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Terms in this set (198)
Where does the heart lie?
within the pericardial sac in the middle mediastinum
What is the heart divided into?
a septal wall into left and right halves
What does each half of the heart consists of?
two chambers: an atrium and a ventricle (4 chambers total)
What is the order of wall thickness from thickest to thinnest?
Left ventricle - right ventricle - left aorta - right aorta
What is a pulmonary embolism?
an obstruction of a pulmonary artery by a blood clot
(In regards to pulmonary embolisms) Where do blood blots form?
in the systemic venous system
Describe the pathway of a pulmonary embolism.
a blood clot forms in the systemic venous system, passes through the inferior vena cava or superior vena cava to the right atrium, then to the right ventricle, then to the pulmonary artery or one of its branches, then blood flow is blocked to the lung and results in acute respiratory distress. It leads to dilation of right ventricle and right atrium - results in heart failure
What is the pericadarditis?
inflammation of the pericardium (always serious)
What is a pericardial friction rub?
distinguished from pleural friction rub by having patient hold breathe. If the sound stops = pleural. If the sound continues = pericardial
What do valves control?
the flow of blood through the heart
What does each valve consist of?
1. valve orifice, surrounded by a fibrous ring
2. fibrous ring (anulus), to which is attached to cusps
3. cusps, flaps which close the valve
What are the four major valves in the human heart?
1. pulmonary valve
2. aortic valve
3. mitral (bicuspid) valve
4. tricuspid valve
What is the pulmonary valve between?
the right ventricle and pulmonary trunk
How many cusps does a pulmonary valve have?
three (anterior, left, and right)
What is the aortic valve between?
between the left ventricle and aorta
How many cusps does an aortic valve have?
three (left, right, and posterior)
What is the mitral valve between?
the left atrium adn left ventricle
How many cusps does a mitral valve have?
two cusps (anterior and posterior)
What is the tricuspid valve between?
the right atrium and right ventricle
How many cusps does a tricuspid valve have?
three (anterior, posterior, and septal)
What are the mtiral and tricuspid valves also called?
the left and right atrioventricular valves respectively
What is the auscultation produced by the heart?
a two-stroke beart ("lub-dup")
Describe the lub sound.
produced by contraction of hte ventricles and closure of the tricuspid and mitral valves
Describe the dup sound.
produced by closure of the pulmonary and aortic valves
What is another name for the pulmonary and aortic valves together?
What is the position of the pulmonary valve?
located behind the medial end of the third left costal cartilage
Where is the pulmonary valve most audible?
over the left second intercostal space
What is the position of the aortic valve?
located behind the left half of the sternum medial to the third intercostal space
Where is the aortic valve most audible?
over the right second intercostal space
What is the position of the mitral valve?
located behind the left half of the sternum medial to the fourth costal cartilage
Where is the mitral valve most audible?
over the left fifth intercostal space at the midclavicular line
When you are listening to the apex of the heart, what is that sound called?
the apex beat
What valve is the most frequently diseased valve of the heart?
Why is the mitral valve more susceptible to disease?
high pressure in left ventricles produces microabrasions on mitral valve cusps
What is the second most commonly diseased valve?
What prevents us to not hear valve closures directly over valves?
1. presence of bone
2. orientation of the heart
3. acoustics of blood flow
What is the position of the tricuspid valve?
located behind the right half of the sternum medial to the fourth intercostal space
Where is the tricuspid valve most audible?
over the left fifth intercostal space at its border with the sternum
What degree is the heart sitting at?
What is the orientation of the heart?
lies obliquely in the thorax, from base to apex it runs forward, downward and to the left
What are the boundaries of the heart?
base and apex
Describe the base of the heart.
formed by the left and right atria
Describe the apex of the heart.
lies in the left fifth intercostal space, formed by the left ventricle
What are the surfaces of the heart?
anterior, diaphragmatic, left and right pulmonary
What is the anterior surface of the heart formed mostly by?
by the right ventricle
What is another name for the anterior surface of the heart?
What is the diaphragmatic surface of the heart formed mostly by?
by the right and left ventricles
What is the left pulmonary surface of the heart formed by?
mostly by the left ventricle
What is the right pulmonary surface of the heart formed by?
mostly by the right atrium
What are the components of the right atrium?
1. right auricle
2. pectinate muscles
3. crista terminalis
4. sinus of venae cavae
5. fossa ovalis
6. openings in the right atrium
(right atrium) Describe the right auricle.
an ear-like appendage from the superior aspect of the right atrium
(right atrium) Describe the pectinate muscles.
prominent parallel ridges located in the anterior atrial wall
(right atrium) What is another name for pectinate muscles?
(right atrium) Describe the crista terminalis.
a vertical muscular ridge which runs from the opening of the superior vena cava to that of the inferior vena cava
(right atrium) What does the crista terminalis mark the termination of?
the pectinate muscles and separates the right atrium proper from the sinus of venae cavae
(right atrium) What is the crista terminalis marked externally by?
a vertical groove
(right atrium) What is the name for the vertical groove that marks the crista terminalis externally?
(right atrium) Describe the sinus of venae cavae.
the smooth-walled area located posterior to the crista terminalis
(right atrium) What does the sinus of venae cavae represent?
the embryonic sinus venous
(right atrium) What does the sinus of the venae cavae receive?
the openings of the superior vena cava, inferior vena cava, coronary sinus, and anterior veins of right ventricle
(right atrium) What is another name for the sinus of venae cavae?
(right atrium) What is another name for the fossa ovalis?
(right atrium) Describe the fossa ovalis.
a depression which is the remnant of the foramen ovale (oval foramen)
(right atrium) The fossa ovalis is a deppression which is the remnant of the foramen ovale. What is the foramen ovale?
An opening between the right and left atrium which closes at birth
(right atrium) What is the sharp border of the fossa ovalis called?
the Limbus Fossa Ovalis
With an atrial septal defect, what percent of adults have the foramen ovale persists as a small opening in ithe superior part of the fossa ovalis?
What is an atrial septal defect called when the defect is small?
probe patent foramen ovale
What is an atrial septal defect called when the defect is large?
a clinical atrial septal defect
What is an atrial septal defect?
Blood is shunted from the left atrium to the right atrium, causing dilation of the right atrium, right ventricle, and pulmonary trunk
(right atrium) What are the openings in the right atrium?
1. superior vena cava
2. inferior vena cava
3. coronary sinus
4. anterior veins of right ventricle
5. right ventricle
For the openings of the right atrium, which opening has no valve?
superior vena cava
For the openings of the right atrium, which 2 openings have a rudimentary valve?
inferior vena cava and coronary sinius
For the openings of the right atrium, which one goes through the tricuspid valve?
the right ventricle
What are the components of the right ventricle?
1. trabeculae carneae
2. papillary muscles
3. chordae tendineae
4. conus arteriosus
5. supraventricular crest
6. septomarginal trabecula
Openings in the right ventricle
(right ventricle) Describe the trabeculae carnae?
interconnectng muscular ridges located in the ventricular wall
(right ventricle) Describe papillary muscles.
cone-shaped muscles which originate from the ventricular wall
(right ventricle) The apices of the papillary muscles are connected to what?
the chordae tendinae
(right ventricle) What are the three papillary muscles in the right ventricle?
1. anterior (largest)
(right ventricle) The papillary muscles are often ____, ____, or ____.
bifid, trifid, or multiple
(right ventricle) Describe the chordae tendineae.
attach the papillary muscles to the borders of the cusps of the tricuspid valve
(right ventricle) What does the chordae tendineae prevent?
eversion of the valve during ventricular contraction
(right ventricle) Describe the conus arteriosus.
the upper portion of the right ventricle which ends in the pulmonary trunk
(right ventricle) Describe supraventricular crest.
a thick, muscular ridge which separates the conus arteriosus from the rest of the right ventricle
(right ventricle) Describe the septomarginal trabecula.
a large trabecula which extends from the interventricular septum to the base of the anterior papillary muscle
(right ventricle) What is another name for septomarginal trabecula?
(right ventricle) What does the septomarginal trabecula transmit?
the right bundle branch of the conduction system
(right ventricle) What are the openings in the right ventricle?
1. right atrium
2. pulmonary trunk
(right ventricle) For the openings in the right ventricle, what is the right atrium pass through?
through the tricuspid valve
(right ventricle) For the openings in the right ventricle, what is the pulmonary trunk pass through?
the pulmonary valve
(Left atrium) What are the components of the left atrium?
1. left auricle
2. pectinate muscles
3. openings in the left atrium
(Left atrium) Describe the left auricle.
the ear-like appendage of the left atrium
(Left atrium) Describe the pectinate muscles.
a few are found in the auricle, but most of the left atrium is smooth
(Left atrium) What are the openings of the left atrium?
1. pulmonary veins
2. left ventricle
(Left atrium) How many pulmonary veins are in the left atrium?
(Left atrium) With the openings of the left atrium, what is the left ventricle pass through?
the Mitral Valve
(Left ventricle) What are the components of the left ventricle?
1. trabeculae carneae
2. papillary muscles
3. chordae tendineae
4. aortic vestibule
5. openings in the left ventricle
(Left ventricle) Describe the trabeculae carneae.
finer and more numerous than in the right ventricle
(Left ventricle) What are the papillary muscles?
anterior and posterior
(Left ventricle) Describe the chordae tendineae.
attached from papillary muscles to borders of the cusps of the mitral valve
(Left ventricle) What is another name for the chordae tendineae?
(Left ventricle) What is the aortic vestibule?
smooth-walled portion of the left ventricle, below the cusps of the aortic valve
(Left ventricle) What are the openings in the left ventricle.
1. left atrium
(Left ventricle) For the openings of the left ventricle, what is the left atrium pass through?
The Mitral Valve
(Left ventricle) For the openings of the left ventricle, what is the aorta pass through?
through the aortic valve
Describe the thickness of the walls of the left ventricle compared to that of the right ventricle?
The walls of the left ventricle are two to three times as thick as those of the right ventricle
What does the septal wall divide the heart into?
left and right halves
Of the right and left halves, what are the four parts it consists of?
1. interatrial septum
2. atrioventricular septum
3. membranous interventricular septum
4. muscular interventricular septum
What is the interatrial septum between?
the two atria
What is the atrioventricular septum?
a small portion above septal cusp of tricuspid valve and below anterior cusp of mitral valve
Describe the membranous interventricular septum.
thin, smooth adn fibrous in structure
Describe the muscular interventricular septum.
What are the two types of enlargement of the heart?
1. muscular hypertrophy
2. chamber dilation
Describe muscular hypertrophy.
-elasticity of blood vessels is lost with age, particularly with atherosclerosis and/or hypertension
-more force is requied to push blood through the arteries
-the walls of the heart grow thicken due to enlargement of cardiac muscle fibers
What might chamber dilation be due to?
septal defects or valve incompetency
What is valve incompetency?
with an incompetent mitral valve, there is regurgitation of blood from the left ventricle into the left atrium. The left atrium may dilate to accommodate the extra blood
In constast to the mitral and tricuspid valves, the pulmonary and aortic valves lack what?
chordae tendineae and papillary muscles
Semilunar valves are each consist of three semilunar cusps which have following features?
3. pulmonary and aortic sinuses
What are the nodules of the semilunar valves?
small central thickenings on the free edge of each cusp
What are the lunules of the semilunar valves?
the thin, crescentic part of the cusps
What are the pulmonary and aortic sinuses of the semilunar valves?
the spaces between the cusps and the walls of the vessel, located superiorly
What is the fibrous skeletonof the heart?
connective tissue framework of the heart
What is the fibrous skeleton of the heart composed of?
1. fibrous rings
2. left and right fibrous trigones
3. membranous part of the septal wall
What is another name of the fibrous rings of the fibrous skeleton of the heart?
Describe the fibrous rings of the fibrous skeleton of the heart?
form the foundation of each of the heart valves (tricuspid, mitral, pulmonary, and aortic)
Describe the left and right fibrous trigones of the fibrous skeleton of the heart?
connect the rings together, and represent the strongest part of the fibrous skeleton
What is the functions of the fibrous skeleton of the heart?
1. to provide a structural framework for the valves
2. to insulate the electrical impulses of the conduction system within the atrial wall from those within the ventricular wall
What is the blood supply to the heart?
the right and left coronary arteries arise from the aorta just superior to the aortic valve (within the right and left aortic sinuses, respectively)
Where does the blood supply to the heart travel within?
the coronary sulcus
What are the branches of the right coronary artery?
1. sinuatrial nodal artery
2. right marginal artery
3. posterior interventricular artery
(right coronary artery) Describe the right marginal artery.
runs along right lower margin of the heart
(right coronary artery) Describe the posterior interventricular artery.
lies within the posterior interventricular sulcus
What are the branches of the left coronary artery?
1. anterior interventricular artery
2. circumflex artery
(left coronary artery) Describe the anterior interventricular artery.
lies within the anterior interventricular sulcus
(left coronary artery) Describe the circumflex artery.
passes posteriorly to anastomose with right coronary artery
(left coronary artery) What is the branch of the circumflex artery?
left marginal artery
(left coronary artery) Describe the left marginal artery.
Runs along left margin of the heart and supplies the left ventricle
What is coronary artery dominance?
refers to which coronary artery gives rise tot he posterior interventricular artery
What is the right coronary dominance?
present in 70% of individuals
What is the left coronary dominance?
present in 30% of individuals
What does the right coronary artery usually supply?
1. right atrium
2. most of right ventricle
3. diaphragmatic surface of left ventricle
4. posterior 1/3 of interventricular septum
5. conduction system to proximal parts of right and left bundle branches
What does the left coronary artery usually supply?
1. left atrium
2. most of left ventricle
3. part of right ventricle
4. anterior 2/3 of interventricular septum
What always supplies a greater portion of the heart's tissue?
left coronary artery
What is coronary artery anastomoses?
branches of the coronary arteries are generally considered to be end arteries.
What do anastomoses occur between?
1. right coronary and circumflex arteries
2. anterior and posterior interventricular arteries
What are the venous drainage of the heart?
1. Coronary sinus
2. anterior veins of right ventricle
3. venae cordis minimae
What is the coronary sinus?
the largest vein of the heart
Where does the coronary sinus lie within?
the coronary sulcus and drains into the right atrium
What kind of valve does the coronary sinus have?
What are the five tributaries that the coronary sinus receives?
1. great cardiac vein
2. middle cardiac vein
3. small cardiac vein
4. posterior vein of the left ventricle
5. oblique vein of the left atrium
What does the great cardiac vein accompany?
anterior interventricular artery
What does the middle cardiac vein accompany?
posterior interventricular artery
What does the small cardiac vein accompany?
the right coronary artery near the right lower margin of the heart
What is the posterior vein of the left ventricle left of?
the middle cardiac vein
Where doe the anterior veins of the right ventricle drains directly into?
the right atrium
What are the smallest veins of the heart?
venae cordis minimae
Where do the venae cordis minimae run within the walls of the heart and drain primarily into?
the right atrium
What is atherosclerosis?
-the deposition of lipid plaques on the inner walls of arteries
-results in a narrowing of the lumen
What is the angina pectoris?
-substernal chest pain upon exertion
- a symptom of partial occlusion of coronary artery branches
When is the angina pectoris occur?
due to insufficient blood flow to heart tissue
What is ischemia?
insufficient blood flow to the heart
What is another name for the myocardial infarction?
When does the myocardial infarction occur?
when a coronary artery branch becomes completely occluded
If a patient survives myocardial infarction, what part of the heart dies and what is it converted to?
the portion of the heart supplied by the artery dies (necrosis) and is converted to fibrous scar tissue
What are the most common sites of myocardial infarction?
1. anterior interventricular artery (40-50%)
2. right coronary artery (30-40%)
3. circumflex artery (15-20%)
Women are more likely to die from a heart attack from which site?
anterior interventricular artery
Where does the subepicardial lymphatic plexus drain to?
The heart has its own contractile mechanism (the conduction system). How does it beat rhythmically?
it does not require a nerve supply to beat rhythmically
What is a nerve supply in the heart necessary for?
to alter the rate of beating
What does sympathetic activation do to heart rate?
increases the heart rate and strength of contraction and dilates the coronary arteries
What does parasympathetic activation do the heart rate?
decreases the heart rate and strength of contraction and constricts the coronary arteries
What is the innervation of the heart via from?
the cardiac plexus
What is the cardiac plexus divisible into?
1. superficial cardiac plexus
2. deep cardiac plexus
Where is the superficial cardiac plexus located?
beneath the arch of the aorta, anterior to the pulmonary trunk
Where is the deep cardiac plexus located?
posterior to the arch of the aorta
Where is the sympathetic innervation to the heart from?
the cervical and thoracic cardiac nerves from the sympathetic trunk (T1-T4)
What is the parasympathetic innervation to the heart from?
What nerves travel with sensory fibers?
sympathetic branches and the vagus
The rhythmic beating of the heart is controlled by specialized cardiac muscle fibers which are collectively known as what?
the conduction system
What are the parts of the conduction system?
1. Sinuatrial node
2. atrioventricular node
3. atrioventricular bundle
4. subendocardial plexus of conduction cells
What is the natural pacemaker of the heart?
Where is the sinuatrial node located?
at the upper end of the crista terminalis, near the junction of the right atrium with the superior vena cava
Where is the atrioventricular node located?
in the septal wall, above the opening for the coronary sinus in the right atrium
Where is the atrioventricular bundle located?
within the septal wall
What is the atrioventricular bundle divided into?
the right bundle branch and the left bundle branch
Where is the subendocardial plexus of conduction cells located?
joined by branches of the left and right bundle branch
What is another name for the subendocardial plexus of conduction cells?
Where does the conduction impulse begin?
the sinuatrial node
Where does the conduction impulse spread through?
the atrial wall until it reaches the atrioventricular node
After it reaches the atrioventricular node, what is theconduction impulse then travel through?
the atrioventricular bundle and its two bundle branches to the subendocardial plexus of conduction cells
From the subendocardial plexus of the conduction cells, where does it then travel through?
the myocardium of the ventricles
What are the great vessels which exit the heart?
1. aorta (from left ventricle)
2. pulmonary trunk (from right ventricle)
What are the branches of the pulmonary trunk which exit the heart?
left and right pulmonary artery
What are the great vessels which enter the heart?
1. Pulmonary veins (to left atrium)
2. Superior Vena Cava (to right atrium)
3. Inferior Vena Cava (to right atrium)
What is Ligamentum Arteriosum?
the remnant of the embryonic ductus arteriosus
What does the ligamentum arteriosum connect?
the arch of the aorta to the left pulmonary artery or pulmonary trunk
Where is the ligamentum arteriosum located?
at the level of the sternal angle
The left recurrent laryngeal nerve hook under?
the aortic arch posterior to the ligamentum arteriosum
The right recurrent laryngeal nerve hook under?
the right subclavian artery
THIS SET IS OFTEN IN FOLDERS WITH...
UNIT II- LARYNX AND THORAX
LYMPHATICS OF THE HEAD AND NECK - UNIT 2
BREAST - UNIT 2
THORACIC WALL - UNIT 2
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