Creado por Fiona Beer
hace casi 9 años
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Pregunta | Respuesta |
Draw a sagittal plane & label mediastinums & key landmarks | |
Location of the heart | * Middle Mediastinum * 2/3 Left of midline * Anterior & Deep to sternum & 3-5 Costal cartilage * Apex @ MCL 5th Intercostal space |
Name Pericardium & heart layers | Pericardium (1) Fibrous, (2) Parietal Serous Pericardium (3) Visceral Serous Pericardium. Cardiac: (1) Epicardium = Visceral serous, (2) Myocardium, (3) Endocardium. Then Fibrous skeleton |
Draw coronal Heart plane | |
Describe Right Atrium | * Veins -> SVC, IVC, Coronary Sinus * Intra-atrial Septum * Fossa Ovalis * Auricle * Internal wall - Smooth posteriorly; Rough anteriorly = Musculi Pectinati. Junction b/w smooth & rough = SULCUS TERMINALIS exteriorly & CRISTAE TERMINALIS internally |
Describe Right Ventricle | * TRABECULAE CARNAE * SUPRAVENTRICULAR CREST * CONUS ARTERIES (INFUNDIBULUM) * PAPILLARY MUSCLES * CHORDAE TENDINAE * Tricuspid valve & Pulmonary valve * SEPTOMARGINAL TRABECULA |
What are TRABECULAE CARNAE | Internal ridged walls in the Ventricles |
Where & What is the SUPRAVENTRICULAR CREST | R Ventricle. thick ridge that separates inflow (rough) & outflow tract (smooth) |
What & where: CONUS ARTERIES (INFUNDIBULUM) | R Ventricle outflow tract. Narrows superiorly, and ends at the entrance to Pulmonary Trunk. Lined with Semilunar Pulmonary valve |
What & where: PAPILLARY MUSCLES. Which one is clinically important | attach to Tendinous cords, which attach to the AV valve. Also attach to the Trabeculae Carnae. Anterior Papillary Muscle - carries part of the conduction system |
What & where: SEPTOMARGINAL TRABECULA | Moderator band. Curved muscle bundle from inferior inter ventricular septum to the base of the anterior papillary muscle - carries part of the conduction system |
Structure: Left Atrium | Mostly smooth walled (except L auricle - Pectinate muscle) fossa ovals depression. 4 Pulm. veins (Superior/Inferior: L/R) enter on the smooth posterior wall. |
Diff: Atriums L/R | LA wall slightly thicker |
Structure: L Ventricle | Thickest wall (x3). Trabecular more & finer. Large papillary muscles. Aortic Vestibule. Bicuspid valve. Has outflow not as obvious. |
Where & names: Heart Valves & Cusps | Semilunar (1) Pulmonary - Anterior, R, L (2) Aortic - Posterior, R, L AV Valves: (R) Tricuspid - Septal, Anterior, Posterior. (L) Mitral - Anterior, Posterior |
Coronary Arteries (Left) | LCA -> AIB (aka LAD) + circumflex -> Variation: LAD -> lateral branch (aka diagonal) Circumflex -> Left Marginal Branch -> (40%) SA nodal branch (10%) Circumflex -> PIA |
LCA supplies | LA, Most LV, Part RV, most IVS, AV bundle, RBB & LBB [ & SA node (40%)] |
Coronary Arteries (Right) | RCA -> Acute (aka Marginal) + PIA + AV nodal branch (60% - RCA -> SA nodal branch) (80% RCA -> PIA - posterior descending) = RCA dominant May supply Apex if LAD is short |
RCA supplies | RA, Most RV, Diaphragmatic surface LV, 60% SA node, 80% AV node |
Cardiac Veins | * Great CV (w AIA) * Middle CV (w PIA) * Small CV (w R marginal branch) Terminate @ coronary sinus Anterior drain directly into heart. |
Lymph | Follows blood vessels -> lymph nodes around trachea -> R lymphatic duct OR Thoracic duct |
Where & What: Fibrous skeleton | Dense CT, fibrous ring around each valve, connects valves & forms part of interatrial & interventrical wall. Function (1) Anchor (2) prevents electrical discord MYOCARDIUM attaches to it. |
Conduction System | (1) SA (2) AV (3) AV Bundle (Bundle of His) (4) Bundle Branches (L&R) (5) Purkinje fibres |
Sympathetic NS on Heart | Sympathetic: >HR, >force, >contractility, > coronary artery flow. Preganglionic cells in lateral horn T1-5. Primarily act on SA node, but also on AV node |
Parasympathetic NS on Heart | Travel in Vagus nerve (CNX). Synapse @ cardiac plexus or near SA & AV nodes. Vagal tone = 60-70bpm |
Heart pain: How & Where | Dermatomes T1-5. chest, upper limb, & other areas. Neck & Jaw (? from Vagus nerve). |
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