The Heart Flashcards by Hector Arredondo

What is diastole?

Begins with a period of ventricular elongation and filling

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What is systole?

A period of ventricular shortening and emptying

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How is the primary heart field developed?

Progenitor heart cells in epiblast (primitive ectoderm) of the third week embryo migrate though the primary streak and form the primary heart field (PHF) which forms the two Arita and most of the two ventricles in the lateral plate mesoderm

Day 15 and 18

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Review heart embryology in notes.

Placeholder

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What is the cardiogenic region?

The combined heart fields, primary heart field and secondary heart field

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What does the secondary heart do?

Form the remainder of the hear and outflow tract not formed by PHF

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Why does he right heart life anteriorly and the left heart posteriorly?

It’s a results of cardiac folding in the 4th week of intrauterine

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What are the parts on the anterior or sternocostal surface?

Right atrium
Right ventricle
Atrio-ventricular groove
AVG

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What is located on the posterior or base heart surface?

Mostly left atrium

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What is located at the diaphragmatic surface of the heart?

Right and left ventricles and posterior interventricular groove (PIG)

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What are the borders of the heart?

Superior: 3rd R CC to 2nd L CC
Inferior: right atrium and R ventricle from 6th cc parasternal to the site of apex bet at 5th L intercostal space MCL (5th LICS, MCL)

Right border: superior vena cava, right atrium, inferior vena cave from 3rd R CC to 6 R CC

Left: Left auricle and left ventricle from 2nd LCC to apex beat site (5th LIS, MCL)

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Where is the apex beat or the site of maximum cardiac impulse?

5th intercostal space, mid-clavículas line (5th LICS, MCL)

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Where is the AV node artery given off?

At the heart crux

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What is the heart crux?

The point of intersection between inter-atrial (IAG), inter-ventricular (IVG) and atrio-ventricular grooves (AVG)

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What is the atrioventricular node necessary for?

Excitation and contraction of the ventricles

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Where is the atrium proper of the right atrium located?

Anteriorly next to the auricular appendage

-they are line by the pectinate muscle

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What is the only part not derived from the venous part of the primitive heart tube (sinus venous) in the right atrium?

The posterior smooth willed sinus called the sinus venerum cavarum

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Where is the sinoatrial node (SAN) located?

At the junction of SVC opening and superior end of crista terminalis

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What are the crista terminalis?

Form the spine of the half comb and lies between the sinus venerum and pectinate muscle and between the opening of SVC and IVC

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The opening of the coronary sinus lies between what 3 structures?

Fossa ovalis
IVC opening
Tricuspid valve opening

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What is the fossa oval is?

A depression on the inter-atrial septum, where the foramen ovale used to be. It’s sharp margin is called limbus/annulus fossa ovalis

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What is the tendon of todaro?

A part of the fibrous part of the heart, it runs from between the valves of IVC and Coronary sinus to the limbus foss oval is

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What are the boundaries to the triangle of Koch?

Tendon of Todaro
Margin of orifice of coronary sinus
Septal leaflet of tricuspid valve

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What lies in the middle of the triangle of Koch?

AVN

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What chamber first received the freshly oxygenated blood from the lungs through the four pulmonary veins?

The left atrium

What forms the largest part of the sternocostal/anterior surface of the heart?

The right atrium

Where is the tricuspid valve?

Between the right atria and ventricle

What is the supraventricular crest?

A thick muscular ridge which links the inflow and outflow tracts of the right ventricle.

What does the supraventricular crest support or separate?

A. Anterosuperior leafleft or tricuspid valve B. Septomarginal band (septomarginal trabeculae = moderator band) Separates the attachments of tricuspid and pulmonary valves

What is the aortic vestibule?

The smooth outflow area of the left ventricle

How much thicker is the left ventricle than the right?

3x thicker Does not have a moderator band

Where is the endocardium of the heart thicker?

On the heart

What is the valve location, anatomical location and auscultation site?

Valve: PAMT Loc: 3rdCC,3rdICS,4th CC,4thICD Site: 2nd Lt ICS, 2nd Rt ICS, cardiac apex (5th Lt ICS MCL), Rt inferiormost ST (? 5th Rt ICS)

When do peripheral arteries fill and when do coronary arteries fill?

P: during systole C: during diastole due to elastic recoil of the aorta

What are cardiac veins missing?

Valves

What kind of ANS innervation do the coronary arteries receive?

Para and sympathetic

What are the branches of the right coronary artery?

``` (VICAN) Ventricular Interventricular septum (perforator) Conus Atrial Nodal ```

What is the distribution of the right coronary artery?

Rt atrium Rt and left ventricles on the diaphragmatic surface Poster 1/3 of IVS Both nodal tissues

What potential anastomoses does the right coronary artery have?

Circumflex LADA Perforator

What are the branches for the Left coronary artery?

``` (VICAN) Ventricular Interventricular septum (perforator) Conus Atrial Nodal ```

Wat is the distribution of the left coronary artery?

``` LT atrium Lt ventricle (most) Rt ventricle (some) Anterior 2/3 of IVS including bundle of His Nodal ```

What are the potential anastomoses for left coronary artery?

RCA PIVA Perforators

How is the coronary dominance decided?

By which of the 2 coronary arteries gives off the posterior interventricular artery (PIVA)

Coronary dominance is most likely in which artery?

The right 65%

What is the artery of sudden death?

LAD

What is the collecting vein or sump of the heart?

Coronary sinus

What forms the coronary sinus?

A merger of the great cardiac vein and oblique vein of Marshall ( of left atrium)

What veins drain into the coronary sinus and what arteries accompany them?

``` A. Great cardiac vein (LADA) B. Middle cardiac vein (PIVA) C. Small cardiac vein (right marginal artery) D. Lt posterior ventricular vein E. Oblique vein of Marshall ```

What veins do not drain into coronary sinus?

Anterior cardiac veins and Vanar cordis minimae

What do the lymphatic of the heart drain?

The cardiac lymphatic plexus located in the subepicardial fat

Where do the lymphatics of the heart drain into?

Tracheo-bronchial lymph nodes

Where does the heart receive sympathetic innervation from?

All 3 cervical ganglia which are from T1-t4/5 thoracic ganglia and they form the cardiac plexus To coronary arteries and nodes SAN and AVN (SAN --Sympathetic to Atria and Nodes)

Where does the heart receive parasympathetic innervation from?

From 2 vagus nerves and 2 RLNs To coronary arteries and atrial wall (APA- Parasympathetic to Atria and Arteries)

Trace the electrical conduction of the heart

``` SAN AVN Atrio-ventricular bundle of his (AVB) Atrio-ventricular bundle branches (AVBBs) Purkinje fibers ```

What is the pacemaker of the heart?

Sino-atrial node (SAN) -has intrinsic rhythmicity and automaticity that generates a wave of depolarization which spread in the atria

Where is the SAN located?>

Between the superior end of crista terminalis and inferior end of SVC, in the anterior wall of right atrium

What is that only tissue through which electrical impulses pass from atria to ventricle?

Atrio-ventricular node (AVN)

Where is the AVN located?

Between the posteroinferior end of inter-atrial septum and septal leaflet of tricuspid valve (also within the triangle of Koch)

Where is AVB located?

In the membranous part of the interventricular septum

What carries impulse to cardiac apex via right and left bundle branches in the inter-ventricular septum?

AVB

What takes impulses to the moderator band?

AV Bundle branches

What are the purkinje fibers of the heart?

Terminal conducting fibers which are located in all parts of the ventricular wall.

List the order of systole (S)?

S1 1. A-V valves shut, with semilunar valves already shut (all 4 valves shut) 2. Isovolumetric ventricular contraction S2 1. Semilunar valves open, 2. Ejection period

List the order of Distole (D)

D1. 1. Semilunar valves closes, while A-V valves are closed 2. Isovolumetric relaxion D2 1.A-V valves open, while semilunar valves are still closed 2. Passive ventricular filling D3 1. Semilunar valves still closed A-V valves are open 2. Active ventricular filling as the atria make a last ditch contraction

Is there ever a time when all four valves are open?

NO, never dude.

What shows various events of the cardiac cycle, pressure changes, phonocardiogram and electrocardiogram?

Wiggers diagram

What relationship does wiggers diagram show?

Fill in later?

Why is cardiac pain referred?

They are innervated by splanchnic nerves, Splanchnic nerves do not receive their own pathway and hitchhike on somatic pathways

The Heart Flashcards

(68 cards)