What is Pericardiocentesis?
- drainage of blood, fluid, or pus from pericardial sac
- usually done to relieve cardiac tamponade
What is Pericardial Effusion?
- inflammation of the pericardium results in accumulation of fluid/pus in pericardial sac = compressed heart
- compressed heart = Cardiac Tamponade
What is Pericarditis?
- inflammation of the pericardium = make pericardium rough and produces friction
- friction = Pericardial Friction Rub (can be observed with stethoscope; untreated can lead to calcification)
What is the surgical significance of the Transverse Pericardial Sinus?
- space allows cardiac surgeons to access area posterior to aorta and pulmonary trunk
- lets them clamp heart or insert tubes of a bypass machine into these large vessels
What is Cardiac Referred Pain?
- ischemia stims visceral pain sensory fibers in heart of Autonomic Nervous system, which share spinal ganglion with somatic sensory fibers of UE and chest wall
- pain seen in areas innervated by Left Medial Brachial Cutaneous (left chest and arm)
Atrial Fibrillation vs Ventricular Fibrillation
AF: irregular twitching of Atrial cardiac muscle fibers to which ventricles respond at irregular intervals
- circulation remains satisfactory
VF: rapid irregular twitching of ventricles rendering Heart unable to pump blood
- use electrical shock (Defibrillation) to stop all heart movements in attempt to correct problem
Artificial Cardiac Pacemaker
- produces regular electrical impulse that is carried to Ventricles by electrodes inserted through large vein to Superior Vena Cava, into Right Atrium past Tricuspid Valve into Endocardium of Trabecula Carnae of Right Ventricle
Cardiac Catheterization
- insertion of catheter into femoral vein which is passed up to Inferior Vena Cava
- allows radiographic visualization of Right Atrium, Right Ventricle, and Pulmonary trunk/arteries
Atrial Septal Defects
- typically incomplete closure of Foramen Ovale
- large opening in Interatrial Septum can be clinically significant as they allow mixture of oxygen rich and oxygen depleted blood
Ligamentum Arteriosum
- adult remnant of Ductus Arteriosus which shunted blood from Pulmonary Trunk to Aorta to bypass nonfunctional lungs in embryo
- Left Recurrent Laryngeal N. of Vagus N. loops around Aortic Arch and Ligamentum Arteriosum, then ascends to Larynx
Angina Pectoris
- pain originating in heart, producing a strangling pain of the chest
- usually result of narrow or obstructed coronary arteries that produces ischemia of myocardium
Myocardial Infarction and Coronary Atherosclerosis
- lack of blood flow to specific area of myocardium, usually Coronary A. blockage
CA: buildup of lipids on internal walls of Coronary arteries decreases size of lumen of that vessel
- inc. likelihood of embolus or plug blocking off vessel
Mediastinum and the Sternal Angle
- Sternal Angle divides Superior and Inferior Mediastinum
- Posterior Mediastinum
- Anterior Mediastinum (in front of heart)
- Middle Mediastinum (heart)
- Posterior Mediastinum (posterior to the heart)
Epicardium, Myocardium, Endocardium
Epicardium: outermost layer, Visceral Serous Pericardium
Myocardium: thick layer; spiraling, overlapping cardiac muscle layers
Endocardium: thin internal endothelial/subendothelial layer lining inside chambers of Heart and valves
4 functions of Fibrous Skeleton of the Heart
- Attachment points for Myocardium
- Attachment points for vales of cuspid valves
- support/strengthen Atrioventricular/Semilunar orifices
- electrically insulated barrier between Atria/Ventricles
3 surfaces of the Heart (SDP)
- Sternocostal: Right Ventricle
- Diaphragmatic: Right and Left Ventricle
- Pulmonary: Paired; Right Atrium and Left Ventricle
- occupy Cardiac Impression on both lungs
What are the 4 borders of the heart?
- Right (Right Atrium)
- Inferior (Right Ventricle)
- Left (Left Ventricle)
- Superior (Right and Left Atria, exit for outflow tracts)
What are the smooth and rough walls of the Right Atrium called?
Smooth = Sinus Venarum
Rough = Pectinate Muscle
Crista Terminalis and Interatrial Septum of Right Atrium
CT: internal ridge separating rough and smooth regions
IS: wall between two atria
- Fossa Ovalis (remnant of Foramen Ovalis)
Tricuspid Valve, Chordae Tendinae, and Papillary Ms.
- separates Right Atrium and Right Ventricle
- Cordae Tendinae attach cusps to papillary muscles
- Anterior Cusp –> Anterior Papillary M.
- Posterior Cusp –> Posterior Papillary M.
- Septal Cusp –> Septal Papillary M.
What are the smooth and rough walls of the Right Ventricle called?
Smooth = Conus Arteriosus
Rough = Trabecula Carnae
What is the Septomarginal Trabeculum and what does it do?
- Moderator Band
- Interventricular Septum to Base of Anterior Papillary M.
- transmits right bundle branch of AV Bundle to Anterior Papillary M.
Pulmonary Valve (Semilunar Valve)
- Right, Left, Anterior Cusps
- Pulmonary Sinuses: spaces between wall of Pulmonary Trunk and Cusps of Pulmonary Valve
Bicuspid Valve
- separates Left Atrium from Left Ventricle
- Cordae Tendineae
- Anterior Papillary M. –> Anterior Cusp
- Posterior Papillary M. –> Posterior Cusp
What are the smooth and rough walls of the Left Ventricle called?
Smooth = Aortic Vestibule
Rough = Trabecula Carnae
Aortic Valve (Semilunar Valve)
- Right, Left, and Posterior Cusps
- separates Left Ventricle from Ascending Aorta; occupies Aortic Orifice
- Aortic Sinuses: space between wall of Ascending Aorta and Cusps of Aortic Valve (house openings for Right and Left Coronary Arteries)