pressure on the heart that occurs when blood or fluid builds up in the space between the heart muscle (myocardium) and the outer covering sac of the heart (pericardium) ECA p. 84
Levels of viscera in Mediastium
...change depending on the position of the person. Anatomical descriptions focus on individuals in supine, but when standing, gravity pulls the heart and associated structures down. ECA p. 84
Area of myocardium (heart muscle) that dies as a result of occlusion of a major artery. 3 main locations for coronary artery occlusion: 1. anterior IV branch of LCA, 2. Right coronary artery, 3. Circumflex branch of the LCA. ECA p. 100
Deposition of lipids on the inner lining of the coronary arteries; slowly results in stenosis of the lumina of the arteries. Begins in early adulthood. ECA p. 100
Surgery to correct obstruction of coronary circulation; segment of artery or vein (often the great saphenous vein) is attached to ascending aorta/proximal coronary artery proximal to stenosis and then distal to it, to create an alternate pathway for the bloodflow. ECA p. 101
Variations of Coronary Arteries
erm, see ECA p. 101. Left dominant - left circumflex supplies posterior interventricular branch, rather than the right coronary artery.
Cardiac Referred Pain
a phenomenon whereby noxious stimuli originating in the heart are perceived by the person as pain arising from a superficial part of the body (i.e., skin on medial aspect of the left upper limb). ECA p. 102
Which nerves innervate diaphragm muscles?
Phrenic n., C3-C5
What drains into the coronary sinus?
Where do surgeousn incert tubes of a coronary bypass machine during cardiac surgery?
Transverse pericardial sinus, ECA Fig B1.11
Insufficiency of blood supply to the heart
In addition to the T5/Rib 2 area, what does the sternal angle deliniate?
1. Separation between superior and inferior mediastinum
2. superior extent of pericardium
3. Arch of aorta beginning and end
4. Site where SVC penetrates the pericardium to enter the heart
5. Superior limit of the pulmonary trunk
6. Level that the trachea bifurcates
Where do the phrenic n. and the pericardiacophrenic a. and v. lie in relation to the root of the lung?
Anterior (between the mediastinal parietal pleura and the fibrous pericardium)
What innervates the diaphragm muscles?
The phrenic nerve (C3-C5).
What are the 3 layers of the pericardium?
Fibrous, Parietal Serous and Visceral Serous
A probe passed down the esophagus to examine the left atrium
Where does the fibrous pericardium attach inferiorially?
To the diaphragmatic fascia.
Is the blood in the left arteries of the heart oxygenated or deoxygenated?
Oxygenated (systemic). The right arteries carry blood away from heart to the lungs.
Are veins to the right heart oxygenated or not?
Deoxygenated (systemic). Veins to the left heart (pulmonary) carry blood from the lungs.
Systemic blood returning from abdominal visceral flows through the liver
What part of the heart is contained within the anterior (sternocostal) surface?
The right ventricle
What part of the heart is contained within the diaphragmatic (inferior) surface?
Mainly the left ventricle
What part of the heart is contained within the left pulmonary surface?
Mainly left ventricle; forms cardiac impression in the lung.
What part of the heart is contained within the right pulmonary surface?
mainly the right atrium
What is the function of arteries as it pertains to the heart?
To carry blood AWAY from the heart (and TO the systems of the body).
Where does the left vagus nerve originate?
From cranial n. 10; passes left of the ligamentum arteriosum, gives off a branch which reccurrs back in larynx (recurrent laryngeal n.)
Where is the ligamentum arteriosum?
Between the Pulmonary trunk and the arch of the aorta; is hollow in an embryo
What are the two surfaces of the Right Atrium?
Rough (pectinate muscles and aurical) and smooth (sinus venarum)
Where is the SA node located?
At the junction of the embryonic sinus venosus and the atrium. Fibers pass down crista terminalis to AV node.
Is the sinous venosus present in an adult?
No; absorbed by the right atrium during development, becomes the smooth sinus venarum
Where does blood enter the right atrium?
Superior and inferior vena cava, coronary sinus
In the wall of the right atrium; remnant of embryonic foramen ovale, impression remains. Located above the inferior vena cava.
Tricuspid valve; between right atrium and ventricle (try it before you buy it!)
Where is the tricuspid valve?
Between the right atrium and ventricle
In the right ventricle....purpose?
Modified trabeculae carnae
Septomarginal trabecula (moderator band)
Where is the bicuspid valve located?
between the L atrium and ventricle
fleshy "beams"; physiologic purpose?
transverse pericardial sinus
Space beneath aortic arch and pulmonary trunk... passage between the reflection of the serous layer around the arterial and venous vessels
Oblique pericardial sinus
blind space underneath/beneath the heart
Describe the embryologic formation of the transverse pericardial sinus.
During development, the heart loops ventrally, the mesontary dissolves/ruptures and creates the TPS.
Where is the sinus venarum located?
In the right atrium of the heart.
How many vessels enter the left atrium? What are they?
4; left and right pulmonary veins (2 each)
What runs in the coronary sulcus?
The right coronary artery,
Where do the right and left coronary arteries originate from?
What are the sulcuses located on the anterior portion of the heart?
Coronary sulcus and anterior interventricular sulcus
What are the 5 localized types of myocardial infarction?
AOA p. 97: supra-apical anterior infarction (anterior interventricular a.), apical anterior infarction (anterior interventricular a.), anterior lateral infarction (anterior interventricular a.), Posterior lateral infarction (circumflex branch), Posterior infarction (Right coronary a.).
Where is the moderator band located? What is it's function?
Aka. the septomarginal trabeculae; located in the right ventricle; carries part of the right bundle branch of the AV bundle of the conduction system of the heart to the anterior papillary muscle.
Auscultation of the cardiac valves
The sounds made by the slamming of the atrioventricular and semilunar valves are best heard downstream at 'auscultation sites'; see AOA p. 95.
In the right ventricle: the conus arteriosus is a conical pouch formed from the upper and left angle of the right ventricle in the chordate heart, from which the pulmonary trunk arises
Where does the parasympathetic innervation to the heart originate from?
The vagus n.
Where does the sympathetic innervation of the heart originate?
The sympathetic trunk (at the thoracic level).