superior: 2 CC-3CC
left boarder:2 CC-5th ICS
Right boarder: 3CC - 6th CC
inferior 5th ICS (i.e the apex) - 6CC
what are the boarders of the heart?
5th intercostal space, where the maximum cardiac impulse is heard
what is the apex beat?
the intertribal groove and the inter ventricular groove make a straight line at the posterior of the heart. the coronary sulculs/ intertribal ventricle grooves runs perpendicular to this line. where they the two lines meet is called the CRUX.
the crux is where the Av artery leaves the right coronary artery. what is the crux on the heart?
anterior (sternocostal)= right atrium and ventricle
posterior (base)=left atrium
which side of the heart is more posterior and which is more anterior?
right and left ventricles
what part of the heart is lying not he diaphragm (inferior boarder)?
- 4 rings (that encircle the valves)
- 2 trigones
- atrial and ventricular septa
- tendon of todaro
- supraventricular cres
the fibrous skeleton in the heart originates embyralogically from the cardiac jelly. what are the structures in it?
- attachment points for myocardium
- insulation so ventricle and atrium contract independently
- helps maintain the structural integrate of the valves.
what is the function of the fibrous skeleton?
connect the rings to the interatrial and inter ventricular septa. the CT that seperate the two atriums and the two ventricles
what are trigones?
crista terminalis represen where the atrium joined to the sinus venomous in the embryonic heart. It adults it is a crescent shaped muscle tissue at the opening into the right auricle. it is also where the pectinate muscles terminate. pectinate muscles are only in the right atrium, and right and left auricle.
the crista terminals is defining feature of the right atrium. what is it?
the junction of the superior boarder of the crista terminals and the SVC opening.
where is the SA node found?
SVC, IVC, Coronary sinus, and the tricuspid valve
what opens into the right atrium?
the remnants of a whole that connected the right and left atrium.
the fossa ovale is located in the right atrium. what is it?
between the fossa oval, ivc and the tricuspid valve
where is the coronary sinus located?
a collagenous tructure that is part of the fibrous skeleton. it runs from the coronary sink to the margin of fossa oval
the tendon of todaro is located in the right atrium. what is it?
triangle of koch
- tendon of Todaro
- attachment of septal leaflet to tricuspid valve
- anteromedial margin of orifice of coronary sinus.
the triangle of koch is located int he right atrium. It contains the AV node. what are it's boundaries?
trabeculae carnae- irregular muscular columns on the wall of the ventricle
what are the rough portions of the right ventricle?
3, they are associated with the 3 valves of the tricuspid. the papillary muscles attach to eh valves via the cordae tendinae. the papillary muscles prevent back flow.
how many papillary muscles are in the right ventricle?
infundibulum (conus areteriosus)
what is the smooth surface of the right ventricle?
it accommodates the 140 degrees change in blood direction in the right ventricle.
it supports the following structures:
- anterosuperficial leaflet of tricuspid (the leaflet are the parts of the valve)
-seperates the tricuspid and the pulmonary valves
the supra ventricular crest is muscular crest located in the right ventricle it separates the smooth infundibulum where blood leaves from the part where blood enters the right ventricle. what is it's function?
- re-enforces the septa and papillary muscles
- conveys right bundle branch to anterior wall
- enhances the supra ventricular crest
- prevents overdsitension
the moderator band is located in the right ventricle. it is a curved muscular band that stretches from the inferior part of the inter ventricular septs to the anterior papillary muscles. What is it's function?
the left ventricle 3x thicker then the R ventricle. the inter ventricular septa is pushed into the right atrium.
why is the right ventricle more pyramidal shaped?
it is rough due to the pectin muscles. functions as a reservoir for the left atrium.
the left atrium is relatively smooth. what about the left auricle?
The left ventricle also has rough trabeculae carne, with 2 papillary muscles and tendinous cord. The inlet is rough and outlet is smooth. what is it called?
anat location: 3344 all are cc except for T
auscultation: 2255 they are all ICS, and interchange left and right
there are two atrioventricular and 2 semilunar valves. the heart consists of a core of CT covered by endocardium. Whare are the heart valves located and where are they heard?
left = P, m
right = A, T
where is the PAMT heard?
s1= closure of AV, beginning of systole
S2= closure of the semilunar valves pulmonary after an aortic valves close, beginning of diastole
normal heart only produces sounds when they close. what is S1 (lub) and what is S2 (dub)?
right and left coronary artery
when blood is pumped into the aorta some of the blood flows back into the coronary sinuses after systole. The sinuses have a right and left coronary osmium. where doe these lead?
S3- caused by oscillation of blood between the walls during atrial filling. ventricular diastolic gallop. occurs right after s2. slow ventricular filling
S4- caused by atria contraction into a non compliant ventricle. ventricular diastolic gallop. fast ventricular filling.
there are two abnormal heart sounds, S3 and S4. what are they caused by?