Term
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Definition
-thick collagen layer with little ability to distend acutely (prevents heart from expanding further)
-fuses superiorly to tunica adventita of great vessels, inferiorly to central tendon of diaphragm, and anteriorly to sternum
-phrenic nerve and pericardiophrenic artery descend through mediastinum lateral to f.pericardium and are in jeopardy during surgery to the heart |
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Term
| Visceral Layer of Serous Pericardium |
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Definition
-epicardium
-layer of simple squamous epithelium (mesothelium)
-beneath-coronary arteries/veins/nerves travel along surface of heart in thin collagen bed, adipose tissue too |
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Term
| Parietal Layer of Serous Pericardium |
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Definition
| -at base of aorta and pulmonary trunk, mesothelium of visceral layer is reflected and becomes continuous with parietal layer |
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Term
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Definition
| -btw visceral and parietal layer with pericardial fluid allowing friction-free movement of heart |
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Term
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Definition
-recess of pericardial cavity
-posterior to aorta and pulmonary trunk, ant to SVC
-if pericardial sac open, can pass finger through sinus from one side of heart to other |
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Term
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Definition
| -recess of pericardial cavity that ends in cul de sac surrounded by pulmonary veins |
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Term
| Innervation of Pericardium |
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Definition
-phrenic nerve
-pain sensation referred to dermatome (ipsilateral supraclavicular region) |
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Term
| Arterial Supply of Pericardium |
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Definition
-pericardiophrenic artery (branch of internal thoracic)
-branches of musculophrenic
-coronary and branches |
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Term
| Venous Drainage of Pericardium |
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Definition
| -pericardiophrenic vein drains to brachiocephalic |
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Term
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Definition
-heart compression
-accumulation of fluid within pericardial cavity resulting in compression of the heart since the fibrous pericardium is in-elastic
-clinical findings: hypotension, compression of SVC (distension of neck veins on inspiration, kussmaul sign)
-can quickly progress to cardiogenic shock and death |
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Term
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Definition
-removal of fluid from pericardial cavity
-sternal approach: left side intercostal space 5/6 (cardiac notch)
-subxiphoid approach: left infrasternal angle |
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Term
| Base of Heart (posterior surface) |
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Definition
| -mainly left atrium, which receives pulmonary veins and is related to vertebral bodies T6-9 |
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Term
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Definition
-inferior lateral portion of L ventricle at intercostal space 5 along midclavicular line
-maximal pulsation of heart occurs here |
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Term
| Anterior (sternocostal) surface of heart |
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Definition
| -consists mainly of right ventricle |
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Term
| Inferior (diaphragmatic) surface of heart |
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Definition
| -consists mainly of L ventricle and related to central tendon of diaphragm |
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Term
| Left (pulmonary) surface of heart |
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Definition
| -consists mainly of L ventricle and occupies cardiac impression in left lung |
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Term
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Definition
| -consists mainly of R atrium located btw SVC and IVC |
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Term
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Definition
| -consists of right atrium SVC and IVC |
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Term
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Definition
| -consists of left ventricle, left atrium, pulmonary trunk, aortic arch |
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Term
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Definition
| -consists of right ventricle |
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Term
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Definition
| -consists of right atrium, left atrium, SVC, ascending aorta, pulmonary trunk |
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Term
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Definition
| -receives venous blood from SVC, IVC, and coronary sinus |
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Term
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Definition
| -conical, muscular pouch on R atrium |
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Term
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Definition
| -form trabeculated part of R or L atrium |
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Term
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Definition
| -smooth part of the right atrium |
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Term
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Definition
| -marks the junction btw trabeculated part and smooth part of right atrium |
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Term
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Definition
| -external shallow groove that also marks (along with crista terminalis)the junction btw trabeculated and smooth parts of right atrium |
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Term
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Definition
| -consists of an interatrial portion and an atrioventricular (AV)portion |
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Term
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Definition
| -oval depression on interatrial portion consisting of valve of the fossa ovalis |
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Term
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Definition
-irregular muscular ridges
-form the trabeculated part of the right ventricle (inflow tract) |
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Term
| Conus Arteriosus (infundibulum) |
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Definition
| -smooth part of right ventricle (outflow tract) |
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Term
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Definition
-Cshaped internal muscular ridge
-marks the junction btw trabeculated and smooth parts of right ventricle |
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Term
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Definition
-trabeculated inflow tract receives blood from right atrium posteriorly through the tricuspid valve
-smooth outflow tract expels blood superiorly and to the left into the pulmonary trunk |
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Term
| Tricuspid Valve (Right Atrioventricular Valve) |
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Definition
-anterior, posterior, and septal cusps tethered to papillary muscles by chorda tendinae
-base attached to fibrous skeleton
-btw right atrium and ventricle |
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Term
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Definition
-cords that extend from the free edge of tricuspid valve (or mitral valve) to papillary muscles
-prevents eversion of tricuspid valve (or mitral valve) into right atrium (or left atrium)
-prevents regurgitation of ventricular blood into right atrium (or left atrium) during systole |
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Term
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Definition
-anterior, posterior, septal (no septal in left ventricle)
-conical muscular projections from ventricular wall and are attached to chordae tendineae |
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Term
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Definition
| -consists of membranous part (located in a sup-post position and continuous with fibrous skeleton) and a muscular part |
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Term
| Septomarginal Trabecula (moderator band) |
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Definition
-curved muscular bundle that extends from interventricular septum to the anterior papillary muscle
-contains part of right bundle branch of the bundle of His to the anterior papillary muscle |
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Term
| Pulmonary Semilunar Valve |
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Definition
-anterior, right, and left cusps
-lies at apex of conus arteriosus
-prevents blood from returning to right ventricle |
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Term
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Definition
| -receives oxygenated blood from the lungs through the pulmonary veins |
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Term
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Definition
| -tubular muscular pouch on left atrium |
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Term
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Definition
| -left atrium -indicates valve of fossa ovalis |
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Term
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Definition
-trabeculate inflow tract receives oxygenated blood from left atrium through mitral valve
-smooth outflow tract expels blood superoanteriorly into ascending aorta |
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Term
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Definition
| -smooth part of left ventricle (outflow tract) |
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Term
| Mitral Valve (Bicuspid Valve, Left Atrioventricular Valve) |
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Definition
-located btw left atrium and ventricle
-composed of two cusps(anterior, posterior) tethered to papillary muscles (anterolateral, posteromedial) by chorda tendineae
-attached to fibrous skeleton at base |
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Term
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Definition
-posterior, right, and left cusps
-lies at apex of aortic vestibule
-prevents blood from returning to left ventricle |
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Term
| Fibrous Skeleton of Heart |
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Definition
-dense framework of collagen w/in heart that keeps orfices of AV valves and semilunar valve patent (no backflow)
-provides attachment for leaflets/cusps
-serves as origin/insertion sites of cardiac myocytes and forms an electrical barrier btw atria and ventricles so that they contract independantly |
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Term
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Definition
-S1 "lub" = closure of tricuspid and bicuspid valves
-S2 "dub" = closure of pulmonary and aortic valves |
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Term
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Definition
**use intercostal spaces as indicator of area
-Left AV Valve= cardiac apex left intercostal space 5
-Right AV Valve= over sternum intercostal space 5
-pulmonary valve= lateral to sternum at L intercostal space 2, or over sternum intercostal space 4
-aortic valve= lateral to sternum right intercostal space 2 |
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Term
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Definition
-right and left coronary arteries supply oxygenated arterial blood to heart - they fill with blood during diastole
-have maximal blood flow during diastole and minimal blood flow during systole |
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Term
| Right Coronary Artery (RCA) |
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Definition
-arises from right aortic sinus of ascending aorta and courses in coronary sulcus
-blood supply is considered right side dominant if post interventricular artery arises from RCA
-supplies: right atrium and ventricle, diaphragmatic left ventricle, posterior 1/3 of IV septum, 60% SA node, 80% AV node
-branches: SA nodal, right marginal, AV nodal, posterior interventricular, septal branches |
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Term
| Left Main Coronary Artery (LMCA) |
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Definition
-arises from left aortic sinus from ascending aorta
-blood supply considered left side dominant(less common) if post interventricular artery arises from LMCA
-branches: left circumflex artery, intermediate ramus, anterior interventricular artery (left ant descending LAD) |
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Term
| Left Circumflex Artery (LCx) |
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Definition
-supplies post surface of left ventricle
branches:
-anterior marginal artery
-obtuse marginal artery
-atrial branches
-posterior marginal artery |
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Term
| Anterior Interventricular Artery |
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Definition
supplies both ventricles and IV septum
branches:
-anterior diagonal artery
-septal branches |
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Term
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Definition
-largest vein draining heart and drains directly into right atrium
-at opening of coronary sinus, crescent-shaped valve remnant present (thebesian valve) |
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Term
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Definition
| -follows anterior interventricular artery and drains into coronary sinus |
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Term
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Definition
| -follows posterior interventricular artery and drains into coronary sinus |
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Term
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Definition
| -follows right marginal artery and drains into coronary sinus |
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Term
| Minor Veins Draining to Coronary Sinus |
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Definition
-oblique vein
-loft posterior ventricular vein
-left marginal vein |
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Term
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Definition
| -found on anterior aspect of right ventricle and drain directly into right atrium |
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Term
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Definition
| -begin within wall of heart and drain directly into nearest heart chamber |
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Term
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Definition
-superficial cardiac plexus located inferior to aortic arch, anterior to right pulmonary artery
-deep cardiac plexus located posterior to aortic arch, anterior to tracheal bifurcation
-both contain parasympathetic(vagus) and sympathetic components |
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Term
| Parasympathetic Innervation |
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Definition
-vagus nerve
-postganglionic axons release acetylcholine (short-lived) that acts on SA/AV nodes, atrial myocytes, and smooth muscle coronary arteries
*functions to decrease HR, conduction velocity through AV node, and contractility of atrial myocytes = vasoconstriction and energy conservation
visceral afferent: baroreceptors (BP changes) and chemoreceptors (arterial O2 changes) |
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Term
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Definition
-norepinephrine (long-lived) activates SA/AV nodes, atrial/ventricular myocytes, smooth muscle of coronary arteries
-increases HR, conduction velocity through AV node, contractility of atrial and ventricular myocytes
*vasodilation |
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Term
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Definition
-afferent sensory neurons associated with sympathetics
-T1-T5 spinal cord segments (dermatomes)
-pain sensation is "classic" down left arm |
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Term
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Definition
-pacemaker of the heart located at junction of SVC and right atrium just beneath epicardium
-from here, impulse spreads throughout right atrium and to AV node via anterior middle and posterior internodal tracts and to left atrium via bachmann bundle
-if all SA node activity destroyed, AV node will assume pacemaker role |
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Term
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Definition
-located on right side of AV portion of atrial septum near ostium of coronary sinus in subendocardial space
-AV septum correspondes to triangle of koch(contains AV node and proximal penetrated portion of bundle of his) |
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Term
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Definition
| -travels in subendocardial space on right side of interventricular septum and divides into right and left bundle branches |
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Term
| Right/Left Bundle Branches |
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Definition
-Left Bundle: thicker, divides into anterior and posterior segment, terminate on purjinke myocytes
-Right Branch: portion enters septomarginal trabecula (moderator band) to supply anterior papillary muscle, terminate on purkinje myocytes |
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Term
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Definition
-calcifications/plaque buildup within tunica intima of blood vessels
-early stages have fatty streaks
-associated with majority of MI's
-hemorrhage, rupture can lead to formation of thrombus
-coronary artery athersclerosis leads to angina pectoris, MI, CHF |
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Term
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Definition
| -sudden onset of predordial (anterior surface of body over heart and stomach) pain |
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Term
| Miocardial Infartcion (MI) |
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Definition
-ischemic necrosis of myocardium of heart
-complications: hemopericardium caused by rupture of free ventricular wall, arterial emboli, pericarditis, ventricular aneurysm, postmyocardial infarction syndrome (autoimmune pericarditis) |
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Term
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Definition
- MI unifocal and solid, follows distribution of specific coronary artery
-often causes shock, pericarditis common
-caused by occlusive thrombus
-volume of collateral arterial flow is cheif factor that affects progression |
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Term
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Definition
-MI multifocal and patchy, follows circumferential distribution
-caused by hypoperfusion of heart (aortic stenosis, hemorrhagic shock, hypoperfusion during cardiopulmonary bypass) |
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Term
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Definition
-inability of heart to pump blood at a rate commensurate with the requirements of the body tissues, or it can so only from elevated filling pressures
-most commonly from progressive deterioration of myocardial contractile function (from ischemic heart disease or HTN)
-reduced cardiac output, damming back of blood into venous system |
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Term
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Definition
-RV susceptible to failure if increase in afterload on RV
-most often occurs with cor pulmonale induced by intrinsices diseases of lung or pulmonary arterial HTN (pulmonary heart disease)
-symptoms: peripheral edema, jugular vein distention, tricuspid valve murmur |
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Term
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Definition
-occurs due to impared left ventricle function caused by MI
-hypertrophy - blood backup - pulmonary edema, coughing
-symptoms: overweight, poor diet, perodic angina, nausea |
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Term
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Definition
-incompetetent "floppy" valve, concerned with mitral regurg
-common in young females
-symptoms: chest pain, fatigue, might show no symptoms |
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