the heart Flashcards by Jacob Amato

Spaces of Middle mediastinum

Superior(above t4-5)
Inferior (below t4-5)
 -anterior (infront of heart)
 -middle (the heart)
 -posterior (behind the heart)

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build up of fluid under the fibrous pericardium leads to

A lot of pain

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where is most of the herat

2/3 to the left

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where is the apex of the heart

At the midclavicular line

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where does the heart sit height

Intercostal space 2-5

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layers of the heart wall superficial to deep

epicardium (visceral layer of the pericardium)
myocardium
endocardium

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where is myocardium is thickest

In the ventricles

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where is the base of the heart

Posteriorly oposite of the apex

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where do the great vessels come out of the heart

At the base of the heart

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where is the apex of heart

the most inferior part at the tip pointing left

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borders of the heart

Inferior (diaphragmatic)
Right
Left
Superior (where vessels come out)

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surface of the heart

Anterior- font
Inferior- on diaphram
R pulmonary
L pulmonary

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differnce between border and surface

Surface is flat side

Border is the sharp edge

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do the r and l parts of the heart work separately

No they work together

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how to know what side of the heart is the front

The aorta and pulmonary trunk(more anterior) are on the front

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how to know what side of the heart is the back

coronary sinus in the AV sulcus

Pulmonary veins

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location of L and R atrium

L: on the left anterior side
R: on the R posterior side

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What separates the atria and ventricles

Atrioventricular valves

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what is between the ventricles and the ejecting vessels

Semilunar valves

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what separates the R and L septum

Interatrial septum

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what separates the R and L ventricles

Interventricular Septum

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what drains into the right atrium

superior vena cava-near the roof
Inferior vena cava- from the floor
coronary sinus- also the floor but much smaller

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what happens to walls of the atrium as you go from septum to walls

Become more roughened

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Roughed walls of the Right atrium

Pectinate mm

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the line that dinotes the separation between smooth wall and roughened wall of the right atrium

crista terminalis

where is the fossa ovalis

In the right atrium, in the interatrial septum, superior to the coronary sinus

what is fossa ovalis a remnant of

Foramen ovale

The RIght AV valve

Tricuspid

cusps of the RIght AV valve

Anterior Septal Posterior

how is the AV valve anchored

Chordae tendineae to papillary mm in the ventricles

what is the texture of the Right ventricles

Roughened

Roughened wall of the ventricle

Trabeculae carnea

Muscles that extend from trabeculae carnea of the atrium to the chordae tendineae

Papillary mm

what is a band of tissue that extends from the Atrial septum to the base of the anterior papillary muscle in the right ventricle

Moderator band (septomarginal trabecula)

The superior part of the Right ventricle to the pulmonary trunk

Conus Arteriosus

where is the pulmonary valve

In the pulmonary trunk at the apex of the infundibulum

Cusps of the Pulmonary trunk

Left Right Anterior

presence of corea tendineae and papillary muscle in the pulmonary valves

none present

what drains into the left atrium

4 pulmonary veins

what part of the left atrium is rough

just the left auricle (most of it is smooth) with pectinate muscle

the little lip on the atrial septum of the left atrium

Valve of foramen ovale

The Left AV vAlve

Bicuspid (mitral Valve)

Cusps of the Left av valve

Anterior | Posterior

thickness of r and l ventricle

L is 3x as thick myocardium

where is the aortic valve

In the aorta

cusps of the aortic valve

Left Right Posterior

How to listen to AV valves

in the 5th intercostal space (tricuspid, just left of sternum) (Bicuspid, far left of sternum)

where to listen to Valves

Down stream

where to listen to semilunar valve

2nd intercostal space (pulmonary is just L of sternum) (Aortic is just R of sternum)

main artiers of the heart

Left and Right coronary arteries

where do the R and L coronary arteries branch from

The ascending aorta

main venous drainage of heart

Coronary sinus

length of right and left coronary arteries

Left is super short

what does the Right Coronary Artery supply

``` R atrium R ventricle Sinu atrial node AV node Interatrial septum Portion of LEft atrium Posteroinferior 1/3 IV septum Portion posterior part of left ventricle ```

where does The right coronary artery run

Right under the Right auricle of the right atrium

Important branches of the Right coronary artery

Anterior R atrial A - Sinu-atrial nodal artery Right Marginal Posterior interventricular A

travel of the Anterior Right Atrial A

TRavels supperiorly over the top of the heart to make the Sinu-atrial nodal a to the SA node

travel of the Right marginal artery

Right along the R border of the heart

where is the posterior interventricular a

between the two ventricles on the septum on the back of the heart

what does the Left coronary artery supply

Left atrium Left Ventricle Interventricular Septum -Atrioventricular bundle and its branches

where does the Left coronary artery travel

Behind the pulmonary trunk, under the left auricle

branches of the Left Coronary Artery

Anterior Interventricular A (LEft anterior descenind A) Circumflex A - left marginal A

where does the Anterior Interventricular A run

Along the interventricular septum on the more left side of the anterior heart over the apex

what does the Anterior Interventricular A anastomose with

Posterior inteventricular

where is the Circumflex A

Goes around the heart on the left side to the back

where does the LEft marginal artery run

Along the left border of the heart

difference between R and L dominant heart

where does the posterior interventricular artery come off

Clinical Significance of R and L dominance

Decides which coronary artery supplies bulk of heart and is a big risk if blocked (possible of Co-dominance)

what dominance is more common

R dominance (60%)

where do veins travel

with arteries

Where is the great cardiac vein

Anteriorly draining directly into the Coronary Sinus | Runs with L anterior descending artery to the posterior

loaction of the midle cardiac vein

Posterior, to run with posterior interventricular artery

location the Small cardiac vein

On the right border of the heart, twists around to drain into the coronary sinus Runs with the right marginal A

what do the anterior cardiac veins drain into

Directly into the Right atrium deep to auricle

HOw to see the veins of the heart

Put a catheder up the inguinal region all the way to arota where they shoot in dye to see all the arteries

what to do if somehting is blocked in the heart

Coronary artery bypass grafts

what causes the heart to beat

Has its own conducting system

Sympa innervation to heart

T1-T5

Parasympathetic innervation to heart

Vagus N (CN X)

ANS and heart

Affects rate

what do the Sympathetic and parasympathetics contribute to with heart

Both superficial and deep cardiac plexuses

where is the superficial plexus of the heart

right on top of the aorta

where is the deep caridac plexus of the heart

at the trachea bifurcation

conduction systm of the heart

``` SA node AV node AV bundle (bundle of His) Bundle branches Purkinje fibers ```

How to deal with Damage to Conduction system of heart

Pacemakers placed subcutaneously throu the Superior Vena cava into the heart