Flashcards in L04 Gross anatomy of heart Deck (75):
Components of cardiovascular system?
Heart, Vessels, Blood
Components of Circulatory system?
Cardiovascular + Lymphatic system
Location of Heart?
Apex at Mid-Clavicular line intersect 5th ICS
2/3 in left of chest in mediastinum, between lungs
Deep to 2nd to 5th ICS
Posterior to sternum
Anterior to vertebral column
5 surfaces of heart.
Base, Sternocostal anterior, diaphragmatic inferior, Left and right pulmonary surfaces
Left border of heart?
1cm from left edge of sternum at 2nd Left Costal Cartilage
Mid-clavicular line at left 5th ICS
Border is left ventricle
Right border of heart?
1cm from right edge of sternum at 3rd right Costal Cartilage
lcm from right edge of sternum at 6th Costal Cartilage
Border is Right Atrium
Name of 2 components of pericardium?
Serous and Fibrous
Definition of pericardium?
fibroserous sac enclosing heart and root of great vessels
Fibrous pericardium functions?
Outermost layer, attachment to adjacent organs and mediastinum, Prevents overfilling
Serous pericardium 2 components?
1) Parietal layer = serous layer = sticks to fibrous pericardium
2) Visceral layer= epicardium
Serous pericardium is a closed sac with pericardial cavity with pericardial fluid
Parietal and Visceral layers are continuous at reflection
Visceral pericardium. What are the 2 tubes and what what do they enclose?
2 tubes= Arterial tube and Venous tube
Arterial tube encloses pulmonary trunk and ascending aorta
Venous tube encloses 4 pulmonary veins, superior and inferior vena cava
2 tubes of pericardium forms 2 sinuses. What are the names?
Transverse and Oblique pericardial sinus
Transverse pericardial sinus location?
Posterior to ascending aorta and pulmonary trunk
Anterior to Superior vena cava and pulmonary veins
Seperates Venous and Arterial Tubes
Ligature can be placed to contrict aorta and pulmonary trunk during surgery
Oblique pericardial sinus location?
Blind ended sac enclosed by J shaped sheath of visceral pericardium
Bound on right by inferior vena cava and right pulmonary vein
Bound on left by left pulmonary veins
3 layers of heart?
Endocardium , Myocardium, Epicardium
What makes up the three layers of the heart?
Endocardium: endothelial cells
Myocardium: thickest, muscles
Epicardium: same as visceral pericardium, connective tissue and coronary arteries
Which chambers make up which surfaces of the heart?
Sternocostal anterior: Right Ventricle
Diaphragmatic inferior: Left and Right Ventricles
Posterior Base: Left Atrium
Left Pulmonary: Lft Ventricle
Right pulmonary: Right Atrium
4 borders of heart (not surfaces)?
Left border= Left Ventricle
Right border= Right atrium (in line with SVC and IVC)
Superior border= L & R superior, great vessels
Inferior border= Left and Right Ventricles
What seperates the two ventricles? Two atria?
Interventricular and interatrial septum
What feature contains coronary arteries on the surface of the heart?
Shallow grooves called SULCI
What are the two sulci names? What do they separate?
Coronary sulci- separate atria and ventricles
Interventricular sulci- separate ventricles
Coronary sulcus is not continuous on which surface?
anterior- interrupted by pulmonary trunk
Interventricular sulcus exists of which surfaces?
Anterior and posterior
What are the structural differences between atria and ventricles?
Thinner walls, smaller, less muscular, interatrial septum, has Auricle
Atria ventricle separation by? Internal and External
Internal = atrio-ventricular orifice
External= coronary sulcus
Name 5 great vessels and routing.
Inferior Vena Cava: body to RA
Superior Vena Cava: Head and Neck to RA
Aorta: LV to body
Pulmonary trunk: RV to lungs
Pulmonary vein: lungs to LA
Link which structures?
Landmark for which nerve?
Origin= ductus arteriosum
Links Arta and Pulmonary trunk
Landmark for Left Recurrent Laryngeal nerve, branch of Left Vagus nerve. LRL nerve splits and loops around aortic arch behind ligamentum arteriosum, then ascend into larynx
What feature is in interatrial septum?
What is it a remnant of?
How can it defect?
Remnant of foramen ovale in fetal heart that bypasses the fetal lung
Atrial Septal Defect (ASD)
Seperated by crista terminalis into which two parts?
What are these parts derived from?
Atrium proper- from primitive atrium
Sinus Venarum- from sinus venosus
Location of Atrium Proper? Sinus Venarum?
Which has rough walls with pectinate muscles?
Atrium proper is anterior to crista terminalis
Sinus Venarum is posterior to crista terminalis
Atrium Proper has rough walls
Sinus Venarum of RA receives blood from?
Inferior and Superior Vena Cava
Location of Sinoatrial Node? Atrioventricular Node?
Lateral aspect of Superior Cavoatrial Junction
Right side of interatrial septum at junction of atria and ventricles
What is found in right ventricles that give shortcut to conducting fibres to anterior cardiac muscles?
Carries right AV bundle
What is the rough, irregular bands of muscles found in both ventricles? Function?
Interconnecting muscle ridges, trap blood, eliminate negative pressure and prevent collapse
What hold the atrio-ventricular valves from prolapsing/ eversion?
Valves- Chordae Tendineae- Papillary Muscles- Ventricle
What are the three papillary muscles attached to tricuspid valve?
Posterior, septal, anterior
What lines the two ventricles upper surface?
Smooth surfaces, lined by:
Right- Conus arteriosus
Left- Aortic Vestibule
Left and Right AV Valve names:
Left- Mitral/ bicuspid
Does septomarginal trabecula exist in both ventricle?
no. only in RV
Which part of Interventricular septum is common place for VSD?
Superior membranous part
Does both Atria have pectinate muscles lining anterior surface?
Does crista terminales exist in both Atria?
No. Only in RA
What are the two parts of LA, derived from embryonically?
Anterior part from embryonic atrium
Posterior part from Pulmonary veins
Left Ventricle is how much thicker and how much stronger?
2 to 3 times thicker
4 to 6 times more force
Right Ventricle to Pulmonary trunk valves?
Semi-lunar valves/ pulmonary valves
Left Ventricle to Aorta valves?
Semilunar Valve/ Aortic V.
Which ventricle has narrower lumen?
Left- smaller conical shape lumen compared to Right crescent shape
All valves but mitral vales have how many cusps?
Main function of heart valves?
Prevent blood regurgitation
2 types of valve defect? Name? What causes what?
Stenosis- behavioral cause e.g. diet
insufficiency- congenital causes
Stenosis means? Insufficiency means?
Stenosis= valves become hardened and narrow, cannot fully open, forces blood back up adjacent chamber
Insufficiency= Valves unable to close completely, allows blood to leak back previous chamber
Valve opening and closing caused by ?
Pressure diff. between chambers and great vessels
Mitral Regurgitation is caused by?
Mitral valve prolapse and flail leaflet
SA node has what ability?
Begins AP without external stimulus, pacemaker potential
where is impulse delayed at?
AV Node at right side of interatrial septum by the atria-ventricular junction
What fibres in interventricular septum?
AV bundle/ Bundle of His
What fibres in myocardium?
What 4 rings? What links the rings? What is the ligament? What part of septum ?
4 rings: Aortic, pulmonary, left, right
Membranous part of interventricular septum
4 functions of cardiac skeleton?
Electrical insulation between atria and ventricles (only allow AV bundle through)
Anchors heart valve cusps
Attachment of cardiac muscles
Prevent valve overdistending
Myocardium muscle arrangement?
Spiral, for twisting motion during contraction. No muscle continues from Atria to ventricles
Where are coronary arteries located?
Right CA runs in Posterior interventricular sulcus
Left CA runs in Anterior interventricular sulcus
Coronary Heart disease (CHD).
Common cause of Myocardia infarction?
Atherosclerotic plaque build up and block functional end arteries (CA).
Do Coronary Veins run with Coronary Arteries?
How do CV drain?
Collect blood via coronary sinus to Right Atrium
Where are the openings for the L/R Coronary Arteries?
Left CA: In Left Aortic sinus
Right CA: In Right Aortic Sinus
3 branches of right CA?
3 branches of left CA?
Right CA- Sinoatrial nodal artery, Right marginal branch, posterior interventricular branch
Left CA- Circumflex Artery, Left Marginal Artery, Anterior interventricular descending artery (LAD)
4 structures supplied each by L/R CA?
Left CA: LA, LV, AV bundle, anterior 1/3 interventricular septum
Right CA: RA, RV,SA & AV nodes, Posterior 2/3 interventricular septum
Those that drain into Coronary Sinus:
Name and route?
Great Cardiac Vein, run from apex along LAD along anterior interventricular sulcus
Small cardiac vein, runs from right CA and Marginal Artery
Posterior cardiac vein, runs with left marginal artery
Middle cardiac vein, run from apex along right posterior descending artery along posterior interventricular sulcus
CV that does not drain into Coronary Sinus?
Anterior Cardiac Vein
Smallest Cardiac Vein
Both bypass sinus to directly enter RA
Size compared to AV Valves?
Catch regurgitating blood, use blood pressure to snap shut
First Heart Sound produced by?
Second H. S. made by?
First: Closing of AV valves at beginning of ventricular systole
Second: Closing of Semilunar Valves at the end of ventricular systole, beginning of diastole
2 heart sounds loudest where?
1st HS loudest at Apex (S1)
2nd HS loudest at Erb's Point (S2)/ Base
5 areas for auscultation?
Aortic Valve: 2nd right ICS
Pulmonary Valve: 2nd Left ICS
Tricuspid Valve: 4th or 5th ICS
Bicuspid Valve: Apex of heart, 5th ICS intersect MCL
Erb's point: 3rd Left ICS
Sympathetic and Parasympathetic innervation location?
At Cardiac Plexus at base of heart
Sympathetic derived from T1-T4/T5 Sympathetic trunk
Parasympathetic derived from Vagus nerve