lec 11

Question 1

what is the pericardium?`

Answer 1

1. double-walled fibrous sac that encloses the heart and the roots of the great vessels

Question 2

paricardium

1. occupies what
2. functions to and protects heart from what

Answer 2

1. most of the middle mediastinum
2. to maintain the position of the heart
3. overfiling

Question 3

what are the different parts of the pericardium?

Answer 3

1. fibrous and serous layer

Question 4

fibrous layer?

Answer 4

1. a tough fibrous layer closed by attachment to the great vessels
2. it blends w/ the central tendon of the diaphragm

Question 5

serous layer?

what layers are there?

Answer 5

1. a smooth inner sac w/ lubricated surfaces that allow movement
2. pariental and visceral

Question 6

what is the parietal and visceral layer, and potential space?

Answer 6

1. lines the inner surface of the fibrous pericardium
2. covers the entire surface of the heart
3. b/w the parental and visceral layers of serous pericardium is the pericardial cavity

Question 7

pericarditis

Answer 7

1. inflammation of pericardium

2. causes substernal pain and produces pericardial effusion

Question 8

cardiac tamponade

Answer 8

1. effusion that impairs cardiac filling, resulting in circulatory failure
2. treatment is by pericardiocentesis

Question 9

heart: external structure
1. described as what 3 things
2. what are the 4 surfaces
3. the base is located where and formed by what

Answer 9

1. apex, base, 4 surfaces
2. sternocostal, diaphragmatic, left pulmonary and right pulmonary
3. posteriorly and formed by left atrium

Question 10

what should we remember about the heart?

Answer 10

1. it doesn’t rest on its base

Question 11

what is the blood flow

Answer 11

1. superior vena cava or inferior vena cava
2. right atrium
3. right ventricle
4. pulmonary artery

a. pulmonary vein
b. left atrium
c. left ventricle
d. aorta

Question 12

atria:
the right atrium 
1. receives venous blood from where (3)
2. coronary sinus: returns what from the heart to the right atrium and lies where
3. auricle: is what

Answer 12

1. superior vena cava, inferior vena cava, coronary sinus
2. blood, posterior part of the coronary groove
3. blind pocket and overlying the ascending aorta

Question 13

interatrial septum

1. fossa ovalis is an oval depression where and the site of what in the fetus

Answer 13

1. where the septum is thin

2. foramen ovale

Question 14

an atrial septal defect allows what

Answer 14

1. allow blood shunt from l to r of the heart

Question 15

atria:
the left atrium
1. forms most of the what
2. receives the openings of 4 what from the lungs
3. left auricle forms what
4. clinical condition: what form on the walls of the left atrium in certain types of heart disease

Answer 15

1. heart
2. pulmonary vein
3. superior part off the left border of the heart
4. thrombi

Question 16

ventricles

1. common structure
   a. irregular bundles of muscle projecting on the inner surface
   b. atrioventricular valves are
   c. semilunar valves: aortic and pulmonary

Answer 16

a. trabeculae carnae
b. right av valve: tricuspid valve
c. bicuspid(mitral) valve

Question 17

right ventricle
1. forms most of the anterior surface and almost all

2. right atrioventricular (tricuspid) valve
   a. what is cusps
   b. what are papillary muscles
   c. what do PM do prior to and during contraction of right ventricle
   d. as the ventricular size decrease, the contraction of papillary muscles attached to the AV valve cusps by chordae tendineae
   e. chordae tendinase

Answer 17

1. inferior border
   2a. fibrous cusps are attached to the annulus fibrosis

b. conical proj into cavity;
c. papillary muscles contract
d. prevent the cusps from prolapsing into the right atrium
e. small tendinous bands that connect the valve cusps to the papillary muscles

Question 18

what are the pulmonary valve and what is the clinical condition

Answer 18

1. 3 semilunar cusps

2. pulmonary valve stenosis

Question 19

Interventricular septum

1. position corresponds to what
2. membranous part
3. muscular part
4. the membranous part is the site of most common congenital heart defect

Answer 19

1. interventricular groove on the surface
2. thin upper part near the atrium
3. thick, major part
4. ventricular septal defect (vsd)

Question 20

left ventricle
1. wall thickness is what and why

2. left atrioventricular are 2 large sets of what attached to cusps through chordae tendineae
3. the mitral valve is most frequently
4. aortic valve are what and located where

Answer 20

1. 2-3 time thicker b/c it contracts against greater resistance than the rv
2. papillary muscles
3. dseased
4. 3 semilunar cusps; right posterosuperior part of the LV

Question 21

area of maximum audibility fotr the pulmonary, aortic, mitral, tricuspid valve,

Answer 21

1. left 2nd intercostal space
2. right 2nd intercostal space
3. apex (5th intercostal space near the mid-clavicular line)
4. lower left sternal border

Question 22

blood supply
1. right cornary artery orginate from where runs in where to the back of the heart where it gives off the posterior intraventricular artery which anastomeses w. what of the left coronary artery

Answer 22

1. right aortic sinus
2. coronary sulcus
3. anterior interventricular artery

Question 23

right cornary artery :

1. branches to what(3)
2. sinuatrial nodal artery- most common site of origin
3. right marginal branch: runs towards the apex of the what
4. in 85% of cases the what supplies the AV node

Answer 23

1. right atrium, right ventricle, interventricular septum
2. t
3. heart
4. right coronary

Question 24

left coronary artery

1. arises from the left of what
2. gives off the what (2)
3. supplies the LV, LA, interventricular septum and some RV

Answer 24

1. left aortic sinus
2. circumflex branch and anterior interventricular artery
3. t

Question 25

venous drainage 1. anterior cardiac veins drain directly into 2. what is coronary sinus 3. what does CS receive and what are they

Answer 25

1. right atrium 2. receives most of the heart veins, runs posterior of the coronary groove and ends in the right atrium 3. great cardiac vein: main tributary of the coronary sinus; travels w/ the anterior intraventricular artery travels w/ the posterior intraventricular artery travels w/ the marginal branch of the right coronary

Question 26

clinical condition 1. although the coronary arrteries anastomose w. each other @ the arteriolar level and are what 2. a sudden block leads to what of the cardiac muscle(myocardial infarction) 3. results in slow narrowing of the lumen of these arteries 4. a clinical syndrome characterized by substernal discomfort resulttign in 5. common surgical treatment for severe coronary arteriosclerosis

Answer 26

1. functional end arteries 2. neurosis 3. coronary arteriosclerosis: 4. angina pectoris 5. coronary artery bypass graft (CABG)

Question 27

nerve supply 1. autonomic and sensory fibers from what(2) 2. sympathetic supply arises from the what(2) 3. postganglionic sympathetic fibers terminate on the 4. stimulation of the sympathetic nerves increases

Answer 27

1. vagus nerve and sympathetic trunk 2. cervical and upper thoracic 3. SA and AV nodes and coronary arteries 4. the heart rate and contractility

Question 28

referred cardiac pain 1 . usually to where(3) 2. mediated by 3. afferents enter what ref=sulting in pain referred to this dermatomes

Answer 28

1. left shoulder, medial side of left arm 2. afferent nerves in cardiac branches of sympathetic trunk 3. t1-t4

Question 29

the conducting sys consists of specialized muscle fiber and conducting fibers that are not

Answer 29

nervius tissue

Question 30

conducting sys conducts impulses that connect the pacemaker region of the heart with what

Answer 30

cardic muscle fiber

Question 31

which contract first? atria or ventricles

Answer 31

atria

Question 32

Sinotriall node(SA) 1. natural pacemaker of the heart 2. location 3. the impulse for contraction begins @ and is conducted throughout where arriving where

Answer 32

1. t 2. junction of the superior vena cava and right atrium 3. SA node; atria by ordibary atrial myocardial fiber; AV node

Question 33

the Atrioventricular node(AV) | 1. location

Answer 33

1. above the opening of the coronary sinus in the atrial septum

Question 34

atriocentricular bundle: 1. passes from the ___ 2. divides into R and L bundles branches that carry the depolarization to the apices 3. from there, the rest of the ventricular myocardium is what by continued branching of the conduction bundles known as

Answer 34

1. av node 2. right and left ventricles 3. depolarized, purkinje fibers

Question 35

clinical considerations 1. artificial pacemakers: 2. passage of impulses over the heart can be amplified tr recorded as what

Answer 35

1. used to correct arrhythmia, abnormalities in cardiac conduction rhythms 2. electrocardiogram: ecg or ekg