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Heart & Great Vessels
Rinaldi 3/8/11 lecture -2hrs
92
Anatomy
Undergraduate 4
03/07/2011

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Cards

Term
anterior & posterior interventricular grooves
Definition
what structure(s) mark(s) the location of the septum between ventricles on the heart?
Term
Right atrium
Definition
what chamber of the heart does the vena cava dump into?
Term
atrioventricular groove (coronary groove)
Definition
what structure on the heart separates the atria from the ventricles?
Term
4
Definition
how many pulmonary veins are there going to the heart?
Term
Right Ventricle
Definition
looking at the heart ANTERIORLY, what chamber would you mostly be viewing?
Term
right atrium, right ventricle, left ventricle
Definition
list all chambers seen in an anterior view of the heart
Term
left atrium and left ventricle
Definition
what chambers of the heart can be seen from a posterior view?
Term
Right brachiocephalic vein
Definition
if you find the clavicle on a radiograph and where it meets the manubrium, what heart structure is right below it?
Term
the aortic knob from the arch of the aorta
Definition
what heart structure will not be clearly seen on a radiograph if there is a coarctation?
Term
the pulmonary trunk
Definition
what structure is located directly below the aortic knob when looking at a radiograph?
Term
the diaphragm
Definition
what structure's shadow obscures the apex of the heart usually?
Term
obese with lots of fat around the heart
Definition
if the normally "oblique shadow" is more horizontal on your chest radiograph, your patient is likely _____
Term
they probably have a long thorax
Definition
if the normally "oblique shadow" is more vertical on your chest radiograph, what can you say about your patient?
Term
the normal angle formed by the left border of the heart
Definition
what is the oblique shadow on a chest radiograph?
Term
1)sinus venarum
2)the part with pectinate muscles
 these are distinguished based on embryonic origin, and morphology (smooth vs. muscular)
Definition
name the two parts of the right atrium and explain why they are distinguished from each other
Term
sinus venosus
Definition
what embryonic structure is the sinus venarum derived from?
Term
sinus venarum
Definition
smooth, thin walled, posterior part of the right atrium that receives the VENA CAVA and CORONARY SINUS
Term
good question, probably says in embryo somewhere, but not in anatomy

(primitive atria)
Definition
what is the part of the atrium with the pectinate muscles and the auricle derived from embryonically?
Term
crista terminalis
Definition
what divides the pectinate muscles and the sinus venarum in the right atrium?
Term
interatrial septum
Definition
what divides the left and right atria?
Term
fossa ovalis, right atrium
Definition
what is a remnant of the fetal foramen ovale valve? what heart chamber is it found in?
Term
up to 25%
Definition
what percent of the population has an atrial septal defect?
Term
oxygenated blood is shunted to the right atrium and overloads the pulmonary system.

Because of this, the right atrium, right ventricle, and pulmonary trunk will become enlarged
Definition
what happens if a person's atrial septal defect is too large?
Term
before birth, right is higher
after birth, left is higher
Definition
before birth is right atrial pressure higher or left atrial pressure? after birth?
Term
right atrioventricular orifice
Definition
the right ventricle receives blood from the right atrium through what structure?
Term
trabeculae carnae
Definition
irregular muscular elevations on the internal surface of the right ventricle
Term
muscular part(inferior) and membranous part(superior and posterior)
Definition
what are the 2 parts of the interventricular septum?
Term
conus arteriosus, in the right ventricle
Definition
cone shaped pouch that leads into the pulmonary trunk (what heart chamber is this in?)
Term
tricuspid/right atrioventricular valve
Definition
what valve guards the right atrioventricular orifice?
Term
semi-lunar (has 3 cusps, but not the same structure as tricuspid)
Definition
what kind of valve is the pulmonary valve?
Term
anterior, posterior, septal
Definition
name the cusps of the right atrioventricular valve
Term
chordae tendonae
Definition
what connects the cusps of the right atrioventricular valve to the papillary muscles?
Term
they prevent reguritation(prevent blood from flowing back into the atria) by preventing the cusps of the valves from prolapsing into the atria


DO NOT open or close the valves!!
Definition
what is the function of the chordae tendonae/papillary muscles in the atrioventricular valves?
Term
anterior goes to anterior
posterior goes to posterior
septal goes to septal

(EASY)
Definition
name the papillary muscles attached to the right atrioventricular valve, and describe which cusp of the valve they anchor
Term
carries the right branch of the AV bundle to the anterior papillary muscle

aka the moderator band
Definition
at the base of the anterior papillary muscle is a structure called the septomarignal trabeculum, what does it do, and what is another name for it?
Term
prevent backflow into atria during ventricular contraction
Definition
function of the atrioventricular valves
Term
LEFT atrium
Definition
what receives oxygenated blood via the 4 pulmonary veins?
Term
mostly smooth, except for pectinate muscles in the left auricle
Definition
is the left atrium's interior mostly smooth or muscle?
Term
left atrioventricular orifice
Definition
the left ventricle receives blood from the left atrium via what structure?
Term
mitral valve aka BICUSPID valve
Definition
what valve guards the left atrioventricular orifice?
Term
anterior and posterior (no septal)
Definition
name the cusps of the mitral valve
Term
left ventricle TC are finer and more numerous than in the right ventricle
Definition
compare the trabeculae carnae of the left ventricle to the right ventricle
Term
left is twice as thick
Definition
which ventricle wall is thicker? right or left?
Term
Right is cRescent shaped left is conical shaped
Definition
describe/compare the shapes of the ventricles
Term
the part that leads to the aorta is smooth

(in the R atrium the smooth part is close to the vessel[vena cava] so remember as you enter and exit the heart the part before the vessels is smooth)
Definition
where is the smooth part of the left ventricle?
Term
aortic valve, semilunar (has no pectinate muscles, the pectinate muscles in the L ventricle support the mitral valve only)
Definition
what valve guards the ASCENDING aorta? what type of valve is it?
Term
AV Valves: prevent backflow to atrium from ventricle during systole

right: tricuspid between RA and RV
left: mitral/bicuspid between LA and LV

Semilunar valves: located at pulmonary trunk and aorta, take blood from the ventricles (both at arteries) have NO chordae tendonae
right: pulmonary valve
left: aortic valve
Definition
list all the valves in the heart and what structures/chambers they guard
Term
anterior and posterior
Definition
name the papillary muscles that are associated with the mitral valve
Term
ventricles (they anchor the AV valves to prevent their prolapse)
Definition
in what heart chambers would you find papillary muscles?
Term
mitral valve
Definition
what is the most commonly diseased valve of the heart?
Term
nodules can form on the cusps, or there can be congentially extra tissue

turbulence erodes the endothelial surface of the valve and makes it smooth so bacterial infections occur more easily (endocarditis)
Definition
what sorts of things can happen to the mitral valve that cause turbulence? why is turbulence bad?
Term
people with a heart murmur might need to take antibiotics because teeth cleaning introduces a lot of bacteria to the blood stream and people with murmurs are more suceptible to endocarditis due to erosion of the heart surfaces
Definition
what kind of people should maybe take antibiotics before they get their teeth cleaned? why?
Term
mitral valve
Definition
prolapse of this valve occurs in 7% of females
Term
endocardial infections
Definition
hemodynamics say that ______ infections occur when transient bacteremias seed ABNORMAL ENDOTHELIAL surfaces
Term
semilunar valves
Definition
what valves normally have nodules and lunules?
Term
3
Definition
how many cusps do semilunar valves have?
Term
pulmonary trunk(anterior) and aorta(posterior)
Definition
what adult structures are formed from a septation and rotation of the truncus arteriosis?
Term
v-diastole: pulmonary and aortic (semilunar)
v-systole: mitral and tricuspid (AV's)
Definition
what valves close in ventricular diastole? ventricular systole?
Term
aortic valve: right, left, posterior
Definition
which semilunar valve is closer to the superior vena cava? name its cusps
Term
left, right, anterior
Definition
name the cusps of the pulmonary valve
Term
THERE IS NO VALVE here!! (valves only guard arteries and atria on either side of the ventricles)
Definition
name the valve guarding the vena cava
Term
THERE IS NO VALVE here!! (valves only guard arteries and atria on either side of the ventricles)
Definition
name the valve guarding pulmonary veins
Term
a fibrous nodule
Definition
what is located at the midpoint of the free edge of semilunar valves?
Term
lunule
Definition
what is a thin connective tissue area on either side of the nodule in a semilunar valve?
Term
coronary arteries
Definition
which arteries arise from aortic sinuses(enlarge areas above the aortic valve where blood pools)
Term
as the aortic sinuses fill following ventricular contraction
Definition
when do the coronary sinuses fill with blood?
Term
myocardium (most importantily) and epicardium
Definition
what heart layers do the coronary arteries supply?
Term
60% of the time it comes off the right coronary artery
40% it comes off the left coronary artery
Definition
where does the sinuatrial nodal (SA) artery come off 60% of the time? 40% of the time?
Term
right marginal
posterior interventricular artery(posterior descending art)
Definition
list the branches of the right coronary artery
Term
atrioventricular(AV) nodal artery -> posterior interventricular -> right coronary artery -> right aortic sinus
Definition
trace the AV nodal artery back to the aortic sinus in a textbook case
Term
circumflex artery, anterior interventricular artery(anterior descending artery aka LAD)
Definition
list the branches of the left coronary arteries
Term
no, they are functionally end arteries, unless a person has a very slow progressing occlusion and is extremely healthy, the coronary arteries are functionally end arteries
Definition
are the coronary arteries anastamosed to provide collateral circulation to the heart?
Term
the branch to the SA node off the right coronary artery
Definition
what artery wraps around the aorta anteriorly?
Term
defined by the artery that gives rise to the posterior interventricular artery.

Most common is right dominant
Definition
how is dominance of the coronary arterial system determined? what is the most common?
Term
1. anterior interventricular artery
2. right coronary artery
3. circumflex artery
Definition
list the 3 most common sites of coronary occulusion in order of most common to least.
Term
radial artery, great saphenous vein, internal thoracic artery
Definition
what vessels are often used in coronary bypass surgery as a graft?
Term
anterior cardiac veins
Definition
which of the heart veins drain directly into the right atrium?
Term
coronary sinus
Definition
what vein runs toward the right and drains in the right atrium. It is a collection of veins joined together to form a large vessel that collects blood from the myocardium of the heart
Term
great cardiac vein: anterior above IV septa
middle cardiac vein: posterior on the IV septa
small cardiac vein: right side of heart
Definition
what veins drain into the coronary sinus? describe the general location of each
Term
2 umbillical arteries and 1 umbillical vein
Definition
list the 3 vessels of fetal circulation
Term
medial umbilical ligaments of the anterior abdominal wall
Definition
what do the umbilical arteries become in the adult?
Term
internal iliac arteries
Definition
what are the umbilical arteries branches of?
Term
unoxygenated
Definition
what kind of blood do the umbilical arteries carry?
Term
ligamentum teres
Definition
what does the umbilical vein become in the adult?
Term
ligamentum venosus (this bypasses liver circulation)
Definition
what is the ligamentum teres continous with in the liver?
Term
inferior vena cava
Definition
what vessel carries oxygenated mom's blood from the umbilical vein to the right atrium?
Term
superior: deoxy blood from the head
inferior: oxy blood from mom
Definition
what type of blood are each parts of the vena cava carrying in the fetus?
Term
foramen ovale
Definition
blood flows from IVC, to right atrium, to ______, to left atrium in the fetus
Term
tricuspid
Definition
blood from the SVC flows -> right atrium, -> _____ valve, -> R atrium -> right ventricle -> pulmonary trunk.
Term
ductus arteriosus
Definition
in the fetus deoxy blood from the head goes from the SVC, -> right atrium, -> right ventricle, -> pulmonary trunk -> _______ -> aorta
Term
the head and neck
Definition
what part of the fetus gets the most oxygenated blood?
Term
2/3 from anterior, 1/3 from posterior (it would be worse therefore to knock out the Left Coronary Artery because it gives rise to the anterior IV artery typically)
Definition
how much of the blood to the septum comes from the anterior interventricular artery? posterior?
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