Gross Anatomy of the Heart

Pregunta	Respuesta
Draw a sagittal plane & label mediastinums & key landmarks	Image: e7f3ff15-57ed-4de6-bbc4-ea9c399ee14b (image/png)
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	Image: 23ef65b6-e50f-4a14-a6fe-a16573107057 (image/png)
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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	Creado por Fiona Beer hace más de 8 años