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<3 > Thoracic Cardiology > Flashcards

Thoracic Cardiology Flashcards

1
Q

What separates the superior and inferior mediastinum?

A

Sternal angle

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2
Q

What are the subdivisions of the inferior mediastinum?

A

Anterior - ant. To heart

Middle - heart

Posterior - posterior to heart

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3
Q

What are the basic characterizations of the heart?

A

2 sided, 4 chambered

Self-initializations

Self adjusting pump

Propels blood to to all parts of body

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4
Q

What does the R side of the heart receive blood from?

Where does it send blood to?

A

Receives blood from superior and inferior vena cava

Pumps blood out to lungs for oxygenation

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5
Q

What does the left side receive blood from?

Where does it pump it out to?

A

Receives Oxygen rich blood from lungs

Pumps it out to entire body via aorta

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6
Q

What is the flow of systemic circulation?

A

From LA —bicuspid valve—> LV

—aortic valve—> aorta —> arterial system

—> capillaries —> venous system —>

superior/inferior vena cava —> heart

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7
Q

What is the flow of pulmonary circulation?

A

Superior/inferior Vena Cava —> RA

RA—tricuspid valve—> RV

RV—pulmonary valve—> pulmonary trunk

Trunk—>R/L lungs —> pulmonary Vs.

—> heart

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8
Q

What are the layers of the Pericardium? (4)

A

Epicardium

Myocardium

Endocardium

Fibrous skeleton of heart

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9
Q

What is the epicardiuM?

What makes it up?

A

Outermost layer of the pericardium

Made up of visceral serous pericardium

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10
Q

What is the myocardium?

A

Thick muscular layer made up of spiraling overlapping layers of cardiac M.

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11
Q

What is the endocardium?

A

Thin internal endothelial and subendothelial layer lining the inside of the chambers of the heart and valves

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12
Q

What makes up the fibrous skeleton of the heart?

A

Dense collagenous fibers

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13
Q

Where is the apex of the heart?

A

Inferolaterally part of the LV and projects predominantly to the left

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14
Q

Where is the base of heart?

A

Posterior portion near the LA

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15
Q

What are the surfaces of the heart? (3)

A

Sternocostal

Diaphragmatic

Pulmonary

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16
Q

Where is the sternocostal surface?

A

Right ventricle

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17
Q

Where is the diaphragmatic surface?

A

R and L ventricles

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18
Q

What are the pulmonary surfaces?

What space does this surface occupy?

A

Paired surfaces of RA and LV

Occupies cardiac impression on BOTH lungs

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19
Q

What are the borders of the heart?

A

Right

Inferior

Left

Superior

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20
Q

Where is the right border of the heart?

A

Along the right atrium

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21
Q

Where is the inferior border of the heart?

A

Right ventricle

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22
Q

Where is the left border of the heart?

A

Along the left ventricle

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23
Q

Where is the superior border of the heart?

A

Along the right and left stria

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24
Q

What does the superior border of the allow for?

A

For an exit point for the aorta and pulmonary trunk

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25
Q

Where is the right atrioventricular groove?

What runs in it?

A

B/w RA and RV

Transmits the Right Coronary A.

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26
Q

Where is the left atrioventricular groove?

What is here?

A

B/w LA and LV

Houses coronary sinus

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27
Q

Where is the Anterior interventricular groove?

What does it transmit?

A

B/w RV and LV on ANTERIOR aspect of the heart

Transmits Anterior interventricular A. And Great Cardiac V.

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28
Q

Where is the Posterior Interventricular groove?

What does it transmit?

A

B/w RV and LV on POSTERIOR aspect of the heart

Transmits Posterior Interventricular a. And the Middle Cardiac V.

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29
Q

What is the sulcus terminalis?

A

External vertical groove corresponding to the internal crista terminalis

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30
Q

What is the ligamentous arteriosus?

A

Embryological remnant of the ductus arteriosus

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31
Q

What is the Ductus Arteriosus?

A

Embryological communication b/w pulmonary trunk and arch of aorta

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32
Q

What are the Internal features of the Right Atrium?

A

Sinus vernarum

Pectinate m.

Crista terminalis

Interatrial septum

Opening for coronary sinus

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33
Q

Where and what is the

Sinus Vernarum?

A

Posterior RA

SMOOTH, thin walled region where vena cava and coronary sinus empty

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34
Q

Where and what is the pectinate msucle?

A

Anterior RA

ROUGH muscular wall

Right auricle

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35
Q

What and where in the crista terminalis?

A

Internal ridge separating smooth and rough regions in the RA

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36
Q

Where and what is the interatrial septum?

A

Wall b/w the 2 atria

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37
Q

What is found within the interatrial septum?

A

Fossa ovalis

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38
Q

What is the fossa ovalis ?

A

Embryonic remnant of the foramen ovalis

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39
Q

What is the

RIGHT atrioventricular orifice?

What can occlude it?

A

Passage from RA to RV

Could be occluded by Tricuspid valve

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40
Q

Where and what is the tricuspid valve?

A

In RV

Separates RA and RV

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41
Q

What are the features found in the tricuspid valve?

A 
Anterior cusp 
Posterior cusp
Septal cusp 
Chorda tendineae
Anterior papillary m. 
Posterior papillary m. 
Septal papillary m.
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42
Q

What is the Chorda tendinae?

A

In the RV’s Tricuspid valve

Attaches free edges of the 3 cusps to the 3 corresponding Papillary Ms.

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43
Q

How is Anterior Papillary M. Joined to the Tricuspid valve?

A

Chorda tendinae joins it to Anterior Cusp

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44
Q

How is the Posterior Papillary M. Jointed to the Tricsupid valve?

A

Chorda tendinae joins it to the posterior cusp

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45
Q

How is the Septal Papillary M. Joined to the Tricuspid valve?

A

Chordae tendinae joins it to the Septal Cusp

46
Q

What and where is the Trabecula carnae?

A

Right Ventricle

Rough muscular region

47
Q

What and where is the septomarginal trabeculum?

A

In RV’s Trabecula Carnae

Moderator band that runs from the interventricular septum to the base of the Anterior Papillary m.

48
Q

What is the role of the septomarginal trabeculum?

A

Transmits the right bundle branch of Atrioventricular bundle to the Anterior papillary M.

49
Q

What and where is the conus arteriosus?

What does it lead into?

A

RV’s infundibulum

SMOOTH walled

Leads into pulmonary trunk

50
Q

What is the rough and smooth wall of the RA?

A

Rough: Pectinate msucle

Smooth: sinus venarum

51
Q

What is the Rough and smooth wall of the Right Ventricle?

A

Rough: Trabecula carnae

Smooth: conus arteriosus

52
Q

What and where is the pulmonary valve?

A

Semilunar valve in RV that separates it from the Pulmonary trunks

53
Q

What cusps does the Pulmonary Valve have?

A

Has Right, Left, and Anterior Cusps

54
Q

Where is the pulmonary sinuses?

A

Space b/w wall of pulmonary trunk and cusps of the pulmonary valve

55
Q

What is the difference between the RIght and Left atrium?

A

left is thicker than the right

56
Q

What and where is the left auricle?

A

In Left atrium and contains the pectinate m.

57
Q

What opening is found in the Left atrium?

A

Opening for the 4 pulmonary veins

58
Q

What and where is the Left Atrioventricular Orifice?

What can occlude it?

A

Passage from the LA and LV

Variably occluded by Bicuspid valve

59
Q

What and where is the Bicuspid (mitral) valve?

A

In the LV

Separates the LA from the LV

60
Q

What are the components of the Bicuspid valve?

A 
Anterior cusp
Posterior cusp
Chordae tendinae
Anterior papillary m. 
Posterior papillary m.
61
Q

What does the chordae tendinae do in the left ventricle?

A

Attaches the free edges of the 2 cusps to ventricular surfaces

62
Q

How is the Anterior papillary m. Joined to the Bicuspid valve?

A

Chordae tendinae joins it to the anterior cusp

63
Q

How is the Posterior papillary m. Joined to the Bicuspid valve?

A

Chordae tendinae joins it to the posterior cusp

64
Q

What is the Rough muscular region of the left ventricle?

A

Trabeculae carnae

65
Q

What and where is the aortic vestibule?

A

Smooth walled Left ventricle area that leads it into the ascending aorta

66
Q

What is the interventricular septum?

A

Myocardial walls that separate the 2 ventricles

67
Q

What is housed in the interventricular septum?

A

Atrioventricular bundle

R and L bundle branches

Subendocardial branches

68
Q

What are the 2 parts to the interventricular septum?

A

Membranous (fibrous) part -belongs to the fibrous skeleton of the heart

Muscular part - larger

69
Q

What and where is the aortic valve?

A

Semilunar valve that separates LV from ascending aorta

Occupies the aortic orifice

70
Q

What are the cusps of the Aortic valve?

A

Right, Let, and Posterior (non-coronary) cusps

71
Q

What is the parts of the pericardium? (4)

A

Serous part

Fibrous part

Oblique pericardial sinus

Transverse pericardial sinus

72
Q

What is the oblique pericardial sinus?

A

Wide recess posterior to the base of the heart

73
Q

What is the transverse pericardial sinus?

A

Transverse passage transverse the origins of the great vessels

74
Q

What is the surgical significance of the Transverse pericardial sinus?

A

Space allows cardiac surgeons to access area posterior to the aorta and pulmonary trunk to clamp or insert

75
Q

What makes up the fibrous skeleton of the heart?

A

Made of dense collagenous fibers

76
Q

What is the function of the fibrous skeleton of the heart?

A
  • Produces attachment points for myocardium
  • Produces attachment points for valves of cuspid valves
  • Supports and strengthens atrioventiruclar and semilunar orifices
  • Provides an electrically insulated barrier between the atria and the ventricles
77
Q

What are the atrioventricular valves?

A

Bicuspid (LA->LV)

Tricuspid (RA->RV)

78
Q

What does the Cardiac conducting system of the heart consists of?

A

Cardiac muscle cells
Specializes conducting fibers
2 bundles of nodal tissue (SA and AV)

79
Q

What is the function of the nodal tissue bundles?

A

Responsible for coordinating cardiac cycle

80
Q

Where is the Sinoatrial node?

A

Located in myocardium where the superior vena cava meets the right atrium

81
Q

What is the function of the SA node?

What does it produce?

A

Initiated and regulates impulses that propagates thru atrial walls via myogenic conduction

Produces diastole

82
Q

What is the pacemaker of the heart?

A

SA node

83
Q

Where is the Atrioventricular node?

A

Located in the interatrial septum near the opening for the coronary sinus

84
Q

What does the AV node respond to?

A

Responds to the impulse from the sinuatrial node that is distributed thru the wall of the atrium and distributes that signal thru the ventricles

85
Q

What does the AV bundle do?

A

Crosses the electrically insulated barrier provided by the fibrous skeleton of heart

Distributes impulse from AV node to the R and L AV bundles

Goes on furhter as the subendocardial branches

86
Q

What do the subendocardial branches do?

A

Distribute the AV nodal impulse form the R. And L. Atrioventricular bundle branches
to…
Interventricular septum

Then to..
Papillary Ms. (anterior first)

And then to rest of ventricular wall

87
Q

What are subendocardial branches also known as?

A

Purkinje fibers

88
Q

What is a myocardial infarction?

What is it usually a result of?

A

Lack of blood flow t a specific area of the myocardium

Usually a result of Blockage in a Coronary A.

89
Q

What is coronary atherosclerosis?

What is it assoc. w/?

A

◦ Buildup of lipids on internal walls of the coronary artery decreases size of lumen of that vessel

◦ Increases likelihood of an embolus, or plug, blocking a vessel off entirely.

Myocardial infarction

90
Q

What is angina pectoris?

What causes it?

A

Pain that originates in heart and produces a strangling pain of chase

Result of narrow or obstructed coronary arteries that produces ischemia of the myocardium

91
Q

Where does Ligamentous Arteriosus travel from and to?

What is it a remnant of?

A

Travels from superior aspect of the pulmonary trunk to inferior concave border of Aortic arch

Remnant of ductus arteriosus

92
Q

What was the function of the ductus arteriosus?

A

Shunted blood from pulmonary trunk to the aorta to bypass the nonfunctionallungs

93
Q

How does the Left Recurrent Laryng N. Of the Vagus N. Travel around the heart?

A

Loops around the aortic arch and ligamentous arteriosus then ascends to the larynx

94
Q

What is Fossa ovalis?

A

Embryological remnant of the Foramen OValis

95
Q

What do Atrial Septal defects typically involve?

How many people usually have this?

A

Involve incomplete closure of the Foramen Ovale

15-20% of adults

96
Q

Why is a patent opening in the ateratrial septum clinically significant?

A

Allows mixture of oxygen rich and oxygen depleted blood

97
Q

What is the cardiac catherteization process?

A

Insertion of a catheter into he femoral vein which is then passed up to the Inferior vena cava

98
Q

What does a Cardiac Catherization allow for?

A

Allows for radiographic visualization of the RA, RV, pulmonary trunk, and pulmonary As.

99
Q

What is the interventricular septum made from?

What does it make it susceptible to?

A

Made from embryologically divergent tissues

Makes it susceptible to defects

100
Q

What is an Artificial Cardiac Pacemaker?

A

Produces a regular electrical impulse that is carried to ventricles via electrodes

101
Q

How are the electrodes of an Artificial Cardiac pacemaker inserted?

A

Thru a large v. —> Superior Vena Cava

SVC —> RA

RA—> tricuspid valve

—> Endocardium of the Trabecular Carnae of the RV

102
Q

What is atrial fibrillation?

How is circulation affected?

A

‣ Irregular twitching of th atrial cardiac muscle fibers to which the ventricles respond at irregular intervals

‣ Circulation usually remains satisfactory

103
Q

What is ventricular fibrillation?

How is it treated??

A

‣ Rapid irregular twitching of the ventricles rendering the heart unable to pump blood

‣ Electric shock administered by electrodes can cease all cardiac movment (defibrillation)
• Hopefully, heart may begin beating regularly after a period of time.

104
Q

What is cardiac referred pain?

A

‣ Ischemia stimulates visceral pain sensory fibers in heart of the autonomic nervous system

105
Q

Why does cardiac referred pain happen?

A

• Visceral sensory fibers share spinal ganglion w/ the somatic sensory fibers of areas such as UE and Superior lateral chest wall

106
Q

What is anginal pain referred to as?

A

Area innervated by the Left Medial Brachial Cutaneous Nerve, left us sternal area, left Pectoralis area and medial aspect of the left upper limb

107
Q

What is Serous Parietal Pericardium adherent to?

A

Fibrous pericardium?

108
Q

What is serous Visceral Pericardium adherent to?

What does it make up?

A

Adherent to the heart

Makes up the epicardium

109
Q

What is a Pericarditis?

What happens if left untreated?

A

Inflammation of the pericardium, which can make the pericardium rough and produce friction.

This friction called a pericardial friction rub can be observed with a stethoscope.

If left untreated the pericardium can calcify.

110
Q

What is pericardial effusion?

A

Inflammation of the pericardium resulting in accumulation of fluid or pus in the pericardial sac which can compress the heart

111
Q

What is cardiac tamponade?

A

Heart compression

112
Q

What is paricardiocentesis?

When is this procedure done?

A

Drainage of blood, fluid or pus from the pericardial sac

Usually done to relieve cardiac tamponade

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