulence; ascending aortic aneurysmal

89
Q

right coronary artery’s origin

A

right aortic sinus

90
Q

blood distribution from right coronary artery?

A

right atrium, SA and AV node, posterior portion of IV septum

91
Q

artery to sinoatrial node’s origin

A

right coronary artery

92
Q

distribution of blood from artery to sinoatrial node?

A

SA node and pulmonary trunk

93
Q

right marginal (acute marginal artery) origin

A

right coronary artery

94
Q

right marginal or acute marginal artery’s distribution of blood?

A

right ventricle and apex

95
Q

posterior intervetnricular or posterior descending artery origin

A

right coronary artery

96
Q

poster interventricular artery’s distribution of blood?

A

right and left ventricles and IV septum

97
Q

AV node origin

A

right coronary artery 80% of the time

98
Q

AV node distribution of blood

A

AV node

99
Q

left coronary artery origin

A

left aortic sinus

100
Q

left coronary artery distribution of blood

A

left atrium and ventricle, IV septum, AV bundle and AV node (20% of the time)

101
Q

artery to SA node (40% of pop) origin

A

left coronary artery

102
Q

Artery to SA node’s distribution of blood?

A

SA node and left atrium

103
Q

anterior interventricular artery origin

A

left coronary artery

104
Q

anterior interventricular artery distribution of blood

A

right and left ventricles and IV septum

105
Q

LAD or lateral diagonal branch origin

A

off LAD

106
Q

LAD distribution of blood

A

left ventricle on the anterior surface

107
Q

circumflex artery origin

A

left coronary artery

108
Q

circumflex distribution of blood?

A

left atrium and ventricle

109
Q

left marginal or obtuse marginal origin

A

left circumflex

110
Q

left marginal distribution of blood

A

left border of left ventricle

111
Q

right coronary artery supplies

A

right atrium, most of right ventricle, diaphragmatic surface of left ventricle, posterior 1/3 of AV septum, SA node in 60% of people and AV node in 80% of people.

112
Q

left coronary artery supplies

A

left atrium, most of left ventricle, anterior 2/3 of AV septum, SA node in 40% of people and AV node in 20% of people.

113
Q

variations in arterial supply is all about which coronary artery supplies blood to the ….

A

posterior interventricular artery

114
Q

right dominant distribution is…

A

70% of people and most common. It is posterior interventricular artery arising from the right coronary artery

115
Q

left dominant distribution is…

A

10% of people and is present when circumflex branch of left coronary gives off the posterior interventricular artery

116
Q

balanced distribution is…

A

20% of people and occurs when both right and left coronary arteries supply the posterior interventricular artery.

117
Q

most common sites of blockage in coronary arteries

A

left anterior descending, base of right coronary, left circumflex branch

118
Q

in coronary artery bypass surgery the distal end of the … artery is attached to the existing coronary artery …to the blockage.

A

internal thoracic or mammary; distal (down stream)

119
Q

often the initial artery used is not long enough so they take …artery from the arm and the …. vein from the leg.

A

radial, great saphenous

120
Q

most of the blood passed through the coronary arteries and then the myocardium returns to the venous circulatory system at the right atrium through either the …. or by a pair of small …..

A

coronary sinus (most blood); anterior cardiac veins

121
Q

most of the blood from coronary circulation returns to … through either the …. or by a small pair of anterior cardiac veins.

A

right atrium; coronary sinus

122
Q

coronary sinus is a direction continuation of the ….vein. It lies in … part of coronary sulcus and opens into ….; it receives all cardiac veins except the ..and ….

A

great cardiac vein; posterior; right atrium; anterior cardiac veins; smallest cardiac veins

123
Q

great cardiac vein lies beside ….artery.

A

anterior interventricular

124
Q

middle cardiac vein lies alongside ….artery.

A

posterior interventricular

125
Q

SA node lies in the …. at the superior end of the … near the superior vena cava.

A

right atrial wall; sulcus terminalis

126
Q

SA node possesses inherent rhythmicity, but rate of contraction increases when directly stimulated by … nerves and decreases when stimulated by … nerves.

A

sympathetic cardiac nerves; parasympathetic cardiac nerves

127
Q

pacemakers can be a substitute of …

A

SA, AV or atrioventricular bundle

128
Q

when putting in a cardiac pacemaker, typically the … vein is catheterized which leads to the ….vein which drains into the …vein which drains into the superior vena cava and thus into the …

A

cephalic, subclavian, brachiocephalic, right atrium

129
Q

sympathetic innervation are the sensory input of …

A

pain from ischemic heart conditions

130
Q

which nerve innervates the heart

A

vagus

131
Q

sympathetic nerves that innervate the heart have their cell bodies in sympathetic chain ganglia from … to …

A

C4-T5

132
Q

afferent innervation to the heart returns to the CNS with sympathetic nerves accounts for referred pain from heart to upper thoracic wall and medial side of ….; pain may also be referred to … or …. because of hearts early development in cardiogenic and neck regions.

A

left upper extremity; neck or right upper extremity

133
Q

first sign of heart attack in males and females

A

chest

134
Q

second sign in females which is different in males

A

nausea, light headedness and unusually tired

135
Q

visceral afferent run with … nerves not the vagus (parasympathetic) nerves

A

sympathetic