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STRUCTURES - WEEK 3 > LEC 22: Heart I (Gross Anatomy) - 09.03.14 > Flashcards

LEC 22: Heart I (Gross Anatomy) - 09.03.14 Flashcards

1
Q

Structure of Pericardium

A

2 sacs

  • Outer, fibrous sac (fibrous pericardium)
  • Inner, serous sac (serous pericardium)
    • Parietal layer
    • Visceral layer (touches heart)
  • Pericardial cavity is the parietal and visceral layers

NB: visceral = epicardium

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2
Q

What are the 3 layers of the wall of the heart

A

A. Endocardium

B. Myocardium (cardiac muscle)

C. Epicardium

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3
Q

sulcus, sulci

A

Latin, “furrow”

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4
Q

What are the anterior sulci of the heart, and what do they mark

A
  1. Anterior Coronary Sulcus
    * Right Atrium vs. Right Ventricle
  2. Anterior Interventricular Sulcus
    * Right Ventricle vs. Left Ventricle

Adipose tissue marks the location of sulci on surface of heart

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5
Q

What are the posterior sulci of the heart, and what do they mark

A
  1. Posterior Coronary Sulcus

Left Atrium vs. Left Ventricle

  1. Posterior Interventricular Sulcus

Right Ventricle vs. Left Ventricle

Adipose tissue marks the location of sulci on surface of heart

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6
Q

What is embedded in the adipose tissue of the sulci

A
  • Coronary arteries
    • supply myocardium with oxygen
    • occlusion results in heart attack
  • Cardiac veins
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7
Q

What is the Right Major Coronary Artery and its branches

A

RIGHT CORONARY ARTERY

  • Sinuatrial nodal branch (supplies SA node)
  • Posterior interventricular branch (PDA)***
  • Atrioventricular nodal artery (supplies AV node)
  • Marginal branch

“SPAM” on the Right Coronary Artery

NB: Posterior Interventricular Artery = Posterior Descending Artery (PDA); supply from RCA or LCA determines dominance

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8
Q

PDA

A

Posterior descending artery = posterior interventricular artery

Artery that gives rise to PDA determines coronary dominance

  • either RCA
  • or Circumflex Branch of LCA
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9
Q

What is the Left Major Coronary Artery and its branches

A

LEFT CORONARY ARTERY

  • Anterior interventricular branch
    • LAD = Left Anterior Descending Artery
    • “Widow maker”
  • Circumflex branch

“AC” on the Left Coronary Artery

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10
Q

Left Anterior Descending (LAD)

A

Anterior Interventricular Branch of Left Coronary Artery

“Widow maker”

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11
Q

What does the Right Coronary Artery Supply

A
  1. Right Atrium
  2. Right Ventricle
  3. Posterior part of Left Ventricle
  4. Posterior part of Interventricular Sulcus (IVS)
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12
Q

What does the Left Coronary Artery Supply

A
  1. Left Atrium
  2. Left Ventricle
  3. Variable amount of Right Ventricle
  4. Most of the Interventricular Sulcus (IVS)
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13
Q

Right Coronary Artery (RCA) Dominance

aka: Right Dominant Coronary Artery

A

RCA gives rise to Posterior Interventricular Artery (PDA)

  • 70% of people
  • most common

NB: Posterior Interventricular Artery = Posterior Descending Artery (PDA)

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14
Q

Left Coronary Artery (LCA) Dominance

aka: Left Dominant Coronary Artery

A

Circumflex branch of LCA gives rise to Posterior Interventricular Artery (PDA)

  • 15% of people

NB: Posterior Interventricular Artery = Posterior Descending Artery (PDA)

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15
Q

Function of cardiac veins

A
  • remove metaoblic products from the myocardium
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16
Q

Function of coronary arteries

A
  • supply myocardium with oxygen
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17
Q

What are the (6) cardiac veins of the heart

A
  • coronary sinus (biggest)
    • in posterior coronary sulcus
  • great cardiac vein
    • in anterior interventricular sulcus
  • middle cardiac vein
    • in posterior interventricular sulcus
  • small cardiac vein
  • anterior cardiac veins (go directly into right atrium)
  • venae cordis minimae (go into all four chambers)
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18
Q

Arteries give off…

A

…arterioles then capillaries

  • not all arteries end in capillaries
  • some arteries or their branches unite with one another to form anastomoses
  • arterial anastomoses form basis for collateral circulation
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19
Q

Examples of arteries with anastomoses

A
  1. posterior intercostal arteries anastomose with anterior intercostal arteries
  2. superior epigastric arteries anastomose with inferior epigastric arteries
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20
Q

end-arteries

A
  • vessels with no anastomoses
  • occlusion of an end-artery results in necrosis of the tissue supplied by the occluded vessel

e.g. Central Artery of the Retina (if occluded, blindness occurs)

21
Q

functional end-arteries

(physiologic end-arteries)

A

branches of the coronary artery are called functional end-arteries

  • they anastomose to some extent, but frequently insufficient to provide adequate collateral circulation
  • not true end-arteries in terms of anatomy
  • end-arteries in terms of physiology
22
Q

coronary occlusion

A
  • myocardial infarct (necrosis of the myocardium)
  • heart attack
23
Q

coronary insufficiency

A
  • myocardial ischemia
  • angina pectoris (cardiac pain; chest pain)
24
Q

Three (3) most common locations of coronary occlusion

A
  1. Right coronary artery (RCA)
  2. Circumflex branch (LCA)
  3. Anterior interventricular branch (LAD) of LCA
    * “Widow maker”
25
Q

Cardiac pain

A
  • referred pain in which pain stimuli originating in heart are perceived by a person as pain arising from T1-T5 dermatones
26
Q

Four (4) functions of the heart

A
  1. a muscular pump
  2. an electrical organ
  3. an endocrine gland
  4. has its own blood supply
27
Q

Thickness of the heart wall

A

Thickness of heart wall = related to workload of heart chambers

Left Ventricle = operates under high pressure, thickest

Right Ventricle = moderate thickness

Atria = thinnest

28
Q

What are the (3) layers of the heart wall

A
  1. Epicardium
  2. Myocardium (cardiac muscle)
  3. Endocardium
29
Q

Epicardium of heart (where sulcus are covered by adipose tissue)

A
  • covered by mesothelium
  • fat cells
  • fibroelastic tissue
  • coronary vessels
  • lymphatics
  • nerves
30
Q

Endocardium (Thicker on the atrium)

A
31
Q

Subendothelial tissue

A
  • Connective Tissue with collagen, elastic fibers, fibroblasts
  • few smooth muscle cells
  • in some areas the ventricle is subendocardium
32
Q

myocardium

A
  • cardiac muscle cells (aka: cardiac myoctes or cardiocytes)
  • contractile cells
  • myoendocrine cells (atrial myocytes, found only in atrium)
  • conducting cells
    • nodal cells
    • bundle branches
    • Purkinje fibers
33
Q

Which way do cardiac muscle fibers in the myocardium run

A

cardiac muscle fibers in the myocardium run in different directions, spirally around ventricles/atria

34
Q

perimysium

A
  • cardiac myocytes are separated by perimysium into bundles/fasicles of various sizes and different orientations
    • reflects spiral arrangements around ventricle
  • contraction leads to twisting and squeezing of the ventricle to expel blood out of ventricle
35
Q

What are the 4 key features of cardiac myocytes

(longitudinal section)

A
  1. branching
  2. central nuclei
  3. striations
  4. intercalated discs (ICD)
36
Q

Cardiac myocytes

(transverse section)

A
  • ~5 capillaries around each cell
  • space is NOT artifact, this is connective tissue space
37
Q

Life-span of cardiac myocytes

A
  • cardiac myocytes are long-lived cells
  • accumulate lipofuscin pigment in old age (yellow-brown, wear and tear pigment)
  • cardiac myocytes cannot regenerate
38
Q

Role of intercalated discs in cardiac myocytes

A
  • specialized intercellular junctions
  • join myocardiocytes together
    • desmossomes (holds together)
    • fascia adherens
    • gap junctions (transmit contractile function, site of electrical impulses)
39
Q

Extracellular Matrix of the Heart

A
  • basal lamina form weave surrounding cardiocytes
  • elastic fiber bundles wrap around cardiocytes
  • collagen fibrils insert onto basal lamina
  • collagen fiber bundles form collagen struts between neighboring cardiocytes
40
Q

atrial myocytes vs. ventricular myocytes

A

Atrial myocytes

  • smaller in size
  • fewer “transverse tubules
  • have granules (contain hormones)

Ventricle myocytes

41
Q

Endocrine function of the heart

A
  • heart is endocrine organ
  • atrial myocytes synthesize atrial natriuretic peptide (ANP) peptide hormone
  • store ANP in granules
  • in response to atrial wall stretch, ANP secreted by exocytosis (blood circulation)
  • ANP blocks sodium reabsorption in renal tubules
    • promotes sodium excretion –> urine excretion
42
Q

Conduction system of heart

A
  • cardiac muscle cells (NOT nervous tissue)
  • specialized for:
    • initiating the normal heart beat
    • conducting the impulses rapidly through heart
    • coordinates the contraction of the 4 heart chambers
43
Q

What are the 4 elements of the cardiac electrical conduction system

A
  1. Sinuatrial node (SA node)
    * pacemaker
  2. Atrioventricular node (AV node)
  3. Atrioventricular bundle (Bundle of His)
  • Right bundle branch
  • Left bundle branch
  1. Purkinje fibers
    * in subendocardium
44
Q

Where are the 4 elements of the cardiac electrical conduction system located.

A
  1. SA node = myocardium of Right Atrium
  2. AV node = lower end of interarterial septum
  3. Bundle of His = running along interventricular septum
  4. Purkinje fibers = in subendocardium of ventricles
45
Q

sulcus terminalis

A
  • groove in Right Atrium of heart
  • landmark for SA node
46
Q

Sinuatrial node (SA node)

A
  • modified atrial myocytes
  • smaller in size
  • fewer myofibrils
  • less organized striations
  • gap junctions and desmosomes
  • irregular meshwork
  • embedded in fibrous tissue
  • autonomic nerves and blood vessels
47
Q

Purkinje fibers

A
  • subendocardium location
  • larger in size
  • glycogen (doesn’t stain well)
  • fewer myofibrils
  • lack T-tubules
  • no typical intercalated discs
  • desmosomes
  • gap junctions
48
Q

Heart Valve

A
  • heart valves consist of fibroelastic tissue covered on both surfaces with endothelium
  • endothelium continuous with that of the lining of the heart chambers and great vessels
  • ventricular side, there is dense plate of collagneous tissue, called lamina fibrosa
  • atrial side, elastic fibers
  • no blood vessels are present in the valves

STRUCTURES - WEEK 3 (4 decks)

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