L04 Gross anatomy of heart Flashcards by Max Kam

Components of cardiovascular system?

Heart, Vessels, Blood

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Components of Circulatory system?

Cardiovascular + Lymphatic system

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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

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5 surfaces of heart.

Base, Sternocostal anterior, diaphragmatic inferior, Left and right pulmonary surfaces

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Left border of heart?

1cm from left edge of sternum at 2nd Left Costal Cartilage

until

Mid-clavicular line at left 5th ICS

Border is left ventricle

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Right border of heart?

1cm from right edge of sternum at 3rd right Costal Cartilage

until

lcm from right edge of sternum at 6th Costal Cartilage

Border is Right Atrium

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Name of 2 components of pericardium?

Serous and Fibrous

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Definition of pericardium?

fibroserous sac enclosing heart and root of great vessels

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Fibrous pericardium functions?

Outermost layer, attachment to adjacent organs and mediastinum, Prevents overfilling

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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

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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

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2 tubes of pericardium forms 2 sinuses. What are the names?

Transverse and Oblique pericardial sinus

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Transverse pericardial sinus location?

Function?

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

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Oblique pericardial sinus location?

Function?

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

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3 layers of heart?

Endocardium , Myocardium, Epicardium

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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

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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

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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

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What seperates the two ventricles? Two atria?

Interventricular and interatrial septum

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What feature contains coronary arteries on the surface of the heart?

Shallow grooves called SULCI

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What are the two sulci names? What do they separate?

Coronary sulci- separate atria and ventricles

Interventricular sulci- separate ventricles

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Coronary sulcus is not continuous on which surface?

anterior- interrupted by pulmonary trunk

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Interventricular sulcus exists of which surfaces?

Anterior and posterior

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What are the structural differences between atria and ventricles?

Thinner walls, smaller, less muscular, interatrial septum, has Auricle

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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 ```

Ligamentum arteriosum. Embryonic origin? 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?

Fossa ovalis Remnant of foramen ovale in fetal heart that bypasses the fetal lung Atrial Septal Defect (ASD)

Right Atrium. Seperated by crista terminalis into which two parts? What are these parts derived from?

Atrium proper- from primitive atrium | Sinus Venarum- from sinus venosus

Right Atrium. 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 | Coronary sinus

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?

Septomarginal Trabecula | Carries right AV bundle

What is the rough, irregular bands of muscles found in both ventricles? Function?

Trabeculae Carneae | 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 | Right- Tricuspid

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?

Yes

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?

Purkinje fibre

Cardiac skeleton. | What 4 rings? What links the rings? What is the ligament? What part of septum ?

4 rings: Aortic, pulmonary, left, right L/R trigones Conus tendon 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?

Coronary sulcus 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?

Yes

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

Cardiac Veins. Those that drain into Coronary Sinus: Name and route?

ANTERIOR SURFACE: Great Cardiac Vein, run from apex along LAD along anterior interventricular sulcus Small cardiac vein, runs from right CA and Marginal Artery POSTERIOR SURFACE 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

``` Semilunar valves: Size compared to AV Valves? Chordae Tendineae? Cusps shape? Function? ```

Smaller No CT Cup Shape 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

Symp. and Parasym. functions?

Sympathetic- increase HR, BP, Force, Speed, dilate CA | Parasymps: Decrease HR, BR, F, Speed, constrict CA

L04 Gross anatomy of heart Flashcards

(75 cards)