Module 2: Cardiac Situs and the Segmental Approach Flashcards
(47 cards)
1
Q
what are segments
A
- the anatomical structures which the cardiovascular system is divided for purpose go evaluation which include the systemic and pulmonary veins, antra, ventricle and great arteries
2
Q
what are connections
A
- decreases the anatomical sequence of structures
- venoatrial, atrial-ventricular, ventriclo-arterial
3
Q
what does concordant mean
A
- normal sequenctional relationship between the hearts chambers, valve,s and great vessels
4
Q
what does discordant mean
A
- refers to an abnormal sequential relationship between chambers, valves, and great vessel
5
Q
what is commitment
A
- describes degree of abnormality of flow through valves to ventricles and great vessels
- if more than 50% of a valve overrides a VSD
6
Q
what is ambiguous
A
- used when precise identification of a chamber can not be determined
7
Q
what are inlet/outlet anomalies
A
- anomalies of structure and flow into the ventricles or out fo the ventricles
8
Q
what is the segmental approach to CHD
A
- systemic approach to defining and charcterizing CHDs
9
Q
what are the 3 steps to the segmental approach
A
- visceral atrial situs + atrial connections
- orientation of the ventricles + connections
- orientation of the great vessels + connections
10
Q
what does visceral atrial situs refer to
A
- position of the atria in relation to the nearby anatomy
11
Q
what are the three 3 steps to determining visceral atrial situs
A
- identify which way apex is pointing
- identify atria
- relate to surrounding structures
12
Q
what are the 3 different cardiac situs
A
- situs solitus
- situs inversus
- situs ambiguous
13
Q
what is situs solitus
A
- morphologic RA is on the right of morphologic LA
14
Q
what is situs inversus
A
- morphologic RA is to the left of the morphologic LA
15
Q
what is situs ambiguous
A
confident assignment of morphologic left and right atria cannot be made
16
Q
what does morphologic mean
A
- has morphologic features of that chamber
17
Q
what does functional mean
A
- functional as a different chamber
- LA is functioning as RA due to transposition
18
Q
what is cardiac position and what are the types
A
- heart position within chest
- right (dextroposition)
- midline (mesopositon)
- left (levoposition)
19
Q
what is dextroposition
A
- most of the heart lies to the right of the sternum
20
Q
what is mesoposition
A
- the heart lies directly behind the sternum
21
Q
what is levoposition
A
- most of the heart lies to the left of the sternum (NORMAL)
22
Q
what is cardiac orientation and what are the three types
A
- apical positon
- right (dextrocardia)
- midline (mesocardia)
- left (levocardia)
23
Q
what is dextrocardia
A
- the apex points to the right side fo the body
24
Q
what is mesocardia
A
- apex lies under the sternum
25
what is levocardia
- apex point to the left (normal)
26
how do we determine dextrocardia
- start with transverse subcostal sweep
- atria and ventricles lie on the left side
- label chest sides
27
what is the correct term if all organs are mirrored dextro
- dextrocardia situs inversus totalis
28
what three disorders can patients with dextrocardia be prone to
- endocardial cushion defect
- pulmonary stenosis
- double outlet RV
29
what does isolated dextrocardia have increased risk of
- ling infection
- sinus infection
- pneumonia
30
what arrest eh signs and symptoms of dextrocardia
- breathing difficulties
- cyanosis
- fatigue
- failure to thrive in children
31
what vessels do we evaluate for the venous segment
- hepatic veins
- IVC
- SVC
- coronary sinus
- pulmonary veins
32
what vessels are interrogated in the vent-atrial connection
- systemic venous return = SVC, IVC
| - pulmonary venous return
33
what are the morphologic features of the RA
- eustachian valve
- venae cavae
- coronary sinus
- chiari network
- RA appendage
34
what are the morphologic features of the LA
- pulmonary veins
| - LA appendage
35
how can we tell if there is concordant connection between the atria and ventricle
- MV always associated with LV
- TV always associated with RV
- TV more apically attached to the IVS
36
what are the morphologic features of the RV
- crescent shape
- TV (3 leaflets)
- large apical trabeculations
- multiple small papillary muscles
- moderator band
- septal leaflet apically displaced
37
what are the morphologic LV
- bullet shapes
- MV (2 leaflets)
- two pap muscle
- fals tendons
- inlet and outlet valves in continuity
38
what is the crux
- where the atria and ventricles meet at the centre fo the hear
39
what are the different AV connections
- bi-ventricular = one atria connect to both ventricle
- uni-ventricular = both atria connect to one ventricle
- common = atria connect to both ventricles through a single multi leaflet structure
40
what can we tell if there is VA concordance
- AV and pV anatomically identical
- Look for fibrous continuity between AV and mV
- look for overriding vessels
41
what are the 3 main variations of normal VA connections
- transposed connection of the great arteries TGA
- double outlet connection
- single outlet connection
42
what is TGA
- main PA arises from the LV
| - aorta arises from the RV
43
what is double outlet connection
- both great arteries arise from a single ventricle almost always the RV
44
what is single outlet connection
- only 1 great artery coming from the ventricle which is overriding or great arteries are fused into a single truncal artery
45
if there are abnormal VA connections how are the ventricles names
- pulmonary ventricle = whichever ventricle pumps to the PV/PA
- systemic ventricle = ventricle pumps out to the AV/ao
46
what are the defining features o the pulmonary trunk
- bifurcation to the LPA and RPA
47
what are the defining features of the aorta
- coronary arteries
| - branches brachiocephalic, LCC, LSC
