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105 Cards in this Set
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- Back
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Describe the layers of pericardium?
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Fibrous pericardium: outer layer, dense connective tissue + attachments to central tendon of diaphragm, sternum + great vessels
Serous pericardium: parietal + visceral layer with pericardial cavity in between |
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Describe the epicardium?
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same as visceral layer of serous periardium. made of connective tissue with epithelial covering
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Describe the endocardium?
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innermost layer of heart covering, simple squamous epitherlium + connective tissue
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Describe walls of right atria?
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smooth posterior wall + trabeculated anterior wall with IVC + SVC draining into smooth posterior wall
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Define auricle?
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a muscular pouch in atria to push blood down into ventricles
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What is fossa ovale and where is it found?
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remains of foramen ovale in atrial septum between L+R atria
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Describe walls of ventricles?
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mostly trabeculated
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What is the moderator band?
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band of muscle carrying right bundle branch of AV bundle, passes from IV septum into anterior wall of RV
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Which chamber forms base of heart?
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Right atrium
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Define aortic vestibule?
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smooth walled opening from LV into aorta
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In general terms what is the cardiac skeleton?
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connective tissue framework which electrically insulates atria from ventricles
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Define annulus fibrosis?
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bands of dense connective tissue around AV, pulmonary and aortic openings to electrically insulate + provide attachment sites for valves + maintain integrity of openings
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Describe origin of AV septum?
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extensions of annulus fibrosis bands at AV openings
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What are valves made of?
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foldings of endocardium with dense connective tissue core
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Describe attachment of valves?
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conencted to cardiac skeleton. AV valves connected to papillary muscle/chordae tendinea,
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Describe papillary muscle?
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Attached to trabeculae of ventricle + also chordae tendinea
3 in RV, 2 larger ones in LV |
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Describe chordae tendinea?
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Attached to papillary muscle + valves
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What is the function of papillary muscle + chordae tendinea?
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to prevent valves turning inside out when pressure high
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In which layer of the heart are the coronary arteries found?
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epicardium with some branches in myocardium
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Where do L&R coronary arteries arise from?
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aortic sinus at root behind valve cusps
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Describe branching of Right Coronary Artery?
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Originates from right aortic sinus
Marginal branch: runs along inferior border to apex Main part continues around base + eventually joins with LCA Posterior descending branch: passes over IV sulcus to apex |
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Describe branching of Left Coronary Artery?
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Originates from left aortic sinus
Enters AV groove + splits Circumflex half passes posteriorly + gives off left marginal Left anterior descending part passes down IV groove to supply large part of both ventricles |
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Describe main method of venous drainage of heart?
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coronary sinus + tributary cardiac veins >> empties into R-atrium
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Describe 2 additional methods of venous drainage of heart?
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venae cordis minimi - from/to each chambers
anterior cardiac vein - anterior RV |
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Describe sympathetic innervation of the heart?
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T1-4 from sympathetic chain > cardiac plexus >AV/SA nodes to inc HR + vasodilation/inc contraction force
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Describe parasympathetic innervation of the heart?
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vagus/CNX > cardiac plexus > AV/SA nodes to dec HR + vasoconstrict/dec contraction force
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Examples of afferent/sensory output of heart?
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cardiovascular reflexes in response to HR changes + ischaemic pain
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How are myocytes connected in cardiac muscle cells?
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intercalated disks: gap junction(electrical) + desmosome(physical)
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What are purkinje fibres?
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modified cardiac myocytes in VENTRICLE walls to spread conduction received from Bundle of His
also bound by intercalated disks |
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Describe SA node?
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modified cardiac muscle cells at top of RA to self-depolarise + start cardiac cycle
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Where is AV node found?
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bottom of atrial septum to delay conduction until whole of atria depolarised
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What is the bundle of His?
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continuation of AV node which divides into L&R to spread depolarisation, joins with purkinje fibres
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Which veins join to form SVC before it enters heart?
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braciocephalic + left subclavian + azygos
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Describe entrance of pulmonary veins to the heart?
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2 on each side entering at base of LA
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Give the 3 branches given off from the aortic arch (L>R)?
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braciocephalic, L carotid + L subclavian
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What does ligamentum arteriosum do?
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connects underside of aortic arch to pulmonary trunk
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In basic terms describe structure of arteries + veins?
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Arteries = thick t. media
Veins = little muscle in t. media but thick t. adventitia |
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Describe elastic arteries?
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Aorta + proximal parts of great vessels with elastic between layers of smooth muscle in t. media
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Describe muscular arteries?
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Only 1 layer of elastic between t. intima + media and many of smooth muscle
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In basic terms describe the structure of arterioles + capillaries?
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Arterioles = only 1 or 2 layers of smooth muscle in t. media
Capillaries = only a t. intima |
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Describe continuous capillaries?
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most common i.e. muscle
H20/CO2/O2 pass freely, all else controlled. Tight junctions |
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Describe fenestrated capillaries?
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pores in epithelium i.e. endocrine glands
large molecules inc. protein can pass |
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Describe discontinuous capillaries?
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gaps in epithelium + BM i.e. bone marrow/spleen
free passage |
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Describe format of CXR used to image thorax?
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P-A to asses heart + lungs + size
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Describe SA node?
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modified cardiac muscle cells at top of RA to self-depolarise + start cardiac cycle
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Where is AV node found?
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bottom of atrial septum to delay conduction until whole of atria depolarised
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What is the bundle of His?
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continuation of AV node which divides into L&R to spread depolarisation, joins with purkinje fibres
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Which veins join SVC before it enters heart?
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R&L braciocephalics + azygos
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Describe entrance of pulmonary veins to the heart?
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2 on each side entering at base of LA
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Describe SA node?
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modified cardiac muscle cells at top of RA to self-depolarise + start cardiac cycle
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Name the 3 branches of the aortic arch (L>R)?
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braciocephalic, L carotid, L subclavian
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What is the role of the ligamentum arteriosum?
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connects underside of aortic arch to the pulmonary trunk
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In general terms describe artery + vein structure?
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Artery = thick t. media
Vein = little/no muscle in t. media but thick t. adventitia |
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Describe continuous capillaries?
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H2O/CO2/O2 pass freely, all else controlled.
tight junctions, most capillaries i.e. muscle |
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Describe fenestrated capillaries?
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pores i.e. endocrine glands, large molecules incl protein can pass
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Describe discontinuous capillaries?
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pores in epithelium + BM i.e. bone marrow/spleen allowing unrestricted access
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In general terms describe structure of arterioles + capillaires?
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Arterioles = only 1 or 2 layes of smooth muscle in t. media
Veins = only t. intima |
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Describe format of CXR of thorax?
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P-A to assess lungs + heart + sizes
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Describe venous drainage of upper 2 posterior intercostal spaces?
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Left = left sup intercostal vein > left braciocephalic
Right = right sup intercostal vein > azygos |
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Describe drainage + route of intercostal nodes?
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drain IC spaces + pleura > thoracic duct > braciocephalic
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Describe drainage of thoracic duct?
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drains LEFT side of body + right pelvis, abdomen + lower limb
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Describe passage of azygos vein?
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drains right, starting at L1 up to join SVC at T4
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Describe end points of hemiazygous + accessory hemiazygous veins?
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hemiazygos = T9
acesssory hemiazygos = T8 |
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Describe passage of oblique fissure?
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from T2 posteriorly to 6th costal cartilage anteriorly
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Describe passage of right horizontal fissure?
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runs along 4th rib to join oblique fissure
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Where is cardiac notch found?
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5th/6th IC space on left for access to heart
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Describe passage of subclavian artery?
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on 1st rib > axillary > brachial > radial + ulnar > palmar arch
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Name anterior branches of abdominal aorta?
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Coeliac
Sup. mesenteric Inf mesenteric |
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Name lateral branches of abdominal aorta?
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suprarenal
renal gonadal (all paired) |
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At what point does the abdominal aorta divide?
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L4 to give common iliacs
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What are the primary origin of arteries to lower limbs?
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EXTERNAL iliacs
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Describe passage of external iliac?
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>femoral> ant + post tibial : post>medial + lateral plantar
ant>dorsalis pedis > arcuate |
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Describe superficial venous drainage of arm starting at hand?
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cephalic (laterally) > axillary vein
basilic (medially) + deep veins > brachial > axillary |
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What is connection between cephalic + basilic veins?
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median cubital vein
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Describe route of short saphenous vein?
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passes behind medial mallelous laterally to ascend up back of thigh + drain into popliteal at back of knee
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Describe route of long saphenous vein?
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passes in front of medial malleolus to ascend up medial front of leg to drain into femoral vein
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Describe perforating + deep veins of the lower limb?
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saphenous tributaries + venae comitantes which becomes popliteal
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Why is median cubital vein not suitable for cannulation?
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becomes bent during normal movement
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Describe route of internal jugular vein?
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joins with subclavian > braciocephalic > SVC
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Describe relationship between diaphragm and venous return?
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Diaphragm pulls open IVC on inspiration > pressure drop > pulling blood back to heart + air into lungs
also inc abdominal pressure compressing viscera against vessels + pushing blood back to heart |
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Describe venous drainage of posterior intercostal spaces?
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Azygos on right from L1 up to t4 to join SVC
Hemiazygos on left from L1 up to T9 to join azygos Acessory hemiazygos on left goes down to join azygos at T8 |
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Describe venous drainage of anterior intercostal spaces?
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Upper 5/6 = internal thoracic vein
Lower = musculophrenic vein |
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Describe arterial supply of anterior intercostal spaces?
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Upper 5/6 = internal thoracic artery
Lower = musculophrenic artery |
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Describe arterial supply of posterior intercostal spaces?
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Top 2 = costocervical trunk > subclavian artery
Remaining 9 = thoracic aorta |
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Where can posterior tibial artery be palpated?
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posterior + inferior to medial malleolus between medial malleolus and Achilles tendon
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Where can femoral pulse be palpated?
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Just inferior to midline of inguinal ligament
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Where can popliteal pulse be palpated?
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Deep within popliteal fossa at back of knee - best with knee flexed to relax
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Where can dorsalis pedis pulse be palpated?
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half way along top of foot lateral to tendon of hallucis longus muscle - with toes dorsi-flexed
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Where can subclavian pulse be palpated?
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at root of neck as passes over 1st rib
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Where can carotid pulse be palpated?
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between trachea and sternocleidomastoid
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Which coronary artery is known as branch of sudden death/widow maker?
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LAD/ anterior IV branch
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Where does LAD artery supply?
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apex, IV septum + half of LV
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Define an end artery?
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an artery which is only supply of oxygenated blood to an area
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What causes claudication?
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anaerobic respiration producing lactic acid
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Define boundaries of upper mediastinum?
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down to sternal angle (T4/5)
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Define boundaries of lower mediastinum?
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Middle = pericardium + content
Anterior = in front Posterior = behind |
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Define boundaries of lower mediastinum?
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Middle = pericardium + content
Anterior = in front Posterior = behind |
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Which layer of pericardium has attachment to diaphragm?
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fibrous pericardium
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Describe tunica adventitia?
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outer connective tissue layer of blood vessels
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What is tunica intima made of?
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epithelium, BM + connective tissue
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2 differences between blood and lymph capillaries?
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Blood has through channel, lymph blind ended
Blood have no anchoring filaments, lymph do |
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Define mesenchymal cells?
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undifferentiated loose connective tissue, derived from mesoderm >> angioblasts
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What do vitelline, umbicial + common cardinal veins drain?
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Vitelline: yolk sac
Umbilical: placenta Common cardinal: embryo |
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Describe atrial partitioning?
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Septum primum grows down from top + up from bottom. Septum secundum only grows down from top
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Describe normal positioning of Augmented limb leadS?
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aVR = negative QRS
aVL = half neg/half positive aVF = positive QRS |
