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Anatomy (MPAS) > Lecture 15: Anatomy of the Great Vessels > Flashcards

Lecture 15: Anatomy of the Great Vessels Flashcards

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1
Q

Parts of the mediastinum

A

Superior

Inferior (middle, posterior, anterior)

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2
Q

Borders of the mediastinum

A

Top: Neck, arm

Left: left lung

Right: right lung

Bottom: Abdomen

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3
Q

Heart orientation and surfaces

A

Ressembles a pyramid that has fallen over

Base (posterior)

Anterior surface

Left pulmonary surface

Diaphragmatic surface (inferior)

Right pulmonary surface

See figure

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4
Q

What is most visible on the anterior side of the heart? Posterior?

A

Anterior: right ventricle

Posterior base: left atrium, part of right atrium

Inferior: left ventricle and part of right ventricle

See figure

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5
Q

What are the great vessels?

A

Aorta: aortic arch, ascending aorta, descending aorta

Pulmonary trunk: right pulmonary artery, left pulmonary artery

Pulmonary veins: two veins from each lung

Vena cavae: Superior vena cava (SVC) and inferior vena cava (IVC)

See figures

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6
Q

What is the ligamentum arteriosum?

A

Shunts blood from pulmonary artery to aortic arch

See figure

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7
Q

Where does the heart connect to the lungs?

A

At the hilum of each lung

1 pulmonary artery enters each lung

2 pulmonary veins leave the lung

See figure

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8
Q

Layers of the pericardium

A

Superficial fibrous pericardium

Two layer serous pericardium

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9
Q

Two layers of the serous pericardium

A

Parietal layer: attached to fibrous pericardium

Visceral layer (epicardium): lines the surface of the heart

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10
Q

What do the serous pericardium layers form? What fluid do they contain?

A

the pericardial cavity

Contains a thin fluid film (serous fluid)

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11
Q

Role of serous fluid

A

Allows heart to move inside pericardium without friction

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12
Q

What is the pericardial sac attached to inferiorly?

A

The diaphragm

Moves with respiration

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13
Q

How are the pericardial sinuses formed?

A

Lines of reflection between the visceral and parietal pericardium

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14
Q

Where is the transverse pericardial sinus?

A

Lies anterior to the superior vena cava and posterior to the ascending aorta and pulmonary trunk

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15
Q

Where is the oblique pericardial sinus?

A

Lies posterior to the heart in the pericardial sac

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16
Q

What are the four chambers of the heart?

A

Right atrium

Right ventricle

Left atrium

Left ventricle

See figures

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17
Q

What is the sinus venarum?

A

In the right atrium of the heart

The smooth, thin-walled posterior part of the atrium on which the SVC, the IVC and the coronary sinus open

Allows blood flow

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18
Q

What are the pectinate muscles?

A

A rough muscular wall of the right atrium

Present in the auricles and part of the atrial wall

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19
Q

What is the role of the right auricle?

A

Small muscular pouch that projects from the right atrium

Increases capacity of right atrium

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20
Q

What is the interatrial septum? What does it contain?

A

Separates the two atria

Has an oval depression called the oval fossa, which is a remnant of the oval foramen and its valve in the fetus

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21
Q

What is the conus arteriosus?

A

The superior tapered portion of the right ventricle

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22
Q

What are the trabeculae carnae?

A

Right ventricle

Irregular muscle elevations

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23
Q

What is the supra ventricular crest?

A

A thick muscular ridge

Separates the ridged muscular wall of the inflow part of the chamber from the smooth wall of the conus arteriosus (outflow part)

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24
Q

What are the different parts of the papillary muscles in the right atrium?

A

Anterior

Posterior

Septal

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25
Where do the chordae tendinae attach?
Papillary muscles
26
What is the role of the papillary muscles and the chordae tendinae?
The papillary muscles begin to contract before the contraction of the ventricles, which tightens the cords and draws the cusps together This prevents the cusps from collapsing as blood is pumped into the semilunar valves
27
What is the septomarginal trabeculae? Function?
Aka Moderator band Right ventricle Curved muscular band that runs from the inferior IV septum to the base of the anterior papillary muscle Carries part of the right bundle branches of the AV bundle of the conducting system to the anterior papillary muscle Facilitates conduction time and allows coordinated contraction
28
What valves are in the right ventricle?
Tricuspid valve Pulmonary valve
29
How many cusps does the tricuspid valve have?
Three. Anterior, posterior and septal
30
How many cusps does the pulmonary valve have?
Three Anterior, right and left
31
Where is the bicuspid valve? How many cusps?
aka mitral Between the left atrium and the left ventricle 2 cusps
32
How many pulmonary veins enter the left atrium?
Four
33
Thickness of left ventricle vs right ventricle
Left ventricle is much thicker
34
How many papillary muscles are in the left ventricle?
Two: anterior and posterior
35
Trabeculae carnae of the left ventricle vs right ventricle
The left side are finer and more numerous than those in the right ventricle
36
General function of the atria
Receiving chambers of the heart
37
Where does blood enter the right atrium?
Deoxygenated blood enters from the superior and inferior vena cava and the coronary sinus
38
Where does blood enter the left atrium?
Oxygenated blood enters the left atrium from the pulmonary veins
39
General function of the ventricles
Discharge chambers
40
What marks the ventricular walls?
Papillary muscles and trabeculae carnae
41
What blood is pumped by the ventricles? Where is it pumped?
Right ventricle pumps deoxygenated blood into the pulmonary trunk Left ventricle pumps oxygenated blood into the aorta
42
What separates the ventricular volume from the atrial volume?
Atrioventricular valves (mitral and tricuspid)
43
What separates ventricular volume from the great vessels of the outflow tract?
Semilunar valves (aortic and pulmonary)
44
What do the valves of the heart ensure?
That blood flow in one direction
45
What are valves of the heart composed of?
Connective tissue and endocardium (inner layer of heart)
46
Where are the atrioventricular valves? What are their names?
Tricuspid and bicuspid (mitral) Located between the atria and ventricles Very tight when closed, don't let blood through
47
Where are the semilunar valves? What are their names?
Semilunar valves are between the ventricles and their corresponding artery Regulate blood flow leaving the heart Allow some regurgitation during ventricular contraction
48
What supports the AV valves?
The chordae tendinae (fibrous cords) Chordae tendinae are attached to papillary muscles (inferior surface of ventricles) Prevents prolapse of the valve leaflets into the atria See figure
49
Parts of the semilunar valves
Sinus: formed by the attachment of the sides of each valve leaflet to the wall of the outflow vessel Lunule: Thickening of the free superior edge of each leaflet Nodule: thickest part of valve leaflet See figure
50
Blood flow in the heart
Blood with low oxygen enters the right atrium from the superior and inferior vena cava It then flows into the right ventricle, where it is pumped through the pulmonary trunk to the lungs. Blood becomes oxygenated in the lungs and then flows into the left atrium. It then flows into the left ventricles and is pumped into the aorta
51
What is the cardiac cycle?
Period of time that begins with contraction of atria and ends with ventricular relaxation
52
What is systole? What is diastole
Period of contraction of the heart Period of relaxation when chambers fill with heart
53
Which parts of the heart undergo diastole and systole?
Both atria and ventricles
54
5 phases of cardiac cycle
See table and figure
55
Where does the heart get its own blood supply from?
The coronary arteries and veins *there is a substantial variation in the branching and the distribution of the coronary arteries See figures
56
What is the first branch of the ascending aorta?
Coronary arteries
57
Anterior coronary arteries
Right and left coronary arteries (RCA and LCA; in atrioventricular groove) Marginal artery (MA) Circumflex artery (CA) Anterior inter ventricular (AIA; left anterior descending/LAD)
58
Anterior coronary veins
Small cardiac (SCV) Anterior cardiac (ACV) Great cardiac (GCV)
59
Posterior coronary arteries
Right coronary artery (RCA) Posterior inter ventricular artery (PIA; found in inter ventricular groove)
60
Posterior coronary veins
Great cardiac vein (GVC) Posterior cardiac vein (PCV) Coronary sinus (CS) Middle cardiac vein (MCV)
61
What collects the majority of the venous blood?
Coronary sinus Opens into the right atrium
62
What do the coronary arteries connect to?
They are terminated, so they do not connect to other arteries, only connected to one another
63
What does the right coronary artery supply?
Right atrium Most of right ventricle Diaphragmatic surface of left ventricle Posterior 1/3 of IVS AV bundle SA node (in 60% of cases) AV node (in 80% of cases)
64
What does the left coronary artery supply?
Left atrium Most of the left ventricle Part of the right ventricle Anterior 2/3 of IVS AV bundle SA node (in 40% of cases)
65
What are the pacemakers of the heart?
SA node (60 bpm) AV node (40 bpm) His bundle (20 bpm)
66
Where is the His bundle located?
IV septum
67
Components of the conduction system of the heart
SA node Intraatrial bundles AV node AV bundle (bundle of His) Right and left bundle branches Septomarginal trabecular (moderator band) Purkinje fibers
68
What are the purkinje fibres?
Special conduction system to carry impulses to heart muscle Synchronize contractions
69
What are the components of the autonomic regulation of the heart?
Parasympathetics Sympathetics
70
Where do the parasympathetic innervations of the heart derive from? What do they travel with? Where of they enter?
Derive from brain stem Travel with vagus nerve Enter cardiac plexus
71
Where do the sympathetic innervations of the heart derive from? Where do they synapse? How do they reach the heart?
Originate from T2-T4 of spinal cord Synapse in cervical sympathetic ganglia Reach heart via cardiac plexus
72
What parts of the heart does sympathetic stimulation act on?
SA node AV node Ventricular myocardium
73
Effect of SNS on heart?
Increase HR Increase electrical conduction Increase excitability and contractility of ventricular myocardium
74
How do sympathetics act on the heart?
Neuronal control Hormonal: epinephrin and norepinephrine
75
What part of heart does PSNS act on?
SA node AV node No influence on ventricles
76
Effect of PSNS on heart?
Decreases HR Decreases electrical conduction and excitability
77
How to count the ribs?
Find the jugular notch Move down the sternum until ridge is felt (sternal angle between manubrium and body of sternum) Costal cartilage of rib II articulates here Identify rib II Continue counting the ribs, moving in a downward and lateral direction See figure
78
Where does the upper limit of the heart reach?
As high as the third costal cartilage on the right side of the sternum Second intercostal space on the left side of the sternum
79
Location of left margin of heart
Descends laterally from the second intercostal space to the apex located hear the midclavicular line in the 5th ICS
80
Location of the lower margin of the heart
Extends from the sternal end of the right 6th cartilage to the apex in the 5th ICS near the MCL
81
Where is the aortic valve area?
2nd right ICS, right sternal border See figure
82
Where is the mitral valve area?
5th ICS, left MCL
83
Where is the pulmonic valve area?
2nd left ICS, left sternal border
84
Where is the tricuspid valve area?
4th left ICS, left MCL
85
Where is the mitral valve area?
Apex of heart, 5th ICS, left MCL
86
Which valves are involved in high pressure systems? Low pressure?
High pressure: aortic, mitral Low pressure: pulmonary, tricuspid

Anatomy (MPAS) (22 decks)

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